Newly diagnosed hypothyroid.

[Clempy]

Hello, 32 year old female here, I was always pretty thin my entire life, always leaned on the more sedentary side, but when I hit my late 20's I started gaining weight, I attributed it to getting older and my lifestyle choices at the time, (too much alcohol, bad diet), I decided to make a change and quit drinking and started exercising quite frequently, 5 years later I am a total gym addict, I even started to get weekly B12, B6 and mic injections because I noticed it significantly helped my energy level, I recently went in to a metabolism clinic to see what my resting calories were and to get a blood panel; cholesterol, platelets etc...lo and behold I'm hypothyroid, I was at 4.66 and while my cholesterol wasn't out of range, it was high/normal, I was asked to discontinue the B injections and start Levothyroxine, after 3 days I started to notice pretty big bruises with no origin, I was always a bruiser, I am very pale, but those stopped when I went onto my B injections, so I just assumed it was a result of discontinuing the injections, then about a week in to the medication a reoccurring neck twinge I occasionally experience came back with a vengeance, I couldn't move my neck, I was essentially immobile for a week, and it is still bothering me. 2 1/2 weeks into this medication my levels are at 1.6, THEN the other evening, dying from not being able to hit the gym, I did some body weight lunges before bed, (easy kid stuff for me, I squat 135lbs normally), and was woken up in the middle of the night by leg cramping, akin to the growing pains I experienced as a kid, I'm on day two of the leg cramps and pretty at a loss, the metabolism "clinic" isn't able to help me, (it's an ob/gyn primarily, so this is out of their scope of practice), and I cannot even CALL an endo until Monday, God knows when I'll be able to get in, can anyone give me some reassurance? I've spoken to a friend that told me she has been in constant pain for 10 years with her hypothyroid medication, I'm freaking out, I don't want to stop working out, I don't want to be in constant pain, does ANY of this sound familiar to anyone? I've been out of the gym for over 2 weeks and feel revolting, I'm about to say screw it and go back today.
-Kill Me

[Clempy]

So I saw an internist, and he wants to go off the meds for six weeks and re test more thoroughly, and of course now my pain symptoms are abating, I'm afraid of starting the process all over again, any advice anyone?!

[Clempy]

TSH reference range 0.450-4.500 uIU/mL
T4 reference rage 0.82-1.77 ng/dL

[Barb135]

Body weight lunges use different muscles than squats.  I don't think the problem is the medication, per se.  It's your body trying to get used to having the hormones it's been going without.

When the thyroid doesn't produce enough hormones, the adrenals kick to try to make up for it.  When you start getting the hormones again, your body has to readjust and it takes time for everything to balance out again. As I noted, it's not unusual for symptoms to worsen or new ones to appear when starting the med, or a new dosage.

TSH is Thyroid Stimulating Hormone.  It's a pituitary hormone that stimulates your thyroid into producing thyroid hormones.  If the thyroid does not respond, the pituitary keeps releasing TSH, so the longer the thyroid "ignores" the pituitary the higher TSH will go and the lover thyroid hormones will go.

Free T4 is one of the actual thyroid hormones. Free T4 is a storage form of hormone.  It can't be used by the individual cells; it must be converted to Free T3, which is the active form of thyroid hormone. Your doctor should be testing Free T3, as well as Free T4.  

What's the reference range for the FT4?  Ranges vary lab to lab and have to come from your own report.

Sometimes we don't, adequately, convert FT4 to FT3 and have to add a source of T3, either in the form of cytomel, which synthetic, or desiccated hormones, which are derived from pig thyroid and contain about 4 times as much T3 as humans produce.  Some people, do fine on synthetic T4 and T3; others only do well on desiccated.

Your FT4 looks relatively high, when compared to some ranges we see, but again, since ranges vary, that's hard to say.  Without a Free T3 test, we have no idea whether you are converting adequately or not.

Have you had potassium levels tested?  Low potassium is quite often a cause of muscle cramps.

[Clempy]

This leg pain is completely new, like I said, I squat with 135 lbs on my back, and now I do 20 body weight lunges and my legs ache and throb, not to mention that sitting in a chair causes cramping, any direct pressure to my legs causes aches, the only difference is the medication. My neck pain is a reoccurring injury, this time it seems exponentially worse than it ever has.

1st lab results, (no clue what any of this means);

TSH - 4.660
T4, free (direct) - 1.24

2nd lab, after 2 weeks on 50 of levo;
TSH - 1.650
T4, free (direct) - 1.40

[Barb135]

I doubt seriously that the thyroid medication is the cause of all your pains.

Hypothyroidism can cause a lot of joint pain, and I had a lot of cramps when I was really hypo (I always had them, but much worse when hypo).  

It takes 4-6 weeks for the thyroid med to reach full potential in your blood and it's not unusual for symptoms to worsen, or new ones to appear when first getting on medication because your body has to get used to having the hormones again.

Is TSH the only thyroid test being done?  You need to also have Free T3 and Free T4, which are the actual thyroid hormones.  If those tests were done, please post the result and reference ranges.  Ranges vary lab to lab and have to come from your own report.

If your friend has been in constant pain, from thyroid issues, for 10 years, she might need to rethink her treatment.  Apparently, it's totally inadequate.