Could I be hypo?
htimpaired
Posts: 1,404 Member
My story is long, but I'll try to give the Cliff Notes version. About 2.5 months ago I began to experience calf tightness/cramps/pinching/aches. It's almost constant, sometimes with swelling. I can get brief moments of relief, with heat, or ice, or epsom salt baths, or compression. I've been through PT with no results. I had ultrasound to rule out a DVT. Bloodwork for rhabdo was negative, my sodium and potassium, magnesium levels were normal. I've seen an orthopedic surgeon twice- Xray was normal. I go for an MRI tomorrow, with a follow up on thursday. Some people have mentioned chronic exertional compartment syndrome, but my ortho hasn't felt that I fit the symptoms and has been hesitent to do the pressure testing without more evidence b/c of the pain factor. My calves make it so I can no longer run or do anything high impact, and most days walking sucks.
Someone on the forums mentioned thyroid as a possibility. About 12 years ago I found lumps on my throat-had thyroid nodules, TSH was normal, had an ultrasound with the radioactive iodine uptake and I guess the nodules were benign, I haven't been seen by an endo since. But I have looked up hypothyroidism, and in addition to the calves from hell, I have other symptoms that could or could not be hypo-constipation, insomnia, I get cold alot, light headedness when standing, dry scalp/dandruff, loss of libido....I'm not tired all the time and I haven't gained weight (other than what I suspect is from my lack of activity coupled with emotional comfort eating).
thoughts? I'm so frustrated and wishing I could find what is wrong with me....
Someone on the forums mentioned thyroid as a possibility. About 12 years ago I found lumps on my throat-had thyroid nodules, TSH was normal, had an ultrasound with the radioactive iodine uptake and I guess the nodules were benign, I haven't been seen by an endo since. But I have looked up hypothyroidism, and in addition to the calves from hell, I have other symptoms that could or could not be hypo-constipation, insomnia, I get cold alot, light headedness when standing, dry scalp/dandruff, loss of libido....I'm not tired all the time and I haven't gained weight (other than what I suspect is from my lack of activity coupled with emotional comfort eating).
thoughts? I'm so frustrated and wishing I could find what is wrong with me....
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htimpaired wrote: »I have looked up hypothyroidism, and in addition to the calves from hell, I have other symptoms that could or could not be hypo: constipation, insomnia, I get cold a lot, light headedness when standing, dry scalp/dandruff, loss of libido.
Those symptoms have 101 causes. The only way to diagnose hypothyroidism is to see an endicrinogist for blood tests and an ultrasound of your neck.
For comparison, my hypo symptoms are increased appetite, weight gain, depression, fatigue, goiter, edema, brain fog, sensitivity to cold… Only one of which is on your list.0 -
htimpaired wrote: »My story is long, but I'll try to give the Cliff Notes version. About 2.5 months ago I began to experience calf tightness/cramps/pinching/aches. It's almost constant, sometimes with swelling. I can get brief moments of relief, with heat, or ice, or epsom salt baths, or compression. I've been through PT with no results. I had ultrasound to rule out a DVT. Bloodwork for rhabdo was negative, my sodium and potassium, magnesium levels were normal. I've seen an orthopedic surgeon twice- Xray was normal. I go for an MRI tomorrow, with a follow up on thursday. Some people have mentioned chronic exertional compartment syndrome, but my ortho hasn't felt that I fit the symptoms and has been hesitent to do the pressure testing without more evidence b/c of the pain factor. My calves make it so I can no longer run or do anything high impact, and most days walking sucks.
Someone on the forums mentioned thyroid as a possibility. About 12 years ago I found lumps on my throat-had thyroid nodules, TSH was normal, had an ultrasound with the radioactive iodine uptake and I guess the nodules were benign, I haven't been seen by an endo since. But I have looked up hypothyroidism, and in addition to the calves from hell, I have other symptoms that could or could not be hypo-constipation, insomnia, I get cold alot, light headedness when standing, dry scalp/dandruff, loss of libido....I'm not tired all the time and I haven't gained weight (other than what I suspect is from my lack of activity coupled with emotional comfort eating).
thoughts? I'm so frustrated and wishing I could find what is wrong with me....
It's definitely possible. All all of these are common hypo symptoms: constipation, insomnia, I get cold alot, light headedness when standing, dry scalp/dandruff, loss of libido. Not everyone experiences the changes in appetite/weight -- many do, but not all. That's why it's only one of many symptoms.
I often think the insomnia is likely more related to an adrenal issue, but adrenal issues are often commonly found with thyroid issues. I would think that you'd want to get the following tests: TSH, Free T4, Free T3, antibodies (TPO, Tg), DHEA and Cortisol. The first 5 are thyroid specific tests and the other two are adrenal tests (which should be done before thyroid treatment anyway). You can have "normal" TSH and still be quite hypo -- ask any of us that have Hashi's and were told for year that we were "within range" or "fine". It's not an uncommon story, sadly.0 -
Might not be a bad idea to be tested for thyroid issues, as well as your vitamin D level and also diabetes. Hypothyroidism shares symptoms with so many other things that I think it is impossible to diagnose by symptom alone. Only a blood test can shed more light here.0
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Well, I got mixed results. I saw my ortho for a follow up today on the MRI, and he agreed to do some of the bloodwork. He said my request was reasonable, but also said "I think it's going to come back normal". He ordered TSH, T4free, and thyroid antibodies. He also ordered B12 and D, and some inflammatory levels. I am going to ask for a copy of the results so I can see the levels, instead of relying on his interpretation, because, he is an ortho doc, after all, not an endo. If it looks questionable, I'm going to request a referral for an endo to review the labs further. He wouldn't order the DHEA and Cortisol, or the T3.
We'll see how far I can get with this.0 -
If the antibodies are present, I would try to get the rest tested. I had them for who knows how long and had to switch doctors several times since I learned of this last May.0
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I was going to suggest B12 deficiency (pernicious anaemia) but as your ortho has ordered this you will find out soon enough whether that's the case. If nothing comes up from those results ask for your iron levels to be checked too as that anaemia can also fit those symptoms. Hope you get some answers0
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Still waiting on the thyroid antibodies and d2 and d3 bloodwork, but my free t4 was 1.3 and my TSH was 4.28. B12 was 656. Iron was normal. What do you guys think?0
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htimpaired wrote: »Well, I got mixed results. I saw my ortho for a follow up today on the MRI, and he agreed to do some of the bloodwork. He said my request was reasonable, but also said "I think it's going to come back normal". He ordered TSH, T4free, and thyroid antibodies. He also ordered B12 and D, and some inflammatory levels. I am going to ask for a copy of the results so I can see the levels, instead of relying on his interpretation, because, he is an ortho doc, after all, not an endo. If it looks questionable, I'm going to request a referral for an endo to review the labs further. He wouldn't order the DHEA and Cortisol, or the T3.
We'll see how far I can get with this.
That's so weird that he would order the FreeT4, but not the FreeT3 -- they go hand in hand. Perhaps you can get someone else to look at your adrenals. Or if you like you can go to places like mymedlab and get the tests done yourself -- just an option.
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htimpaired wrote: »Still waiting on the thyroid antibodies and d2 and d3 bloodwork, but my free t4 was 1.3 and my TSH was 4.28. B12 was 656. Iron was normal. What do you guys think?
Looks like hypo given your symptoms and bloodwork. Anything above 3 for TSH is hypo and some docs want to get you under 2.0-2.5 (provided there are no antibodies at play). The old standards said 5, but the news one done in 2005 or so were lowered to 3. Your T4 is on the lower side but not out of range (yet). You'll here that phrase a LOT -- you're "within range". If either of the antibodies come back positive, that will be even more persuasive. I'm not familiar with that B12 range, so I'll leave that to others.
If I were you, I'd start looking around for a doc that specializes in thyroid or treats a lot of thyroid patients. A lot of endos are not good for thyroid -- they either are very old school or focus primarily on diabetes so don't have as much knowledge of thyroid. I'd look for someone -- whether endo or GP -- who takes a functional or integrative approach. In my experience, these docs look beyond just the TSH tests.
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You are hypo based on your TSH.0
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Did the panel include total T4 and T3 along with free? Your TSH is not ideal, but indicates that either your thyroid is not operating at peak performance or there's a conflicting hormone interfering with your T3/T4. You need a repeat reading to rule out lab error (high degree of error in all hormone testing). Ask for a full hormone panel including RT3. Your TSH should ideally be within 0.3-3.0. FT4 is good and B12 readings are excellent!
A lot happens in 12 years and if you had RAI previously this may have impacted your thyroid gland's ability to produce T4. Doesn't seem like anything drastic from your symptoms or results, but you need to have this reviewed by a endo who specializes in thyroid disorders.
Always ask for copies of your results and chart. If you find a doc not willing to be a partner in this communication dump them!0 -
:-( The Thyrogobin Ab was <20, the Thyroid Peroxidase Ab was 6. I am guessing that means antibodies are normal?0
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htimpaired wrote: »:-( The Thyrogobin Ab was <20, the Thyroid Peroxidase Ab was 6. I am guessing that means antibodies are normal?
Yup - thyroglobulin antibodies are present in serum whenever the thyroid gland is inflamed/injured. <30 is excellent.
Thyroid peroxidase (TPOAb) is also normal (<35).
Sounds like you have a very thorough investigative doc - eliminating any and all root causes. We don't see too many docs requesting these panels even though additional blood samples are not needed and the test are cheap.0 -
Unfortuantely it means I'm back at square one trying to figure out what's wrong with me.0
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Since your symptoms are localized I would steer clear of systemic issues and see if you can bring your doc to localized as this is only occurring in the calf muscles. If you've eliminated electrolytics and I'm assuming this is occurring in both calves, so I would guess neuro-muscular, but I'm grasping at straws here. Is there a sports med specialist you can get referred to?0
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Yea, they've (ortho) has done assessments like ultrasound, MRI, xray. He's referred me to a chiropractor now. Guess I'll see what else comes up.0
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htimpaired wrote: »:-( The Thyrogobin Ab was <20, the Thyroid Peroxidase Ab was 6. I am guessing that means antibodies are normal?
Just a short info - you can have Hashimoto's without having elevated antibodies. I was diagnosed based on scans.
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allergictodiets wrote: »htimpaired wrote: »:-( The Thyrogobin Ab was <20, the Thyroid Peroxidase Ab was 6. I am guessing that means antibodies are normal?
Just a short info - you can have Hashimoto's without having elevated antibodies. I was diagnosed based on scans.
It's totally possible. TPO and Tg are the most common Hashi's antibodies, but they aren't the only antibodies. I think I saw something somewhere that said 90% of Hashi's people will have one or both of the antibodies, but 10% will have neither. That's why docs often also do ultrasounds of the thyroid to see if there is an inflammation present.
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I asked my doc for a referral to endo even though he doesn't believe that they'll do anything with these numbers. Unfortunately the earliest I could get in with the end is the end of September.0
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That's a pretty normal wait to get in to see an endo. And like others above said, it may be that the endo doesn't help that much, since many are strict TSH/T4 folks and many are focused on diabetes. If I were in your shoes, I'd go to mymedlabs or somesuch and get Free T3 and RT3 labs done. Your TSH & symptoms would tend to indicate that at least something is going on with your thyroid levels, and those might answer the question. However, I agree that with the specific calf pain, it may well be something else. Good luck!0
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The endo around here does see my co-worker who has numbers similar to yours. She takes a low does of levothyroxine. I'm going to the endo in early September. My last TSH was 13 (womp womp womp). I hope you get some answers!0
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75% of Americans have thyroid related health issues and many of them don't know it.0
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