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Exercise Intolerance: pain, weakness and injury

I've read that hypothyroidism can cause exercise intolerance.  I have been very ill since exposure to some toxic pesticides.  Part of the poisoning is that I became hypothyroid.  I used to be a keen athlete cycling many miles a week and competing often.  Now I am unable to do any exercise.  I suffer from pain in my joints, particularly my knees.  If I try and do any level of exercise, I suffer injuries and weakness afterwards which take ages to heal (some haven't healed at all).  For example, an hour's walk incorporating a hill can leave my foot flexors so weak that I can then struggle to lift up my foot for weeks at a time and have to back off doing anything at all.  Swimming can cause sharp shoulder pain and weakness.  

I have some periods when I feel a bit better (relatively- nothing like when I was well). I notice that the joint pains are worse when I get my period.  Could this exercise intolerance be due to hypothyroidism?  I am struggling to work out what is the direct result of poisoning and what is the result of hypothyroidism. Anyone experience similar?  My TSH is now 4.88 (still too high- was below 2 when well).  However, it did get to 0.7 a few months ago and I still had these problems.  Free T4 is now 14.1 (range is 12-22 I think). Free T4 did go up to 18.1 a few months ago and I still had these difficulties.  Free T3 is now 5.1 (range 4-8 I think).  This is higher than it has been since I got ill.  It was 4.3 earlier on in the year.  When it was that low I could barely walk on the flat.

Any info much appreciated.  Thank you
39 Responses
649848 tn?1534637300
It's true that hypothyroidism can cause exercise intolerance.  

Looking back at your profile page, I see that you've posted some similar threads and that you are/were on thyroid replacement medication.  Please tell us what medication you are currently on, and how long you've been on it.  Your FT levels are still quite low in their ranges.

Walking for an hour is a lot of exercise at one time, if you aren't used to it and if I didn't walk that long on a daily basis, I'd get really sore, as well.  Even though you say you used to be athletic, if you haven't been used to exercising for a while, you should always start out slowly and work up to what you can tolerate.  For instance, rather than walking for an hour uphill, try walking for 10 minutes, 3 times/day on level ground and gradually work up to the hour walk.

I also very highly recommend yoga as an excellent form of exercise.  Yoga centers on stretching and relaxing, and will help keep muscles toned and in shape.  I have not been doing my yoga, daily, as I had been for some time, and I can certainly tell a difference.  There are a variety of typed of yoga - one that will fit nearly everyone's capabilities.  There's even yoga for seniors and chair yoga.  

Additionally, I find that the  more I weigh, the more difficult it is to exercise.  
Avatar universal

Thanks for your answer.  I'm currently taking 25mcg levothyroxine 1 day and 50mcg the next.  I started on 25mcg in Feb and was increased to 50mcg on alternate days beg this month (Dec).  I got a funny reaction (painful puffy eyes) when my dose was increased straight to 50mcg (last Sept) hence the alternate days approach.  I was tried on T3 and it gave me an unbearable pressure in my head, but think that was because the dose was too high (started on 10mcg tablets).  I was going to ask to try T3 again, but  a lower dose, but because my T3 has come up from 4.3 to 5.1 on 25mcg levothyroxine, my GP thinks adding in T3 may not be necessary.  

It's not that body's not used to exercise I don't think, as I have physio every week and do gentle swimming for 20 mins 3 times a week.  I also walk 40 mins per day to and from work (on the flat) in a bid to keep up whatever fitness I can. However, whenever I try and  increase to anything more than the above exercise-wise, it all goes wrong.  I've been trying to increase my walking tolerance since beginning of last year.   My physios tried everything, including getting me to do work on a stepper first, to build up leg muscles. Even having strong looking muscles doesn't resolve the problem though.

By way  of contrast, until end of 2010 I used to compete in cycle endurance events.  I came 3rd in the UK's longest mountain bike race (7 day event through mountains) and completed in an 8 day race across Germany through the Bavarian mountains.  I also used to love cross country running and would train with a triathlon club at their swimming sessions.  Until last year I  had a body that was pretty much up to any sporting challenge, including some pretty extreme endurance sports.

I weigh less than 9 stone, so don't think  it can be weight on my joints.  I just don't understand how my body works anymore.  Can hypothyroidism have such a radical effect on someone, or is it more likely to be the poisoning?  (I was exposed to organophosphates which as well as disrupting endocrine function can cause muscle pain and weakness).  I'm just trying to work out whether there's hope for me in that corrected thyroid levels might help me, or whether this is all just organophosphate which the thyroid meds won't help).  
798555 tn?1292791151
["exposure to some toxic pesticides.  Part of the poisoning is that I became hypothyroid"]

- So you tested negative for Hashimoto antobodies TGab and TPO tests?

You need to know this. Otherwise how did the doc just assume your thyriod took a beating from the toxicity? - it is possible though, very fragile gland.

As a past endurance athlete myself, I can understand your frustration. Untreated and then under-trated Hoshimoto is what made me stop competing. Even though I am a lot better than a few years ago, i do a variety of out-door adventure sports at a much more average normal pace.

Your FT3 is still low. You could try multi-dosing at a lower daily dose. if that still does work well after three weeks (headache), can you get Armour or Canada's ERFA thyroid there or try a generic cytomel?

So I can assume your more in tune with your body than average. You say you have pain and weakness. Hypo muscle pain if looked at closer is usually muscle tightness that never relaxes, this is felt as pain at the end of muscles where it tuns to tendon fiber and will pull on joints. An experienced muscle "body worker" or manual PT or therapeutic massage professional can feel the difference in your muscles if this is what is happening. It is not a good idea to over exercise with this type of pain as muscle adhesion and many knots can result and damage muscle fibers. That can take years to fix with trigger point therapy, active release technique,  malic acid and magnesium. I've gone though all that so I know.

So get those FT3 levels up to where you don't get new pain, and then concentrate on fixing any residual pain if any is left over. If you do have small muscle knots and adhesion, they are very tight too stretch out and generally require the above info to correct. If you tie a knot in a sock, you can still stretch the sock on either end, but the knot remains - same thing with muscles.
798555 tn?1292791151
I will also add that hypo thyroid can magnify and bring back past injuries that were thought to have healed. Any repetitive motion injury or stiffness (runners: plantar fascitis, IT band and periformus syndrome), cyclists: weak hamstrings, tight psoas, hip flexors, tight quads and sagitaroius) can become more evident with low thyroid levels.

Ft3 is more important to muscle than FT4, most feel better with FT3 in upper third of the range. So hopefully if you get T3 higher, you will feel better. If not, then the individual muscles might need some work on them.
Avatar universal
Thanks so much for your reply.  It's so helpful.  My doctor has no idea why my thyroid has gone wrong.  No-one in the NHS can find any explanation for what has happened to my health.  However, I've had private tests which show I have a large amount of organophosphate stuck on my DNA and in my fat, so have assumed this must be significant, since my health collapsed immediately following exposure and it is a known endocrine disruptor.  To be honest though, this is my assumption as a layman.  NHS has done every test they can think of and, as all have come back negative, have just put me in the "unexplained medical symptoms basket."  All very frustrating...  

I must confess I don't know much about the antibodies tests.  I know I had a TPO test which was negative, but I don't know about the TGab.  Should I ask for this?  If it's positive, would that mean I have autoimmune thyroid problems, rather than chemical induced?  Sorry if this is an obvious question, but I'm just a beginner when it comes to this sort of thing.  

When you say multi-dosing, do you mean trying to add in T3 again, on top of the levothyroxine?  I'm seeing my GP on Thursday and was going to ask her to increase my levothyroxine to 50mcg/day, but do you think it's better to try to add in T3 again instead but, as you say at a much lower dose?  

I can't tell you what a relief it is to hear that you were able to get back to adventure sports.  Any glimmer of hope is so welcome.  Right now if I could just get to be able to do a decent country walk that would be such a huge leap forwards.  

Thanks again for taking the time to respond so thoroughly- it's really kind of you and much appreciated.  Happy New Year by the way!  
393685 tn?1425816122
Toxic chemicals can alter thyroid function. It is based around the immune system. You may not have antibodies altering this. I'd check a few common things associated that links low thyroid, metobolism. Check your Magnesium, Vit D, Vit B , ferriten/iron and hard minerals. You may need to have a hard mineral analysis done that most traditional doctors aren't trained to do correctly also.
649848 tn?1534637300
There's a whole list of organophosphates and they all affect the body in different ways; you would need to know exactly which compound you were exposed to.
798555 tn?1292791151
Per the first part of my primary reply, it would be helpful to further look into the cause of your hypothyroid as a first step- if it actually was from the toxic exposure or autoimmune Hashimoto hypothyroid. You have good reason to assume your hypo is from toxic exposure, but you could have Hashimoto going on at the same time.

So just try to rule out Hashimoto first. You tested neg on the TPO antitbody test. Now get the TGab antibody test performed.

The reason? Hashimoto is forever, with increasing replacement thyroid hormones (med) for life in parallel with the antibodies slowly munching on the gland. Non- autoimmune is not always permanent and is caused by many things, things that are not-permanent. I'm no expert on toxicity, but many forms are not permanent.

And you could have Hashimoto along with toxicity going on. In addition to the TGab test, get all the toxicity testing you need based on what was in that pesticide. If you know the name of the brand it was, have you looked into the MSDS information sheet, tells health facts and long, short term health hazzards about the chemical. In the US by law the manufacture has to disclose this in a work place (other countries I do not know about).

The vitamins and minerals as stated in others reply'ss are also known to be related to hypos with muscle pain.

So the info I first posted is good for an athletic person dealing with pain from low thyroid hormone.  
798555 tn?1292791151

Part two:

Obviously this is not something your going to solve overnight. You need to gather more info about what is going on after testing all that everyone mentioned.

Bottom line is not to exercise near the level you used to or anything that brings on body pain until this is resolved, since it can promote more micro trauma to the muscles - more pain for you. Adult athletes bodies, due to pushing their bodies to the limit, are for the most part different than most people that engage in general exercise. Your muscles have been put through their full use and have had many micro injuries, which may be more evident in the form of pain while still being hypo. You can still have hypo symptoms while in range. You can find a lot of proof here that many people feel better with T3 in the upper third.

I did compete  while hypo for years in an elite class and as a result accumulated a lot of  muscle trauma from repetitive motion and normal injuries that made a lasting impact.  That's why I now suspect I have to do all that stuff to get better thats listed in the later half of my first reply to you. Its amassing what you can do while hypo if there is an adrenalin high. But, over exercise with hypo symptoms = you might pay the price later on.
798555 tn?1292791151
well, I'm going on forever here arent I?

[ "When you say multi-dosing, do you mean trying to add in T3 again, on top of the levothyroxine?" ]

- Specifically taking T3 again with your levothyroxine, but splitting and taking the daily dose of T3 two separate times. Most do this and feel better since T3 works for about 4-5 hours and is very strong feeling at first.

Its quite a puzzle you have to work out. In time you will figure it out.
Happy new year!

Avatar universal
Thanks so much all for your comments.

I saw my GP this morning and as per suggestions, am going to start taking T3 at a much lower dose- initially 2.5mcg/day and then increasing to 5mcg (taken 2.5mcg in AM and 2.5mcg PM) if I can tolerate it.  Will also take T4.  

GP didn't know about the Tgab test.  I've looked up online and can only find info relating to this test be used in relation to thyroid cancer here.  Is it definitely used to rule out Hashimotos too?  If so, any info would be useful, as I may be able to use that to persuade my GP I should have that test too.

The organophosphates I have in my fat and on DNA (cholormandelic acid) are a metabolite of some different original organophosphate.  They're not sure what, but have given a suggestion, so will look up the side effects of that- thanks for the suggestion.  I got ill after my house was treated by a pest control company who said they only used carbamate (I also have that in my fat but not to anywhere near the same extent).  You paid them once and they guaranteed to rid the house of fleas.  I had them round 3 times as the fleas didn't go and I wonder if they got fed up with coming out and put down something they weren't allowed to (they of course say they only used a very dilute carbamate, but I can't see how else I would be riddled with organophosphate).  This of course makes matters difficult for me, as I don't know for sure which organophosphate I was exposed to.  

I have had tests to look at nutritional status etc and I was deficient in Vit D and B12 and low in selenium and zinc.  Magnesium and iron were ok.  II have been on supplements for all I was low in since May (as well as high dose vit C, a high dose multi-B supplement, milk thistle and evening primrose oil) and am now in the normal range. Is this what you mean by hard minerals, Stella 5349, or should I be looking at something else too?

Thanks so much for all of your thoughts- what a mine of information and wisdom you all are.    
798555 tn?1292791151
TGab test is very commonly taken at the same time as TPO. Thyroglobulin antibodies "TgAb" is a test used to check blood levels of antibodies the body has made against the compound thyroglobulin, a protein produced and used by the thyroid gland. People with Hashimoto can have high TPO , and/or/also high TGab. Anyone thats been here a while knows this, your DR should too. Is not a thyroid cancer diagnostic.

Magnessium, specifically magnessium glycinate or magnessium taurate and the 2nd best - mag citrate will help ease muscle pain in pretty much anyone, even if mag levels are OK. Mag cannot be OD'd, you will just "go" easier in the morning - thats how you guess your dose. Best if taken at night (while the body rebuilds) sepparated from thyroid meds.

Vit tested by D-25 is best at 50 or above.

B6 is important for muscles and nerves.
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