muscle twitches all over

[luv_ng]

For the past 4 weeks I have been having weird muscle twitches all over. Primarily in the legs I would say - calves, thighs, even the foot. Also to lesser extent, buttocks, shoulders, forearms. And there is tightness in the hamstring area. Note I also get some light jerks when Im abt to fall asleep.
I went to PCP and did blood test and PCP advised a visit to neuro, Blood work seems normal except that I have hashimoto's and thyroid anit-bodies are high. (last year my thyroid levels were a little off). I went to Neuro and he does not think much of it. Neuro did a clinical exam to check weakness in limbs and did'nt find anything.
I'm a bit worried though. Do I need to be worried about something serious showing up?

[Red_Star]

An electrolyte imbalance is a common cause of muscle cramping. Electrolytes include potassium, calcium, magnesium, sodium.

"By combining the results of 3 studies in adults, Heaney18 concluded that optimal calcium absorption occurred at 25(OH)D levels of 32 ng/mL or greater." - Mayo Clinic - Vitamin D Insufficiency

I know from experience calcium serum is not accurate. Ionized calcium is better. I personally have found nothing beats the chvostek sign (check youtube for a demo) for low calcium levels.  When I get my vitamin D up to absorb the calcium properly that sign disappears. I have had myclonic jerks very notably before sleep. For me this was due to magnesium deficiency and vitamin B12 deficiency.

[luv_ng]

Thanks again. I see I mistyped the FREE T4 range. It's 0.80 to 1.73.  And my value is 1.15. So you are saying I should be in the second half closer to the 1.73 value ?

I'll be taking some Vit D supplements. Hopefully that helps with these issues. What about B6. Is that something I need to get restored ? How do I check value.

[gimel]

Please check the range you listed for Free T4.  

Vitamin D is best at 55-60, so yours is extremely low.  B12 should be in the upper end of its range, which means about 900 as a target.  

Low D can cause symptoms such as these.


Vitamin D deficiency is associated with many conditions, including bone loss, kidney disease, lung disorders, diabetes, stomach and intestine problems, and heart disease. Vitamin D supplementation has been found to help prevent or treat vitamin D deficiency.

Low B12 can cause fatigue and the following symptoms.


    Weakness, tiredness, or light-headedness
    Rapid heartbeat and breathing
    Pale skin
    Sore tongue
    Easy bruising or bleeding, including bleeding gums
    Stomach upset and weight loss
    Diarrhea or constipation
  
Ferritin is another that can cause symptoms that mimic hypothyroidism and is very important for metabolizing thyroid hormone.  So you should make sure to get that checked.  

[luv_ng]

Thanks Gimel

The doctor when he did a physical check thought that he could "feel" my thyroid and some roughness. Not sure what that meant. But they asked me to do a thyroid ultrasound.
My vitamin D is very low. It's 13 (minimum is 39 isn't it ?).
My B12 is around 400. Though I've been taking b12 tablets for last 2 weeks.  
Could this also be causing these symptoms. ?

[gimel]

Reference range for Free T4 test?

Your symptoms are not related to antibodies.  Hypo symptoms correlate best with Free T3 levels.  Even though your Free T3 is within the so-called "normal" range that does not mean it is optimal for you.  Due to the erroneous assumptions behind the way ranges are established, many people find that being in the lower half of the range is inadequate for them.  Your Free T3 is at 48 % of the range.  Many members say that relief from hypothyroid symptoms required Free T4 at the middle of its range and Free T3 in the upper third of its range, or as necessary to relieve symptoms.  

Even though your calcium is below the range limit, test results fluctuate from test to test and I suggest that you should continue to test your calcium, since some of those symptoms could relate.

[luv_ng]

Reference range for free T3 is 2.0 to 4.7
Reference range for free T4 is 1.15

I'm within range for both the above. It's the antibodies that is way off.


My calcium seems to be pretty good in the report. 9.7

[gimel]

Your doctor ran a lot of outdated tests, which makes me wonder about his knowledge of thyroid issues.  You only needed the TSH, Free T4 and Free T3, along with the tests for possibility of Hashi's, which are TPO ab and TG ab.  To best assess  your Free T4 and Free T3, I really need to know the reference ranges shown on the lab report for those.  Also, have you ever been tested for calcium?

[luv_ng]

Here are all the details ---
Free thyroxine index - 2.1
Resin T3 uptake ratio - 0.86
Resin T3 uptake serum - 25.8%
Thyroxine T-4, serum 8.2 (ug/dL)
Triiodothyronine (T-3), Serum - 90 (ng/dL)
TSH - ICMA - 4.4 (uU/mL)

Thyroid peroxide(TPO) Ab - 294
Thyroglobulin, Antibody 69.8
(These two above were very high)

Anti TPO (AMA) AB >1000 (normal is Less than 35)
T3 (thyronine), total - 112
T3 uptake - 33.1
T3, Free (FT3) - 3.3
Thyroxine (T4) - 7.0
Thyroxine, FREE (FT4) - 1.15
TSH - 3.92

[gimel]

Don't know if all those could be hypothyroid related, but restless leg syndrome can be related to hypothyroidism, so let's have a look at your thyroid test results and reference ranges shown on the lab report.  Just being in the normal ranges does not mean your thyroid hormone levels are optimal.