[i]Causal relationship between thyroid dysfunction and hallux valgus[/i]

[helvella]

Hallux valgus is commonly referred to as a bunion.

The paper is complex - but the take-home is that there is a genetic relationship in at least some patients between hallux valgus and hypothyroidism.

Another one to add to the list...

Causal relationship between thyroid dysfunction and hallux valgus: A two-sample Mendelian randomization study.Frontiers in Endocrinology, 08 Mar 2023, 14:1115834

DOI: 10.3389/fendo.2023.1115834 PMID: 36967762 PMCID: PMC10030973

Abstract

Introduction

Previous observational studies have reported that thyroid dysfunction is associated with hallux valgus (HV). However, the causal effect of thyroid dysfunction on hallux valgus is still unknown. To assess whether there is a causal relationship between thyroid dysfunction and hallux valgus, we performed a two-sample Mendelian randomization (MR) study.

Methods

The data of the two-sample Mendelian randomization study were obtained from public databases. In this study, hypothyroidism, hyperthyroidism, free thyroxine (FT4), and thyrotropin (TSH) were chosen as exposures. The single nucleotide polymorphisms (SNP) of hypothyroidism and hyperthyroidism were from the genome-wide association studies (GWAS) of the IEU database, including 337,159 subjects. Data for FT4 and TSH (72,167 subjects) were extracted from the ThyroidOmics Consortium. HV was used as the outcome. The SNPs associated with HV were selected from a GWAS of 202,617 individuals in the fignngen database. The inverse variance weighted (IVW) method was used as the primary analysis. Four complementary methods were applied, including MR-presso, MR-Egger, and weighted median. In addition, Cochran's Q test, MR-presso, MR-Egger regression, and the leave-one-out test were used as sensitivity analysis, and the MR-pleiotropy test was performed to examine pleiotropy.

Results

According to the results of IVW, we found that there was a causal relationship between hypothyroidism and HV, and hypothyroidism increased the incidence of HV (OR = 2.838 (95% CI: 1.116-7.213); p = 0.028). There were no significant causal effects of hyperthyroidism, FT4, and TSH on HV (p > 0.05). Sensitivity analyses showed that the results were robust and reliable, and no horizontal pleiotropy was detected.

Conclusions

Our findings provided genetic support that hypothyroidism might increase the risk of HV. It will predict the occurrence of HV in patients with hypothyroidism and provide suggestions for early prevention and intervention.

Full paper freely accessible here:

europepmc.org/article/PMC/P...

[DippyDame]

Interesting!

Over the last few years I've come to the conclusion that if something ails the body then ( low) T3 is likely to have an impact ...on a cellular level.

Obsessive maybe but...

I have been diagnosed with several conditions over decades...

FMS, CFS, IBS, hypothyroidism, diverticulitis, skin conditions, peeling nails, hearing loss, eye/ sight issues,rotor cuff tendinitis and more....enought to make me sound like a raging hypochondriac.

Tests, scopes, scans alternative treatments etc neither revealed nor cured most of them.

Then I found this site and with some invaluable guidance and help I started to dig. Then I read ...and read!

I wish I could retain more!!

Long story, short.....T3 ( and in my case supraphysiological doses) began to resolve many of these issues. Unfortunately not all, because some of the damage done was " deep seated"....but as many of us know T3 is key.

I'm also convinced there is a strong genetic link....in my case the fairly commonDio2 snp but I also have a very rare genetic deletion discovered as a result of a close family member's near fatal illness.

In retrospect, looking back at known medical "clues", my maternal grandmother who was bedridden for years, and very possibly my mother who often functioned on aspirin and died young from a heart attack, very possibly had undiagnosed thyroid disease.

As a result I've become known in the family for saying,

"It's T3"....not necessarily glandular, but maybe cellular.

So, having now added another rant....

Yes, this doesn't surprise me in the least.

Medics must learn about, and understand, T3 and how to diagnose and medicate inadequate levels.

That would save a lot of people a lot of misery!

Thankfully bunions are not on my symptoms list, but....

Thank you for posting helvella

[Batty1 in reply to DippyDame]

Off subject but what did you experience when you had rotor cuff tendinitis?

[DippyDame in reply to Batty1]

Shoulder pain especially with movement...and during the night

GP gave me a shoulder steroid injection which after a few days eased the pain, which eventually cleared...had almost no trouble since.

I'm not sure if that was thyroid related...it was before I introduced T3.

Maybe also because my then levo dose was increased...I can't be sure.

I just took the levo back then and accepted what GP told me.....that eventually changed once I started to "dig into" thyroid disease!!!

But I can say that a therapeutic dose of T3 definitely cured coccyx pain... that had been crippling me despite my chiropractor's treatment

[Italiangirl123]

This is amazing! Having started on 25 mcg levo I am now up to 75mcg. In the last two or three weeks I have been woken up during the night by a pain in my right foot where a bunion would be if I had one… It seems to disappear in the day, but I am now monitoring the frequency of this phenomenon. Will try and make some sense of the paper! Thanks

[helvella Administrator Thyroid UK in reply to Italiangirl123]

Unfortunately, it doesn't help you know what best to do!

If you (or anyone else) sees a good paper on what to do if you think you are getting a bunion, you would add a link in a reply?

[arTistapple]

I always think fasciitis (known thyroid sx) could lead to bunions. It’s all about the weakened muscles in the feet. It’s hardly surprising bones in feet become displaced, sometimes permanently (without surgery) when hypothyroid. However it’s too late once the bunion has appeared (without surgery). Must say my fasciitis has improved enormously since levo. I’d quite forgotten that one, because I never really associated it with being hypo! Well there you go, another actual improvement to be grateful for.

[helvella Administrator Thyroid UK in reply to arTistapple]

Well, I had plantar fasciitis before diagnosis. And everything I was told to do made it worse.

Improved and resolved on levothyroxine!

[arTistapple in reply to helvella]

That’s brilliant. I went around with it for years. Just accepted it in the end - brain fog or just utterly drained.

[waveylines]

Thanks Helvella.... Just shows you how much the body is affected by our thyroid!! And sadly I do have one.... though I think mine is probably linked to being flat footed from childhood. Defo not due to high heels as some medics allege.... Am tall never needed to make myself taller!! 😂

[asidist]

Thanks for sharing this, would never have thought! I have baby bunions though from my mom’s side (hers were bad and required surgery), whereas hashi’s / thyroid issues are only on my dad’s side, so in my case seemingly not related?

I’ve worn five fingered shoes (Vibrams) for over a decade now and swear by them. (Also wear as much minimalist/flexible footwear with wide toe boxes as possible to keep feet in natural form and all the muscles toned.) Regularly wearing the Five Fingers especially seems to have completely stopped any progression of the bunions (despite poor thyroid functioning!), as the shoes keep toes spaced apart. Not a huge fan of most current styles however - desperately waiting for Vibram to make more comfortable styles again

[helvella Administrator Thyroid UK in reply to asidist]

Thanks for that.

Quite clearly, it isn't the thyroid level that is being blamed in this specific study. (Other studies might well have found out the impact of thyroid hormone levels themselves.) But genes that are common to (some) who are hypothyroid as well as hallux valgus.

Very glad you have found footwear that prevented further development of them.

[asidist in reply to helvella]

Oh gotcha thanks for clarifying, read the abstract too quickly.

[RedApple Administrator in reply to asidist]

asidist, 'footwear with wide toe boxes as possible to keep feet in natural form '

A lot, lot more expensive than your five fingered footware (I could never wear those!), but so, so beautiful, very bunion friendly and hand made from gorgeous Italian leather in Wales. Shame you're not in the UK, the shop is so worth visiting. shandals.co.uk/

[TiggerMe in reply to RedApple]

My sister has a pair of these Shandals, thoroughly enjoyed the train trip up to get measured... made a weekend of it, lovely area.... don't remember ever seeing her wear them though?

Edit... Turns out 5 years on they are great and still going strong but day to day she wears Vivobarefoot for everything else

[RedApple Administrator in reply to TiggerMe]

I imagine they take quite a bit of getting used to. I'm not good at tolerating anything between my toes, have never worn flip flops etc. And they're def not 'trendy' or 'elegant' looking for females. Being a 'leather holic', I just drool over the amazingly beautiful craftsmanship and materials.

[TiggerMe in reply to RedApple]

Certainly the more comfortable bohemian alternative to Jimmy Choo's 😆

I've always had a pair of vivo's as beach/ watersport shoes, they again are super comfortable but about as attractive as a pair of cornish pasties on your feet! But comfort has always been king to me 😁

[asidist in reply to TiggerMe]

Ditto! Love Vivos - my hiking boots are Vivo Trackers. Couldn’t live without them - my feet would cramp within minutes and get so sore wearing “normal” highly structured hiking boots.

[TiggerMe in reply to asidist]

Ah yes, Sister swears by them as her dog walking boots, I'm a devout Salomon wearer as I didn't get the super flexy gene

[asidist in reply to TiggerMe]

“Super flexy gene” 😂 Never considered a relationship between that and preferring minimalist footwear (but am hypermobile!)

[asidist in reply to RedApple]

beautiful!