Pain Thyroid Area During and Following exercise

[hefner33]

Hey. I have this weird issue where if I do some exertional exercise where it brings on heavy breathing, i get a pain, tenderness where my thyroid is. Right below my adams apple. It makes a congested feeling, uncomfortable. If pressed it hurts and is sore. Ive had the thyroid test (tsh, t3,t4) and a thyroid scan 2 years ago. It doesnt hurt when not exercising.

Ive had a pretty extensive cardio workup for other reasons and ive tried acid reflux medications.

So Im not sure if its the thyroid buts its that area where its located that hurts. Thanks!

[gimel]

If you will give us your location in Georgia, perhaps we can recommend a doctor for you.

[hefner33]

Thanks

Is there association that lists Dr's that understand the true tests that need to be done? Kinda like Lyme drs? Fighting with current drs just is a headache cause you don't know what they believe in or what there experience is. And frustrating jumping to another after another cause it goes into the system.

I'd like to go to a funational Dr and spoke to some but they wanted an arm and a leg just for a visit.

Anyway thanks for the help

[gimel]

Unfortunately you did not get what you asked for.  You got Total T3, not Free T3.  Free T3 is the small portion of Total T3 that is not attached to protein molecules.  Only the small, free portion is biologically active.  

Your Free T4 this time is somewhat higher and not bad.  If your Total T3 is indicative of your Free T3 level, then that will be too low for many people.  Even though TSH is only a fair indication of thyroid status, your TSH is approaching levels that sometimes are associated with Hashimoto's Thyroiditis.  You could check that by doing two tests, Thyroid Peroxidase antibodies and Thyroglobulin antibodies.  Both are required.  Might also be a good idea to do an ultrasound of the thyroid gland.

Do you think you can get the doctor to do the Free T3, TPO ab, TG ab and ultrasound tests?  Also did you ask about Vitamin D, B12 and ferritin?

[hefner33]

Hey Gimel

Just got recently tested and these are my results
T4,Free(Direct) 1.25 0.82-1.77
Tsh                         3.950 0.450-4.500
Triiodothyronine (T3) 105 71-180

So Dr said everything's in normal range

[hefner33]

Hey. I went to have a full panel today so Ill see where Im at now. This is my message from my Dr

"I ordered what I think is a full panel but it doesn't include antibodies since not helpful unless panel is abnormal. Use our lab Mon-Fri to get it done.

Jack"

I asked everything you stated. Basically copied it

[gimel]

I think that to really evaluate your thyroid status you need to insist on being tested for both Free T4 and Free T3 each time you go for tests.   Also with some of those symptoms you mention, I think it would be a good idea to check out the possibility of Hashimoto's Thyroiditis, even though your TSH is not all that high.  Other than that the suggestions I made in my 9/12 message still stand.  

[hefner33]

Thank you. No the link was just something i look up before asking for blood test to show to the Dr because literally in the past i have asked for test that people recommended and the Dr had no idea about the test.

Yeah that list doesn't really correlate with the pain i get when exercising.

Thanks for the info

[gimel]

Not sure about your question.  Are you asking if that lab would bo okay to get the recommended tests done?  Or are you asking about getting all those tests listed on the link done?

Regarding the pain question, this is a section taken from an extremely long list of symptoms that can be related to hypothyroidism.

Pain:

    Migraines
    Chronic headaches
    Chronic back and loin pain
    Wrist pain
    Muscles and joint pain
    Carpal Tunnel Syndrome (hands or forearms)
    Tarsal Tunnel syndrome (legs)
    Joint stiffness
    Tendonitis
    Heel spur
    Plantar fasciitis
    Arthritis
    Gout
    Painful soles of feet
    Muscle cramps
    Aching bones
    Aching muscles
    Joint pain
    TMJ
    Fibromyalgia

[hefner33]

Thanks for that info.

Would this work?
https://www.directlabs.com/mobile/TestDetail.aspx?testid=1719

Also, would hypo cause the pain during exercise I described before?

Thanks again

[gimel]

From your very limited lab test results, TSH is a pituitary hormone that is affected by so many things that at best it is only an indicator, to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones, which are Free T4 and Free T3.  Whenever you go in for tests you should make sure they test for both Free T4 and Free T3.  Free T3 is the test that correlates best with hypo symptoms, while Free T4 and TSH do not correlate.  

Your Free T4 is at rock bottom, when it should be at the middle of the range, at minimum.  You don't even know what your Free T3 level is and it should be in the upper third of its range or as needed to relieve hypo symptoms.  

There are two basic types of hypothyroidism.  One is primary, or Hashimoto's Thyroiditis, which is caused by the autoimmune system erroneously determining that the thyroid gland is foreign to the body and produces antibodies to attack and eventually destroy the gland.  Hashi's is characterized by increasing levels of TSH and diminishing levels of Free T4 and Free T3.  The second type is central hypothyroidism which is a dysfunction of the hypothalamus/pituitary system.  Central hypothyroidism is characterized by relatively low TSH and resultant low Free T4 and Free T3.  You should get your doctor to test for the antibodies of Hashi's to confirm or rule out that possibility.  Those tests are TPO ab and TG ab.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve hypo symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results and especially not TSH results.  

So you need to either get your doctor to prescribe you a starter dose of thyroid med and then gradually increase as needed to relieve symptoms, or if that doctor is not agreeable to do that, then you will need to find a good thyroid doctor that will do so.  

Since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, you should also get those tested and supplemented as needed to optimize.  D should be about 55-60, B12 in the upper part of its range, and ferritin should be about 70 minimum.

[hefner33]

Palps, frequent pacs/pvcs,  abnormal sweating, exercise intolerance,  

[gimel]

Symptoms in general.

[hefner33]

Oh sorry left out ranges

Tsh:0.300 uIU/ML - 5.000 uIU/ML

T4:.80 ng/dL - 2.20 ng/dL

[hefner33]

Tsh: 2.57
T4: .82

Thought I had a t3. As for the scan done a while back it was negative for nodules.

As far as symptoms do you mean in general or just when I have that pain?

[gimel]

Please post your thyroid test results and reference ranges shown on the lab report.  Do you have any other symptoms?