Hypothyroid- Muscle pains, nerve pains

[mikeg00031]

I was dx'd with hypo T about 3 weeks ago.free  t3 at 1.50 t4 at .97. TSH in low normal range. May be central hypothydoisim..... I get a lot of shooting nerve pains in feet and hands especially. Doc says its from trigger points. I say its from low Thyroid- although perhaps the low thyroid is causing the trigger points which in turn causes the shooting stinging nerve pains as the nerves are bening pinched in the muscle. I am now on slow release, compounded t3 (22mcg twice per day) as well as synthroid 75/day. Any one else out there get these symptoms? How long after being on replacement therapy does this symptom abate... weeks? months ?

[mikeg00031]

i realize I was given a rather hefty starting dose, but I think my doc did that because my symptoms were quite bad and my numbers - especially t3- so low. I am aware of the hyper symptoms and have had none. I'll keep you posted on the labs- appreciate the feedback.

[gimel]

The typical starting dose of T4 med is 25-50 mcg.  For a T3 med it is usually 5-10 mcg.  That is why I asked if you were started on those doses all at once.  The jeopardy is that the body can react to excessive starting doses by having hyper like symptoms, which are very unpleasant.  You were fortunate not to experience that, but it doesn't give me much confidence in your doctor.  

Regarding your various pains, I thought you might be interested to see these sections that were taking from a very long list of symptoms that may be related to hypothyroidism.

Numbness and Tingling:

    Legs
    Feet
    Arms
    Hands
    Back
    Face

Pain:

    Migraines
    Chronic headaches
    Chronic back and loin pain
    Wrist pain
    Muscles and joint pain
    Carpal Tunnel Syndrome (hands or forearms)
    Tarsal Tunnel syndrome (legs)
    Joint stiffness
    Tendonitis
    Heel spur
    Plantar fasciitis
    Arthritis
    Gout
    Painful soles of feet
    Muscle cramps
    Aching bones
    Aching muscles
    Joint pain
    TMJ
    Fibromyalgia


Yes I have been a hypothyroid patient for over 40 years.  Most of that time I was undiagnosed and then under treated.  Only after finding this Forum and learning about the importance of Free T3 was I able to get some T3 added to my med.  After some tweaking of dosages to get my Free T4 and Free T3 optimal I felt better than I could even remember.  Along with that I also had to supplement D, B12 and ferritin.

Effects on symptoms sometimes lag changes in serum levels of thyroid hormones.  It is hard to predict the timeframe for symptom relief because it depends somewhat on severity of the hypothyroidism and how long it persisted.    

Since you are going back in a week for re-test of Free T4 and Free T3, I also suggest that you test for Reverse T3, to establish a baseline for that.  Also, I suggest that you test for Vitamin D, B12 and ferritin.  Hypo patients don't seem to produce enough stomach acid and thus don't absorb vitamins and nutrients well.  All three are important for you.  

Also keep in mind that a good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  You can get some good insight from this link written by a good thyroid doctor.  You should also find out if your doctor is going to be willing to treat clinically, rather than just getting your lab results anywhere within their ranges.  

http://www.hormonerestoration.com/Thyroid.html

[mikeg00031]

Yes both prescribed at once and rechecking levels in a week. reference range for  freeT3 is 1.81-4.06, so clearly I am very low there at 1.50. free T4 is .8-1.7 so I am low in the range there at .97. My TSH was 1.49 and the range is .4-4.5 -- so it looks like my pituitry is not responding well to the low levels of t3 and t4. I used to get very severe shooting pains in the feet which have abated somewhat in the last week or two. I should tell you that until 6 months ago I had high blood sugars but such has been in vg control since Dec1-- by that I mean sugars always in the 90s. Diabetic neuropathy has been ruled out by a very renowned diabetologist with the exception of some loss of sensation in the feet.  But I still feel widespread muscle soreness and tightness-- and I was told by a local doc that these tight muscles pinch on the nerves and cause these shooting pains. i think my scalenes are tight and pinching nerves that extend down my arms- I have similar pain patterns on the dorsum of each arm/hand. Does this sound like it could be from the low t3 and t4? Are you a hypo patient, Gimel? how long does it typically take once good levels of t3,4 are achieved for the symptoms to abate? weeks. months ? thanks much

[gimel]

Please post the reference ranges for those tests, as shown on your lab report.  Those pains are frequently related to hypothyroidism.  

Were you started on the 22 mcg of T3 and 75 of T4 all at once?