Joint pain in fingers

[forestgirljo]

I m on levothyroxine 100mg daily and have been for about 4 years now. It has suited me well but I have started to get swollen and painful knuckles. I have also had a creaky left knee for some time now. Has anybody else had joint problems or know if this can be a side effect of medication? I am very active and like to exercise regularly.

[Lora7again]

You said 100mcg suits you but that is quite a low dose and my elderly Dad takes that amount but I do realise everyone requires different amounts of Levothyroxine.

Do you have any blood tests to share with us? We need TSH, T4, T3 and antibodies. Also any vitamin levels you might have B12, Iron and Ferritin, Vitamin D and Folate. This would give us a better idea of what is going on.

[forestgirljo in reply to Lora7again]

I will look into testing as due now 🙏

[shaws Administrator in reply to forestgirljo]

When testing remember to allow a gap of 24 hours between last dose of levo and test and take it afterwards. This helps keep the TSH at its highest and may prevent a reduction in dose. and hopefully you might get an increase in hormones.

I'm sure you are aware of the following in order to get the best results:-

The earliest blood draw (fasting) you can drink water.

Alow a gap of 24 hours between last dose of levo and test and take afterwards. You also need a Free T3 as wel as a Free T4 blood test as these are more informative than T3 and T4 on their own.

[Lalatoot]

Fluid can collect in the soft tissue. When undermedicated I became very stiff in several knuckle joints and my left knee. Maybe it is time to look at blood results and see if you need more levo

[SlowDragon Administrator]

Do you always get same brand of levothyroxine at each prescription?

When were levels last tested?

Add results and ranges if you have them

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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

What vitamin supplements are you currently taking?

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood 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)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

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

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

[forestgirljo in reply to SlowDragon]

Thankyou, I will look into testing as I am due now although not sure how it will work with all this going on. 🙏

[SlowDragon Administrator in reply to forestgirljo]

Medichecks have added small extra cost to test to include tracked postal return...as post is currently pretty slow

Only do test early morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test...and only do test on Monday or Tuesday

Come back with new post once you get full results

[MTC1 in reply to SlowDragon]

Thank you for the testing sites

[Marz]

Swelling in joints can indicate inflammation - also under treatment. Inflammation can often start with gut and gut issues can stem from Low T3. So how are your VitD levels and how is your T3 level ?

Am only speaking from experience - I am nor a medic 😷

[forestgirljo in reply to Marz]

Thankyou for your response 🙏 my vit D levels were borderline and I was prescribed tablets which I took for a couple of years. My levels were checked last summer and were fine so I stopped taking tablets (I also spend a lot of time outdoors). My t 3- I have never understood any of it. I did once get a print out from my drs of my results which they seemed reluctant to do but there was no mention of t3 on there. Is it under another heading? 😫

[Marz in reply to forestgirljo]

T3 is the most important test as it is the active hormone needed in every cell of your body. Rarely tested by the NHS. Are you able to have Private Testing through thyroiduk.org and click onto ABOUT TESTING to learn more. Also lots more information about understanding the thyroid.

You are legally entitled to copies of all your test results. Ask at Reception - you do not have to give a reason.

Borderline VitD is not optimal ! Your level is good around 100+

The tests you need are - TSH - FT4 - FT3 and anti-bodies TPO & Tg . Also B12 - Folare - Ferritin - VitD.

[SlowDragon Administrator in reply to forestgirljo]

NHS rarely if ever tests Ft3...yet it’s most important result of all

Levothyroxine is Ft4. Ft4 has to be converted in gut and liver and cells into Ft3. We need optimal vitamin levels for good conversion

Low Ft3 is common problem on only levothyroxine

Low vitamin D is extremely common and if you have not continued to supplement likely levels have dropped.

With autoimmune thyroid disease, aka Hashimoto’s, we nearly always need to supplement vitamin D continuously. We either need more or can’t make enough

If cost is an issue ...suggest you start with just retesting vitamin D

When supplementing should Test twice yearly via

NHS postal kit test

vitamindtest.org.uk

GP will only prescribe to bring levels to 50nmol.

ouh.nhs.uk/osteoporosis/use...

But with Hashimoto’s improving to around 80nmol or 100nmol may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamins

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

ncbi.nlm.nih.gov/pubmed/286...

Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

endocrine-abstracts.org/ea/...

Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.

Simple film outlining the basics

drbradshook.com/understandi...