joint pain and hypothyroid--Hashimotos?

Always been cold---cold is like knives to my skin...positive raynoids,tired...hip pain prior to diagnoses...put on 50 . levothyroxine, now I'm on 75.  Geez...the joint pain has increased to every joint since meds....sob with new dose...I feel like I need to crawl out of my body!  here are my levels..Thyroglobulin antibodies--68,  thyroid peroxidase antibodies-653,  T4-free--0.1,  TSH-150...also slight iron deficiency anemia--Hemoglobin is 10.4, and hematocrit is 31.0, with MCV-79.3, MCH at 26.7 and RDW at 19.0.    I only went to see my Doc because I had new onset dizzyness waking me from a dead sleep...now I crave sleep...so much pain in my joints only lets my body collapse when dead exhausted...put myself on iron, notice much less dizzyness.   Can this be Hashimotos?..I suspect an autoimmune problem.   thanks for any input...scheduled to see an endocrinologist next week...I want to be guarded>   techmom6  

[goolarra]

Is your FT4 really 0.1, or is that a typo?  Please provide the reference range for that as ranges vary lab to lab.  What dose were you on when those labs were drawn, and how long had you been on it?  

Both antibodies are elevated, so, yes, it looks like Hashi's.  

[techmom6]

Hi...I finally feel like I can talk to someone..thank you for replying back...Yes..my T4-free was 0.1-Low...range for the lab was 0.8-1.8...this was prior to any meds......what does this mean?      I also had an ultrasound of thyroid...right lobe measurees 2.8 x1.2x1 cm, and left was 4x1.4x1...I've had some left side neck pain...nothing noticeable...My G.P. said it was no problem.   I'm glad I'm on the right track of thinking hashimoto......techmom6

[goolarra]

That's one of the lowest FT4s I've seen.  Mine was 0.4 on diagnosis of hypo, and I know how I felt!  It means that you are very, very hypo.  Of course, your TSH of 150 is consistent with your very low FT4.

Hashi's can take years or decades to detroy your thyroid function, or it can go like gangbusters and destroy it in a few months.  You were starting out at such a deficit at 0.1 FT4 that you already had a long way to go, and you may be losing more and more thyroid function every day.  If your meds increases aren't keeping up with the degeneration of your thyroid, you will feel worse for a while.

Are you working on your iron deficiency?  Iron is necessary for the metabolism of thyroid hormones, so if you are deficient, your meds may not be doing you as much good as they should.  I know it takes a while to get iron up...

How long have you been on 75 mcg, and have you had any further blood work since starting meds?

Imaging is not my forte, but it appears your left lobe is considerably bigger than your right.  Both goiter (inflammation and enlargement of the thyroid) and nodules (tissue overgrowths) are very common with Hashi's.  Were there any other impressions on the U/S report?  Unless large or suspicious, nodules are usually just monitored for changes.  

[Brucergoldberg]

Goolarra is addressing the technical stuff, but i will tell you that when i first became hypo, the joint pain was horrible.  Mine was mainly in my back (under the right shoulder blade and wrapped around to rib cage)  and in my knees.  the knee pain was so bad i had to use a wheel chair and a cane at work.  Despite multiple MRI they could not find anything wrong with me.  turns out it was the thyroid.

Is it in one speficic area?  you can ask your doctor for lidocane patches (these are patches you put over the joints that hurt) until you get some thyroid flowing in your system.   You can also ask for a TENS unit which if your doctor prescribes will be covered by your insurance.  The tens unit helped with the knee pain for me.    Then things eventually got better.  

[Barb135]

I agree with everything goolarra has said; please provide further information, such as how long you've been on the med and whether or not you've had further blood work done.  When are you scheduled for retesting?

My FT4, at dx, was 0.6, with a TSH of 55+, and I know how I felt, so I, too, can identify.

What is the reference range for the RDW?  Yours seems quite high, which indicates that you might have a vitamin B12 deficiency. Pernicious Anemia is another autoimmune disease and can present the most horrible fatigue, you can imagine. Once a person has one autoimmune disease, chances are greater that they will get another.

You should also get your vitamin D tested, since deficiency can present hypothyroid-like symptoms.  

[techmom6]

thank you again...other tests proved neg. for lymes, rheumatoid arthritis, and lupus.  I only started 50 of levo. about 8 weeks ago, and 75 of levo. just since this past monday.   guess I'm in for a long haul of feeling lousy....unfortunately...with 6 kids,and 30 plus hours weekly of work....(responding to others as an EMT),   rest and relaxation, is not for me.   Endocrinologist is scheduled for next week....hopefully, she will be empathetic.  I feel like I'm 80 years old--at least my body....and my general practitioner has little knowledge on this subject....said I was hypo....I've felt sick for years..but I thought this was normal....I run 4 miles every few days...push thru the pain and agony..no one really knows...lifesaver6

[techmom6]

Thank you...yes, the pain is unbearable at times...trying to stay away from pain patches and meds...I need to stay on top of my wits...I drive an ambulance, and respond as an EMT.   I definitely empathize with you having used a wheelchair, and a cane...I've felt that a cane would help me at home...but people talk in this community...so I need to look as nothing's wrong.   My pains are limited to back ribs, hips...yikes, trying to roll in bed is horrible!, knees...ankles....lifesaver6

[techmom6]

thanks again...I accidently sent a message to barb... I've only been on levo. 75 mcg since this monday...only diagnosed about 8 weeks ago...only because I c/o dizzy and cold....you are all a great help to me...I don't feel all alone anymore...and now I know why I've always felt ill...random fevers...bronchitis every year...thanks to all my 2nd hand smoke exposure..and partners on the ambulance who think smoking outside the door is far enough.   pains in my hips since I carried my son 7 years ago...other test results came back neg. for lymes, lupus and r.a.......techmom6---aka lifesaver6

[techmom6]

thank you Barb...yes , my pharmacist told me to take iron....thanks for the heads up on other autoimmune illnesses.....hoping things will get better...one can only hope...right?

[flyingfool]

I also would highly recommend B-12 and Vit D tests.  It is pretty common for people with Hypo to also be deficient in these as well.

Also it is important to get the Free T3 levels as well. in fact that may be the most important to obtain. yet Dr's are resistant on testing for this.  That strikes me as amazingly silly since your body ONLY uses T3 at the cellular level. Why would you not want to test the very hormone your body uses?  It makes no sense to me what so ever.

Also when you have labs. ALWAYS post both your result along with the reference ranges.

Many people here have found that in order to feel well, they need to meet BOTH of the following:

1) Free T4 to be in the MIDDLE of the range or slightly higher (50% or more of the range)

AND

2) Free T3 to be in the UPPER 1/3 of the range (66.7% of the range)

Your test for FT4 would indicate you significantly below the bottom of the ranges we normally see listed.

T4 is a storage hormone and must be converted into T3 that ultimately is used by the body.  Since you have so few T4 hormone molecules in your blood, you don't have any to convert so it would stand to reason your T3 levels will also likely be very low.

When either T4 or T3 hormone molecule gets attached to a protein they become useless.  Only the molecules that are unattached and thus "free" are able to be used. This is why it is so important to make sure you get tested for both FREE (unattached) hormones.  A "total" T4 or "total" T3 will count all of the hormone molecules even the ones that are attached and thus useless.  As a result a "total" test is far less useful and is considered outdated.

Moral of the story.  DEMAND that the FREE T4 and FREE T3 always be tested.

Finally with such a severe low thyroid. Your adrenal system will try to "make up" for the lack of Thyroid. So you may also want to get your adrenals checked for adrenal fatigue.

[techmom6]

Thank you...I was finding myself addressing the adrenals.....this group is making life bearable, and not like I'm making up my symptoms, as my Doctor hinted...to quote"I've never heard of low thyroid and joint pain".   made me feel like a real fool.   techmom6

[Barb135]

Phooy on your doctor!!!  Joint pain is a classic example of hypothyroidism and if he doesn't know that, he shouldn't be trying to treat you.

Many doctors think we're hypochondriacs because symptoms of hypo can be so varied.  My doctor said all my pain was from arthritis, but, ironically, nearly all went away when my thyroid levels started rising.  He shouldn't have been trying to treat me, either........ He actually called me a hypochondriac, one day, before I was dx'd hypo. He hadn't even thought to test thyroid; I had to beg for that.  We do have to keep in mind, though that not everything that goes wrong with us is thyroid related.

I'll stress again, the importance of the vitamin B12, because deficiency can make you feel like you want to die.  I've have pernicious anemia for a long time and I currently take a shot weekly, in order to keep my levels high in the range, so I feel well.  It would be best to get tested, but if you can't, you might try supplementing with a liquid or sublingual B12 and see if that brings your energy level up.  Of course, if you start taking a supplement, then test, your levels would be falsely high.