Confused hypo/hyper with gabapentin

[Melissa1105]

I have terrible throbbing, burning and needles in my feet. A heaviness. My elbows and hips hurt too alithough not as bad or as easily as my feet. My GP told me today the pain is related to my thyroid issues she gave me gabapentin to try.

I have a rather large goiter, but it doesn’t interfere with my eating or speech. Ive taken 2 grains of NatureThroid daily for six months even though my TSH is 1.2 before I started it. It was prescribed by a MD that is a self proclaimed specialist on thyroid disorders. His speciality is family practice.

I’m confused. DOES thyroid imbalances cause body pain? Have you had this type of pain? If so, what did you do?

Thanks, Melissa

Follow up: I will look up my results. Ive never had blood drawn after I started NatureThroid. I’ve been on it for five months. I DO have blood work from before I started the NatureThroid.

As for my pain. I have both, burning AND aching muscles and joints. My feet plus my hips and hands. The back of my legs tighten up. I have to stretch constantly. I feel better. But it starts all over again.

As far as my other labs: My A1c is fine. I’m not sure I ever had my folate or B12 tested

I had saliva tests 10 days after I started the NatureThroid. Back in August, 2017.

TSH .7

Free T4 1.7

Free T3 2.6

TPOab 15

My progesterone was low which thru off my ratio to estrogen too. I supplement progesterone now.

My cortisol was

4.9 morning (average)

6.7 noon (high) top of the range is 3.0

6.9 evening (high) top of the range is 1.9

3.7 nite (high) top of the range is 1.0

Any ideas?

[greygoose]

I'm sorry, but none of those results make any sense without the ranges. Can you edit your post to add in the results, please?

It is perfectly possible for hypothyroidism to cause all sorts of pains, anywhere in the body. But, your symptom sound very much like nutritional deficiencies. You really need to have your vit D, vit B12, folate and ferritin tested. Being hypo often causes these to be low.

And if your doctor knows the pain could be due to hypo, why doesn't she just increase your dose rather than give you epilepsy medication?

[Melissa1105 in reply to greygoose]

I am very close to hYperthyroid. The NatureThroid doc (man) will not increase my dose or get blood work. My PCP (woman) is a different doc who gave me the gabapentin because she believes thyroid issues can cause neuropathic pain.

I see an endo next Tuesday. Having taken 1 grain of NatureThroid for six months I really want to increase the dose to see if it helps—-BUT I look hyper in blood work. I really don’t know if the endo will be supportive of NatureThroid-let alone writing me a script for a higher dose. I need labs. I will ask for Vit D, B12, folate and ferritin. Thanks.

[greygoose in reply to Melissa1105]

Well, impossible to comment on your results, because they are meaningless without the ranges. Can you add the ranges, please?

That TSH, is that 0.7? That's not even suppressed, it's still in range. But, I don't know about the Frees. But I cannot imagine an FT3 range that would be lower than 2.6.

Anyway, you cannot 'go hyper' because you are hypo. It doesn't work like that. You may be slightly over-medicated, but I rather doubt it.

I doubt the pain in your elbow and hip is neuropathic. Neuropathies tend to be in the extremities, like toes and fingers.

[Maje in reply to Melissa1105]

Hyperthyoid is prevented or even stopped dead by taking vitamin A - take regulary. Cheers, Maje

[Melissa1105 in reply to Maje]

Really?! That’s cool. I’ll look into it. Cool help on this site. I’m lovin it!

[greygoose in reply to Melissa1105]

Melissa, you are not hyperthyroid. And I think if vit A could do that, we'd all know about it!

[Hidden in reply to Maje]

High dose vitamin A is very dangerous ! It builds up in the body and can damage the liver so caution is needed!

I was treated with Roaccutane (Accutane) which is a derivative of vitamin A and originally used as a cancer treatment, I had it as a very strong acne medication for my cystic acne (I'm in my 50s not a teenager) and had to have regular blood tests for liver damage. It also causes depression and was taken off the market in the US, so a vitamin to treat with caution.

[Maje in reply to Hidden]

Excessive doses only usually come about with water-based laboratory-made Vit A. Natural stuff is OK as is oil based. Only standard dose needs to be taken for the thyroid. When I was a child of five or so the Govt gave cod liver oil to all babies. Mom kept ours on the top shelf of the kitchen cupboard, which was about ten inches below the ceiling. I wanted it so much I used to shin up the cupboard shelves to get it then I drank the entire bottle to the last drop. I did this on several occasions with no harmful effects whatsover. Cheers, Maje

[helvella in reply to Maje]

There is plenty of evidence, in my view, that excess vitamin A from "natural" sources can be dangerous. Examples of sources reported include any food liver, halibut liver oil, seal liver, shark liver, sailfish liver curry and the near-fabled polar bear liver.

The effects of excess intake of vitamin A can, in humans, have a long latency before becoming apparent - possibly six months.

The effects of vitamin A (in excess) include causing birth defects when taken by the mother.

(However, vitamin A as betacarotene - the provitamin - can result in coloured skin, but is usually regarded as safe even in high doses.)

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

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

ods.od.nih.gov/factsheets/V...

[Hidden in reply to Maje]

I also had to sign a birth control charter, and have regular pregnancy tests before and during my 8 months of treatment with Roaccutane (for acne) because it causes birth defects in unborn babies, highly embarrassing and unnecessary at my age but insisted on by the Manufacturers. This med is a retinol; vitamin A derivative

Care is needed with all supplements and natural sources are not necessarily safer, It's well known that pregnant women should avoid excess Vitamin A intake, including Cod Liver Oil, confirmed by NHS website

nhs.uk/chq/Pages/1757.aspx?...

[applesandoranges21 in reply to greygoose]

Could it be that the dr is of the opinion that the signs and symptoms are representative of peripheral neuropathy rather than pain due to thyroid issues. May I ask you why you feel it is connected with the thyroid? Just interested and curious that's all. Thanks GG.

[greygoose in reply to applesandoranges21]

The OP said that the doctor thought the pains were due to thyroid, that the doctor thought they were signs and symptoms of peripheral neuropathy caused by being hypo. I didn't say that. I said that it's perfectly possible to have all sorts of aches and pains when you're hypo, but I thought her symptoms sounded more like nutritional deficiencies. Which is why I suggested she get her nutrients tested.

[Melissa1105 in reply to greygoose]

You are correct. My PCP posited that my burning, throbbing feet and tight legs are from neuropathic problems caused by my thyroid issues. Curious though. The pain started within a week of the goiter. I’m not kidding. Almost simultaneously.

[greygoose in reply to Melissa1105]

You really do need more blood tests. We're all just groping in the dark at the moment.

[Melissa1105 in reply to greygoose]

Will do on Tuesday at the endo appt. I’ll post the result as soon as I receive be them. I appreciate your help in lieu of current labs. Thank you all.

[greygoose in reply to Melissa1105]

You're welcome.

[applesandoranges21 in reply to greygoose]

You ended your posting stating that you did not hink that it could be due to neuropathy

[greygoose in reply to applesandoranges21]

I said 'I doubt the pain in your elbow and hip is neuropathic. Neuropathies tend to be in the extremities, like toes and fingers.'

However, if your read carefully, I mention fingers and toes, so that sort of suggests that I do think the problems with her feet were due to neuropathy.

But, even then I did not say that I thought the pain in her elbow and hip were due to thyroid. They could be, but I didn't say that. In fact, I think they're more likely to be due to low nutrients.

[Melissa1105]

TSH 0.7 Range 0.5-3.0 uU/mL

FT4 1.7 Range 0.7-2.5 ng/

FT3 2.6 Range 2.4-4.2 pg/mL

TPOab 15 Range 0-150 IU/mL

All these results were a saliva test I took BEFORE I took any NatureThroid. The doc who prescribed it refuses to up the dose or get labs. (1 grain, two times a day). My labs make my look hyper. Do they not? I’m on the edge of very low TSH on every blood or saliva lab I’ve ever taken. I have no idea what my labs are after six months on one grain twice a day. All I know is I still hurt.

Btw-the gabapentin was given by my PCP for burning, hot, stinging, throbbing feet. It’s working. But my achy muscles and joints with stiffness has not subsided on the gabapentin.

[Marz in reply to Melissa1105]

greygoose will not have seen your reply as you forgot to click Reply button beneath her post 😊😊

You are only HYPER when the FT3 is over range. Yours is VERY low.

Low VitD and Low B12 can cause pain - a B12 level below 500 can cause neurological issues. I think you are in the US so VitD needs to be at least 60. Folate and Ferritin mid-range. Thyroid hormones rarely work well when vitamin and minerak levels are low.

Check out Sally Pacholok film on You Tube - Could it be B12 ? Book by the same name. VitD is a steroidal pro-hormone and anti inflammatory - so more than a hormone ....

[Astridnova in reply to Melissa1105]

Just in case you were not sure:

'Hypo' means 'under', that is 'low'. Hypothyroid means lacking enough thyroid hormones.

'Hyper' means 'over', that is 'high'. Hyperthyroidism means having too much thyroid hormone.

[greygoose in reply to Melissa1105]

In no way shape or form do those labs look hyper! Hyper would be a TSH of 0.01 or something like that. Yours is still in-range.

It would also be an FT4 well over-range. Yours is only just over mid-range - mid-range being 1.6.

And hyper would be an FT3 also well over-range. Yours is right down the bottom of the range - mid-range there is 3.3, you are well under it. Your FT3 says you are hypo, which is why your doc prescribed NatureThroid. But, he is being a complete ass in refusing to retest. Retesting after six weeks is essential. It's possible that your FT3 is still too low. It's FT3 that makes you hypo or hyper, not the TSH.

[applesandoranges21 in reply to Melissa1105]

Hi Melissa I had a TSH of 0.7 my endo said have subclinical hyperthyroidism so you are quite right.

You need labs doing. How can any dr know exactly what is going on without labs?

Have you had an MRI scan of your spine? Vit B12 deficiency may be the cause of the burning/throbbing. have u had any antibiotics especially any fluoroquinolones? There is a condition called antibiotic toxicity and fluroquinolone toxicity syndrome. Did your doc mention adrenal stress or adrenal fatigue?

Have u heard of the gluten syndrome or gluten ataxia?

[Melissa1105 in reply to applesandoranges21]

That’s what my PCP says. I’m sub clinical.

Labs? The doc who wrote the script for NatureThroid is more interested in publishing books and bragging than treating me. The whole setup in meeting and being treated by him was weird. Emails only after a first eval. And no, he refuses to get labs. Six months on NatureThroid 1grain twice a day. I feel no better. He just blows me off in my emails. I’m so frustrated.

I HAVE had an MRI of my spine and hips. Only usual degenerative issues for my age in my hips. Nothing to trigger widespread pain.

No antibiotics. I’m otherwise healthy knock on wood. And gluten intolerance? I tried gluten free for six months. Nothing changed.

I’m telling you-it’s this freakin goiter or not enough NatureThroid.

Oh thanks apples. You’ve got some great ideas!

[applesandoranges21 in reply to Melissa1105]

Melissa an you dump the dr who prescribed Naturethyroid. Whats his name?

[Melissa1105 in reply to applesandoranges21]

Yes. Dumped.

[applesandoranges21 in reply to Melissa1105]

Good get your money back as well. Save all his e mails as well as your own.

[Angel_of_the_North in reply to applesandoranges21]

When I had a TSH of 0.45 I wasn't told I was subclinically hyper. Actually I had secondary hypothyoidism (low everything) and once you are on meds, it's really impossible to tell from your bloods if you are subclinical anything - just whether you are over or undermedicated and a low in range free t3 when taking NDT = undermedication. It's very very statistically normal and usual to have a TSH between 0.5 and 1 - in fact more normal than to have one of 3

[applesandoranges21 in reply to Angel_of_the_North]

angel What treatment did u receive for the sub clinical hypothyroidism?

[Angel_of_the_North in reply to applesandoranges21]

I wasn't subclinical - secondary hypo - NHS only looked at TSH and said I euthryroid but had adrenal problems.

[applesandoranges21 in reply to Angel_of_the_North]

sorry angel my mistake. So they left u untreated then? Did they treat the adrenal issues?

[Angel_of_the_North in reply to applesandoranges21]

So, they did loads of tests and then pronounced me "normal".

[Melissa1105 in reply to Angel_of_the_North]

Thanks angel. You’re right. I’m low or mid in all. I’m taking NatureThroid now. I’m thinking of going off of it temporarily before my endo appt to see where my baseline is. You’re right: meds just push you towards a direction.

[applesandoranges21]

Did the dr mention anything about the periformis muscle , wrenching of this can cause the type of pain you describe.

[Melissa1105 in reply to applesandoranges21]

I get regular chiro and massage therapy. Piriformis issues have been ruled out. Thanks though. And my pain is on both sides of my body equally.

[applesandoranges21 in reply to Melissa1105]

Have they ruled out disc problems, bulging discs etc?

Did you have deep massage therapy?

[Melissa1105 in reply to applesandoranges21]

No spine issues. I DO get deep tissue massage. She spanks me!! I’m sore sometimes the next day. But it hurts SO good ; )

[Astridnova]

Yes, I have had similar pain from hypothyroid, although I would associate the pins and needles with inadequate vitamin B12, which is something that often accompanies thyroid problems - either as pernicious anaemia or other problems with gut absorption. Both conditions can result in brain injury etc. Get tested for B12 and try to get above the upper therapeutic limit, which most sufferers think is too low. You can get sublingual lozenges of B12, rather than stuff around with doctors and B12 injections, although some people do say that they need the injections.

[applesandoranges21 in reply to Astridnova]

Hi Astridnova Like your style. Some people with gut issues such as leaky gut syndrome cannot absorb B12 so need the jabs. Best xx

[Melissa1105 in reply to applesandoranges21]

Astro and apples-I’m going to request my B12 checked on Tuesday. I’m determined to get to the bottom of this! Seven years I’ve hurt. Time is up!!

[applesandoranges21 in reply to Melissa1105]

Hi Melissa Don't blame you ask for nerve conduction tests too and/or a referral to a neurologist.

[Melissa1105 in reply to applesandoranges21]

Got it! Asking on Tuesday. I’ve had one unprofessionally conducted nerve conduction test. Electrodes placed while I watched her-plus I could see the girl turning up the machine! It was a joke.

[Hidden]

Your FT3 is low and should be higher in the range. Please post all of your results with the ranges when you have them for help. Also include exactly what you were taking and for how long. Leave off NDT for approx 12 hours before test which should be done first thing on an empty stomach. You are not hyper.

[Melissa1105]

Thanks all!!

So Tuesday at the endo I’ll ask for B12, Vit D, folate and ferretin labs. I currently receive huge weekly IV infusions of a Myers cocktail. It includes B12. My last lab for Vit D was 53. That was a few months ago.

[Marz in reply to Melissa1105]

If your infusion contains B12 - then your B12 test result will be skewed and of little value - unless of course you wish to see if you are absorbing any B12 from the infusion ....

I responded to you further up this thread - but no response from you

[Melissa1105 in reply to Marz]

Hi again Marz. I am so overwhelmed and happy with the responses-I forgot to personally respond. Yes. The B12 in my vitamin IV (and oral supplements) may skew my results of lab work. But I can’t do anything now. My infusions are weekly. The last one was 03/08/18 -before I got too much interest in this thread. I AM interested as you said to see if I’m absorbing it as well as the folic acid in it. I take 10,000 IU of vitamin D. Another interesting labs to see.

I’ll look up the you tube video on B12.

Thank you hon. This whole convo has been terrific.

[applesandoranges21]

My vit D target level was set at a minimum of 75 nngs. I believe it should be higher 100 but depends on what other condition you may have.

[Clarrisa]

Hi Melissa, I wondered if the pains you experience are positional in any way at all or occur more during certain times of the day? Do or did you have occupation that involved lifting &/or turning & twisting?

[Melissa1105 in reply to Clarrisa]

Excellent question Clarissa. I started hurting IONE day. Literally. I’m not kidding. I noticed the goiter and within a week I hurt all over. Could t walk in the am. My last two fingers locked down in the am. Hips, elbows, fingers, and feet ache severely. Tender elbows. Like I had the flu. That was seven years ago. In the last few years my feet burn and throb when I’m on them too long. But my whole body is super stiff if I sit for more than 30 minutes.

I’ve been to several endos, chiros, neurologists, ENT, just a thyroid specialist, I’ve lost count. No. It’s not positional unless you count if I sit more than 30 minutes makes me stiff and achy! Lol. 🙃 No. my job as a part time accountant allows me move freely. I DO drive for 4 hours round trip one day a week. That leaves me in pain!! But I warm up and pop pain relievers.

You have great questions. Oh, I do yoga. But that feels great because the stiffness leaves.

[Clarrisa]

You mentioned feeling like the flu, but this did not effect your respiratory tract? No occasional bleeding (nose) or getting winded on walks?

I really hope your thyroid labs will help to explain away your symptoms.

[Melissa1105]

No hon. No respiratory issues. In fact I’m healthy except for this pain and migraines. I’m crisscrossing my fingers for tomorrow’s appt too.

[Melissa1105]

Okay all. I saw the endo locally. He IS supportive of NDT and NatureThroid. Good news. He drew blood for a thyroid panel, B12, Vit A, Vit D and folate. No ferretin for some reason. Once I have those results in 3-5 days-I will post the results with the ranges. I REALLY appreciate all your responses and PMs. This is more help than I’ve had from MDs in 7 years!! Okay. I’ll post my results soon. Thanks again.

[Melissa1105]

Okay. Here are the results. The endo is putting me on synthroid 75 mcg plus Cytomel 2.5 mcg twice a day.

Vit D. 34.9 >30

B12. >2000 232-1245

Folate 19.0 >3.0

TSH 0.45 0.27-4.20

FT3 2.4 3.0-4.4

FT4 0.78 0.71-1.73

TGBAnti <1.0 0.0-0.9

TPOAnti 10 0-34

Any help is appreciated. What do you think of the endo wanting me to take the synthroid and cytomel?

Melissa-

[Melissa1105]

Bump. Any help is appreciated.