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sore neck, tremor, etc.

I have had early in the mornings sore neck muscles, palpitation, tremor and sweating. I have no sweating during daytime. I don't know whether these are due to overmedication (Thyroid Erfa) or undermedication. I am hypercalcemic. The neck muscles are also weak and stiff when I have those other symptoms. Ihave also a slightly enlarged lymph nodule(?) in the neck. The parathyroids were not seen in MRI scannin for parathyroids. I have a lung tumour (not specified what it is).

Yesterday I saw a neurologist. He prescribed a MRI of the neck region of the vertebral column. The neurological tests were normal. I think these symptoms may result from inflammation of the muscles or from some internal medicine problem.

Do you think these symptoms are from thyroid overmedication? My free T3 is about 5,3 (upper limit 7,1)
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Avatar universal
Today I got to know that my serum lysozyme is elevated. My ACE is at the upper reference limit. Could these indicate sarcoidosis? I have an unspecified  tumor in my lung.

I have hyperparathyroidism, some immunedeficiency and chronic infection. I have had odd neck muscle pain and weakness for three months. Various symptoms for several years.
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Avatar universal
I don't understand my latest Endo doctor.

I took this from parathyroid.com, which says the same as you: "LOW VITAMIN D is discussed on this page of parathyroid.com. This is an advanced parathyroid page, and if you have recently been told that you have hyperparathyroidism (parathyroid disease) and/or high calcium in your blood, then you should read our other parathyroid pages first. We will give a short synopsis of Vitamin D in the blood, and low vitamin D levels... with some facts and take away points.  Then, this page will get more complex. If your endocrinologist tells you that your calcium is high because your Vitamin D levels are low... and wants to give you Vitamin D to make your calcium go down... then you should print this page and take it to them. This is wrong. As shown below, low vitamin D levels can never make calcium levels go into the high range. There is no way our bodies can do this."

The discrepancy may result from setting a limit for low and high calcium. I have somewhere asked that how much must ionized calcium be elevated to diagnosis of hypercalcemia. My ionized calcium is only hundredth parts above the upper reference limit. The upper limit is 1.30. My values are 1.30-1.34 (at 4 different times). But as I realize, if I have elevated PTH, I should have low normal or below normal ionized calcium. Really, I had one time ionized calcium 1.25 within the reference range (1.16-1.30), and at the same time PTH was high 13 (ref. 1-7.5). But in parathyroid.com, it was said that calcium may vary although there is hyperparathyroidism.

I don't aunderstand calcium metabolism, it is so difficult. Or doctors are wrong.
Helpful - 0
1756321 tn?1547095325
It is very rare for an adult to have persistent calcium levels above 10.1mg/dL.  99.9% of the time high calcium is due to a parathyroid problem. High calcium and high PTH is the classic diagnosis of hyperparathyroidism however 20% of patients will not follow this pattern. 18% will have normal calcium levels and high PTH and 2% will have high calcium levels with normal PTH. The severity of hyperparathyroidism cannot be measured by how high calcium levels are.

Other rare causes causes of high calcium: cancer, sarcoidosis, excess vitamin D intake, certain drugs, milk-alkali syndrome, paget's disease of the bone.  Testing should include ionized calcium as well as serum calcium. Ionized calcium is clinically more accurate.

RBC (red blood cell) magnesium is a better blood test than magnesium serum.  However both blood tests are not accurate as only 1% of magnesium is in the blood.

Vitamin D levels has nothing to do with making the diagnosis of hyperparathyroidism.  Low Vitamin D does not cause high PTH and high calcium.  The parathyroid tumour is making PTH which is taking calcium out of the bones and into the blood.  98% of people with primary hyperparathyroidism have a parathyroid adenoma (tumour - 90% of patients with parathyroid disease have just one bad parathyroid gland) and 2% have hyperplasia (enlargement of all four parathyroid glands) regardless of what their vitamin D level is.

Treatment for hyperparathyroidism: surgery.  Parathyroid disease is typically cured in under 20 minutes using minimally invasive methods allowing you to go home an hour or two after your parathyroid operation.

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Avatar universal
I continue the latest text: The doctor did not comment on my neck problem because I did not yet have the MRI result.
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Avatar universal
Red_Star and Goolarra, thank you for your replies. Yesterday I saw an endocrinologist. He was very busy, and I could not ask all my questions. The doctor said that I don't have hyperparathyroidism but I have vitamin D deficiency and therefore my PTH is high.

We discussed my vitamin D doses and levels in my blood. Last spring the level was 62 (it is within reference). Then in summer, one doctor said, that I must stop the vitamin taking for summer because of hypercalcemia. I only decreased the dose. I was fairly long times in sunshine during the summer. Because of the decreased dose my vitamin D level decreased by August below the lower reference value, it was 37 (lowere ref. value 40). I asked the Endo doctor that why I should take more the vitamin when many people do not take it at all. He said that there are individual differences. He also stressed that 40 is not enough but it should be 80!

I am still wondering why PTH is taking calcium from my bones excessively (over reference value; both Ca and PTH are high!).

Magnesium was left without attention. I really forgot it. From the list copied by Red_Star I can only take into special consideration hypothyroidism and possible hyperparathyroidism. My hypothyroidism is in medical control and I do not have hyperparathyroidism as the Endo yesterday said.

The plan suggested by the Endo is that I shall take 50 microg vitamin D (as i was taking in spring). Then At the end of this year the vit D level should be taken and the dose concluded from that again.
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Avatar universal
I'd ask your doctor about taking the magnesium every day.  I have a heart arrhythmia (SVT), which has been great for over a year now.  I really can't positively say why that is, but I had added a magnesium supplement before my SVT improved so much.
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1756321 tn?1547095325
Forgot to add that too much vitamin D supplementation can also deplete magnesium.
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1756321 tn?1547095325
Magnesium is essential to heart health. It helps maintain a normal heart rhythm and is sometimes given intravenously (IV) in the hospital to reduce the chance of atrial fibrillation and cardiac arrhythmia (irregular heartbeat). Dietary magnesium deficiency results in altered heart rhythm, and several studies support the value of IV magnesium in preventing post surgical atrial fibrillation.

Kohno H, Koyanagi T, Kasegawa H, Miyazaki M. Three-day magnesium administration prevents atrial fibrillation after coronary artery bypass grafting. Ann Thorac Surg. 2005 Jan;79(1):117-26.

6. Naito Y, Nakajima M, Inoue H, Hibino N, Mizutani E, Tsuchiya K. [Prophylactic effect of magnesium infusion against postoperative atrial fibrillation] Kyobu Geka. 2006 Aug;59(9):793-7; discussion 798-801. Japanese.

7. Henyan NN, Gillespie EL, White CM, Kluger J, Coleman CI. Impact of intravenous magnesium on post-cardiothoracic surgery atrial fibrillation and length of hospital stay: a meta-analysis.Ann Thorac Surg. 2005 Dec;80(6):2402-6.

Causes of magnesium deficiency:

Lacking magnesium in the diet
Mental stress
Physical stress
Coffee
Sugar
High sodium diet
Alcohol
Cola type sodas
Tobacco
Monosodium glutamate (MSG)
Vitamin B12 deficiency
Sleep deprivation
Mercury (silver coloured amalgam filling normally contains 52% mercury; vaccines; fish)
High perspiration
Medical drugs of all types, especially diuretics, digitalis
Hypothyroidism
Diabetes
Pancreatitis
Arteriosclerosis
Kidney disease/failure
Chronic pain
Loud noises
A high carbohydrate diet
A low carbohydrate diet
A low calorie diet
A high calcium diet (especially too much milk)
Hyperparathyroidism
Malabsorption problems caused by chronic diarrhea or vomiting
Fluoride
High zinc levels
Low potassium levels
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Avatar universal
Yes, my dose was suddenly dropped from 3 to 2,5 pills. I had never made so great changes suddenly. I though that it may not be good for me. I have been on this dose, sometimes trying to decrease one quarter of pill or increase one quarter. I dont' know what is the best, so I'll stay on 2,5 pills.

When I at first gradually started Thyroxine, I had bad symptoms, when I changed gradually to Armour, I had bad symptoms, and again, when I changed to Thyroid I had bad symptoms. The change to Armour was done during ten weeks. During that time I had both medicines, Thyroxine decreasing and Armour increasing. When I was on mere Armour, I tried two times to use both medicines at the same time, but I think I could not tolerate the combination. I have marked my symptoms to a diary fefore and during the thyroid medication. It is not so easy to treat hypothyroidism as doctors suppose (" one pill thyroxine a day"). It was not earlier than after about three years of the medication ( one year Thyroxine and two on Armour) I found that my cognitive problems had  improved, I was no longer fatigued and my mood was good. But, for instance, variable muscle weakness remained. And I was very apt to infections.

I take magnesium citrate when I have leg cramps. Maybe I should take it in every day.

Last year I had many diseases. I had to seek intensively for the treatment of the A-fib for six months. Then it was cured. To have the cholecystectomy was a minor battle. In this year I have been seeking causes for periodic tremors, neck pains and neck and shoulder weaknesses. Such a situation grows up ones strength (Finnish "Sisu").
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Avatar universal
You might have an entirely different experience taking some thyroxine WITH your Erfa than you had taking it alone.  You'd still have all the benefits of the Erfa, but would also get your FT4 to a better level.

So, was your dose lowered due to the A-fib?

If you're worried about your magnesium levels, you might just try supplementing magnesium.  Magnesium is water soluble, so what your body doesn't need, it will flush.  

It sounds like you have a lot going on...  
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Avatar universal
Just a moment ago I read on Wikipedia that hypercalcemia can cause hypomagnesemia.
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Avatar universal
I take 1.5 pills in the morning and 1 in the afternoon. Because I sometimes have neck muscle pain and tremor early in the morning they cannot be due to hyper but preferly due to hypo. One time I could on such early morning symptoms sleep again by taking part of the morning dose of Thyroid. Thyroid wouldn't help hyper.

Somebody has supposed to me to take some Thyroxine with Thyroid. This is not a good idea for me, it does not work.

I had many diseases last year, eg. three times sinus infection, two times diarrhea due to antibiotics, mild immunedeficiency, pain in abdomen possibly due to gall stones (cholecystectomia in December). I had respiratory problems (phrenic tightness), atrial fibrillation. Late in the year new symptoms appeared, nausea in the forenoons, weakness and pain in neck muscles and left arm. My ALAT rose intermittently in autumn, proBNP rose high, they both are noprmal now. But I have now hypercalcemia and often hypernatremia etc. etc. I have had some muscle weakness for many years, eg. bladder, legs in 2009, nowadays every now and then neck and left shoulder. I think they are due to hypercalcemia.

So, I had af last year. It may be due to infections or now I think partly due to hypercalcemia, and absolutely it was due to dehydration. I also have low antidiuretic hormone. Yes, I had higher thyroid medication in spring 2010. I felt very well in March apart from abdominal symptoms. Then I got flu and the well feeling was gone. In  April I again felt very well, when my Thyroid dose was 3 pills. Then I got the af at the end of April, and the well feeling was totally gone. I had a very bad af for six months. I haven't it no longer.

My situation has been very complicated due to the many diseasesa and disturbances. I don't always know what is a cause of a single symptom. I hope that all my symptoms and disturbances were due to hyperparathyroidism. But it may be too simple a solution.
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Avatar universal
Do you know where I could find a study about effects of magnesium on muscles or heart. Doctors do not say anything if I ask whether it helps for muscle cramps or heart rhythm (I had atrial fibrillation last year). "People think that it helps but there are no evidence. You can take it."
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Avatar universal
Your labs don't look in any way overmedicated to me.  Your FT4 is way down in the lower quarter of the range, and midrange is the rule of thumb for FT4.  FT3, thanks to the Erfa, doesn't look too bad...it's just a little over midpoint.  Both FT3 and FT4 (especially) have room for an increase.

If you felt very good last year with higher FT3 and FT4 and a higher dose of meds, then you ought to try to get your numbers back to where they were then.  Everyone is very individual, and we all have to find the part of the range where we feel best.  It sounds like you might have a pretty good idea of where that is since you know your results from last year when you were feeling well.  That's very valuable information...use it as a guide.  

The only thing I can say about your labs is that your FT4 could be a bit higher.  Occasional symptoms can be caused by both hypo and overmedication.  However, the T3 content of Erfa is quite high, and T3 is very fast-acting, so "peaks and valleys" in symptoms can often be related to T3 levels.  Do you split your dose?
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Avatar universal
My recent laboratory results were: TSH 0.023 (ref. 0.3-4.2), free T4V 13.3 (ref. 12-22), free T3V 5.3 (2.8-7.1) August 10, 2011. The Thgyroid Erfa medication lowers TSH. Last year, when my daily dose and thyroid hormones were higher than now, I felt very good. At the present time I feel quite well for most of the day but have occasional symptoms. Could overmedication cause only occasional symptoms?
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Avatar universal
TSH of 0.018 can be indicative of hypER or overmedication.  Rememer, TSH is counterintuitive...the higher it is, the closer you get to hypO, the lower it is to hypER.  Reference range for TSH is 0.3-3.0, so yours is distinctly below range...in hyper territory.  However, please be aware that many factors, including the meds taken, can suppress TSH, and it often becomes an unreliable indicator of thyroid status.  FREE T3 and FREE T4 are much more important for determining meds adjustments.  Just because we are "in range" does not mean we will feel well.  I might feel well low in the range, and you might have to be high in the range.  

Do you have recent thyroid labs to post?  If so, please do along with reference ranges, which vary lab to lab and have to come from your own lab report.
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Avatar universal
How can my thyroid be overactive if my TSH is 0.018 or so and my free T3 is within the limits. I take every now and then magnesium for my leg cramps. Doctors do not admit that magnecium deficiency can exist.
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1756321 tn?1547095325
This may be from an overactive thyroid gland. Another possibility is a magnesium deficiency which lists all your symptoms.
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Avatar universal
I have started thyroid medication 4,5 years ago. First I had Thyroxine, then Armour Thyroid and now Thyroid Erfa. I do no more remember my symptoms before the medication. I had lots of them. I have had cysts in my thyroid (growing and shrinking in size, the largest one was 28 mm a couple of years ago, now maybe no larger than 6 or 8 mm). My TSH is far below 0, but I think my daily Thyroid dose (2,25-2,5 pills) is OK. Should I increase the dose for autumn and winter?
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Avatar universal
I also have the sore neck and pain in the mornings,infact it wakes me up but I also have headaches with mine.I sweat thru out the day and have the heart palpitations but I am hypo but with now symptons of hyper Hmmm right! So I go in today for an MRI and on Tuesday for an ultra sound of my Thyroid so we will see whats up. I was on Levothroxin and have been changed to Synthroid, I will say that I had these befor I even knew I had a thyroid problem so I was wondering if you had yours before of after starting your meds?
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