Shoes that help???

[Loobs39]

I have found over the past few weeks that my legs ache more than usual. I had a partial knee replacement 14 weeks ago but have recovered remarkably well so I can't see how it can be that (especially as it effects both legs). I can walk 3 or so miles a day but my legs ache terribly afterward, specifically lower legs and also the soles of my feet. I am taking all relevant medication (low thyroid) so Thyroxine, Vit B12, Selenium etc. - all the things that help so cannot see that I am deficient in anything. I am now wondering if it could be my footwear. I am wearing gym type shoes (Sketchers) as anything too firm is uncomfortable - they are comfortable and reasonably well cushioned but I am considering buying a pair of shoes specifically to help with leg pain. However, they are extremely expensive - has anyone bought these and did they help??

[Marz]

I have Vionic insoles - expensive but help my walking. Am sure there are other good orthotics that are less expensive. 3 miles of walking sounds great - I am envious - have just done 20 minutes and I need to gather my spoons before my next task 🧘‍♂️

[SlowDragon Administrator]

You didn’t mention vitamin D

Have you had vitamin D tested

Are you supplementing?

[Loobs39 in reply to SlowDragon]

Sorry yes, I do take Vit D and have been for some years. I am having a phone consultation with the GP this afternoon as I cannot get any further Levo without it!! I am wondering if it is possible that at 75 mg (or whatever the quantity is) of Levo is too low although I have no other symptoms apart from occasionally feeling cold - I am tempted to ask for an increase to 100 although it would simply be to see if my leg aches go - is that a symptom of under-medication?? I have been on Levo for 5 or 6 years, on 75 mg for 2 years?

[SlowDragon Administrator in reply to Loobs39]

Well 75mcg is only one step up from starter dose

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

When were thyroid levels last tested?

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

Do you have Hashimoto’s?

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

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...

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

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

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

List of hypothyroid symptoms

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

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

If not tested vitamins for 6 months it would be good idea to test

[Loobs39 in reply to SlowDragon]

My last test was June 2019. However I very stupidly took my levo the night before and the draw was at 8 in the morning (testing cholesterol as well). TSH 0.29 (0.3 - 5.6)

and T4 13.8 (6.3 - 14.0). Based on these results I had to fight to stay on 75 and not be reduced to 50!!!

I do have Hashimotos, Perniscous anaemia, Lichen Sclerosus and Arthritis so basically the full set.

One thing that was (and always is) low is my ferritin 56 (11.0 - 307) but I do struggle to raise this. I have just had my B12 jab (3 monthly) so not the PA and my Lichen sclerosus seems to have completely gone?? I cannot believe that it is simply age (I am 64) and it breaks my heart as I love walking and was so thrilled to manage after my knee replacement. I don't think the ache is arthritis as it isn't simply joints, it is my legs generally?

[SlowDragon Administrator in reply to Loobs39]

Absolutely essential to regularly retest vitamin D ....sounds like ache caused by low vitamin D

With Hashimoto’s we frequently need high dose vitamin D even as maintenance dose

How much vitamin D do you take?

Do you supplement magnesium too?

Hashimoto’s, arthritis and lichen planus all frequently respond well to strictly gluten free diet

Are you gluten free?

Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten intolerance. Second most common is lactose intolerance

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find strictly gluten free diet reduces symptoms, sometimes significantly. Either due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test, or buy test online BEFORE trying strictly gluten free diet

Assuming test is negative you can immediately go on strictly gluten free diet

If coeliac test is positive you will need to remain on high gluten diet until endoscopy, with maximum 6 weeks wait, officially

Trying strictly gluten free diet for 3-6 months

If no noticeable improvement, reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

[Loobs39 in reply to SlowDragon]

I have been gluten free for 5 years or so. I had to stop eating it as it had started to make me ill (looking back I had had a problem with it for years but it slowly got worse) to the point where I lost loads of weight and was too scared to eat anything because food made me ill. I take loads of supplements - Vit D, Selenium, Magnesium, Zinc plus fish oil capsules, turmeric (Golden Paste - I make it myself) so really cannot think what it could be. Just had my phone consult with GP and need to arrange another blood test for this week so I will ask to get ferritin and Vit D tested too. I will not take levo for the 2 days before but take a dose straight after the test. I'll post the results here if that's OK?

[SlowDragon Administrator in reply to Loobs39]

Only leave 24 hours between last dose levothyroxine and blood test

Always test as early as possible in morning before eating or drinking anything other than water

Yes come back with new post once you get results

[Marz]

Yes ! Some better than others according to shape !

[Loobs39]

OK got my blood test results

T4 12.8 (6.3 - 14)

TSH 0.48 (0.3 - 5.6)

Ferritin even worse than last time 47 (11 - 307) so now taking daily supplement.

Does this look OK for 75 mg of levo??

By the way, bought some Sketchers walk shoes (like wearing carpet) - really comfortable!!