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Hypothyroid muscle pain - Patience or Cymbalta?

I have been hypothyroid for three years.  Undertreated for the last year ~ until February when I wised up and switched doctors. Anyways, I believe that being non/undertreated for so long led to painful muscle cramps and pain.  (By the end I was in a constant state of pain - it was horrible) After I switched doctors she changed my prescription from 25 MCG Levothyroxine to 30 MG Armour I began to feel tremendously better.

  When I got up to 90 mg I felt normal for almost a month.  Then the pains returned and I upped it to 120 mg.  That is when I realized that my hypo muscle pains are also my hyper symptoms. When I was on 120 mg of Armour my Free T3 tested 5.67 (top range 4.2) My doctor changed it to 60 mg Armour.

My new doctor wrote a prescription for Cymbalta for the muscle pains and I have not picked it up.  I was hoping the pains would resolve on their own with proper hormone replacement.
  
I have been on 60 mg for three weeks now and when I move around normally throughout the day by the end my muscles in my thighs and calves cramp and burn. If I don't rest the knots develop and then begins the stabbing pains.  

I have been tested for magnesium, iron, B12, calcium, Titer, ANA, the whole gamma can't even remember everything.... I have had TONS of testing from brain MRI (rule out MS) Nerve and muscle testing, fibromyalgia tender point exam....you name it.

I know for me this is a symptom of thyroid but I am getting impatient.  With a vacation quickly approaching I need to be able to move around normally.  

Has anyone had success with an antidepressant for pain?  How long until I feel the results? Should I just wait this out because it can take months if not years to find the right hormone dosage? Will I be able to stop the antidepressant?  

I do not like to take any prescriptions other than for thyroid. Seems as though my system is sensitive to any of them and end up with the terrible side effects.

I do supplement...I found that iodine and selenium are terrible for me.  But I take 1000 mg of Vitamin C, Folic Acid, B12, adrenal support, and a multi-vitamin.  I do separate the thyroid hormone and supplements by 4 hours and take Armour on an empty stomach.

Thoughts?

33 Responses
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Avatar universal
How sure are you that your hypothyroidism has been adequately tested and treated?  
Helpful - 0
10281715 tn?1409013061
I have suffered for years with muscle and nerve pain, and always chasing my tail to figure out the derivative.  Bottom line, I also have hypothyroid and most likely it is a cause, but I don't think any drug out there that treats the thyroid is sufficient enough to tackle the muscle pains.

I take parnate 10 mg when the pain gets bad. It is an MAOI inhibitor and has diet restrictions as well as drug interactions, however it is a super drug for muscle and nerve pain. If you take parnate with a little ativan- like .05 mg, it gives you total reprieve. Also, parnate and ativan can be stopped for long periods of time after treatment without return of symptoms.  Good luck and perhaps, you already had luck before I reached you.

I am going to try cymbalta to see if I can get results- for only one reason and that is that the food and drug limitations don't exist with cymbalta. I'll give it a try as I am relapsing after a few years of not having any parnate. If it doesn't work, it will be back to parnate.
Helpful - 0
Avatar universal
I have the same pains.  I'm experimenting and I think Kelp might be the answer.  Give it a shot, ...I hope it helps.
Helpful - 0
798555 tn?1292787551
What type of Dr was this?

So this SP02 records the oxygen in the blood the whole night?

"From what I read this type of condition is common in people with primary hypothyroidism. " - I never read that.

Sounds like you might have sleep apnea, the sleep study will find out (if you can actually sleep with all those wires on you).

Sinus drainage can also cause temporary symptoms identical to sleep apnea.
Helpful - 0
Avatar universal
This is more of an update in case anyone else reads this post.

Although I thought my doctor was crazy... :) I still have severe muscle pains. brain fog, and am exhausted.  She didn't want to test reverse T3, estrogen, or anything else.  I started on Armour in February 2013.  Before than I was on levothyroxine for one year.  
She sent me home with an SP02 and pulse monitor to wear as I slept.

Some info first though: I am 35-years-old, hypothyroid, 5' 8" and 135 pounds.
When I sleep my oxygen level drops to 69%  Normal being in the upper 90%  
20% of my sleep is below 80%
From what I read this type of condition is common in people with primary hypothyroidism.

I will begin using oxygen at night (oh my gosh) until the formal sleep study to find out why this is happening.  

The doctor said each night that I sleep I am damaging my muscles from lack of oxygen.  When my oxygen drops that low the test showed my pulse increases to 140 BPM to compensate.

After all this time I finally have an answer as to why I feel so bad.  
Never thought this could be a thyroid symptom!
Helpful - 0
798555 tn?1292787551
"A pain cycle"

- Interesting. Body pain from thyroid does not come in cycles.

Not unless your at the beginning of Hashimoto, and unfortunately experiencing the Hashi roller coaster of hypo to hyper (or just less hypo).

Its directly equivalent to thyroid hormone levels, which do not follow a cycle. You might what to get a few thyroid labs fairly close to each other to see if anything odd is happening.

I would tell the Drs this and keep the appt.
Helpful - 0
798555 tn?1292787551
"This means you must get up to taking a full replacement dose of T4/T3 hormones which is usually around 3 grains or 180 mg of Armour........"

- Sorry , that's not true. The amount of thyroid needed depends on the individual and how far their own thyroid is impaired. 3 grains is more than average.
Helpful - 0
Avatar universal
Hi, I strongly recommend that you read this article from Stop the Thyroid Madness which discusses the mistakes that people make when starting to take Armour. And give a copy to your doctor.

What has possibly happened to you is that at 90-120 Armour the T3 in it is sufficient to turn off any production from your own natural thyroid and consequently put you back into a hypo situation. This means you must get up to taking a full replacement dose of T4/T3 hormones which is usually around 3 grains or 180 mg of Armour (which contains 114 mcg T4 and 27 mcg T3).

Incidentally I would stay away from antidepressant and pain killers...

http://www.*************************/mistakes-patients-make/
Helpful - 0
Avatar universal
How did I miss these posts :)

Actually my Vitamin D, 25 is 38.7 Range 25.0 - 80.0
I will be picking Vitamin D up today!

This 6-week pain cycle is over.  My muscles are warm to the touch, tension headache, but otherwise all is better.  Of course because my appointment is finally here.  I wait to long to get in.  I always think it will resolve and become impatient when weeks pass and I feel worse.

I wonder if I should cancel the appointment. Although this has been a normal cycle for me.  I had a longer break with the switch to Armour.  I do wonder though, like you said, the switch to 60 mg may have resurfaced the symptoms and I need more patience. I have only been taking Armour since February.  Otherwise it has been levothyroxine.

I worry that if I cancel I will regret it in a couple of weeks if everything begins to return.

One of my theories is I am not weathering through the estrogen spikes before ovulation and menstrual cycle.  I use to track the pain symptoms on an estrogen/progesterone chart.  It showed that the worse the pain and symptoms were during ovulation and menstruating the longer the recovery.  If the symptoms were tolerable I bounced back quicker or even bounced back a little between ovulation and menstruating.

Does anyone have a pain cycle?  Does it become worse before better?

Just another reason to schedule that hysterectomy! Besides the adenomyosis, congestion, endometriosis, and grape fruit size uterus.
Helpful - 0
798555 tn?1292787551
Muscle pain from thyroid or hormonal or chemical imbalance in the body cannot resolve it self in a couple weeks. Covering up the pain with meds or anti-inflamitories is another story.

This may be part of the reason - "I have been on 60 mg for three weeks now" .

In some people, any changes in thyroid med makes symptoms appear. If the changes were positive, the symptoms should get better in more than a couple weeks.

Since it sounds like you were pain free (right ?) for some time, I would say this is a possibility again.

This post is quite lengthy, I skimmed it. Is your vit D-25 up to 60?

Magnesium serum is a worthless test. Many benefit from more magnesium taken 4 hours from thyroid med. Magnesium glycinate (KAL is one brand) is the best magnesium there is as far as its elemental magnesium amount and absorb-ability - this works for muscle and nerve pain. Magnesium citrate is close, but not as good.

The 'hot' herb supplements used to aid in digestion work as inflamitories when taken on an empty stomach. Garlic, tumeric, cyanne ect, goggle for more.

To experiment with serotonin, 5-HTP is available anywhere. Its from a natural amino acid, and increases serotonin in the brain.

People with long term muscle pain are better off learning advanced stretching in the forms of Active Release and Myofacial Release - I learned some of both and save hundred$ as opposed from going to a muscle therapist for every ache and pain.
Helpful - 0
1756321 tn?1547095325
Your other posts look to be lost in the googleverse. :)
Helpful - 0
1756321 tn?1547095325
My endo has just prescribed LDN (Low Dose Natrexone) for my autoimmune diseases. Was tested for celiac disease to no surprise since celiac disease patients are nearly 4 times more likely to develop an autoimmune thyroid condition. I have pernicious anaemia and vitiligo too just to add.

The following info is from the book "The Everything Guide To Thyroid Disease" by Theodore C. Friedman, MD, PhD and Winnie Yu Scherer:

"Although the majority of people with Hashimoto's will not develop any other disorders, it's important to know what some of these autoimmune conditions are in case you do start to experience symptoms. Keep in mind, too, that you may be more likely to develop Hashimoto's if you have one of these other conditions.

Type 1 diabetes
Pernicious Anaemia
Addison's Disease
Vitiligo
Celiac Disease
Alopecia Areta
Systematic Lupus Erthematosus (SLE)
Rheumatoid Arthritis
Sjogren's Syndrome
Inflammatory Bowel Disease
Multiple Sclerosis (MS)"


Helpful - 0
Avatar universal
Thank you Lisa!
I was still wondering if an antidepressant would help the pain.  Several doctors have sworn by it ~ but I want to know from someone in pain that has tried it!  

I am hunting for a doctor to treat the muscle pain as thyroid as well.  
I have a appointment next Thursday with my Internal doctor.  I wish she would bring ideas to the table.  I want to discuss Reverse T3 as they have suggested.  
My doctor won't test for autoimmune hypo because she said it wouldn't change the treatment.
If anything resolves for you and the muscle pains will you keep me up to date?  
Helpful - 0
Avatar universal
Thank you Lisa!
I was still wondering if an antidepressant would help the pain.  Several doctors have sworn by it ~ but I want to know from someone in pain that has tried it!  

I am hunting for a doctor to treat the muscle pain as thyroid as well.  
I have a appointment next Thursday with my Internal doctor.  I wish she would bring ideas to the table.  I want to discuss Reverse T3 as they have suggested.  
My doctor won't test for autoimmune hypo because she said it wouldn't change the treatment.
If anything resolves for you and the muscle pains will you keep me up to date?  
Helpful - 0
Avatar universal
Hi. I have hashimotos and was put on cymbalta because I was diagnosed with fibromyalgia. I really thought my muscle and joint aches and pains were from my thyroid but couldn't find anyone to treat that so figured I would give cymbalta a try. Took it for several months but it didn't touch my aches and pains. So doc then wanted to add lyrica and Tylenol for arthritis. I said no to the additional drugs and stopped the cymbalta. Those medications are not without risks and side effects. If I can find someone to treat the source of the problem (thyroid) then hopefully I won't have any symptoms to treat. This is not to say that cymbalta would not help you. Just wanted to relate my experience.
Helpful - 0
798555 tn?1292787551
Hey, your pretty efficient today (even with brain fog)!

I figured someone could find one of my old posts. That was one of them on muscle pain.
Helpful - 0
Avatar universal
What about potassium?  You have to be careful of it and ask your doctor before supplementing because too much is worse than too little, but potassium can cause leg cramps as well.

"I have two weeks to resolve this one and am exploring all possibilities. Desperate enough to "contemplate" an anti-depressant...."

I agree that neither a thyroid meds adjustment nor an anti-depressant is going to help in that timeframe.  Could you be stressing yourself out about this vacation and making your symptoms worse?  Easier said than done, I know, but try to relax???  
Helpful - 0
1756321 tn?1547095325
My own answer is conflicting information about serotonin. ha!
Helpful - 0
1756321 tn?1547095325
Helpful - 0
1756321 tn?1547095325
Thanks lazy moose. "It forces the stuck T3 into the cells to restart the normal process." Yeah that explains why i need to be really hyper to get rid of some hypo symptoms. When my free T3 dropped back to normal range :(
Helpful - 0
1756321 tn?1547095325
Antidepressants mode of action is stated to be increasing serotonin (honestly brain fog is rubbish...i should of thought of this already lol) but this info comes to mind from integrative psychiatry's article on serotonin...

"Once your natural serotonin levels are low enough to cause syptoms it is very difficult to significantly raise serotonin levels enough by food alone. SSRI's or selective serotonin reuptake inhibitors and SNRIs, serotonin and norepinephrine reuptake inhibitors do not actually increase the amount of serotonin molecules in the brain. SSRI’s are thought to block the reabsorption (reuptake) of serotonin by certain nerve cells in the brain. This theoretically leaves more serotonin available in the brain. However if you have low serotonin to begin with these medications either will not work well, or work for a while then "poop out".

Natural serotonin supplements are likely to be the most effective means to raise serotonin levels in the brain while being safe and without the side effects of anti depression medications. Derived from seeds of Griffonia simpicifolia, a native African plant, 5-HTP, or 5-hydroxy tryptophan, is a safe dietary supplement that introduces higher levels of tryptophan into the blood stream which then enter the central nervous system and facilitate the needed synthesis of serotonin.

Lifestyle Changes to increase Serotonin:

Get plenty of exercise (30 minutes at least three times a week)
Eat regularly throughout the day.
Get plenty of natural sunlight
Manage stress and negative emotions
Get 6-8 hours of quality sleep a night
Set time aside for fun and relaxation
Take a multivitamin daily
Prayer and Meditation
Take a serotonin supplement"
Helpful - 0
798555 tn?1292787551
Reverse T3 is corrected by giving more T3 med than T4. It forces the stuck T3 into the cells to restart the normal process. Like takeing a plunger to a toilet!

Yes you need to look at your T levels closly and RT3.

Adjust meds if needed. Then wait.

But- There are a few of us that continue to battle hypo muscle pain. And we continue to look for reasons. Desiccated made my pain a lot better, but some is still there. My therery is most with this were hypo for a long time and microscopicaly damaged muscle and tendon fibers not knowing we were hypo.

I have quite a few recent posts on this with lots of helpful info if you google lazymoose pain 2012.  Look it up, read the comments, if thyroid med wont resolve it, there are other things I listed that you can do to help. I'm just to lazy to repeat all of it again! Look it up.
Helpful - 0
1756321 tn?1547095325
The internet if full of conflicting info lol. Ahhh but the internet saved my life so i forgive it for being rather bipolar. :) I have read taking T3 only to clear out rT3 which takes about 12 weeks so i read. All i can think of for now is try armour maybe three times a day and take magnesium supplements. And a good pain killer to see if that helps. Temp fix until you return from your holiday. I don't think the anti depressants kick in for weeks either (not to sure about that).
Helpful - 0
Avatar universal
On 90 mg I had the most normal days.

One of my hypo symptoms is lightheaded - now knowing that my pulse drops to 50 causes that. (Should have been a thyroid red flag to previous physicians ~ but no)

I was steadily on 90 mg, feeling like all this stuff was behind me.  I started becoming exhausted.  I was thinking it was menstrual related since it was early.  About a week went by and I had a lightheaded day with the exhaustion, then the severe muscle pains. Thinking back to my pre medication day I thought I needed to increase.  
I made the doctor appointment and upped to 120 mg on my own.

I do NOT want to take an anti-depressant.  I even had a neurologist become pissy with me about refusing pain medication and anti-depressants.  I need this slump to end because of our upcoming vacation.  I have two weeks to resolve this one and am exploring all possibilities. Desperate enough to "contemplate" an anti-depressant....LOL

If there was a RT3 problem...how is it corrected?  I am getting conflicting information from the web.....

Ohhhh If only I could find a compassionate doctor that was here to help rather than push more meds....Just lucky I found one that will test Free t's I guess!

Thanks for all the information!
Helpful - 0
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