Broken wrist and plaster cast

[Fleur2016]

Hello. I was diagnosed with Hashimoto’s around 12 weeks ago. Feeling better with meds but I fractured my wrist on Easter Monday. It’s in a cast and when it is put on it’s ok but a couple of days later it feels loose. I do find my hands are cold and my doctor is monitoring me for raynauds but said it’s likely my Hashimoto’s causing my cold hands. I have more blood tests in 4 weeks. Did any one else have this problem if in plaster and what did you do? I am in plaster for 3 weeks initially then having a CT scan. Thanks.

[overunbykids]

19 months ago i fell and severed ligaments on both sides of my ankle, had bone bruising as well as damaged tendons. I could not move my foot at all and it dropped into an inverted position. I developed chronic regional pain syndrome in my foot and was supposed to be put in a fiberglass cast from knee down for 2 months. It had to be cut off twice and replaced as it became so loose over the first month as I was rubbing raw patches all over, and yes, my foot got really cold, too. My Ortho specialist at the fracture clinic ended up placing me in a camboot instead. I had to wear it for the next 7 months but spent 15 months all up in rehabilitation therapy. I still to this day suffer pain daily, and limp badly with each step on my worst Hashi days. I am not sure how much of that loosness of the casts was due to hashimotos, or just from normal swelling going down after my injury as I slowly healed. All I could do for the cold foot was heat packs and thick large socks

[SlowDragon Administrator]

Are you still only on 25mcg of Levothyroxine?

Bloods should be retested 6-8 weeks after each dose increase

Standard starter dose is 50mcg Levothyroxine unless over 50 years old

Essential to test vitamin levels too. Extremely common with Hashimoto's for vitamin levels to be very low

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many people need a TSH well under one) and FT4 in top third of range and FT3 at least half way in range

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw). This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

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

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Medichecks currently have an offer on until end of May - 20% off

thyroiduk.org.uk/index.html

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

NHS guidelines on Levothyroxine including what foods to avoid (note recommended to avoid calcium rich foods at least four hours away from Levo)

nhs.uk/medicines/levothyrox...

NICE guidelines

cks.nice.org.uk/hypothyroid...

The initial recommended dose is:

For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response.

The usual maintenance dose is 100–200 micrograms once daily.

[Fleur2016 in reply to SlowDragon]

Hi,

Thanks for replying. I am on 25 one day and 50 the next. Will go on to 50 each day next my gp is keen to do things slowly which although it’s frustrating I am just glad I feel better. I feel so much better already and being gluten free for 9 weeks is helping. It just shows me how rubbish I have been feeling. My plan is to see her for my next blood test and see my gp. She did a full blood work including vitamin check last time and showed me the results and all ok. She only checked TSH which I know is not good enough so I asked for full tests again this time. As they had done all the thyroid tests last time I thought they would again. If she doesn’t I will go private as although my TSH was 4.7 originally it was my antibodies that worried me at 1000 (range under 200). My TSH was 3.5 on 25mg.

[SlowDragon Administrator in reply to Fleur2016]

You are legally entitled to printed copies of your blood test results and ranges.

UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Vitamins may be within range, but that's not the same as optimal

Vitamin D at least around 80nmol and around 100nmol may be better. GP will say anything over 50 is fine

B12 -most hypothyroid patients need B12 at least over 500, possibly higher. Range is typically 210-750. Anything under 500 may cause symptoms

Folate, similar - needs to be near top of range, frequently bumping along bottom

Ferritin - post today all about this

healthunlocked.com/thyroidu...

TSH should be under 2 on Levothyroxine, many patients need it significantly under 1

Unless you are over 60 years old and other complex medical issues GP is being over cautious

[Fleur2016 in reply to SlowDragon]

Thank you. I will ask her when I see her. I looked at the NICE guidelines and saw they are supposed to be lower on levo.

[MaisieGray]

When you say that your GP is monitoring you for Raynaud's, do you mean that you have it already diagnosed and he's investigating further into primary/secondary, autoimmune/non-autoimmune, causation etc; or monitoring you to decide if you have it? If the former, then there are specific investigations to be carried out, it's not just a case of passive oversight; if the latter, it should be straightforward enough to diagnose from a single consideration of your symptoms. I've had it for 51 years now, and speaking only from my own experience of course, have never known it to change the size of my hands/wrists or feet/ankles, at least such that it's been noticeable. Even at its worst, (it temporarily abated during, and became slightly less severe after each pregnancy) and it was really severe (it also affected my nose, and nipples but not my tongue, and I'd often fall over due to no feeling in my feet) the effect of blood restriction has only ever been in fingers and toes and not the body of my hands and feet such that it would affect a plaster cast. Others might have had a different experience though.

[Fleur2016 in reply to MaisieGray]

Thank you. No tests she wants to sort my thyroid first but thank you for the information,

[fibrolinda]

After I was diagnosed with Raynaud's I was told the fleshy part of my hand, above wrist on little finger side, showed classic Raynaud's...… little red blotches all over, very clear to see. Whether true or not I don't know 🙂 but got them I do,

[SianJane01]

Hi. If your cast is loose you should get a new one as it wont be supporting the bone. I have autoimmune hypothyroidism and broke my wrist badly so needed surgery and a metal plate inserted in my wrist. During the 6 weeks of wearing a cast I had it replaced six times! Mostly as I was in a lot of pain after the surgery and with the scar. I phoned the hospital plaster clinic each time I was in pain when the cast loosened and hurt my scar (think as swelling subsides) and they happily changed it each time. Hope you feel better soon x

[Fleur2016 in reply to SianJane01]

Thank you for replying. I am going to ring Friday. It’s been changed once already and they said to call if it loosened. I have to go to my dads first oncology appointment with him tomorrow which will take all day as I have a 3 hour train ride each way. Thank you for posting I am glad it’s not just me with a loose cast.

[SianJane01]

Hope you can get it changed soon. That’s what the plaster clinic are there for so don’t worry about asking for a new cast x