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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?
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?
Do you have the rest of your labs from when your FT3 was 5.67? If so please post with ranges. Although FT3 correlates best with symptoms, FT4 cannot be ignored, either. Had you taken your Armour before that blood draw?
120 mg to 60 mg in one jump is a huge adjustment.
120 mg to 60 mg in one jump is a huge adjustment.
Wow the responses are fast!! Thank you so much!
I did not take Armour the morning of the blood test.
I began taking Armour twice a day but when she dropped it to 60 mg I ended up only taking it once a day. Yesterday after the morning 60 mg I cut a 30 mg in half in the afternoon to see if the T3 would help but still had painful thigh cramps in the evening.
I don't have my Free T4 right now...still waiting for them to mail and COMPLETELY spaced to ask when the nurse called about the high T3. I am with you on the brain fog ;)
Although on 90 mg at the end of March
Free T3 4.53 Range 2.30 - 4.20
Free T4 1.37 range .89 - 1.76
She asked me to stop taking the 30 mg Armour in the afternoon for twice a week. When the muscle pains began again I upped it on my own. I told my doctor that for the last three years I did everything my primary requested and this time I need to try it my way. She trumped me when my Free T3 came back high....oops
I thought the same thing about 120 mg to 60 mg. I think she was angry that I bumped it to 120 mg before I went in to see her. But, when you are feeling terrible and it takes two weeks to get in.....I needed to try something! So, in her mind she was taking me from 90 mg to 60 mg. Doesn't help the nurse had my doses down wrong in my file.
What do you do when you are at their mercy to write a prescription....
I did not take Armour the morning of the blood test.
I began taking Armour twice a day but when she dropped it to 60 mg I ended up only taking it once a day. Yesterday after the morning 60 mg I cut a 30 mg in half in the afternoon to see if the T3 would help but still had painful thigh cramps in the evening.
I don't have my Free T4 right now...still waiting for them to mail and COMPLETELY spaced to ask when the nurse called about the high T3. I am with you on the brain fog ;)
Although on 90 mg at the end of March
Free T3 4.53 Range 2.30 - 4.20
Free T4 1.37 range .89 - 1.76
She asked me to stop taking the 30 mg Armour in the afternoon for twice a week. When the muscle pains began again I upped it on my own. I told my doctor that for the last three years I did everything my primary requested and this time I need to try it my way. She trumped me when my Free T3 came back high....oops
I thought the same thing about 120 mg to 60 mg. I think she was angry that I bumped it to 120 mg before I went in to see her. But, when you are feeling terrible and it takes two weeks to get in.....I needed to try something! So, in her mind she was taking me from 90 mg to 60 mg. Doesn't help the nurse had my doses down wrong in my file.
What do you do when you are at their mercy to write a prescription....
Okay so you don't feel any better taking it more than once a day. That is sometimes the problem. As Dr Cabot says (my fav doc in Australia who is a famous author here) - if the medication does not work as expected check reverse T3. A good tip! Have you had that test done?
No, I have not had the reverse T3 done.
I thought it was obsolete, but I am at the point to try anything!
If I recall correctly the other health board website said it was obsolete. (I was banned for posting a reference to a website...honest mistake)
What would this test tell me? I will start reading up on that...Thanks!
I thought it was obsolete, but I am at the point to try anything!
If I recall correctly the other health board website said it was obsolete. (I was banned for posting a reference to a website...honest mistake)
What would this test tell me? I will start reading up on that...Thanks!
I am still contemplating the Cymbalta route until I can find out more information. Three years ~ with glimpses of how I use to feel ~ is so long.
I was really opposed to an anti-depressant, bit I am feeling defeated and am contemplating giving in. Although not without a little knowledge first!
I was really opposed to an anti-depressant, bit I am feeling defeated and am contemplating giving in. Although not without a little knowledge first!
If only we could write our own scripts...but, then, we wouldn't need them at all, would we? Job security???
At the end of March, on 90 mg, both FT3 and FT4 were a little high. FT3 much more so than FT4. I know you still had leg cramps at that point, but how were your other hypo symptoms? The jump from 120 to 60 is still big. Even assuming that, in her mind, she was adjusting from 90 to 60, what would have been wrong with half that, perhaps?
RT3 is not obsolete, but it is a controversial topic. Much of mainstream medicine doesn't give it much credence. You can research RT3 dominance or Wilson's syndrome (also called Wilson's temperature syndrome) if you want to explore it further.
At the end of March, on 90 mg, both FT3 and FT4 were a little high. FT3 much more so than FT4. I know you still had leg cramps at that point, but how were your other hypo symptoms? The jump from 120 to 60 is still big. Even assuming that, in her mind, she was adjusting from 90 to 60, what would have been wrong with half that, perhaps?
RT3 is not obsolete, but it is a controversial topic. Much of mainstream medicine doesn't give it much credence. You can research RT3 dominance or Wilson's syndrome (also called Wilson's temperature syndrome) if you want to explore it further.
Reverse T3 is obsolete? O_o I just requested it. :) Normally reverse T3 doesn't cause problems until it rises too high and starts blocking too many free T3 receptors. I personally wouldn't touch any anti depressant myself. YT video search: Antidepressants and School Shootings, Suicide, Addiction.
Doc tried to push me on some type of drug (found out it was an anti depressant) for my burning feet (that is one of my many thyroid symptoms that only go away when i'm very hyperthyroid). I declined.
Doc tried to push me on some type of drug (found out it was an anti depressant) for my burning feet (that is one of my many thyroid symptoms that only go away when i'm very hyperthyroid). I declined.
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!
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!
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).
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.
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.
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"
"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"
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 :(
http://www.medhelp.org/posts/Thyroid-Disorders/Hoshimoto-muscle-pain---in-depth/show/1823938
LazyMoose is...well Lazy hehehe
LazyMoose is...well Lazy hehehe
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???
"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???
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.
I figured someone could find one of my old posts. That was one of them on muscle pain.
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.
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?
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?
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?
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?
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)"
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)"
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.
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.
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