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Low T3 has caused severe muscle/joint pain.
Starting T3 Med helped and had ZERO PAIN that lasted about a week then came back. My endocrinologist prescribed me compounded T3 (4/day) and switched my Unithroid to Tirosint, I guess due to absorption issues and my lab work. I’ve found that hypothyroidism can cause mild to severe muscle/joint pain and low T3 is the culprit. One problem is that T3 has a very short half life so I take it now every 3 to 4 hours. I’m wondering if anyone else has had this severe joint/muscle pain and how did you resolve it. I have pain medication for a lower back pain but it doesn’t phase this pain at all. Adding T3 helps but I don’t know the optimal dosages to take for T3 and T4. Anyone experiencing this horrible problem? I’ve made an appointment with a hormone doctor. I think endocrinologists deal more with diabetes than thyroid problems.
I had undiagnosed hypothyroidism for a long time, and have dealt with muscle pain that I now believe was probably thyroid related, in hindsight.
I've been running since 2001. I used to get very severe muscle pain in the fronts of my thighs any time I would take several days off of running, back when I first started running. (Consistently, I would run, then for 72 hours have front of thigh pain, over and over again.) I now know that that isn't normal as a runner, especially for someone in their 20s as I was at the time (recovery from a run was excruciatingly long for me back then). Eventually the pain stopped occurring (because I stopped taking several day breaks of running?). I had some hypothyroidism symptoms back then - weight gain, low mood, but it was never diagnosed and I never had thyroid hormones tested, and consistent exercise helped both reverse the weight gain and low mood. I think my hypothyroidism symptoms dropped off for a while between 2002-2010, or possibly running kept symptoms at bay.
In 2015-2016, when my hypothyroidism became very apparent (but still not to me), my muscles would be more fatigued or sore than usual after runs (still not as bad as in 2001-2002), and for me it was still especially the front of my thighs/quads. I also was dealing with more hip soreness (IT band syndrome), which can be a hypo symptom. I'm certain in hindsight that I had hypothyroidism at this time (due to extreme fatigue, brain fog, weight gain, and my thyroid growing to an enormous size and needing to be removed in 2018 due to problematic nodules). I also injured my shoulder in 2017, doing a side plank which really should not have been a problem, but caused a shoulder separation, so it is possibly hypothyroidism was affecting shoulder strength as well. (Shoulder and hips are the two most common joints that can be affected by hypothyroidism, but that does not mean other joints may not also be affected.) Soreness in the fronts of the thighs is the most common place for muscle soreness in someone with hypothyroidism, but does not mean other muscles can't be affected either, I just had shoulder, thigh, and hip problems and it's easy for me to associate those with hypothyroidism. (I had Achilles soreness in 2011 and hamstring issues in 2012 or 2013, but I was definitely not as hypo at the time and that was probably 99% running volume and surface related.)
Was this most recent thigh muscle pain thyroid related? I put on about 35-40 pounds in 2015 and 2016, and had been running marathons in 2012 and 2013, so my body was used to a high volume of running but not running in a body carrying so much extra weight. I lost the weight in 2017, and even before getting treatment for my thyroid in 2018, the muscle pain went away and thankfully hasn't returned (I haven't had any serious long term running injury since 2016). But, it is possible my body was suffering from lower levels of thyroid hormone in 2016 when I was dealing with muscle pain than it was in 2018 when I was finally diagnosed, since I went very hypo after thyroid surgery before getting to the correct dose. The muscle pain did not return, but by this point I was consistently running almost every day and working on improving my speed and at a healthy weight.
For me, any time I've experienced what I now believe was hypothyroidism related muscle pain, it was because I had been using those muscles first to perturb then. Was it the hypothyroidism that caused the pain? Or the running? I think hypothyroidism slowed down the muscle recovery process after the runs, and constantly running on muscles that were not recovered was just making things worse, but this is one thing I'll never really know if that was the cause. (Just thankful this is no longer a problem for me.) When I was most hypo I've ever been in my life following thyroid surgery, I actually didn't have any muscle pain despite jumping back into running almost every day, possibly because my body is now conditioned to do a lot of running without that much muscle damage. (I get delayed onset muscle soreness (DOMS), but almost never from just running, only if I do strength training or hill repeats. It is now predictable, comes on around 16-24 hours, and leaves completely by about 48 hours, and I can run and not do more damage while experiencing DOMS, so much better situation going on now for me.)
For medication... I used to take 2 ibuprofen before some and then later almost every run for a loooooong time (2012 - April/May 2017). As soon as that study came out that said ibuprofen causes an increased risk of heart attacks, I stopped completely. But I do think that because my muscle soreness was muscle pain, the medication helped and allowed me to continue running despite constantly sore muscles.
Is there something you are doing to trigger the back pain? I know it can be hard to determine where the back pain is coming from (muscles, bones, etc.). It's possible it is thyroid related, but I don't know how common it is for hypothyroidism to cause back pain, or how common it is for hypothyroidism to cause general muscle soreness not related to activity. Would I have had any muscle problems if I wasn't also running several times a week? (Hindsight here makes me think that if I hadn't started swimming/running in 2000 and then never stopped, I would still be overweight or now obese and would have a whole slew of different problems.)
Are you sure the T3 fixed the problem? Is it possible the pain just went away for a week and then came back? I take both T4 and T3 now, I'm probably still slightly hypo if I'm going by symptoms although labs say "I'm fine." If you were on just T3 and switched to T4, then it will take awhile to get to a stable concentration of T4 (much longer halflife than T3), and maybe you've dropped hypo as you are building that concentration up in your body. If it were me, I wouldn't automatically assume the back pain is all T3 related and would also seek out other potential causes. Are you physically active? I've found I feel much, much better (less afternoon fatigue on a daily basis) when I exercise in the morning, I'm not sure if the activity helps me convert T4 better to T3, but it sure does feel like it to me. It's possible exercise endorphins improve my mood and energy levels.
I'm on 137 mcg levothyroxine (T4) and 10 mcg (split up 2 into two doses about 6 hours apart) liothyronine T3. I don't have a thyroid so this is all the thyroid hormone my body gets that day, and most days it does an almost but not quite adequate job of making me feel close to what I used to feel like in 2014. My energy level has never been back to close to normal, but I'm working on it (lots of caffeine in the afternoon helps, in the past even that wasn't enough to surpass the extreme fatigue I experience every day). The more I run in the morning, the better I feel. If I could be at a dose where I feel good even on days I skip running, I would be thrilled, but I'm not there yet. I am at least muscle pain free most days unless I inflict weight lifting or running up hills on myself, but luckily even that doesn't seem to cause that severe DOMS any more.
Good luck and I hope you can get to a better place with your back pain.
I've been running since 2001. I used to get very severe muscle pain in the fronts of my thighs any time I would take several days off of running, back when I first started running. (Consistently, I would run, then for 72 hours have front of thigh pain, over and over again.) I now know that that isn't normal as a runner, especially for someone in their 20s as I was at the time (recovery from a run was excruciatingly long for me back then). Eventually the pain stopped occurring (because I stopped taking several day breaks of running?). I had some hypothyroidism symptoms back then - weight gain, low mood, but it was never diagnosed and I never had thyroid hormones tested, and consistent exercise helped both reverse the weight gain and low mood. I think my hypothyroidism symptoms dropped off for a while between 2002-2010, or possibly running kept symptoms at bay.
In 2015-2016, when my hypothyroidism became very apparent (but still not to me), my muscles would be more fatigued or sore than usual after runs (still not as bad as in 2001-2002), and for me it was still especially the front of my thighs/quads. I also was dealing with more hip soreness (IT band syndrome), which can be a hypo symptom. I'm certain in hindsight that I had hypothyroidism at this time (due to extreme fatigue, brain fog, weight gain, and my thyroid growing to an enormous size and needing to be removed in 2018 due to problematic nodules). I also injured my shoulder in 2017, doing a side plank which really should not have been a problem, but caused a shoulder separation, so it is possibly hypothyroidism was affecting shoulder strength as well. (Shoulder and hips are the two most common joints that can be affected by hypothyroidism, but that does not mean other joints may not also be affected.) Soreness in the fronts of the thighs is the most common place for muscle soreness in someone with hypothyroidism, but does not mean other muscles can't be affected either, I just had shoulder, thigh, and hip problems and it's easy for me to associate those with hypothyroidism. (I had Achilles soreness in 2011 and hamstring issues in 2012 or 2013, but I was definitely not as hypo at the time and that was probably 99% running volume and surface related.)
Was this most recent thigh muscle pain thyroid related? I put on about 35-40 pounds in 2015 and 2016, and had been running marathons in 2012 and 2013, so my body was used to a high volume of running but not running in a body carrying so much extra weight. I lost the weight in 2017, and even before getting treatment for my thyroid in 2018, the muscle pain went away and thankfully hasn't returned (I haven't had any serious long term running injury since 2016). But, it is possible my body was suffering from lower levels of thyroid hormone in 2016 when I was dealing with muscle pain than it was in 2018 when I was finally diagnosed, since I went very hypo after thyroid surgery before getting to the correct dose. The muscle pain did not return, but by this point I was consistently running almost every day and working on improving my speed and at a healthy weight.
For me, any time I've experienced what I now believe was hypothyroidism related muscle pain, it was because I had been using those muscles first to perturb then. Was it the hypothyroidism that caused the pain? Or the running? I think hypothyroidism slowed down the muscle recovery process after the runs, and constantly running on muscles that were not recovered was just making things worse, but this is one thing I'll never really know if that was the cause. (Just thankful this is no longer a problem for me.) When I was most hypo I've ever been in my life following thyroid surgery, I actually didn't have any muscle pain despite jumping back into running almost every day, possibly because my body is now conditioned to do a lot of running without that much muscle damage. (I get delayed onset muscle soreness (DOMS), but almost never from just running, only if I do strength training or hill repeats. It is now predictable, comes on around 16-24 hours, and leaves completely by about 48 hours, and I can run and not do more damage while experiencing DOMS, so much better situation going on now for me.)
For medication... I used to take 2 ibuprofen before some and then later almost every run for a loooooong time (2012 - April/May 2017). As soon as that study came out that said ibuprofen causes an increased risk of heart attacks, I stopped completely. But I do think that because my muscle soreness was muscle pain, the medication helped and allowed me to continue running despite constantly sore muscles.
Is there something you are doing to trigger the back pain? I know it can be hard to determine where the back pain is coming from (muscles, bones, etc.). It's possible it is thyroid related, but I don't know how common it is for hypothyroidism to cause back pain, or how common it is for hypothyroidism to cause general muscle soreness not related to activity. Would I have had any muscle problems if I wasn't also running several times a week? (Hindsight here makes me think that if I hadn't started swimming/running in 2000 and then never stopped, I would still be overweight or now obese and would have a whole slew of different problems.)
Are you sure the T3 fixed the problem? Is it possible the pain just went away for a week and then came back? I take both T4 and T3 now, I'm probably still slightly hypo if I'm going by symptoms although labs say "I'm fine." If you were on just T3 and switched to T4, then it will take awhile to get to a stable concentration of T4 (much longer halflife than T3), and maybe you've dropped hypo as you are building that concentration up in your body. If it were me, I wouldn't automatically assume the back pain is all T3 related and would also seek out other potential causes. Are you physically active? I've found I feel much, much better (less afternoon fatigue on a daily basis) when I exercise in the morning, I'm not sure if the activity helps me convert T4 better to T3, but it sure does feel like it to me. It's possible exercise endorphins improve my mood and energy levels.
I'm on 137 mcg levothyroxine (T4) and 10 mcg (split up 2 into two doses about 6 hours apart) liothyronine T3. I don't have a thyroid so this is all the thyroid hormone my body gets that day, and most days it does an almost but not quite adequate job of making me feel close to what I used to feel like in 2014. My energy level has never been back to close to normal, but I'm working on it (lots of caffeine in the afternoon helps, in the past even that wasn't enough to surpass the extreme fatigue I experience every day). The more I run in the morning, the better I feel. If I could be at a dose where I feel good even on days I skip running, I would be thrilled, but I'm not there yet. I am at least muscle pain free most days unless I inflict weight lifting or running up hills on myself, but luckily even that doesn't seem to cause that severe DOMS any more.
Good luck and I hope you can get to a better place with your back pain.
COMMUNITY LEADER
The only way we can tell what your problem is, is if you can provide current lab results. What are your most recent thyroid lab results? If you have a copy of the report, please post the results of Free T4, Free T3, TSH and any other thyroid related labs, including Reverse T3 (rT3) and antibody tests.
What's your actual dose of, both, T4 (Tirosint?) and T3 medications and how long have you been on them? There's a good chance you have a problem converting T4 to T3, which is the usable thyroid hormone.
It's true that T3 has a short half life - effects, typically, last for several hours and it's recommended that dosages be divided into multiples throughout the day.
If you're still having pain, there's a good chance your hormone dosage isn't high enough or the pain isn't thyroid related. Muscle/joint pain can be caused by numerous conditions, so the easiest thing to do is start from scratch. Once you tell us your current thyroid hormone levels, we'll have something to go on. If you haven't been tested for Free T4/Free T3, you need to insist on those tests asap.
There are also some vitamin/mineral deficiencies experienced by those of us with hypothyroidism. Those include (but aren't limited to) Vitamin B-12, Vitamin D and Ferritin. If you've had any of these tests, also please post results and be sure to post reference ranges for any/all lab results, since ranges vary lab to lab and have to come from your own report(s). These are all required for proper metabolism of thyroid hormones, plus deficiencies can cause symptoms similar to hypothyroidism.
Magnesium is one of the main minerals related to muscle/joint pain and a good share of people are deficient. If you've been tested for this, also please let us know.
You're correct that endocrinologists, typically, specialize in diabetes and know very little about thyroid. Be aware that some "hormone doctors" will rely more on reproductive or adrenal hormones than thyroid.
What's your actual dose of, both, T4 (Tirosint?) and T3 medications and how long have you been on them? There's a good chance you have a problem converting T4 to T3, which is the usable thyroid hormone.
It's true that T3 has a short half life - effects, typically, last for several hours and it's recommended that dosages be divided into multiples throughout the day.
If you're still having pain, there's a good chance your hormone dosage isn't high enough or the pain isn't thyroid related. Muscle/joint pain can be caused by numerous conditions, so the easiest thing to do is start from scratch. Once you tell us your current thyroid hormone levels, we'll have something to go on. If you haven't been tested for Free T4/Free T3, you need to insist on those tests asap.
There are also some vitamin/mineral deficiencies experienced by those of us with hypothyroidism. Those include (but aren't limited to) Vitamin B-12, Vitamin D and Ferritin. If you've had any of these tests, also please post results and be sure to post reference ranges for any/all lab results, since ranges vary lab to lab and have to come from your own report(s). These are all required for proper metabolism of thyroid hormones, plus deficiencies can cause symptoms similar to hypothyroidism.
Magnesium is one of the main minerals related to muscle/joint pain and a good share of people are deficient. If you've been tested for this, also please let us know.
You're correct that endocrinologists, typically, specialize in diabetes and know very little about thyroid. Be aware that some "hormone doctors" will rely more on reproductive or adrenal hormones than thyroid.
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I would echo Barb's comment about other possible causes. We tend to get so fixated on the thyroid, and rightfully so, that we discount all other causes. A lady friend was describing her symptoms to me, brain fog, joint pain, extreme fatigue, etc. I told her to get a thyroid blood panel. Her levels were normal but it turns out she had Lyme. Avoid getting tunnel vision and find a dr that will listen to you.
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