Inbalance between thyroid hormones and the dopaminergic system..(a hypothesis)

[janland]

Hi everyone..

I read this article recently..a bit hard going..but I found very interesting.

It was from...

ncbi.nim.nih.gov/pmc

I think it also mentions iron/ferritin levels as well..

[LotteM]

The link doesn't work. Maybe some part missing?

And yes, dysfunctioning thyroid can induce RLS symptoms.

[Hidden in reply to LotteM]

I think this is it

ncbi.nlm.nih.gov/pmc/articl...

[janland in reply to Hidden]

Yes... that's right..

That's the link.. sorry for mistake.

[Hidden in reply to janland]

No problem, that happens to me sometimes.

[Hidden]

Hi Janland, as Lotte says, part of the URL you posted is missing.

This is the complete link

ncbi.nlm.nih.gov/pmc/articl...

I think part of the reason you might have struggled to understand this article is the poor grammar, bad spelling and apparently some inaccurate information. I'm surprised it got published!

However, it is known that there's a connection between RLS and thyroid problems.

Thyroid gland activity is regulated by a hormone secreted from the

pituitary gland in a "feedback loop", when thyroxine levels get low or extra thyroxine is needed, the pituitary gland secretes Thyroid Stimulating Hormone (TSH) which triggers the thyroid gland to release thyroxine. When thyroxine levels get high, TSH secretion goes down, hence the thyroid gland releases less thyroxine.

This article seems to be saying that high dopamine levels inhibits TSH levels and hence lowers thyroxine. Conversely, if dopamine levels are too low. TSH is too high. so too much thyroxine is released and this causes RLS symptoms.

At least that what I think it's saying! It's also the opposite to what I previously thought, i.e. that too little thyroxine causes RLS, not too much.

I'll have to check that now.

[janland in reply to Hidden]

Thanks yes..

If you find out ..is..

Is it too much or too little thyroxine which contributes to rls...I would be much obliged.

I actually printed that out and left with my gp about a month ago...but no feedback from gp ..not sure if it was even read..!

I'm told my thyroid levels are"normal".. but it's such a delicate balance..

Rls I believe has to do with the whole balance of the body.. kidney function.. minerals.. dopamine so intricate really..

Thank you so much for your advice.

Jan

[Hidden in reply to janland]

G'morning.

A little more of a search suggests that it is an excess of thyroxine, hyperthyroidism that's associated with RLS.

One article I found was a bit ambiguous as it compared people with "thyroid disease" with normal (euthyroid) people and said the former had more RLS symptoms. However it didn't distinguish between people with underactive thyroid and overactive.

I found another couple of articles which suggest it's mainly an excess of TSH (hence thyroxine) that leads to RLS symptoms.

Contradictions, a couple of articles I found say that excess TSH causes the 1st three RLS symptoms, but not the 4th i.e. symptoms worse at night. Another srticle, though, said it caused all four.

One articles suggested that thyroid imbalance was a central factor in RLS.

From all of that, as far as I can make out, there does appear to be an inverse relationship between dopamine levels and TSH levels. Higher Dopamine is associated with lower TSH and vice versa.

Taking a dopamine agonist lowers TSH levels.

The implication of this is that lower levels of dopamine leads to higher levels of TSH, hence hyperthyroid which then causes RLS.

One article suggests that this is THE cause of idiopathic RLS.

However, this isn't entirely credible because.

1 There isn't consistent evidence that excess thyroxine leads to RLS to be worse at night.

2 The theory assumes that dopamine levels are low in RLS, whereas there's evidence that dopamine levels are normal or even high in RLS

3 It appears to contradict theories explaining augmentation which suggest that levels of dopamine that are too high cause RLS symptoms.

4 It doesn't explain why people with apparently normal levels of thyroxine can suffer RLS.

My own thoughts are

1 If thyroxine levels are the main factor in RLS then RLS sufferers must be somehow "oversensitive" to fluctuations in Thyroxine, but there's no evidence for this

2 Even if it were true that excess thyroxine were the main factor in idiopathic RLS, it's primary cause seems to be dopaminergic since, they're saying that excess TSH is due to low dopamine.

Overall, it's easy to accept that "secondary" RLS can be caused by excess thyroxine. There isn't as yet ant convincing evidence that all cases of idiopathic RLS are associated with excess thyroxine.

In any event not all cases of hyperthyroid are due to excess TSH.

Possibly one of the misconceptions about RLS is that it is a single disease, which in fact, it isn't. It's a set of symptoms which consistently occur together - the definition of "syndrome".

Excess thyroxine may cause the syndrome, but there are others things which cause it. My wife has mild RLS, she also has HYPOthyroidism.

Willis Eckbom Disease (WED) however may be a single disease, primarily a dopaminergic dysfunction.

Lastly, the thyroxine theory may not have any real impact on WED treatment. Obviously if RLS is present in people with excess thyroxine then treatment to lower thyroxine may relieve RLS symptpms. If you lowered thyroxine levels in someone with WED who didn't have excess thyroxine, it would cause hypothyroidism.

I'd say, for the time being at least, if your thyroxine and TSH levels are consistently normal then it doesn't affect the treatment you might try for RLS.

I hope that makes sense!

[janland in reply to Hidden]

Hello and thank you for all that long research and information..

It's very perplexing to say the least..

I know even tiny fluctuations of thyroid hormones can cause sensitivity..or in some people who may be more sensitive..

I do wish someone would research rls or WED more thoroughly..

It's driving me crazy every night.

When I had steroids in summer..plus vit D and calcium..(for low platelets)

The rls went away..

I'm now trying more electroyes.. potassium etc.. minerals..

I have Soooo many sleepless nights..

I'm taking extra iron these days too..

My diet is mostly natural so I really don't know.. unless it's something to do with age where people don't assimilate vitamins so well..?

Thank you so much.

Jan

[Hidden in reply to janland]

I found another article that might interest you.

This much clearer

ncbi.nlm.nih.gov/pubmed/232...

I've copied the abstract in below, which states the main points.

Willis–Ekbom’s disease (WED), formerly called restless legs syndrome, is more common in pregnant than in non-pregnant women, implying that the physiological and biochemical changes during pregnancy influence its development. During pregnancy, many hormone levels undergo significant changes, and some hormones significantly increase in activity and can interfere with other hormones. For example, the steroid hormone estradiol interferes with the neuroendocrine hormone dopamine. During pregnancy, the activity of the thyroid axis is enhanced to meet the increased demand for thyroid hormones during this state. Dopamine is a neuroendocrine hormone that diminishes the levels of thyrotropin and consequently of thyroxine, and one of the roles of the dopaminergic system is to counteract the activity of thyroid hormones. When the activity of dopamine is not sufficient to modulate thyroid hormones, WED may occur. Robust evidence in the medical literature suggests that an imbalance between thyroid hormones and the dopaminergic system underpins WED pathophysiology. In this article, we present evidence that this imbalance may also mediate transient WED during pregnancy. It is possible that the main hormonal alteration responsible for transient WED of pregnancy is the excessive modulation of dopamine release in the pituitary stalk by estradiol. The reduced quantities of dopamine then cause decreased modulation of thyrotropin, leading to enhanced thyroid axis activity and subsequent WED symptoms. Iron deficiency may also be a predisposing factor for WED during pregnancy, as it can both diminish dopamine and increase thyroid hormone.

Note Thyrotropin = Thyroid Stimulating Hormone (TSH),

decreased modulation = disinhibition or more simply 'more'

[janland in reply to Hidden]

Hello again and thank you for the above article re Dopamine..pregancy thyroid hormones and iron..

I'm finding it quite baffling when reading this actually..

I get restless legs very badly every 4-5 days during the week..so hardly any sleep..

If not pregnant..

do you think this article means..

Not enough dopamine.. therefore... thyroid hormones are low...so need more levothyroxine?..

I'm trying to up intake of iron..but it's a slow process cos tablets affect stomach so can only tolerate 100 mg of ferrous sulphate per day..

I'm now trying potassium again..in the form of electrolyte mix..few drops each day...

So distressed about the condition..

Do you think vitamins D plays a part..?

Many thanks

Jan

[Hidden in reply to janland]

HYPERthyroid is associatef with RLS, i.e. too much thyroxine. Not too little. I confess I thought it was the other way round.

This study is saying because of this known mechanism during pregnancy i.e. estradiol lowers dopamine hence TSH and thyroxine go UP, then the theory is that WED is caused by raised TSH and thyroxine generally, not just in pregnancy.

Low dopamine = high thyroxine.

At least that's the theory.

I've never been pregnant

Vitamin D relieves RLS symptoms in people with a vitamin D deficiency. At this time of year, most of us!

Taking an oral iron supplement is more effective.if you do the following

1. Do NOT take it every day, only take it every two days. This tricks your body into absorbing more.

2 When you take it. also take a vitamin C tablet or a glass of orange juice. This helps more to be absorbed

3 Take a "gentle" iron. Stronger iron formulations cause more problems and aren't necessarily more effective.

Its better to take it on an empty stomach, but not a good idea if it upsets your stomach.

I also take a senakot at the same time to prevent constipation.

[Pippins2 in reply to Hidden]

Hi I have hyperthyroidism due to Graves Disease and would like to point out that with hyperthyroidism TSH is extremely low in fact non existent in most cases .It is T3 and T4 levels which are high. I take anti thyroid meds to try to lower my T3 and T4 and raise my TSH. This is a balancing act and I can all too easily go hypothyroid temporarily. My point is I haven't found any difference in my RLS whether hypo, hyper or in range x

[Hidden in reply to Pippins2]

You're an example of what I wrote before, i.e. that not all cases of hyperthyroidism are due to raised TSH which somewhat disproves the hypothesis that thyroxine fluctuations are the cause of symptoms in idiopathic RLS.

[ColinW1969]

doesnt work

[janland in reply to ColinW1969]

Please Google....

"Inbalance between thyroid hormones and the dopaminergic system"

Sorry for confusion.

Jan

[Hidden in reply to ColinW1969]

This is the link

ncbi.nlm.nih.gov/pmc/articl...

[janland in reply to ColinW1969]

Manerva has shown the right link now below my emails..

[Hidden]

Hi again Jan, I have posted the link to that article several times. If people read through all the responses to a post before adding their own comment, they would have seen that.

Sorry, it's one of my pet hates. People just add comments that sometimes appear random, irrelevant or suggest things that have already been suggested, or have already failed. It doesn't help.

[Kaarina Administrator in reply to Hidden]

A good posting, Manerva. Thank you. Unfortunately this often happens.

[Hidden in reply to Kaarina]

Sorry It happens a lot, I should be more tolerant.

[janland in reply to Hidden]

Thank you for your support..

Yes..I didn't put the full link in my post...

Fortunately you helped.