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Hypothyroid Myopathy
Dear Doctor
I was diagnosed with Hashimoto's 4 years ago. At the same time I developed a problem with the muscles of the diaphrapgm. These muscles are either in spasm, (with the spasms often spreading up my chest wall), or the muscles
are tight and almost immovable. My breathing is severely restricted because of the lack of movement in the secondary muscles of respiration. It is particularly badly affected during the night, disturbing my sleep.
I take salbuterol by inhaler, which relaxes the smooth muscle and brings the spasms under some control, but does not get rid of the pain.
I have been told by one of my doctors the diaphragm problem is 'hypothyroid myopathy' caused by too little thyroid replacement. However, my TSH is at the bottom of range (0.25), so I am reluctant to increase my dose of
T4 or T3. ( I take 175 mcg T4 and 35 mcg T3 at present). Taking T3 has improved my energy levels but has made no difference to the diaphragm spasms and pain.
Very low dose of diazepam and a low dose of TAD (amitryptiline) have been no help and had intolerable side effects. I am interested in treating the cause of the muscle spasms, which I understand may be due to a dysfunction in the mitochondria caused by the thyroid disease. Can you suggest what I can do to improve my quality of life ?
Thank you.
I was diagnosed with Hashimoto's 4 years ago. At the same time I developed a problem with the muscles of the diaphrapgm. These muscles are either in spasm, (with the spasms often spreading up my chest wall), or the muscles
are tight and almost immovable. My breathing is severely restricted because of the lack of movement in the secondary muscles of respiration. It is particularly badly affected during the night, disturbing my sleep.
I take salbuterol by inhaler, which relaxes the smooth muscle and brings the spasms under some control, but does not get rid of the pain.
I have been told by one of my doctors the diaphragm problem is 'hypothyroid myopathy' caused by too little thyroid replacement. However, my TSH is at the bottom of range (0.25), so I am reluctant to increase my dose of
T4 or T3. ( I take 175 mcg T4 and 35 mcg T3 at present). Taking T3 has improved my energy levels but has made no difference to the diaphragm spasms and pain.
Very low dose of diazepam and a low dose of TAD (amitryptiline) have been no help and had intolerable side effects. I am interested in treating the cause of the muscle spasms, which I understand may be due to a dysfunction in the mitochondria caused by the thyroid disease. Can you suggest what I can do to improve my quality of life ?
Thank you.
A related discussion, Does Hypothyroid cause pain? was started.
Thank you for your reply. I only just increased my T3 - three months ago - at the suggestion of the doctor who looks after my thyroid condition. Four months ago my TSH was 1.2, and I was suffering constantly from fatigue. Hence the reason for increasing the T3.
MEDICAL PROFESSIONAL
From a thyroid standpoint, there is not much more besides the trial of T3 therapy you already have tried. The overall thyroid dose is high - maybe a second opinion from an endocrinologist would help to see if the T3 dose could be lowered and TSH brought up into the mid-normal range.
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