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Joint pains - What is it? Thyroid, Arthritis, Fibro?

Hi All, Please help, I have hashimotos, Lately everyday most of the day I am having lots of joint pains/swelling/stiff in hands (every joint) , Large toes,wrists.                                                                                                                                                                     Two weeks ago had a synthroid increase from .50 per day to .75 for four days and .50 for three days.                   LAB RESULTS - Tsh - 4.61, free T4 - 1.60 (range .90-1.80), T4 total - 9.5 (range 4.5-12.5), T-uptake I think this is T3  31.4 (range 25-35), T7 calculated 2.97 (range 1.20-4.30), TPO antibody - negative, Sed rate 15 (range 0-20), RA latex turbid <10.0(range  .0-.13.5). White cell count good, red in range but low, vit D in range but low.No temps but it runs 96 a lot,                                                                                                                                                      My endo said it did not show RA (is this correct with these numbers?)                                                                     My PCP said he thinks maybe fibro but I do not have all the trigger points, only in the neck                                    My question - what is causing all the joint pain?                                                                                                                                        
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Avatar universal
Looking at our labs, TSH is a pituitary hormone that is affected by so many things that at best it is only an indicator, to be considered along with more important indicators such as symptoms, and also levels of the biologically active thyroid hormones, Free T3 and Free T4.   Once you start taking thyroid meds, TSH is even less useful for diagnostic purposes.  

Looking at the rest of your tests, your Free T4 is middle of its range, which is adequate.  The rest of your thyroid tests are somewhat outdated and also not very useful.  It would have been far more revealing to have a Free T3 test.  I say that because scientific studies have shown that  Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  You should make sure they always test for Free T3 along with Free T4 each time you go in for tests.  

For your info, this link lists typical hypo symptoms.  You will find yours in the list.  
http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html

In view of your symptoms, which are frequently related to being hypo, I expect that a Free T3 test would show it to be in the lower part of its range.  I expect that to be the case because many hypo patients taking thyroid meds find that their body is not adequately converting the T4 med to T3, resulting in a Free T3 that is too low in the range.  Many members myself included, say that symptom relief required Free T3 in the upper third of its range and Free T4 around the middle of its range.  

Also, your Vitamin D is too low and needs to be supplemented to bring  it up to about 55 - 60.  You also should test for B12 and ferritin.  Hypo patients are frequently too low in the ranges for those also.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

So what you need is a good thyroid doctor that will treat clinically, as described.  Also you need to be tested for B12 and ferritin and supplement for those as necessary to bring B12 up to the upper part of its range and ferritin to around 80 minimum.  You can ask your current doctor about al this and see if he is willing to treat clinically as described.  If no, then if you will tell us your location perhaps we can recommend a doctor for you.





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Avatar universal
When were those labs done, recently or before the increase?  Do you have any other symptoms besides the joint pain /swelling/stiffness?  What was the actual result on your Vitamin D test?

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Avatar universal
The labs were done right before the increase. I do have fatigue, headaches, 3 very small nodules, slow metabolism.  Vit D was 39. Thanks for the help!
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Avatar universal
The labs were done right before the increase. I do have fatigue, headaches, 3 very small nodules, slow metabolism.  Vit D was 39. Thanks for the help!
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Avatar universal
B12 - 692, ferritin - 52.6. Any recommendation for a Dallas Tx doc would be great, the two I have been to, do not use Armor and not sure if they use cytomel. I have looked on web but can't seem to locate any. I appreciate all your help!
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Avatar universal

Just sent PM with info.  Just click on your name and go to your personal page.  Then click on messages.
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