Aa
Hyperthyroid (possible Graves') with neurological symptoms
27male5'10"180lbs. Father dx Lupus. cousin born with thyroid problems.
symptoms:
four months ago went swimming, painless infection after a few days feeling pressure 50% hearing loss left ear. Treated with 2 rounds of antibiotics due to recurrence. Left upper eyelid twitching started with the ear problem which is fine movement twitching and persistent. Three weeks ago started having attacks when my heartbeat went up to 180 bpm. since three weeks ago, stiff neck and shoulder with a sensation of something in my throat. Since last week, needle sensation twitching and jerking in both arms and legs. right arm weak.
Tests:
1- First CBC potassium 4.7mmol/L and WBC(neutrophil) normal. repeat CBC in ER after the attack (two days later)potassium 3.3 and elevated WBC(neutrophil). Third CBC normal.
2- Thyroid function: repeated this test three times: first one: TSH:0.32 mIU/L * Free T4* (NOT T4): 23 pmol/L second one:TSH: 0.78 Free T4: 28 third one: TSH:0.68 *Free T4*: 22 all done within one week
3- thyroid ultrasound: normal
Questions:
1- Since my *free T4* levels are not that high (borderline high 23 to 28 normal being 12-22), Can thyroid cause numbness and tingling in both arms and both legs?
2- Can thyroid cause twitching and jerking movements (including the back and forth lateral movements of my Index finger several times a day and each time for one minute) and all over my legs and arms followed by muscle weakness?( Choreia caused by hyperthyroidisim?)
3- Can GBS, ALS or MS be the cause and this borderline hyperthyroid be just a coincidence? Can they present themselves this way (especially since I am experiencing all of this after the ear infection and have funny sensation in my throat and all over my neck)?
4- If it is Choreia or any other neurological/muscular problem due to hyperthyroidism, will it cause permanent damage (will I stay like this or become worse) or do they completely disappear after hyperthyroidism treatment
symptoms:
four months ago went swimming, painless infection after a few days feeling pressure 50% hearing loss left ear. Treated with 2 rounds of antibiotics due to recurrence. Left upper eyelid twitching started with the ear problem which is fine movement twitching and persistent. Three weeks ago started having attacks when my heartbeat went up to 180 bpm. since three weeks ago, stiff neck and shoulder with a sensation of something in my throat. Since last week, needle sensation twitching and jerking in both arms and legs. right arm weak.
Tests:
1- First CBC potassium 4.7mmol/L and WBC(neutrophil) normal. repeat CBC in ER after the attack (two days later)potassium 3.3 and elevated WBC(neutrophil). Third CBC normal.
2- Thyroid function: repeated this test three times: first one: TSH:0.32 mIU/L * Free T4* (NOT T4): 23 pmol/L second one:TSH: 0.78 Free T4: 28 third one: TSH:0.68 *Free T4*: 22 all done within one week
3- thyroid ultrasound: normal
Questions:
1- Since my *free T4* levels are not that high (borderline high 23 to 28 normal being 12-22), Can thyroid cause numbness and tingling in both arms and both legs?
2- Can thyroid cause twitching and jerking movements (including the back and forth lateral movements of my Index finger several times a day and each time for one minute) and all over my legs and arms followed by muscle weakness?( Choreia caused by hyperthyroidisim?)
3- Can GBS, ALS or MS be the cause and this borderline hyperthyroid be just a coincidence? Can they present themselves this way (especially since I am experiencing all of this after the ear infection and have funny sensation in my throat and all over my neck)?
4- If it is Choreia or any other neurological/muscular problem due to hyperthyroidism, will it cause permanent damage (will I stay like this or become worse) or do they completely disappear after hyperthyroidism treatment
Sounds like we're in the same boat.....can't blame the thyroid for neurological problems. Fact is, that based on a history of 25 years of thyroid trouble I can assure you that there is in my opinion a link between thyroid levels being off and neurological problems. Whenever my Ft4 levels are just over 18 and my TSH gets below 0.5 I get similar symptoms. Whenever that happens, I adjust my meds and the neurological symptoms will disappear. I too will get muscle twitches, hand and leg jerks, muscle pain and panic attacks.My neurologist is convinced that it's Thyroid related but my Endo is not. The question remains if the symptoms of being Hyperthyroid might cause part of the neurological symptoms you describe. If you're Hyper it will cause you to be more nervous,which could result in panic attacks. Muscle twitches can be caused by this mental condition. Don't get discouraged and keep asking questions. Hope you feel better soon.
It is very difficult to get a Lyme diagnosis. Most physicians have no idea of it. If your doc does a simple ELISA test, it most likely will be missed. Again, I have all your symptoms.
I am sorry to hear about your long illness. I truely am and I hope that you are doing OK now. Thanks for the link, I will discuss the possibility of Lyme with my neurologist. The problem is that this borderline overactive thyroid that I have has become an excellent reason for doctors to dismiss everything I say and say "Obviously it is your thyroid, you will be fine". Well if it was obvious that it is the thyroid, the endocrinologist and Dr. Lupo here wouldn't have advised me to persue neurological assessment. I gotta see a new neuro.
Many thanks for your reply doctor.
I saw a neurologist yesterday and he told me that all my neurological exam was normal except for deep tendon reflexes that were increased in all four limbs. He said that EMG, MRI or spinal tap are not required because this increase in reflexes is consistent with other overactive thyroid symptoms that I have such as tachycardia, sweaty feet and palms (occasionally), panic attacks and anxiety.
I am not a doctor but I understand your point that the thyroid numbers are not that off but both my endocrinologist and the neurologist think that it is the thyroid.
Just to update: I feel that the weakness in my left arm is better now but since yesterday, basically most muscles in my body are painful (like the pain that you get after exercise). I also feel that I hurt my tendons/joints/muscles(?) more easily, for example if I yawn and extend my arm, I will injure my elbow joint and it is sore for a few days.
These are the questions that I ask myself:
IF IT IS THE THYROID: how come I dont have many of the hyperthyroid symptoms and how come the numbers are just borderline and not too high? Can I get all these neurological symptoms that even the neurologist admitted I have, with just a borderline high thyroid?!
IF IT IS PRIMARY NEUROLOGICAL: how come it is symmetrical in all four limbs? If it was MS or ALS wouldn't it almost always be assymetrical? Can it spread from neck to all four limbs in a month? The neurologist was confident that all the twitching, weakness, cramps, soreness and everything else was due to my thyroid.
The endocrinologist however, was sure that I am hyperthyroid but thought that thyroid wouldn't cause all these neurological symptoms. Also what I don't understand is that where does fast heart beat and anxiety and irritability especially panic attacks fit if there is something neurological?
I don't want to sound like George in Seinfeld but can it be Myasthenia Gravis? or Lupus? (my father has lupus)
Again, thank you so much for your help doctor.
Saeed
I saw a neurologist yesterday and he told me that all my neurological exam was normal except for deep tendon reflexes that were increased in all four limbs. He said that EMG, MRI or spinal tap are not required because this increase in reflexes is consistent with other overactive thyroid symptoms that I have such as tachycardia, sweaty feet and palms (occasionally), panic attacks and anxiety.
I am not a doctor but I understand your point that the thyroid numbers are not that off but both my endocrinologist and the neurologist think that it is the thyroid.
Just to update: I feel that the weakness in my left arm is better now but since yesterday, basically most muscles in my body are painful (like the pain that you get after exercise). I also feel that I hurt my tendons/joints/muscles(?) more easily, for example if I yawn and extend my arm, I will injure my elbow joint and it is sore for a few days.
These are the questions that I ask myself:
IF IT IS THE THYROID: how come I dont have many of the hyperthyroid symptoms and how come the numbers are just borderline and not too high? Can I get all these neurological symptoms that even the neurologist admitted I have, with just a borderline high thyroid?!
IF IT IS PRIMARY NEUROLOGICAL: how come it is symmetrical in all four limbs? If it was MS or ALS wouldn't it almost always be assymetrical? Can it spread from neck to all four limbs in a month? The neurologist was confident that all the twitching, weakness, cramps, soreness and everything else was due to my thyroid.
The endocrinologist however, was sure that I am hyperthyroid but thought that thyroid wouldn't cause all these neurological symptoms. Also what I don't understand is that where does fast heart beat and anxiety and irritability especially panic attacks fit if there is something neurological?
I don't want to sound like George in Seinfeld but can it be Myasthenia Gravis? or Lupus? (my father has lupus)
Again, thank you so much for your help doctor.
Saeed
I have your symptoms and have Lyme disease. It is often misdiagnosed as MS, ALS, or Lupus. I've been sick for 24 years and only got a diagnosis in December.
My doctor did this presentation. I travel 1,000 miles to see him.
http://www.lymeinducedautism.com/images/Lymewhat_is_it_part_3,_LIA.pdf
My doctor did this presentation. I travel 1,000 miles to see him.
http://www.lymeinducedautism.com/images/Lymewhat_is_it_part_3,_LIA.pdf
MEDICAL PROFESSIONAL
Would pursue neuro evaluation as a priority.
I don't think the thyroid is the answer and the TSH is fluctuating within the low-normal range in a way that is not likely clinically significant.
I don't think the thyroid is the answer and the TSH is fluctuating within the low-normal range in a way that is not likely clinically significant.
Thanks for the link.
What is really strange is that my TSH and free T4 seem to go up together and not oposite directions of each other. My right arm is weak for four days now and I get twitches all over my body. I woke up last night because of my *left* arm twitching which is supposed to be the good arm. I also get twitches in my both legs.
I think there is a good chance I have ALS but I am not worried about it, I am not even worried about dying. I am just worried that I may have ALS or some other disease and not know about it until I am disabled to the point that I can not take the lead in my dying process. I just want to know what is wrong with me and if it is somethhing that nothing can be done about it, start living my life the way I want and prepare for the exit. Pathetic and bitter irony I know, need a terminal illness diagnosis to start "living" the way I want for a few days.
Sorry I did not answer your questions in my last post, yes I am from Canada (originally Iranian) and my name is Saeed, 27 male, I did a TSI test but have not heard from the endo yet and I am scheduled for a RIUT as I mentioned.
I am assuming you have Graves'. I am happy to hear that the meds worked out for you and I definately hope that you be and stay well. Thanks for the link again. I will try it now.
What is really strange is that my TSH and free T4 seem to go up together and not oposite directions of each other. My right arm is weak for four days now and I get twitches all over my body. I woke up last night because of my *left* arm twitching which is supposed to be the good arm. I also get twitches in my both legs.
I think there is a good chance I have ALS but I am not worried about it, I am not even worried about dying. I am just worried that I may have ALS or some other disease and not know about it until I am disabled to the point that I can not take the lead in my dying process. I just want to know what is wrong with me and if it is somethhing that nothing can be done about it, start living my life the way I want and prepare for the exit. Pathetic and bitter irony I know, need a terminal illness diagnosis to start "living" the way I want for a few days.
Sorry I did not answer your questions in my last post, yes I am from Canada (originally Iranian) and my name is Saeed, 27 male, I did a TSI test but have not heard from the endo yet and I am scheduled for a RIUT as I mentioned.
I am assuming you have Graves'. I am happy to hear that the meds worked out for you and I definately hope that you be and stay well. Thanks for the link again. I will try it now.
Your tsh is jumping around a lot. You might be sub clinical hyper. I always ask Elaine Moore who has a site where you can ask her a question and only she answers. She is an expert on auto immune diseases.
http://elaine-moore.com/QA/tabid/57/Default.aspx click on question and answer. You have to join to post something.
http://elaine-moore.com/QA/tabid/57/Default.aspx click on question and answer. You have to join to post something.
Hi
I am really confused GravesGirl. An endocrinologist diagnosed me with hyperthyroidism based on above data and my rapid heart rate and sweating. This doctor here says it is normal. Honestly to me the numbers don't look too off. I am concerned this thyroid thing is completely irrelevant (although I am already on propranolol for it and awaiting radioactive iodine uptake test) and the whole thing is neurological in nature. I am thinking about MS, ALS, GBS, MG or brain tumor.
I am really confused GravesGirl. An endocrinologist diagnosed me with hyperthyroidism based on above data and my rapid heart rate and sweating. This doctor here says it is normal. Honestly to me the numbers don't look too off. I am concerned this thyroid thing is completely irrelevant (although I am already on propranolol for it and awaiting radioactive iodine uptake test) and the whole thing is neurological in nature. I am thinking about MS, ALS, GBS, MG or brain tumor.
MEDICAL PROFESSIONAL
Your TSH is essentially normal, so would pursue neurological evaluation first and recheck the TSH (and free T4) in 4-6 weeks to see if there is any clear trend towards a thyroid problem.
Hi!
What you are describing I have heard before from people with Graves. I did have the stiff neck and shoulder,still do on and off, had some muscle twitching in my eye on and off too. The numbness and tingling can be a symptom too, I get this more when I am more hypo. I have been on anti thyroid meds 3 years, starting to wean off because of normal labs and a real low dose of 1.25. Your lab ranges are different form mine.You must be from another country. All these symptoms do subside witth meds, nothing really permanent, it all has to do with thyroid levels.Graves causes weak muscles,sometimes even muscle wasting if bad enough but it comes back. Upper arms and legs mostly affected. Have you had your TSI tested? The antibody for Graves.
What you are describing I have heard before from people with Graves. I did have the stiff neck and shoulder,still do on and off, had some muscle twitching in my eye on and off too. The numbness and tingling can be a symptom too, I get this more when I am more hypo. I have been on anti thyroid meds 3 years, starting to wean off because of normal labs and a real low dose of 1.25. Your lab ranges are different form mine.You must be from another country. All these symptoms do subside witth meds, nothing really permanent, it all has to do with thyroid levels.Graves causes weak muscles,sometimes even muscle wasting if bad enough but it comes back. Upper arms and legs mostly affected. Have you had your TSI tested? The antibody for Graves.
You are reading content posted in the Thyroid Cancer / Nodules & Hyperthyroidism Forum
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
