I'm 33m, 6'3, 160 lbs caucasian and my life has been turned upside down in the last 6 months. My issues started about a year ago when I started having pain when sitting after doing some intense landscaping. In January I was diagnosed with sciatica and eventually got an MRI showing a 2mm protrusion on my l5/s1 nerve. At this point my symptoms included weakness/fatigue keeping me off my feet and pain in glutes and down my left leg and numbness in foot. I couldn't stand / sit / walk for more than about 5 minutes. A little unusual, but fairly classic signs of a back injury. I ended up getting an injection which did not help.
I did a few months of physical therapy and my back symptoms seemed to improve, but my muscle fatigue in my hips/glutes was getting worse. Every time I seemed to be getting better and started to increase my activity, I would end up overdoing it and becoming incredibly sore in my hips to the point i'd have to lay down. It felt like I'd completely overdone it at the gym. On a better day I did two 5 minute walks and a little bit of sitting. I woke up sore for the next 4 days straight.
In mid August I started feeling sick. Fatigued, lousy, and I noticed I was getting muscle twitches in my legs, arms, and torso. I thought it was a bug or virus of some kind but after a couple weeks I went to see a doctor and got diagnosed with hypothyroidism / hashimotos with a tsh level of 36.
They put me on 75 mcg levothyraxine but the next 3 weeks my symptoms just got worse. I felt off, out of sync, numbness in my forearms that comes and goes along with numbness on the left side of my face. In addition, aches and pains in my hips were causing me to have trouble sleeping. But I did notice my strength appeared to be getting slightly better in my legs. I was pretty desperate so I tried changing my diet, cut out gluten, dairy, and grains.
The endocrinologist I saw was concerned and sent me to get tested for adrenal deficiency, but my levels were normal. She switched me to 100 mcg synthroid and then referred me to get more testing done. My ANA came back positive speckled so I saw a rheumatologist who didn't seem to think I had any of those diseases. Tests confirmed negative for lupus and a host of others. She said it's possible it's all explained by thyroid but referred me to a neurologist.
At 4 weeks into the pill, I finally felt some relief. My energy came back, the pain in my hips went away, I felt stronger. I had 4 good days in a row and felt like I was on the road to recovery. But the next week+ was very up and down, with more downs than ups.
-The neurologist didn't seem to think I had a neuro disease after evaluating me, but we did a brain mri and some blood tests. I had elevated b1 (248 nmol/L, normal is 78-185) and b6 (87 ng/mL, normal is 2.1-21.7) which can cause muscle/nerve issues but I'm not sure if this is the source of some of my problems or not because I only started taking b-complex supplements after my symptoms started. EMG/nerve conduction test was normal. Brain MRI came back normal, although they did notate a 4mm radke's cist (appears unlikely to be causing my symptoms based on what i've read about it).
I had another great stretch of about 7 days where I felt like myself again. I thought I was finally getting better. I had my tsh tested again and it was down to 3.8. Then I started feeling out of sync and off again, and symptoms came back as of last Wednesday. Still practically housebound, pain in hips, muscle twitching, fatigued, intolerance of working out. I can walk maybe 10-15 minutes before I start getting weak/sore.
Do you think this can all be explained by hashimotos? Is my body trying to adjust to the synthetic hormones (I'm about 8 weeks in, 5 weeks since I've switched to 100 mcg). I've read that muscle issues tend to take longer to resolve for thyroid issues. Do I likely have something else? Do I have b6 toxicity? Does my back injury have a role in this still?
Medication I've been off and on: diclofenac, gabapentin, tylenol, advil, morphine (only a few times) and of course synthroid
Attached photo: test results from recent thyroid and neurology blood pannels (within last 2 weeks)