Pitting Edema

[SNOWKITTEN]

I've been having really bad pitting Edema in my legs/ankles/feet that keep getting worse. Its gotten so bad I have a hard time bending over, doing ANY activity and I keep falling (its also painful). I also have fatigue, muscle pain, joint pain, severe leg cramps, body swelling (different from the pitting edema), stiff hands, loss of coordination, loss of concentration, memory symptoms, cold hands (and cold in general), dizziness, nausea, weight gain (40+ lbs in two months), loss of appetite, muscle cramps, depression, anxiety, etc...
I've had low protein levels (not significant but enough to be low and decreasing) for the past 3 years. I kept seeing my provider but since my urine is normal for protein she was going to ignore it untill I started falling.

Test results.....
Urine is normal
Heart is normal
Cholesterol/glucose/sodium normal
Low Protein (5.2)
Low Albumin (3.1)
Low vitamin D (13) (was put on meds that havn't helped above symptoms)
Low calcium (8.3)
Low MCH (26.9)
Low MCHC (33.2)
Low IGA (49)
Low IGG (225)
High TSH (4.95)
High Transferrin (355)
High Alpha-1-antitrypsin, feces (145)
Celiac disease panel- Negative
EGD normal (except mild gastritis)

My question is does anyone have any idea what is wrong or could be wrong? Im very miserable and it has seriously affected my daily life.

Oh it should also be noted that I crave protein like crazy and no matter how much I eat, It doesn't increase my levels

[jemma116]

I'll have to start taking my magnesium again then.

I have suffered on and off throughout my life with fluid retention - due to hormonal problems, kidney problems and recently from taking Ibuprofen.  I know if I consume too much salt in my diet then I will puff up and get very thirsty.

Thanks Red_Star for the info.

[Red_Star]

I have very bad oedema besides the myxedema. My abdomen and stomach looks like a bad case of ascites. Ugh!  This fluid retention has improved with thyroxine but i'm not optimally treated by any means.  Pitting oedema is rare in hypothyroidism.  

The body uses magnesium to convert vitamin D to active vitamin D so vitamin D supplement "side effects" are usually due to magnesium deficiency. Too much calcium also lowers magnesium. Magnesium is the boss and is needed for vitamin D and calcium absorption.

Magnesium, like thyroid hormone, is needed for ATP (energy). And ATP is needed for the sodium potassium pump (Na+/K+-ATPase) that moves potassium ions into the cell and sodium ions out of the cell. Mess with that pump and you have swelling and fluid retention.

*"Rapid pitting recovery under 40 seconds - hypoalbuminemia:

• Impaired protein synthesis
– protein intake: starvation, kwashiokor
– absorption of proteins: malabsorption
– hepatic synthesis due to liver disease

• Increased loss of protein
– Skin loss:  burns, weeping skin diseases
– Urinary loss:  nephrotic syndrome
– Fecal loss:  bowel disease

Slow pitting time over 40 seconds - normoalbuminemic edema:

•Systemic venous hypertension
– Congestive heart failure
– Pericardial diseases, tricuspid valve disease

•Regional venous hypertension
– Inferior vena cava syndrome
– Venous thrombosis
– Lower extremity venous insufficiency

Excerpt from Edema - Brad Anawalt, MDVA Puget Sound University of Washington

[SNOWKITTEN]

I didn't start taking the vitamin d untill after the swelling. So chain of events are...

-3 years ago started feeling tired/sore/weak
   -Had blood test, low protein was only finding (was told to eat more protein)
- 7 months ago noticed swelling
   -Went to doc, she tested my urine (neg for protein) and put me on lasix for 30 days
- 6 months ago, swelling worse, returned to doctor
   -Labs were taken, protein/calcium were low
   -Doc told me they would wait untill after i was finished nursing to pursue
-3 months ago, Had fasting labs for annual
   -Protein low, albumin low, vitamin D REALLY low, calcuim low, TSH high
   -Was put on 8 week of HIGH dose vit d, with vitD maintenance after
   -TSH ignored
-2 months aog, swelling even worse, started falling. Returned to doc
   -Doc said she would look into it and call internal med
1.5 months ago, internal med said unless i was having chronic diarhea to not do anymore work up. but Doc decided to have me do a stool sample.
   -High Alpha-1-antitrypsin, feces
   -Refered to internal med gastroenterologist for EGD
-1 month ago, asked to do celiac panel
   -negative panel
-2 weeks ago, EGD
   -Normal

[SNOWKITTEN]

I didn't start taking the vitamin d untill after the swelling. So chain of events are...

-3 years ago started feeling tired/sore/weak
   -Had blood test, low protein was only finding (was told to eat more protein)
- 7 months ago noticed swelling
   -Went to doc, she tested my urine (neg for protein) and put me on lasix for 30 days
- 6 months ago, swelling worse, returned to doctor
   -Labs were taken, protein/calcium were low
   -Doc told me they would wait untill after i was finished nursing to pursue
-3 months ago, Had fasting labs for annual

swelling even worse, started falling. Returned to doc
   -

[jemma116]

As you said in your other reply that you do take Vitamin D, have a look on the leaflet for any side effects.

I know my aunty who is 81 now has to take calcium and Vitamin D, and she has had to stop taking the Vitamin D.  I do remember he complaining about swollen fingers.

Is there any other long term medication that could be causing the swelling?
It may be to do with the hypothyroidism.

I presume that you have cut down on your salt and sugar intake?

Hope you get a better night's sleep tonight.

[SNOWKITTEN]

I was amazed at the amount of symptoms as well. I know you dont have to have ALL of the symptoms, but it amazed me at how many i DID have.
I actually had a really really bad night last night. Woke up from a nap so swollen/stiff/sore that i was in tears (im not a cryer). I know the new meds wont take effect for a few weeks but im not even sure if they will help with the swelling in the first place since pitting edema is not a symptom. Im wondering if i have something else with hypothyroidism as well.