Exercise Intolerance: pain, weakness and injury

[mrspickle]

I've read that hypothyroidism can cause exercise intolerance.  I have been very ill since exposure to some toxic pesticides.  Part of the poisoning is that I became hypothyroid.  I used to be a keen athlete cycling many miles a week and competing often.  Now I am unable to do any exercise.  I suffer from pain in my joints, particularly my knees.  If I try and do any level of exercise, I suffer injuries and weakness afterwards which take ages to heal (some haven't healed at all).  For example, an hour's walk incorporating a hill can leave my foot flexors so weak that I can then struggle to lift up my foot for weeks at a time and have to back off doing anything at all.  Swimming can cause sharp shoulder pain and weakness.  

I have some periods when I feel a bit better (relatively- nothing like when I was well). I notice that the joint pains are worse when I get my period.  Could this exercise intolerance be due to hypothyroidism?  I am struggling to work out what is the direct result of poisoning and what is the result of hypothyroidism. Anyone experience similar?  My TSH is now 4.88 (still too high- was below 2 when well).  However, it did get to 0.7 a few months ago and I still had these problems.  Free T4 is now 14.1 (range is 12-22 I think). Free T4 did go up to 18.1 a few months ago and I still had these difficulties.  Free T3 is now 5.1 (range 4-8 I think).  This is higher than it has been since I got ill.  It was 4.3 earlier on in the year.  When it was that low I could barely walk on the flat.

Any info much appreciated.  Thank you

[stefan1983]

I have been diagnosed with hypothyroidism as well 2 weeks ago. I have got elevated TGab which means I probably have Hashimoto's. not sure whether there was a trigger or not but my mom's got it so I suppose no surprise here. I am a male as well, from the UK and was wondering what professor you went to as my GP has only ordered I do another FT4 test in july even though it was fine, only TSH and TGab were higher than normal.

Also, is this professor private?

many thanks and hoping you are feeling better now

[Barb135]

If you don't need the extra T4, there's no point in trying to force it.  If you need an increase, you can always split a 25 mcg pill and take only 1/2 per day, or even quarter it. Some people have to increase in very small increments.  

Of course, I can bear with you, regarding your labs.  I'm just curious what levels you ended up at, that allows you to do so much more than you could before.

[mrspickle]

Fingers crossed you have similar results too.

Barb123, I will dig out the results and reference ranges at home.  My paperwork is in a huge heap in the spare room, so you'll have to bear with me, as it could take me a while to find them....  Yes, I take 50mcg T4 every morning.  My endocrinologist did try to put me up to 75mcg, but I couldn't handle it; it made me feel really quite manic and on edge, even when we tried to introduce the extra 25mcg slowly, starting with every other day.  

[flowergal23]

Thank you for the update, I'd previously been on synthetic T4 for over 20 years and joint pain has been an issue for as long as I can remember.  I'm now three months on a T3/T4 med and though it's early days yet, I hope I have as good results as you have had.  This gives me hope!

[Barb135]

NeedSomeHelp123 is no longer active on the forum, but we do appreciate the update.

I assume that you're taking a T4 med, along with the 10 mcg T3?  What T4 med/dose are you on?

Can you please post current levels of FT3/FT4, with reference ranges, so we can see where you are?

[mrspickle]

Hi,

Sorry for the delay in posting with progress.  I always feel so frustrated when I find a forum which matches my syptoms but then the updates stop before the outcome of treatments tried is known.  So apologies again for the delay.

By way of update, my T3 dose has been increased slowly from 2.5mcg per day to 10mcg per day.  The difference in my joint pains is incredible.  I went from having sprainey painful knees a lot of the time, with other joints feeling weak too, to having these symptoms only when I had my period, to having them hardly at all.  I've had near to normal feeling joints since Spring. I've gone from not being able to walk across the house in bare feet because of the pain in my knees and feet without orthotics, to forgetting to put shoes on and wandering around the house for hours at a time before I remember!  

I've also gone from being able to do only very small amounts of swimming (and when I did having painful joints etc) to being able to hammer up and down the pool for 50 lengths at a fair old pace.

Having done no classes at the gym since the hypothyroidism set in, I can now go to pilates classes again.  I can also use my bike to run local errands (we're talking only small trips here, but given I couldn't cycle the length of my street on it a while ago- and at one point struggled to even walk its length,  you'll appreciate the sort of level of difference I'm talking about.)

The introduction of T3 for me has been life changing.  The quality of my life has increased no end and I'm even daring to dream I may be able to get back a semblance of my old sporty life again.

My T3 is now near to the upper range and my T4 which had fallen from near top end to right towards the bottom has now climbed back up to closer to what it was at diagnosis (and this is without increasing my T4 dose from the 50mcg it has been at for ages- not sure how the T3 helps there but it seems to).

Having said all of this, over the last few weeks my foot flexors and knees have started to feel slightly odd again (nothing like they were but just a little dead and strained again).  I'm really hoping this is just to do with the weather getting colder.  I'm going to find out about increasing my dose to see if this can help at all....

I hope this is of help to anyone in a similar position.  If you're struggling with joint pain and haven't tried T3 and you're low in range, I'd really recommend you speak to your doctor about giving this a go.  

If there are any changes over winter/a higher dose helps me in relation to teh recent minor set back,  I'll post again with an update.  

Best wishes to all who have this condition.  

[NeedSomeHelp123]

How are you doing now?  Any update?  Feeling  better symptom-wise?  How are your thyroid levels?

[gimel]

Congrats to you for finding the doctor.  A Professor of Endocrinology?  From your description of his diagnosis and treatment plan, then I assume he must teach clinical Endocrinology, rather than the "Immaculate TSH Belief" and Reference Range Endocrinology".  So where have all his students disappeared to?   We don't seem to be able to find any of them to treat all of our long suffering hypothyroid patients.  LOL

[artfemme]

Yaay for YOU ! Congratulations to you and your doctor, best wishes, and thanks for sharing.

[mrspickle]

Just thought I would provide an update:  I have been to see a Professor of Endocrinology who has said that he thinks all of the pain, weakness and inability to do exercise is due to the hypothyroidism.  He wants to see me every month for at least 6 months and to closely monitor my blood levels and medication until I have good levels and symptoms.  He said in 78% of cases getting the levels right will reverse these symptoms. He is going to increase my T3 and do all of the things you wise people have been suggesting.  

I will post again as and when there is any change.  I should add that the the small amounts of T3 I have been taking since January have definitely produced a small improvement.  My knees don't feel so sprainey all the time anymore- yeay!

Sending best wishes to all who have helped or are in a similar position.    

[Kimemitch]

This has been a great thread for me! Thank you! Reminded that I am not alone and it is not in my head!

[mrspickle]

Thank you

[LazyMoose]

transdermal magnesium spray  - good stuff , but messy, its magnesium cloride, a brine, sprays on oily, soaks in, then leaves salty residue that can be wiped off with a damp cloth. It more for top layers of muscles.

Epsom salt also is a magnessium.

I'd still take any of those oral mags for deep muscles , in addition to using spray on the muscles that really hurt.

[mrspickle]

BTW my GP is going to run the Tgab test when I next have my bloods done (2 weeks' time) so thanks for that suggestion.

[mrspickle]

Thanks so much for all of the info on muscle release and supplements.  The alternative type doctor who did the mitochondrial function (ATP etc) tests which were poo-pooed by the NHS has recommended a transdermal magnesium spray as well as Epsom salt baths. Do you think that's worth trying, or just go straight to oral mag glycinate?  

Thanks in advance

[LazyMoose]

Magnessium malate has a form of malic acid in it. Salts and esters of malic acid are known as malates and seems to mostly be marketed towards the fibromyalgia crowd and muscle heads since it improves the ATP process.

good link on mag and mailc acid:

http://www.betterhealthinternational.com/lib_MamFib.asp

[LazyMoose]

Info pasted from a supplements company about quality and why mag blood level tests vs whats really in the muscles is not that accurate or useful..

[ "Quality of magnesium is important. Magnesium oxide is a cheap salt of magnesium and never used in Wellness Resources products. Oxide salts break apart in metabolism and the oxide requires an antioxidant to neutralize it. Why spend precious antioxidants neutralizing a low quality form of magnesium supplement? Companies using oxide minerals are clearly not quality focused, regardless of what they say.

A lack of magnesium poses an interesting catch-22 in terms of how to get magnesium into cells. This is because magnesium is "pumped" across cell membranes and the pump requires magnesium to function in an optimal way. A supplement of magnesium oxide or chloride may increase blood levels of magnesium, but the magnesium may not be able transport across cell membranes due to the lack of magnesium required to run the pump. " ]

[LazyMoose]

A standard Magnesium blood test is not that accurate. The more accurate one is called RBC Magnesium, (for red blood cell magnesium) and it has a very wide range.

Dosing magnesium is very basic, take preferably at bedtime, and base increase on ease of doing #2 in the morning  LOL! Yes, if you read about it, this is how well known holistic Drs dose it. The key is using only very high quality of magnesium in tablet form as: magnesium glycinate or magnesium taurate and the 2nd best - mag citrate. There are some powdered mix types out there as well, they calm you, Im not sure how effective they are on muscle fiber though. There is a lot of good info about the benefits of magnesium from a holistic point of view. Its food for nerves, brain, digestive system and muscles.

Cheap magnessium< if you read on the back label is mag oxide and will not be absorbed. Its primarily a laxative and a marketing gimmick in tablet form.

Malic acid is a fruit acid that binds with alkaline minerals- calcium and magnesium ,and supposedly can help with the absorption of these. I've read max per day is 2400mg, I only take 1600mg daily (two big capsules).

Foam rollers feel nice but dont penetrate the muscle fiber deep enough to make a lasting effect. Great tool to start with and warm up, best to end with a soft ball or golf ball or just strong thumbs 10 -20 seconds for actual trigger point release. And active release has an actual technique to it of "anchoring" the muscle sorter than its own anchoring point in the shortened position, then moving to the lengthen position. U-tube active release. Its amassing.

[mrspickle]

Thanks everyone for all of your interesting comments. I'm sorry for the delay in replying.    

Brucergoldberg, the chemicals I was exposed to were permethrin, carbamate and organophosphate.  Tests on lymphocyte sensitivity and toxic screens have shown that the thing I react to the most, by miles, is organophosphate.  

Artfemme- so sorry to hear what happened to you.  I have been sauna-ing in an infrared sauna since last summer and have managed to reduce the levels of the chemicals in my fat by 1/3 but my symptoms are no better.  Thanks for the info on paint. I have some VOC free paint which I have used in a different room, but as I couldn't find the colour I liked for another room, used normal stuff.  I'm kicking myself now.  I'm going get it painted over asap.  

Needsomehelp123, I haven't been tested for adrenal dysfuntion.  It's a good suggestion though, I think, and one I have considered.  However, I want to try and get my thyroid numbers normal first and see if that results in any improvement before looking into this.  I'm worried that if I start adding in all sorts of things at the same time I won't know what's doing what!  

The suggestion of mitochondrial dysfunction is also a good one, I think.  I was tested and have problems with the ATP cycle, as outlined by lazymoose (fount of wisdom as always).  The tests were done by an alternative type practitioner, but when I went to see a neurologist who works at the leading centre for mitochondrial dysfunction in the UK and showed him the results he was really dismissive and said that those results didn't mean anything, so I'm none the wiser on that front.  ,

Lazymoose, thanks as ever for your info.  When I have my bloods done my magnesium comes back normal.  Isn't there quite  a narrow range for magnesium?  I thought it could be OD'd?  I'm happy to try anything that might help, but I'm just a bit worried about the magnesium?  Will try the Malic Acid though.  

I have  a foam roller to try and break down muscle knots which I'll persist with.  

I'm seeing my doctor next week and am going to ask about having the Tgab test again.

I'll post if there's any improvement and, if so, what it seems to be related to.  

Thanks all once again for so generously sharing your information and knowledge.      

[LazyMoose]

There have been occasional posts here about muscle and exercise intolerance the last few years.  I've made several posts , not questions, addressing this issue and what I've found to work since I've been experimenting on myself for a few years. I'll summarize what I've learned so far:

First of all there can be many reasons for muscle pain with hypothyroid, any or all of the below info:.

If you read my comments and others on this whole post it should help answer some of your questions about exercise intolerance and muscle pain with hypothyroid. You first need to look at the Free T3 level, upper third of the range is best for pain. Second, all the vitamins and minerals that others mentioned here need to be looked at.

Sometimes changing from synthetic thy med to natural dessicated helps some people, only try this after synthetics have been tried at the highest level your body is comfortable with.

4 point adrenal saliva test (with DHEA) from online or a holistic type Dr. If adrenals fluctuate, treat with herbal adaptogens.

Hypothyroid myopathy as it is called, does exist, but there is very little info on it. It is similar to other myopathies that elevated lactic acid levels (partially from low magnesium ) disrupt the ATP muscle rebuilding process resulting in fatigued painful muscles and tendons. It can actually physicaly damage the muscle. If this is the case, magnessium glycinate, mag tuarate, or mag malate taken at night can help release the build up of lactic acid and you will feel better the next day/morning. Malic acid taken with meals also helps do the same thing. Lastly, some peoples muscles are so full of adhesion and knots, they need to try different forms of myofascial release- trigger point release, Active Release Technique to manually release the lactic acid and re-align the muscle fibers in the longitudinal direction that they naturally layed before the damage occurred.

I did all the above starting three years ago, in that order and have very much improved.

[NeedSomeHelp123]

Do you think you could have mitochondrial myopathy?

http://mda.org/disease/mitochondrial-myopathies/signs-and-symptoms

[NeedSomeHelp123]

Hello, I have read your posts and I can completely relate 100%.  NO one else seems to complain about exercise intolerance but it is my number one complaint and I have been suffering for three years with this.

Are you better?  I am terrified I will never be able to walk again.  I am at the point where I want a wheelchair when I am at the mall.  Haven't done it yet, but it's hard for me to do anything cardiovascular.

QUESTION:  Do you ever have lower back pain?

I am discouraged you never feel better, especially in terms of the exercise intolerance, even when you get your thyroid numbers better.  It makes me think, possibly, that it might not be the thyroid that causes this for us.

Have you been tested for adrenal dysfunction?

(for whatever reason, my Medhelp account does not alert me when I get a reply to a posting, but I believe I do get messages in my inbox, so feel free to private message me if I do not respond to any posts on the message board)

[artfemme]

What a great thread ! Thanks to Lazymoose for all that good information. I too trace my problem with my thyroid to chemical exposure. It followed upon several rear-ended car accidents from which I had a hard time healing. When I did body work for the first one (whiplash, concussion and herniated disc, with field-and-ground disorder, light and sound sensitivity, and extreme weight loss with vomiting) I did neuro-organizational work with my kinesiologist, who postulated something wrong with my hypothalamus. I was cut lose from PT for the combined second and third accidents (2 in 11 months, at stoplights when I was stationary...my luck...more whiplash, concussion, herniations, torn tendons etc.)  after several years because I just didn't get better and my neurologist stated at that time that he thought I might have "fibromyalgia"...which is now thought simply to be hypothyroidism, or to at least contain a component of hypo. But I got better after I stopped PT and went and got Rolfed, which is a form of massage that does exactly what Lazymoose talks about....breaks up adhesions between the muscles and released deep tissue spasms. I finally had no back pain or sciatica for the first time in 3 years. I might add I had been a yoga practitioner for 15 years and a body surfer, and I cycled on the bike path 11 miles several times a week. When younger, I trained as a dancer.

However, while I was still being Rolfed and in lawsuits about the car accidents, a pipe broke in my loft and my landlord did little true clean up and mold, which had always been a slight problem at the beach (and turned out to be mostly from an incomplete seal between my place and the bathrooms of the 2 units below me) grew all over everything. When I tried to clean the extensive growth of multi-colored (thus multi-species) molds off the walls with bleach they puffed their toxins at me and I collapsed.Then, instead of doing a REAL abatement with industrial hygienists sealing off the rooms and with hepa-filters, etc. my landlord hired a bogus company to come in and spray with Tilex and god-knows-what-else...ineffective and made me sicker....and in the middle of this, my neighbor had someone come to spray disease on a tree opposite my open bedroom window, at which point I had numbness and tingling and headaches etc. I had to get OSHA to come out and make her stop, and it turned out that the pesticide used was a banned one. There was a lawsuit about all this that went on for 4 years, and which I ultimately won.  A toxicologist stated I would probably have health problems for the rest of my life, which my terrible lawyer refused to promote properly......it wasn't just the toxins from the molds (which did not show up as allergies, but rather as auto-immune response on every level through ELISA blood testing) I think it was the chemicals as well. When all my dry cleaned goods...everything I owned  including shoes were brought back after cleaning with perchlorethylene and in out-gassing plastic bags...was brought back to my loft with me back in residence after I moved back from the hotel I had to stay in for 2 months...I once again collapsed, instantly got sores inside my mouth and started itching. ALL of these things are known endocrine system disruptors.

My hair started falling out after that, and I had to have eyelid and forehead surgery to correct a peripheral vision problem from a drooping lid that when I look at photos now was obviously facial myxedema. My WBC was in the dumper. I gained 40 lbs. and developed every single symptom of hypo that there is except constipation. I started practically hemorrhaging with my period and my gynecologist said she thought I had sub-clinical hypothyroidism. Another doctor I saw for something completely unrelated took one look at my missing eyebrows and puffy pale skin and told me I needed to be checked for hypothyroidism....but my TSH was below 2.0, so every endocrinologist I've ever seen (SIX of them) has said I'm not hypo. In the meantime my FREE levels, when I finally insisted they be tested, were in the dumper, my Vit D way below normal, and my RBC showed I had pernicious anemia. This, coupled with my rising cholesterol and glucose levels, my low eGFR and high creatinine and high calcium levels at least persuaded my PCP to give me levothyoxine and Cytomel. If it had been left up to endocrinologists I'd be dead...if only because of the myxedema that made my ankles overflow my shoes etc. and my blood pressure soaring to 196/98. All of that got corrected with T4 and T3, in a very short amount of time...though I am now having a dis-equaliberating  rT3 problem.

I'm sure the car accidents and the fact that my sister has Hashi's (although my antibody tests are ok) predisposed me towards a thyroid problem, but I am quite sure that pesticides and environmental toxins pushed me over the edge. Also, what I know about toxins is that they are retained in body fat (even if you are not overweight, we all have some) and therefore released into your system when body fat is burned during exercise. Perhaps this can explain some of your difficulty. The most recent suggestion to me is to try an infrared sauna. I also used milk thistle and evening primrose oil as you are doing, and found they helped. And unless you used a VOC-free paint, the fumes released from painting your room would absolutely trigger a response. I have a rash ever since exposure, and when I'm exposed to off-gassing fresh paint (or carpeting, or fiberboard furniture) it gets worse...and I never had that problem before such an extreme load on my system. And like Lazymoose, I only started to feel better when I started taking T3.  

Hope this helps, if only to let you know that at least based on MY experience, you're not alone and I would suspect Brucegoldberg's DDT exposure, known to stay in the body, known to be an endocrine disruptor, didn't help him a lot either.

Good luck everybody.

[LazyMoose]

Muscle pain being relieved from T3 all depends how long your muscles have hurt and if you injured them from over exercise while hypo. I think you have to look at improvement on a month to month basis, not day to day.

T3 was noticeable in my muscles recovering from new exercise but it was more minimal for old injuries. I seem to be the worse case scenario of anyone I read about here with pain from being hypo. I needed to repair damaged muscle tissue over most of the major muscles with a self devised plan I started quite a while ago (part of the info on my Dec 31 comment to you). Hopefully recovery will be easier for you.

Remember , before coming to conclusions, you need to see if you have antibodies attacking your thyroid (Hashimoto).  Were you able to look into the TGab antibody test yet to see if that is the cause of your hypo thyroid?

Regular, non-autoimmune hypothyroid can be caused by many things, chemicals might be one of them - very little info on this.