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1392168 tn?1280074408

Could swollen ankles mean something terrible?

Hello.

When I was eighteen I was diagnozed with an underactive thyroid. I am now 20 and 2 months. My doctors still haven't figured out what dosage of medication I need to be on. I take Levothyroxine, 150mg. But whenever I get blood tests to see if my hormones have evened out yet they always keep saying 'Oh just a little bit more.' But they have said that everytime since 50, 75, 100, 125, 150...

I got a pain in my chest a few months ago and saw 2/3 doctors. One said rib pain, one said Esophicitus (and the medicine I took for that seemed to make it go away), the other said pain in the wall of my chest. All of them listened to my chest.

One doctor got me to do an EKG just incase, and the results of that are incoming.

I have been having unexplained dizziness too. Though my doctor said this was most likely unrelated as I had tinitus with it. My doctor gave me some over-the-counter medication like travelling sickness pills which seem to keep it at bay for now.

But I recently read that swollen ankles can mean heart failure and other terrible diseases. Then, I read that they are a symtom of an underactive thyroid? I seem to have swollen ankles though I don't know how to be sure, though I ask others for an objective oppinion. One said no, one said yes. In the past month I have also noticed I've been gaining weight a lot faster than usual.

I do not have a good diet, though, and am overweight. I have made a diet and exersise plan for myself for the next month to see if the problem of weight gain continues when I do that.

I guess I'm just scared. Who wants heart failure? But apparently a doctor can hear heart murmours and/or fluid building on the chest in cases of heart failure, and they all listened to my chest and reported nothing.
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Avatar universal
Hello - let me add my 0.02 (my point about your swelling at end)

I symptoms since teens and in my late teens they diagnosed me with PCOS. I never had cystic ovaries but they used to say the treatment was the same for my condition (high testosterone). Simply put they never knew what I had and they put me on hormonal control until my 30's after terrible side effects I finally threw it all out after reading an article that vegetarians had significantly reduced hormone loads and the lower the body fat, the lower the hormone load. This lifestyle change was honestly the best thing I ever did for myself. I went veggie, got my weight down, and my symptoms improved dramatically...not perfect but manageable, more manageable than  it ever was under medication. I'm not advocating this specifically for you, just to point out there are often alternatives docs don't mention!

So, you are young and this is all confusing stuff but for one, the "bad stuff" is really rare. They thought I had a brain tumor for a year at 19 and scared me half to death. Next thing, use the internet cautiously but take charge of your health, it is your body and doctors mean well but they make mistakes.

Leg/ankle swelling. I have dealt with swollen legs since teens. I am 47 now. My legs when my hormones are cranky usually preperiod....can swell so bad I put on 10lbs overnight, my legs feel like concrete and my feet bones/ankles are like massive sausage tubes and I am thin.

I am healthy. always have been, they feared I had a kidney problem once due to this,I don't, kidneys, heart and everything else is perfect. As menopause slowly approaches it has mellowed out, it is hormones and OTC progesterone has helped. You might consider talking to your endo but fyi - I am uneasy with synthetic hormones after my experience so just be careful they have a tendency to throw synthetic hormone control at women.

fyi - buy some compression socks when you think you are going to swell, they work amazingly well and force yourself to walk, elevate your legs in eve don't set at desk too long etc. It helps more than a bucket of spironolactone (the diuretic they tend to prescribe).

Hope this helps, take good care! Kel
Helpful - 0
Avatar universal
I totally agree with your concern about ranges.  I also strongly believe that the only value for TSH testing is to distinguish between primary and central hypothyroidism.  If you want to know why TSH is totally inadequate, have a look at my rant in this link.

http://www.medhelp.org/posts/Thyroid-Disorders/False-Negative-to-TSH-possible/show/2660369#post_12908248

So clinical treatment is the best approach for hypothyroid patients.  That means adjusting Free T4 and Free T3 levels as necessary to relieve symptoms, without being constrained by resultant TSH levels.  I say the latter because scientific studies have shown that TSH frequently becomes  suppressed when taking doses of thyroid meds adequate to relieve symptoms, therefore you cannot set a target for TSH between .5 and 2.  The only objective has to be symptom relief.  TSH becomes irrelevant when taking thyroid meds.  

If you haven't seen it, I also thought you would enjoy reading this link.

https://www.nahypothyroidism.org/why-doesnt-my-doctor-know-all-of-this/
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Avatar universal
I have had hypothyroidism for a number of years.  I am middle aged and was off medication for a couple of years.  Initially, my TSH  was high but still in what most labs call "normal".  A good point to remember is how labs get these "normal" values and why they are probably not a good reference:  normal values are calculated by averaging the results of all the people the lab tests and then finding a mean value.  Something like 96% of people will fall within 2 standard deviations above and below this mean value (think Bell Curve).  Not real important to know the math, but IMPORTANT to know that these "NORMAL" values are, for the most part the average results of middle aged people with symptoms of hypothyroid.  i.e.  Lab values compare you to others who are symptomatic.  So, at best you are comparing yourself to other symptomatic people.  We don't really know what results look like for a healthy young person, because we never test healthy young people for thyroid function, unless there is a problem.  Lab values for other tests are better served by this system as we do often check all age groups for CBC and biochemical profiles.  The others are right, there is no set value for dosage of medication.  The appropriate dose is the dosage at which symptoms abate.  Usually this is a TSH less than 2 and greater that 0.5.  I am not sure Synthroid is the best medication to treat hypothyroid.  It is not bio-identical, and is only T4.  Quite a few people with hypothyroid have difficulty converting the T4 to the bio-active T3.  What I have seen with Synthroid is that your labs will look wonderful, but you still hurt all over, gain weight by looking at food, and are going bald etc.  I would suggest you try either a bio-identical, compounded preparation or one of the dessicated thyroid products like Westhroid or Euthroyd.  Armour Thyroid went under a change in compounding a few years back and quit working for me. What I have noticed is that as my TSH has gotten high enough to be in the current "abnormal" range I am having swelling of feet and ankles and what is called "pretibial edema"...swelling over the top  of the front bone in the lower leg.  I had blood pressure medication changed due to my lower leg swelling.  Didn't help.  What has helped is getting back on dessicated thyroid medication.
Helpful - 0
10771583 tn?1412675389
I can understand why you're concerned about the edema, considering that you're very young.  I have the opposite problem. I'm 68 years old and I was having heart palpitations and excessive sweating and I, too, thought my problem was heart related. It turns out that my Graves' disease was "acting up" because I was only taking 5 mg of methimazole per day. Once the doctor increased my dose to 10 mg, I felt much, much better in three days. I know it's easy to obsess about symptoms, but my advice to you is to try to divert your mind from obsessive thoughts about heart trouble and to listen to your doctor, if you trust your doctor. If you think your doctor is competent and if your doctor is concerned about your situation,then you are fortunate. It's not a good idea to look up every symptom on the Internet because, unless you have a medical background, you could become a hypochondriac and you could make your condition worse.  Weight gain is typical with thyroid patients. Because I have Graves' disease with Hashimoto's antibodies, I can't seem to lose weight. At first I was very upset about the weight gain, but I finally decided that, if I work out and try to control my calories and carbs, at least I won't gain more weight. In all honesty, the only people I envy are those who can eat everything they want and not put on weight!
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Avatar universal
Forgot to mention you should NOT be taking water pills for pitting edema, as it makes it worse.  It is acidic build up, not water! Again, please read up for yourself!
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Avatar universal
First timer, but had to share...
I have hypothyroidism that went undiagnosed for years, and how have hashimoto's. My feet and legs blow up like balloons (pitting edema).  I couldn't loose weight! I'm about 70 lbs over weight due to declining health!
Two general practitioner and my endocrinologist said they didn't understand and couldn't help me.  Blood tests were order and I read my own blood work.  Voila answers to my blood work.  I discovered alkaline imbalance.  I read everything I could get my eyes on! I studied alkaline diet and started switched to fruits and vegetables and drink lemons In alkaline water. (No sugars,dairy, meats or seafood, alcohol, no breads and only rice pastas and brown rice).
I have lost 17lbs in one month!  My swelling has been reduced dramatically!
If you want to get better read up on alkaline diet for yourself.  Our bodies should be more alkaline than acidic, but With modern diets, people are eating way to much acidic foods, destroying the balance in our bodies.  If you want to get better read up on alkaline diet for yourself!
I am not doctor and no expert, but what I do know is that no medical professional could help, so I did my own research and it has started to help within one month!
Helpful - 0
Avatar universal
Did you ever get your hypothyroid figured out?  Reason I'm asking is I have developed swelling on only my left ankle but it's like a small pouch of swelling below my ankle and not on my right ankle.  I have never been tested for any thyroid problems but have an appointment next week.  I have several symptoms though of thyroid issues.  I am overweight and sit for several hours at work in front of a computer but it's so odd that i just have a small pouch of swelling below my left ankle.  It doesn't hurt and feels spongy to the touch.  I went to the ER and they said I have no infection or clots and to check with my primary.  Please help!!!
Helpful - 0
1392168 tn?1280074408
It's odd, that when I have gone on a diet in the past I did lose weight relatively easily. I lost 4-5 pounds in my first week, which was more than I was aiming for, as I want to do it slowly like 2 pounds a week. Though, I got ill and just lost the willpower to continue. So I'm hoping It might be okay again. C: Even so, if it's harder at least I'll do it slowly and healthily!

C: Thanks again for your help!

I'm on 150mcg at the moment.
Helpful - 0
1097839 tn?1344579942
hey PurpleBadger. I get swollen ankles from being hypothyroid aswell, my sister does too. My stomach is also really swollen although I'm supposedly normal body weight for my height my middle is really podgy.

I'm on 125mcg thyroxine and am now also trialing liothyronine (which is T3 meds, brand name in the states is cytomel I believe). I started on 50mcg thyroxine about a year ago and was increased by 25mcg every 6 weeks till I got to the present dose. My brother and sister are both on 150mcg and have both been on as much as 200mcg in the past.

I expect your heart will be fine. It's understandable you will be concerned about your health when you don't feel so good and stuff like swollen ankles is really demoralsing I know!

Along with all the advice others have already given about getting your test results and starting to be an active participation in your treathment for hypothyroid, it definately makes sense to start eating healthily and aiming for a healthy weight.

Personally I've struggled to lose any since I was diagnosed hypothyroid and you might find it's more difficult than you want it to be, but if you don't make an effort the risk is that your weight issues will get worse and there are loads of health implications around being too heavy so I really applaud you for starting paying attention to that even though maybe you haven't been till now.


good luck, wishing you well.

Helpful - 0
Avatar universal
Hypochondriacs have health problems as well.   LOL


When you can, push to get tested for free T3 and free T4 (FT3 and FT4, not total T3 and total T4), TSH, thyroid antibodies tests (TPO ab and TG ab), and vitamins D and B.
Helpful - 0
1392168 tn?1280074408
I agree, I'm gonna' make an effort to ask for results.

I'd like to see them, yes please. It's sometimes hard to tell if they are swollen. I know this seems strange, but, since I am overweight and since I tend to be a bit of a hypocondriac anyways...
Helpful - 0
393685 tn?1425812522
I never had discoloration with my swelling from Hypothyroidism. My skin was just being pulled from the retention.

I remember vividly one day visiting my grandmother in the hospitol. I took my grandfather to see her with my mom.

Serioulsy - I had a hard time walking the swelling was so bad and my feet were so swollen I couldn't get a pair of shoes on - only flip-flops

Even those my feet puffed up around. I was miserable with that and moon face too. I thought back that pictures would tell more than words so I started taking shots of me in my trasiston to wellness was taking place.

I did post them here if you want to look at the differences just in head shots pretty much.  
Helpful - 0
734073 tn?1278896325
By law the doctoir must give you a copy if you request it. After all, it's your blood and your body! Don't depend on any doctors word as if they are God. They are only human and make mistakes. The best advice is to be educated as much as possible about every aspect of thyroid and continue seeking input from others who have similar thyroid issues and are doing well. Read! Read! Read! and Ask! Ask! Ask! Good luck!
Helpful - 0
1392168 tn?1280074408
Thank you very much for all your help!

I don't know if it is edema... It seems like it could be, but aren't there any other visible signs from circulation problems like feet going bluer or something?

I don't know my test results... In truth, I haven't been as involved as I should be. My doctor likes to just tell me what she thinks not what the results are, but I have one coming up and shall ask for all the info.
Helpful - 0
393685 tn?1425812522
There is alot of research out there that proves inflammation and edema are associated with the low function of T3 hormone in the body which is directly linked to hypothyroidism and/ or low function of thyroid. This is a very common ailment of the disease along with other  edema in other areas... Moon-face.. fingers - neck - legs and feet - and stomach.

When the thyroid is not functioning or converting the T4 med hormone correctly into the direct T3 that we need to help speed up the system to function normal the swelling is very prominent for us.

I won't debunk Lyme totally but a simple test can prove negative or positive to rule that out.

A common situation - especially if you are not converting the med right is a magnesium depletion or iodine level abnormality.

An RBC ( ONLY) magnesium test can determine if you are low but many find just discussing taking the supplement with the doctor to see can be something. Iodine on the other hand should be testing in a loading test and shouldn't be trialed as an OTC supplement. Many do - but it could have complications.

Another issue is a VitB and D depletion in hypos

In many cases the Free T3 and Free T4 blood labs are not being monitored to see if you are sufficient in direct T3 ratios with the T4 conversion. make sure they are running those labs.

Can you share the actual tests you had done? get a copy from the office.
Helpful - 0
263988 tn?1281954296
I've had leg/ankle/foot edema due to hypothyroidism. When my hypoT was severe I had over all swelling which my doctor called pre-myxedema.

Pericarditis and a pericardial effusion caused it too. Those were caused by hypoT. It was awful and eventually went away. My doctors thought I had the first signs of heart failure because my ankles/feet were swollen. Thankfully that wasn't the problem. They were so swollen I couldn't put my special compression support hose over them. I had to go without for several months. My doctors kept giving me water pills to decrease the swelling but they didn't work.

I had those two conditions at once and that confused the doctors.
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Avatar universal
Just for info, I have personal knowledge of someone with leg edema, apparently from hypothyroidism and its effects on metabolism.   In that case the excess weight was preventing the lymphatic system from doing its job, and there was excessive fluid buildup in the lower extremities.  

Of course there are other possibilities, but since  there is an apparent thyroid problem already identified,that's a good place to start looking for answers.  To assess your current thyroid status, we really need for you to post your  thyroid test results and their associated reference ranges.  

If it is edema associated with hypothyroidism, then it can be reversed with proper medication and treatment, along with a healthier lifestyle.  So the sooner you can get started in the right direction, the better.  Let's look at your test data and reference ranges and members can help interpret and advise further.  
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1392168 tn?1280074408
No, I'm afraid I don't live near woods or anything. I don't get any pain in my ankles with the swelling and the scary thing is that I don't know how I could have gotten them.

Normal was a bad word... I was just wondering, is there an unusually high dose?

It's so hard, though. I agree it could be edema, but then I wonder - can that be reversed with a healthier lifestyle or am I basically screwed now? It's difficult when you try to investigate and sites basically say, 'This is because you are overweight,' 'This is because you sit for long periods of time with your feet down,' And then, suddenly, 'YOU HAVE HEART FAILURE.'
Helpful - 0
Avatar universal
I have to ask this Purple. Do you garden, or have pets or live near woods?
Reason I ask is that lately, I've also had severe ankle pain, but it looks like my ankle is swollen!
  I almost 100% i have Lyme Disease. I got a bull eye rash several months back, had the fatigue, fingers were tingling when I woke up, now it's day& night ankle and hip pain and the ankle definitely looks swollen. I've not broken it or injured it at all.
We have deer everywhere near where we live! I found deer ticks in our house even. Try getting to a doctor that specializes in infectious disease instead of these Thryroid doctor's.
I'm also noticing my heart seems to have palpatations too.. like your heart is beating rapidly, sort of like panic attacks.
I'm not a physician, so I cannot diagnose you, but your symptoms sound very similar to mine and there is Lyme Disease in the UK also. We're in the states, but I've known enough people who got Lyme Disease to know it can be a very powerful disease and affect you badly, even though it's just spread by a tiny tick.
To think a miniscule tick would cause such painful symptoms seems absurd, but it's true.
Try looking at the film Under Our Skin and see if the people in the movie have similar symptoms to you. I hope that helps you. I'm also noticed I"ve been very dizzy lately....sort of a really spacey feeling.... like you don't feel safe enough to drive a car.
Helpful - 0
Avatar universal
There is no "normal" dose of thyroxine.  The dosage should be tailored to raise your active thyroid hormone levels (free T3 and free T4) enough to relieve symptoms.  Dosage should not be based on TSH levels.  That doesn't work.

I'm just grasping here, but could your swollen ankles be a sign of the beginning of edema?  This can occur when your weight interferes with the normal function of the lymphatic system, causing fluid retention in lower extremities
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1392168 tn?1280074408
What dose of Thyroxine is 'normal' to be on? Or, what is everyone on?
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1392168 tn?1280074408
I don't actually remember how I was diagnosed, which is worrying. My mum told me, though she does not have the condition I don't know my father and he may have. Apparently, they suspected it when I was younger. I was having many tests and MRI's for my eye condition.

I don't know. They keep saying 'Oh, our tests show you need just a little bit of a higher dosage.' Yet it's gone up a whole 100mg? How can that have been a little more each time? I think I should question more about it, maybe?

I have to admit I have not been taking my medicines at the same time... I never thought it was inportant but I shall correct that.

I do not eat alot of salt in foods, but I eat salty snacks so I have cut back on them. Though, my blood pressure has always been in a safe zone when I have visited the doctors.

Thank you for your help.
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Avatar universal
On what test basis is your doctor deciding your dosage?  If it is based on TSH, that doesn't work.   I would be interested to know what other thyroid testing has been done and what were the results, along with reference ranges.
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1386249 tn?1303092096
I can tell you right now that having thyroid disease will give you heart palps.  I get them often and Ive had this disease for many years.  As far as your ankles, I never, in the 17 years of having the disease, heard of swollen ankles being a part of thyroid.  How is your sodium intake or bloodpressure?  Your gaining weight is, unfortunately, common with this disease.  My question is...why is your dosage constantly going up?  This can be making you dizzy.  Are you sleeping ok?  Insomnia is another side effect and I get dizzy spells for lack of rest.  Are you taking your meds every day at the same time, on an empty stomach??  This is important and I can't stress that enough.  It runs in my family, all three sisters, my father, my aunts all have it.  We compare notes all the time.  I, unfortunately, have the worse case, but the lowest dosage.  My body is very sensitive.  Taking your meds exactly how its prescribed is important.  My sisters have higher doses than I, but I believe skipping a dose and taking it at different times of the day plays a big role on their levels being off.  I have to get my levels checked every three months bc my body is so sensitive.  A good diet plan is a great idea.  
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