musles aches

[mari c]

I'm a female age 36.  In Sept 2004 I had 2 episodes of right sided weakness.  My right arm & leg felt weightless for about 5 minutes.  I had an MRI of my head and blood workup for a TIA.  I was about 6 months postpartum.  All results were normal. In mid November I started having vague muscles aches in my arms & legs.  Saw Neurologist-Neo exam was normal.  He order blood work for vitamin & mineral deficiencies-all normal but he checked my TSH and found I had hypothyroidism.  Started on thyroid hormone replacement (TSH was 18 on 1/31/05, 7 on 3/21, 3 on 4/27).  In late February my muscles aches started getting worse-more prominent, more frequent, involved more muslces of the legs & arms and now sometimes the hands.  In late April the muscles started to feel very tight after just making dinner & doing dishes but I could still walk and go upstairs.  No apparent weakness.  Also noticed I was clearing my throat a lot and had a lot of mucus.  Now my throat is a bit sore and the quality of my voice has decreased.  Sometimes at night in bed it feels like my throat is shaking.  I've also been checked for lyme, lupus, CPK, sed rate + more - all normal.  EMG 4/14-normal.  Rheumatoid exam-normal. I saw a Neuromuscular specialist (5/9) at a major medical center in NE-exam was normal.  He thought it was still my thyroid and suggested I do some swimming which I have been doing.  My throid medication was increased on 4/29 to get me to a low normal level but yet the symptoms continue and perhaps are worse.  Could this still be my thyroid?  I'm concerned about a neuromuscular disease.

[CCF-Neuro-M.D.-PW]

Unfortunately I cannot give you a clinical diagnosis over the internet. You seem to have had a fairly thorough workup and it is encouraging that your results have not detected a neurological or muscle disease.

At this point, if your symtoms are persistent you might benefit from a muscle biopsy - this can detect some enzymatic abnormalities of muscle that can be difficult to pick with routine blood work and that can present in later life with cramps, aches, particularly after exercise or a carbohydrate load. These disorders are called muscle adenylate cyclase deficiency, phosphofructokinase deficiency among other - all can be ruled out by a muscle biospy.

Thyoid disease can cause a myopathy (muscle disease) but should normalize over time with normalization of your thyroid function. Your symptoms are not suggestive of ALS.