Attention Non-Tremor Dominant subtype, also called Akinetic-Rigid Parkinson

[Parkie-]

Edited Aug 24: it is very interesting to see the similarities within some of the replies to this post. PLEASE DO SHARE info if you proceed with ft3 testing and/or treatment for thyroid. And if anyone out there has already got some PD relief from thyroid treatment, info would greatly be appreciated. Thank you (end of edit).

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I came across a post in Healthunlocked’s Thyroid UK section which mentions the following study regarding a link between thyroid hormone FT3 and Akinetic Rigid Parkinson:

Thyroid hormone level is associated with motor symptoms in de novo Parkinson's disease ncbi.nlm.nih.gov/pubmed/259...

‘’The decreased free triiodothyronine level was associated with akinetic-rigid motor subtype’’ (free triiodothyronine = Free T3 hormone)

‘’FT3 level was below the normal range in approximately

40 % of the patients with PD. The fT4 level mainly contributes

to the negative correlation with the TSH level in

the negative-feedback control mechanism of the hypothalamus–

pituitary–thyroid (HPT) axis. Therefore, the

decline in the fT3 level in patients with PD may have been

OVERLOOKED or masked because of nearly normal ranges of

fT4 and TSH.''

‘’observations seem to suggest thyroid state

affects motor symptoms in patients with PD. Moreover,

hypothyroidism and PD have common manifestations,

such as hypokinesia, facial hypomimia and voice abnormalities,

which not only make the differential diagnosis

harder but also mutually mask the appearance of one of

these disorders during the course of the other.

Our findings may suggest a causal physiological linkage

between these diseases.’’

‘’Dopamine, a key neurotransmitter in PD, has an acute

inhibitory effect on TSH secretion. This effect occurs only

during the first 2 h following intake. However, this

inhibitory effect CAN BE LARGER IN PATIENTS WITH PD than

healthy subjects.’’

So if you are non-tremor dominant and PD meds worsen your condition, you may want to get your FT3 tested…

Furthermore, if you can’t seem to be able to exercise for more than a few minutes without getting all weak and shaky, maybe you have a co-existing illness or even a wrong PD diagnosis:

Muscle Metabolism and Exercise Tolerance in Subclinical Hypothyroidism: A Controlled Trial of Levothyroxine academic.oup.com/jcem/artic...

‘’Neuromuscular symptoms and impaired muscle energy metabolism have been described in subclinical hypothyroidism’’.

Another study indicates that endocrine disorders can mimic PD:

Endocrine disorders and the neurologic manifestations by Jeesuk Yu, MD, PhD:

‘’Muscle weakness, pain, and stiffness are common symptoms

of endocrine disorders. Systemic characteristic symptoms

of specific endocrine disorders usually precede the onset of

weakness, but muscle weakness may be the initial symptom.’’

‘’Endocrine myopathy should be considered as one of the

etiology of muscle weakness, because specific treatment is

available in endocrine myopathy’’.

‘’ Thyroid dysfunction (hyper- or hypothyroidism), parathyroid

disorders (hyper- or hypoparathyroidism), and adrenal diseases

(Cushing disease, Addison disease, or hyperaldosteronism)

may cause endocrine myopathies.’’

‘’Weakness is usually much more prominent in the legs

than in the arms, and abnormal gait can be the initial symptom

of either proximal or distal leg weakness’’.

‘’The serum creatine kinase is usually normal. However

it can be elevated which does not correlate with the severity of

muscle weakness’’.

‘’Muscle stiffness and spasms occur in

myotonia, dystonia, and other movement disorders, but can

be present in hypothyroidism or thyrotoxicosis when motor

unit activity is continuous. In hypothyroidism, the stiffness

gets worsen by activity and may be painful with the slowing

of muscular contraction and relaxation in performing tendon

reflexes’’

Unfortunately, when GP’s, and even Endocrinologists, test your Thyroid level, they start with TSH, and if within range, do not go on testing T4 and T3 levels even if your symptoms of hypo or hyperthyroidism are obvious. And even if TSH is ABNORMAL, they usually test T4 and rarely go on testing T3.

It appears that FT3 are the only available form of thyroid hormones for your body to use up. You can read more :

thyroiduk.org.uk/tuk/testin... and thyroiduk.org.uk/tuk/testin...

If you have further info on this subject, **PLEASE SHARE** on this reference page. Anything you know about this can be useful to others. Thank you.

[Grumpy77]

Too difficult, complex and technical to understand

[Xenos]

Grumpy is right : a layman translation would be welcome, but at the same time, it looks very interesting to me since I am non tremor dominant, L-Dopa doesn't do anything to me, and I have weakness especially in the legs (going upstairs is a challenge).

I will re-read your post Parkie, thank you.

[munchybunch in reply to Xenos]

Same as my husband. He’s like that. Isn’t it just saying get f3 checked?

[Xenos in reply to munchybunch]

It seems so to me either.

[munchybunch]

Thanks for that. I’m really interested in it . My husband does not react well to Pd drugs is rigidity dominant and has lack of arm swing as most obvious symptom. It was the first thing we all noticed. Parlor what do you think pls?

[grower in reply to munchybunch]

me too

[Parkie- in reply to munchybunch]

Hello Munchy. My first major symptom was also loss of arm swing. I tried levodopa, pramipexole, rasagiline which all made my stiffness worse and/or gave me temporary resting tremors, or arryhtmia. Mucuna puriens did not show improvement and gave me important side effects. B1 was showing improvement on constipation, eczema and a bit on stiffness but I get overdose symptoms right away, even at low doses...

[munchybunch in reply to Parkie-]

Hi parkie, so does that mean you have thyroid issues as well as Pd ? Or is the Pd actually not Pd but thyroid. ? So complicated ! My husband is a bit of an enigma as he did not respond to pramipexole at had terrible reaction to sifrol. Now he’s on low dose of madapar but he doesn’t even think it makes any difference. Trying to re read yr article does it say that sometimes you can think u have Pd but in fact you have thyroid problems? Is that it!?thanks

[Parkie- in reply to munchybunch]

Hi munchy. I was diagnosed as PD but doubt I have it due to meds not responding, exercise intolerance and major weakness issue.

I "hope" I have a thyroid issue and not PD. My ft3 are low but within range limits. I may have both PD and thyro issues, I wont know before I see an endocrinologist in October.

Update May 2020: Just realised I never followed-up... Saw two endocrinologists who did not think I have thyroid problems. Since they just looked at me for a minute and ignored my low ft3 level, I guess I will never know for sure. Still have incredible muscle weakness upon exercise. Still wondering if I have pd...

[felixned]

It is very important and useful information. Thank you so much.

[Parkie- in reply to felixned]

Welcome! Yes indeed, precious info... It gives hope.

[PixelPaul]

This is very interesting to me. I have been diagnosed with having symptoms "consistent with" PD, but experience no symptom relief with any of the usual medications. I did find the linked paper very difficult to understand. Is someone able to summarize it?