Neuropathy and Hashimoto's

[mtgardner]

I just had testing for neuropathy that showed I have it and the testing doctor says he thinks my Hashimoto's caused it.  I also had an ultrasound that showed I have only a sliver of my thyroid left due to the Hashi's destroying it.


I didn't know neuropathy could be caused by thyroid conditions and I am wondering how it is treated.  Has anyone else here experience this? Marie

[mtgardner]

I had heard the same on the tests that they may not be beneficial so I ran it by a doctor I trust.  He told me the difference is in the tester.  The doctor doing my testing I was told is tops in his field in our area so I was encouraged to go ahead and get the tests.  How the tests are given and interpreted seems to be where it is at.

I have hand symptoms as well.  I am thinking it  all ties into my autonomic dysfunction and my Hashimoto's and may be what is known as autoimmune autonomic neuropathy.  If that is the case a different treatment will be needed so specific diagnoses is important.  My primary doctor and I are now considering my going to an autonomic testing center for further evaluation.  

There is an eMedicine article that talks about the treatment for autoimmune autonomic neuropathy in both the "treatment and medications" and "follow up" sections.  At least early in the condition trials of  immunoglobulin , prednisone, mycophenolate mofetil, and plasmapheresis found some success in some patients.

http://emedicine.medscape.com/article/1154266-overview

For sure correct diagnoses is crucial for treatment.  That is where I am right now trying to define my condition as exactly as possible. I realized too that finding out what deficiencies are present and correcting them goes a long ways.  Thanks for your help with this.  Marie

[Barb135]

I totally agree that even though your B12 is in range, it's WAY too low.  That's another of those areas where it is preferable to be at the top of the range, rather than the bottom.  You might want to ask about starting on shots.  

I had nerve conduction tests done on both my hands and feet, a few years ago, using electrical stimulus; after it was all said and done, I was told by another doctor that those tests aren't very useful.  That was when my B12 levels were tested and found to be extremely low; I was then diagnosed with pernicious anemia and started on shots.  I was also told that some of the neuropathy would never go away because there was too much damage done.  

[LazyMoose]

"When my Vit B12 was checked in Jan. it was 303 (270-685)."

- In range , but low "in range".  Bet you need more B12.

[mtgardner]

I was left to cruise on a synthetic T-4 for decades.  I asked to have all checked again several months ago.  The free T3 was low.  I was put on Armour by the doctor I had then but I had SOB and became quite fatigued.
I was in between doctors for a short time and was advised by one of my specialists to go off the Armour and go back on a synthetic T4.  We wanted to wait four weeks-6 weeks to re-test then add in a synthetic T3.
I have another week and a half before we can retest and my new doctor also wants to send me to an Endo.  I have no doubt the synthetic T3 will be added in post haste as soon as I can get the labs done and back.

I really appreciate the advice on the foot pain.  Some of these things are just not written down anywhere.  For many many years I have felt I carried fluid which causes pain if you put pressure on it.  This is especially true of the lower legs.  They are super sensitive.

Earlier this year my B12 was tested.  I know it should be again as it can change.  My Vit D has been low  and my RBC is starting to be sub normal.  We will check all those again.  When my Vit B12 was checked in Jan. it was 303 (270-685).

[LazyMoose]

Physiatrist are kind of rare doctors but very usefull for managing all types of 'structural' body pain when other doctors dont have a clue what to do!

They are good at pointing out the problem and sending you somewhere else to get it 'fixed'. I know one that fully acknowledges body pain that Hashimoto can bring on when levels are off.

That electrical stimulation test is more commonly used in diagnosing hand numbness like in carple tunnel.

When it comes to foot pain (unless its broken bones) podiatrists are not the brightest out there. A lot of foot pain and even numbness is from swollen/inflamed calf muscles ( a Hashi thing with some people) pinching the nerves.  Chances are that your calf muscles are rock hard and stuck that way. This condition really can mess up your feet. If this is the case, higher T3, magnessium, B12, potassium and a good massage therapist will help in getting things reversed. And lowering your fasting blood glucose will help too, if its over 100.

Just what do your last thyroid labs look like?

[mtgardner]

First of all thanks for the information as I am going to have some blood work done in a few weeks so will have the doctor add those to the list.

I was having a burning sensation in my feet for quite a while plus bee sting like pains in my feet and legs which I also feel a few other places.  When I use my feet a lot for driving later the muscle contract tightly and one of the toes contracts sideways.  Nothing but time helps. Parts of my feet also go numb at times and I have a lot of general pain.  Plus I feel like I am walking on pads which subdue sensation.

I first went to a podiatrist I knew.  He had me close my eyes then did many pokes with a pin which I was supposed to identify.  I might add here his foot pokes were more in number then the ones a neurologist did many months before.  He felt I had lost some sensation and referred me to another doctor.

This doctor was a physiatrist who has been in the field for 24 years  and works in the area of electodiagnostics.  He uses nerve conduction studies (NCS) and EMG tests to diagnose.  The following is an explanation of what they do although you might well be more versed in this then I as I had never heard of a physiatrist before now.

http://en.wikipedia.org/wiki/Physical_medicine_and_rehabilitation

I felt like a frog in biology class with electricity applied and eventually legs can jump a bit. I haven't seen the actual report as yet and this doctor preferred to work quietly so we were not carrying on a long conversation.  After wards when we went through my medical history he told me my diagnoses and said he felt the most likely cause was my thyroid condition.  He then referred me back to my podiatrist and my new general doctor who is sending me to an endo.

I realize this puts a new slant on my autonomic function disorder as sometimes all these things are tied together.  I most likely will get testing soon at an autonomic testing center to get more answers.  Marie

[Barb135]

Get your vitamin B12 tested.  Low levels of B12 are as much, or more, likely to cause neuropathy as Hashimoto's is.   In addition, many with Hashi's have low B12 levels.  

I, too, would be interested in knowing what test they did for neuropathy.  

[LazyMoose]

Yes, it happens. Feel it in your feet?

**How were you tested for it?** Didnt know of one.

It can get better as thyroid levels improve .........Free t3 levels are the key sometimes, upper third of range. Magnessium too.