Muscle Cramps related to Hypothyroid?

[PetalBug]

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.  

[estrelinha]

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.

[jojo449152]

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.

[sick and tired 47]

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!!!

[PetalBug]

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.

[jojo449152]

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.  

[PetalBug]

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!!

[gimel]

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.

[Dawn1214]

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

[PetalBug]

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?

[Smilerdeb]

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.

[Catrionna]

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!!

[FTB4]

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)