Joint pain

[marsaday]

I am doing very well with my thyroid treatment. Functioning pretty much at full power ::

However, this year i have developed pain in my forearms and i am pretty sure it is arthritis type stuff. I work physically and play sport but it is not related to these activities. I know i am getting older (46) as well, but this type of thing is new for me and i know a lot of thyroid patients have muscle/joint type pains, but as i say this is new for me.

Anyway i went to the doctor and i had some bloods done. I am supposed to have a phone consult on thursday, but i did managed to get some results yesterday on the phone.

Everything is normal according to the receptionist. I understand about the thyroid tests, but i am not sure what they will have done to look at inflammation.

Some questions:

1) So can anyone help me with what i need to be looking at in regards to arthritis type markers.

2) I am assuming the NHS will just fob me off, but i would like to know how i can go about improving this area because i don't want it to get worse.

3) Is this a thyroid issue or a cortisol one. I am thinking it might be a lower cortisol issue (but i don't have low cortisol on the bloods). The reason i say this is that recently i have tried the early morning T3 dosing routine using 3mcg T3 and it has really helped with my joint/arm pains. So this is good, but it is still a worry i have been getting these issues.

Bloods taken at 9am:

TSH 0.37

Ft4 21 (10-22)

Serum cortisol 420 (133-537)

Testosterone 15.5 (8.6-29)

Vit D 102

This is all i got, but there were more and i suppose i will get the rest on thursday.

Taking 125 T4, 3mcg T3, 6mg progesterone per day. Vitamin D 5000 x 2 per week. No meds taken before the blood draw.

My TSH and FT4 is usually around this level, Ft4 has been around 19 to 21 so no changes here. Testosterone has dropped in the last 2 yrs from 21 to mid teens, but i am not showing any Low testosterone issues like fatter stomach, lower libido etc, so don't think this is an issue. NHS don't do the FT3, but generally my T3 level is higher. Usually around the high 5 area.

Thanks for any feedback.

[ITYFIALMCTT]

As you know, there are no specific blood tests or markers for osteoarthritis, but particular tests like RF or anti-CCP may partly rule out other causes of joint pain, such as rheumatoid arthritis (however, if you've presented with a very different pattern of pain or typical symptoms this might have been ruled out already).

For the blood tests you've just had, it's likely that they measured CRP and/or ESR as they're both measures of inflammation: labtestsonline.org.uk/under...

Have you been supplementing with vitamin D for some time and always had a decent level like the one that you report? (Asking because if you've previously been chronically deficient it can take a while to correct any underlying MSK issues.)

[marsaday in reply to ITYFIALMCTT]

Been doing the Vit D since last autumn. I have found it makes a real difference, but i don't take it every day and in the summer i was maybe just taking 1 x 5000 IU tablet every 2 weeks.

I knew CRP was a measurement for inflam, but not sure about the others. I will ask about them, but assume all is ok as that is what the receptionist told me yesterday.

What are MSK issues ?

[ITYFIALMCTT in reply to marsaday]

musculoskeletal

It would be helpful if you post up the remainder of your results when you receive them. It's a common saying round here that you should never assume that everything is OK (there have been some amazing mistakes) and that "Fine or normal are opinions".

[marsaday]

Hopefully i will get them on the phone on thursday.

[marsaday]

ESR was 2 (1-10)

CRP was non detected

Rheumatoid factor was non detected.

The doctor was pretty useless when i asked him what the issue may be. He suggested i have a face to face meeting with him, but i said it probably wasn't worth it.

I have been taking T3 at 4am for 16 days now and this has made a really big difference to how i feel. My joint pain has improved a lot, so i am thinking this is cortisol related.

Good to get some feedback from the forum though.

[YulianaRossenova]

You are overdosed, Marsaday.

Besides, the higher ft4 is, the less it will be convertet to ft3. So, overdosing with t4 will definitely block conversion. no one needs that.

The morning ft4 level, that is 24+ hours with no hormone intake, should be little short of midrange. And tsh between 1.70-1.90.

I know you are following a different routine of taking t4 but still... tsh should be a bit higher and ft4 a bit lower in your case, like 0.8 and 18.50-19 about 8 hours after t4 intake and tsh might be even higher since you have the blood drawn in the morning when tsh is physiologically higher.

So you are definitely overdosed with t4 IMHO.

I get bone pain in forearms when overdosed.

Also you may need less than 3 mcg t3. Overdosing witj t3 also gives bone pain. You may need 0.5 mcg t3, or 1, or 2.

3 mcg t3 usually raise ft3 levels with a whole unit. That is from 3 to 4 for example. 3 mcg is for relatively poor converters. Are you sure you are such a poor converter?

[marsaday]

It is a possibility.

I have recently tried using 100mcg per day and noticed i had more energy for the next 4 days BUT i then had a huge tiredness wave hit me on the 4th evening. The next day the tiredness hit me at lunchtime, so i could see the body was getting depleted in T4 after just a short time.

I convert well so i could look at using a smaller T3 dose.

Thanks for the input as we both seem to go against conventional ways of looking at this issue = we think maybe we need less and most people actually think you need more thyroid meds.

I will be getting some new blood tests done in january as well. So i may try an alternate 100/125 routine and see how i go on.