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Muscle Cramps related to Hypothyroid?
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Muscle Cramps related to Hypothyroid?

Hi everyone!

I am new here and just had a quick question.  Ofcourse it's one of those questions that doesn't make sense without some background information, so here goes....

I am 29 years old, about 12 years ago, at age 17, I was diagnosed with Grave's Disease (hyperthyroidism).  At that time I really didn't realize what that meant and a lot of me just really didn't care.  After 12 years of these symptoms I decided to go back to my endocrinologist and do something about it.  So in November I went to see Dr. D (my endocrinologist) and after him yelling at me for not coming back sooner and some labwork, sure enough I still had Grave's Disease.  Out of the couple of options he gave me to "cure" the condition.  I decided with the radioactive iodine therapy.  

On 12/4/2008, I took one little pill and my life has been worse ever since.  My follow up with him was 6 weeks later.  When I saw him in mid January and he asked about my symptoms, Dr. D decided that my thyroid levels probably was not low enough and he wouldn't draw my labs that visit.  He said he would wait another six weeks and then maybe draw my labs.  About a week later everything hit me like a ton of bricks....I had absolutely no energy, I was constipated and depressed just to name a little.  Without realizing it, I had also gained about 15 pounds.  So I called up Dr. D.  He told the nurse to have me come in for labwork.  The following morning I arrived for my labwork and later that afternoon they called me to ask where I would like my Levothyroxine script called into.  I started on 100mcg per day, the following day.  

About a week later I started having muscle cramps.  There really wasn't a trigger at all, I could just be sitting on the couch reading and get a huge cramp in the side of my neck.  Or try and prop my leg up and my thigh would immediately cramp up.  No area in my body was safe.  I just would cramp up without any warning.  This went on for a week and I called Dr. D's office.  I told the receptionist my symptoms, after speaking with the nurse, she spoke with Dr. D, who said to cut my Levothyroxine in half and only take 50mcg daily for a week and then continue with the whole dose.  I took the new dose for a week without really seeing any relief for my muscle cramps.  Then started taking the whole dose again.

By this time I was starting to have different symptoms.  The best way I can describe the new symptom was racing thoughts.  I would wake up in the middle of the night with my brain just racing away with thoughts and I wouldn't be able to go back to sleep.  It didn't matter what time I woke up, my head would just be going crazy with thoughts.  I couldn't keep my thoughts straight either when I was awake.  So I called Dr. D's office again, only for the nurse to tell me that it takes a good month for Levothyroxine to get into your system and that she didn't think the racing thoughts had anything to do with the med.  She spoke with Dr. D and he said for me to go to an outpatient lab and have my labwork drawn.  The next day I got a call from the nurse who stated that my thyroid levels were just where the doc wanted them and maybe I should see my primary care physician or a psychiatrist for the symptoms I had been having.

Now completely frustrated, I called up a PCP, since I didn't have one to begin with who made me an appointment for later in the week.  On 2/20/2009, I went and saw the new PCP.  I told her about the muscle cramps and the racing thoughts.  She attributed my racing thoughts to my recent trial of Chantix and told me that it was the medication still in my system.  (I had taking Chantix back in late november to try and quit smoking, but had broke out into a rash). For the muscle cramps she was certainly perplexed.  She decided to draw a whole bunch of labwork on me.  That afternoon she called me to let me know my CK level was 1,683.  She asked if I was dehydrated and I let her know I drank plenty of water.  She told me to watch my NSAID use and she would see me the following week in her office.  Last tuesday I went to see her and she stated that she found articles for correlation between muscle cramps and hypothyroidism.  I told her I had found the same articles online and they stated that once your thyroid levels came back into range the muscle cramps would stop.  Mine hadn't stopped and according to my endocrinologist my thyroid levels were good.  She then stated that she thought the muscle cramps were coming from my high CK levels and that once my CK levels came down the muscle cramps would stop.

I guess somewhere in the beginning of all this I should have let you all know that I am a registered nurse, who worked a cardiac unit before changing over to a dialysis clinic awhile ago.  I guess I could be incorrect on this one but I was always taught that CK's were enzymes that lived in muscles in your body and are released when that muscle is damaged.  So I guess this is where I am getting confused????  How can an enzyme that lives in your muscles until they are damaged or cramped be causing the muscle to cramp????

If the muscle cramps are related to my hypothyroidism and that my levels are too low, why did my endocrinologist decide to LOWER my levothyroxine dose for a week, instead of raising it or drawing my labwork first....

My PCP decided to draw my CK level on my last visit 3/4/2009, she stated she would be happy with when she saw a downward trend.  Now on the day I went and had my labs drawn I hadn't had a cramp in 2 days.  I could have told the lady that the result would be lower because I knew I hadn't had a cramp in a couple of days.  Low and behold when the result came in at 460, my doc called me with the happy news and pretty much said call us if you need anything else......

Errrrrrrr, this is very frustrating.....

My endocrinologist doesn't want to see me until april/may.....I guess I'm just supposed to live with the muscle cramps for the rest of my life.  They don't happen everyday, but when they do they are pretty much debilitating for hours.  It's annoying....

Anyone been through this situation or have suggestions as to what I should do??  My husband wants me to go to another Endocrinologist and PCP.  
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523918_tn?1244553431
Several vitamin deficiency states may directly or indirectly lead to muscle cramps, also Low blood levels of either calcium or magnesium. There are many causes, may be you should ask for a second oppinion.
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Avatar_f_tn
yes muscle cramps can be related to Hypothyroidism.  I have them.  Went in with them as my main complaint last summer.  At that visit dr did tsh, which was high, put on synthroid, small improvement after 2 months, cramps came back, raised dose from 50 mcg to 88,  after 2 more months I am feeling better, the cramps are still here but at a level I can function and pretty much do daily activity.  So it can take a while.  My current tsh is 1.74, started at 6.5.    I had the brain fog, racing thought thing for about a week, and it went away, I think once I leveled off.  Get slight anxiety once in a while, again I can live with this.
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Avatar_f_tn
Hi! Welcome to the community.
I too have had HORRIBLE muscle spasms with hypothyroid. I would advise you to get other opinions, have lots of labs, calcium,potassium, magnesium and PTH done.
   It does take 6-8 weeks for your levels to be optimal my Dr. said. I felt much better after several weeks  maintaining a "normal" level. I also take fish oil ( double dose, good quality brand), 2000 mg of vitamin C , magnesium, 400 mg. daily and calcium 1000mg. dailly.I  found the fish oil and vitamin C taken per my DO dr really helps.. recently ran out of fish oil for one week and the spasms started up again... so back on now.
   I wish you luck. You are nurse and I would "ask" around for the best endo you in your
area. Someone who listens to pt, runs tests, and is pro active in treating thyroid issues. It took me 4 endos to find the "right "one but I would not go back to a resteraunt that did not give good service. Your body/health is so important... I wish you the best!!!
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Avatar_f_tn
Thanks for the information.

Yes all my other labs i.e. Potassium, Magnesium, Calcium were in normal range. The only other elevated lab was cholesterol and that I also know can happen with hypothyroidism.

Everyone told me my endocrinologist was the best in my area, I just don't understand why he lowered my dose for a week.  You would think that he had run into the muscle cramps before and would know it was maybe because I needed more of Levothyroxine not less of it.....I don't know.
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Avatar_f_tn
Did your endo think the cramping was a side effect of the med?  I know there is an adjustment period in your body and it will do wack things until the levo levels off.  I went through a few weeks of feeling hyper before I leveled off.  I have found that my PCP knew nothing about muscle cramps as a hypo symptom.  He  wanted me to see a rhuematoligist.  Perhaps cramping is rare.  Seems a lot of people on this forum have it.

Everyone talks about vitamin levels and taking certain ones.  I feel better after stopping vit supplements and getting the levo to do it's job.  If we are deficient in thyroid hormone shouldn't getting that level right be the first focus on getting us to feel better?  Sure vitamins have their place, but my priority is the right  dose of levo first.  
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Avatar_f_tn
Yeah I think cause I spent so many years with hyper-thyroidism, my body may be just used to that, so maybe that means the muscle cramps will just take me longer to adjust.  I guess I'm just annoyed that it seems I'm having more problems now than I ever did before!  

My PCP that I had went to that told me that the CK's were actually causing the muscle cramps just annoyed the **** out of me, because I know that is not the case!!  I have an appointment to see a new PCP in April.  My endocrinologist doesn't want to see me until April/May.  Hopefully by that time the muscle cramps will be gone.

I guess it will all work out eventually!!
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Avatar_m_tn
What thyroid tests have been done and what were the actual  results that your doctor thought were "good"?  By the way, I started having leg cramps when I drifted back into hypo t.  after getting retested for free T3 and free T4, along with TSH, I found that my body was not converting T4 very well and my free T3 was low.  My doctor switched me from Synthroid (T4 only) to Armour thyroid (T4 and T3 both) and in just a couple of days the cramping was gone, along with some other symptoms I was having.
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Avatar_f_tn
I was taken off my synthroid for an uptake and went hypo after being hyper for a few years due to being overmedicated. I have been struggling with muscle cramps and also muscle spasms since going off the medication. Today I found out i am finally within the proper ranges. (Yea!!!! It has been a long haul). I am still experiancing the spasms and cramps and am also hoping within the next few weeks these muscle problems will go away. I am glad to hear I am not the only one because for a while I thought I was going crazy..

Dawn
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Avatar_f_tn
I am not sure what "normal" per my endocrinologist, since I haven't even seen him since starting on the levothyroxine.  I just went to a lab to have my labs drawn, and then the nurse from his office called me to tell me they were all within normal range.....and to continue on my current dosage.  I know they drew a T3 and T4, but don't know the results.

The PCP I went and saw just drew a TSH which was 5.82, I actually got those lab results!!  I guess I should call my endocrinologist and see if they'll fax me my lab results?
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Avatar_f_tn
With a TSH of 5.82 you are most definately Hypo.
I have had muscle cramps when both Hypo or Hyper so I got my vitamin levels checked and was found to be deficient in Vitamin B12, D and Calcium after having RAI last June.
I have since stabalised my levels and went on a D/Calcium and B12 everyday.
Since then I have found the cramps subsided and I wasnt so bad.
'Get your vitamin levels checked and ask for the FREE T's to be done next time , not the T3 and T4.
Free T3 and Free T4 are much more accurate and what may be 'normal' in your Endo's eyes are ...your levels are 'within range' but that doesnt mean they are 'normal ' for you.
I am better with my TSH around 2.3...any higher or lower than that, I feel cr@ppy.
Log your symptoms each day then gradually you will see a 'pattern' emerge.
Thats how I got my levels good and they have been stable for many months now.
I too suffer with Graves Disease (which isnt curable, by the way) and hyperthyroidism prior to RAI in June 2008.
My antibodies went down under normal range after RAI which was a relief.
Let us know how you go.
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Avatar_f_tn
I'd watch the CK levels closely.  Start requesting copies of all your labs.  Normal mag reference ranges for some labs can be on the low side, I know that I see doctors wanting levels of 1.8 or higher, so a level under 1.8 could cause spasms, IMO.
The high CK can also cause muscle spasms.  Did you have your urine checked?  If your UA shows blood but the microscopic analysis show low or no RBC's, it could be indicative that your spilling another compound, like myogloblin, that is read as blood on the basic UA.  There are several metabolism disorders and myopathies, like McArdle's syndrome, that can cause high CPK/CK and rhabdo with even small amounts of physical activity.  It may be something you've had for a while, but has become aggrevated by your thyroid.
   http://www.nlm.nih.gov/medlineplus/ency/article/000329.htm    <--McArdle's
   http://www.nlm.nih.gov/medlineplus/ency/article/000473.htm    <--- rhabdo
I've seen Chantix really mess some people up-  would it cause elevated CK so long after discontinuation?
Are you taking any medication or herbal supplements that can effect the liver?  Were your liver enzymes ok?  I'm guessing your BUN/CR levels were ok since labs were normal.  Seriously, I'd be more worried about the CK then thyroid right now- it can cause damage a lot faster.  It also worries me that your doctor isn't worried.  Did they check your troponin and CKBM when they checked the CK?  Or a lactic acid level?  Have you had an EKG?  
Just my opinion... and I am by no means a doctor.  Good luck!!
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Avatar_m_tn
I had a terrible time with muscle cramps and spasms, side of the neck, cramps at the base of my calves, severe pain in my legs and hips when I went to bed at night. I found from reading this forum that many people with Hashimoto's had the same symptoms, I also found several of them had taken Vitamin D, Magnesium and B12, I was ready to try anything (I had not been tested for a lack of these vitamins in my system) I started taking all three about 5 Days ago, and what a difference! all I have now is a little stiffness on the right side of my neck and that seems to be improving. I would bet that Thyroid problems has something to do with muscle aches and pain, I never had this problem prior to Hashimoto's, so there has to be a connection, all these people suffering from the same symptoms cannot be wrong, even if some MD's will not connect the dots. (Just my opinion)
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Avatar_f_tn
First, I want to say thank you to everyone who has posted here.  I have been experiencing these horrible spasms for a couple of months now and my endo has offered me no real confirmation that this is due to my hypo state.  He has said that it could be related but that he has never heard of someone having the severity of the muscle spasms that I am having.  While I don't wish this on anyone, it comes as a great relief to know that I am not alone, that there are answers to what is happening to me and that this will not go on forever.  

I was diagnosed with hyperthyroidism this past June.  I went to three endos and decided that the third one seemed the most pro active in helping me.  I went on methimazole to lower my levels and had RAI treatment in late September. I had been  working out regularly all Fall because I am getting married in March.  I suddenly noticed that I was struggling on the treadmill.  My lower back would stiffen up and eventually I had to stop going to the gym.  Around the same time I started having these random cramps that seemed to arrive with the slightest of movements.  At first they were mostly in my neck, shoulders and upper arms.  Now they are in my legs as well.  They last a minute or so but are excruciatingly painful and there is no way to know when they are coming.  

In addition to the cramps I am experiencing an overall stiffness and discomfort in my lower back once I have been on my feet for any length of time.  It makes it very uncomfortable and hard to walk.  Once I sit I am relieved of the pain.  Does anyone have this type of lower back pain?  I never had this pain prior to my thyroid issues.  I am going to see an ortho doc this Friday to rule out any other problems, mainly because at this point I am worried I won't be able to stand, let alone dance on my wedding day.  

I go back to my endo in one week for repeat labs and am going to ask to have all of these vitamin levels checked out, and for the methimazole to be stopped and some type of thyroid hormone treatment started.  My levels clearly indicated hypo three weeks ago, at which time my doc cut my methimazole dose by 2/3 and said he wanted to retest me in 4 weeks to see if I was hypo because the RAI treatment has worked and/or I was on too high of a dose of methimazole.  
Bottom line I'm hypo and I want to start heading into the normal range!!!
Many thanks again for making me realize I am not alone in this.!
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Avatar_f_tn
arghhh..I am having the same experience. did the RAI treatment only 30 days ago and my levels droppped in half in 4 weeks, which is too fast in my mind, as it should take a year. The cramps started last week during yoga, reaching for things, putting on seat belts. Im pissed off! I lived with Grave;s disease for 8 years and had some slight annoyances, but no major life disturbances. My family and DRs. convinced me to do RAI and that I would " feel so much better" even though I didnt feel bad. Now Im getting fat and cant even exercise! So my skin's cleared up a bit and Im sleeping better, but I feel like I should have listened to my gut (my chubby aching crampy muscled, diarrhea gut) hope that wasnt too much info. I had my DR do extra tests, as I am a Dietitian and one of my Vitamin D levels was borderline low. Im also thinking that muscle build-up has been extraordinary for me over the past month since treatment and my body cant keep up. I hope its fixable because my levels are not yet close to normal, but Im already having hypo symptoms. The left chest and left arm spasm was lots of fun at gym today. Its frustrating that my heart rate ran at 120 resting for years and now, at 80 resting I get to feel what a heart attack might feel like. Im venting and Im annoyed and I hope it gets better for all!
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Avatar_m_tn
I have graves disease (hyper Thyroid).  I opted for the radio active iodone uptake.  I had too.  I was suffering from heart palputations, vision problems, breathing problems when playing tennis, sweating.  After 6 weeks, I would get severe muscle cramps if I excerted a muscle while playing tennis.  It would cripple me.  This forum is a relief to me to know that I can tell people it's is not my hydration intake but the disease.  Plus I can now tell my doctor that this seems to be a common problem.
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Avatar_f_tn
I'm a Personal Trainer and I suspected I had Graves and harrassed my GP for tests. Unlike the text book Hyperthyroidism I gained weight so it took some convincing. I experienced periods of manic activity which, if coincided with a night on the town, became a source of entertainment, followed by weeks of exhaustion. Eventually I got to see 'specialist' who put me on Carbimazole which seemed to stabilize me for a year but due to the toxity of the drug, I had to come off it. I was fine for another year before I went haywire again. I had radioactive iodine therapy and went from 11 stone to 13 1/2 stone in less than 2 months after therapy......and one physician had the cheek to tell me that calorie expenditure was closely linked to exercise....DER....what would I know!!!! As a PT I knew if I couldn't lose weight, then no-one could with this condition!! I realised that I was on a hiding to nothing and decided to read more in the matter myself. Dr. Shomon's book explained alot. Armed with some of her theories I returned to the specilaist (any of this sound familiar???!!!) who said nothing further could be offered. I 'sacked' him and saw his Registrar who was much more helpful. He explained the relevance of all the various hormones, CK, TSH etc. I regularly had blood tests as anyone out there with this disorder knows it fluctuates... I;ve met many people with Hypothyroidism who gain weight but my muscle cramps are so severe I feel the muscle is going to rip off it's origin or insertion point..and it can strike at any time, though I do believe, in my case, it is related to hydration as if I'm honest I;m not that good at taking fluids....And if I have just one alcoholic drink...WELL...do I suffer..anyone else found this? I also find my core temp goes up and down like a yoyo (one  minute boiling hot, next freezing cold, not related to environment) and my libido abandoned me bigtime....great this disease...no wonder they call it Graves - I feel fit for the Grave  now!! I asked for T3 therapy and wondered if anyone out there has had it and if it worked...I'm told there are risks and it doesn't work on everyone AND probably the 2 biggest reasons for not giving it are the expense and the lack of research into it!! But, in America research has proved it to be sucessful in raising people 'out of the fog' and in weight loss. Something worth considering... If the food industry insists on using growth hormones to rear meat I believe we will continue to see an upward trend on what was once considered to be a rare disease.
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1202943_tn?1347844252
Your story sounds similar to mine. I also have Graves and received RAI in Feb 2010.  A couple of months after I started having hypo symptoms. I had blood work done and my dr said it wasn't time to start replacement medicine. Four months post RAI I started having bad cramping and many other hypo symptoms.  My dr said my TSH still showed .001, so the cramping wasn't caused by lack of thyroid.  6months after RAI the cramping had become severe & constant. The cramping was in my neck, shoulders, hips, thighs, chest, & butt. I was also gaining weight, moving slowly, losing hair, & having hot flashes. I got in with a specialist and she said I had been hypo for months. All these symptoms were from low thyroid.  She started me on 75mcg synthroid and I in a couple months all the cramping was gone.

Questions for you:
Are you currently taking and thyroid meds?
Do you know if your dr is testing Free T3 & Free T4 or just TSH?
Can you post your latest lab results?

I worked my way up to 150mcg synthroid. I was felling better, but still had lingering hypo symptoms a year later. Fatigue, swelling of my face & eyes, hair loss, hot flashes & inability to lose weight with proper diet and exercise.
Four months ago I added 2.5mcg cytomel(T3) twice a day, for two weeks. Then up to 5mcg twice a day since. I also reduced my synthroid to 137mcg. I am feeling so much better.. All symptoms have improved!   Make sure you start slowly if adding T3 and be patient when giving your body time to adjust.
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Avatar_m_tn
I can't believe what I'm reading here. I am up at 4:00 AM, been up for two hours because of extremely severe cramping in my left leg and right foot. Some background: I had a "thyroid storm" a couple of years ago, and had to have a total thyroidectomy. The surgeon was able to save at least two and "possibly" three parathyroids. I'm on Levothyroxine (sp?) 125 mcg. Also on vit D, B-complex, B-12, multivitamins, morphine (had two level spinal fusion 2007), but these cramps remind me of what runners sometimes get--like a charlie horse, but often they last for hours, that's why I'm up. As soon as I lie down in bed they return. This goes on all night, but not every night. I can sometimes go a week or more without a single spasm, and then boom! they start up again. I'm disabled from the spinal surgery, my left leg is always partially numb, cant feel the left foot. Terrible back and hip pain, from sciatica since the surgery. I feel like I'm losing my mind--the reason I'm typing this is to keep my mind off the pain after a sudden attack of leg and foot cramps tonight. I have a pretty high tolerance for pain, but this is ridiculous. Now that I've gotten all that of my chest, I just want to thank everyone for their comments. My PCP offers no help, just sends me to a pain specialist, and that is worse than no answer at all. I had to take myself off the Fentanyl patch, which I wore for several years, until Medicare stopped paying for it last Jan. I couldn't afford $700 a month for them, so I went through withdrawal at home and nearly died. That is when the cramps started--during withdrawal. I'm not a drug abuser, never took more meds than prescribed, when I went off the patch I couldn't get out of bed for 9 days, no eating and virtually no fluids. The hospital ER treated me like I was some kind of druggie, which really frosted me. They re-hydrated me and sent me home.. I still have no answers for the cramps, they gave me a muscle relaxant (Methocarbonal) to take when they happen, but they do nothing to stop the cramps. Sorry for venting, but I'm relieved to find I'm not nuts, that others are having the same kind of symptoms, though I wouldn't wish them on my worst enemy. I wish all good luck getting help for this problem.
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Avatar_m_tn
I've had leg cramping when I got into being hypothyroid.  Please post your thyroid test results and their reference ranges shown on the lab report so that members can assess your testing and treatment.
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Avatar_f_tn
I have beeb on this same rollercoaster that you described for 9 years, hypothyroid, levoflox, crippling muscle cramps all over my body. My PCP found the hypothyroid .. I was sent to a neurologist who is looking into a diagnosis of MS or possibly  a hereditary dx of dyskinsia or  something like that. About two months ago, I stopped all the meds I was on for about a month. The cramps were like you described, "debilitating." I went to my PCP and was put back on 75 mg of  levoflox and only a week into it all muscle cramps have stopped. I was having severe sweats 24 hours a day as well. At my age I dismissed the sweats as menopause. After going on the higher dose of levo, they disappeared as well. I have been trying to decide if the cramps were as well a sympton of hypothyroid. My CK levels were up  and down. I am getting blood tests done this week and will bet my Dr. tells me that both  thyroid and CK are within range. Can't wait to ask her the results.
I came online to just ponder if there could be a correlation and your decription of your issues tells me that there could be. Thank You so much for sharing and I hope you get relief from the symptons soon.
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649848_tn?1357751184
This is a very old thread and most of the previous posters no longer participate in the forum, so it's unlikely they will respond.

Your situation will get much better attention if you start your own thread, and list whatever test results you have, along with reference ranges, which vary lab to lab and must come from your own report.  Also please list what med(s) you are on, the dosage and how long you've been on it, as well as whatever symptoms you have.

You can start a new thread by clicking the orange "Post a Question" button at the top of this page.  You will get a blank page to type in your information, then click the green "Post a Comment" button.
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Avatar_m_tn
In my life it went just like the first post on here. To many side affects come with Hypothyroidism to write but it is mental and the cramps and spasms are unbearable. In my case every doctor I seen would never connect my cramps and Hypothyroidism as the cause. Everything I would say to the Doctors just go's in one ear and out the other. I was very upset over this. This all started with me in 2000 i have been on a high dose of Lex 300mg and have to take sometimes up to 6 350mg soma a day just to keep them cramps down. They have never went away even after blood work is right. Now for the first time in years everything was under-control  My weight was 140 cramps stay away most days and I felt great till I lost my job and unable to see  doctor to get my meds. And guess what it's starts all over again...I cant move without cramping up in pain again and it's only been a month since I have been off my meds. But there is a new symdom now dizzy spells like i am going to pass out. And I gained 20 pounds in a month with no energy. All I can say is stick with it ' it will never go away or stop but at some point it will be manageable it just takes time. It took me 12 years and lots of doctors. But most of all never stop taking your meds .  
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Avatar_m_tn
When I read your story, I couldn't help but wonder if you have ever been tested for Free T3 and Reverse T3 , to make sure all that T4 is being properly converted.  Free T3 largely regulates metabolism and many other body functions.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  

Many members report that symptom relief for them required that Free T3 was adjusted into the upper part of its range.  So usually we recommend testing for Free T3 and Free T4 as the first step.  Infrequently we see that a member will have adequate Free T3, but still have hypo symptoms possibly due to the Free T3 effect being partially offset by excess Reverse T3.  In those cases we then recommend testing for Reverse T3 as well.  

You said that all your symptoms never went away even when the blood work was right.  So, in your case, I think you should go ahead and request testing for both Free T3 and Reverse T4 so you will you know if your body is properly converting the T4 to T3, adequate to relieve hypo symptoms.  
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649848_tn?1357751184
Blank
Barb135
FL
798555_tn?1292791151
Blank
LazyMoose
MN