Muscle twitches and spasms in lower legs

[Lindsey13]

I had Graves and a PT 30 years ago. I had a good 25 years on 100 Levo. I was then changed 88 Tirosint and for the past three years have been fine. This year, however, I have had periods of being hypo (as confirmed by bloods) Now my bloods including calcium/vitD are ‘normal’ but I have the most annoying muscle twitches as well as aches up my shins (same as you get when you exercise too much) However the most alarming symptom is the occasional spasms up the fronts of both my shins. My hands are usually cold and I am now suffering from awful anxiety.

[jimh111]

You need the actual blood test results rather than being told they are 'normal' as most people on levothyroxine need a TSH that is in the lower half of its reference interval.

Try supplementing with magnesium as deficiency can cause muscular spasms. A good form is magnesium citrate, there are others, magnesium oxide and hydroxine are no good. Hypothyroidism leads to lower intracellular magnesium levels, this cannot be measured in a blood test. So, make sure you are on an adequate dose of levothyroxine as judged by your signs and symptoms as well as TSH, fT3, fT4.

[Lindsey13 in reply to jimh111]

Hi, my TSH is very low and has always been - 0.17 (due to my PT I think) My most recent FT4 is 1.4 and FT3 is 2.7

[Lindsey13 in reply to Lindsey13]

Calcium total

Was 9.4 (8.4 a 10.2) Magnesium 2.2 (1.6 - 2.3) TGab 15.31 (less than 4) Vitamin D 116 ( 75 - 250)

[jimh111 in reply to Lindsey13]

What are the reference intervals for these results?

Ignore the Mg result, magnesium blood tests do not reflect intracellular levels and so are of little value. The best test for magnesium is to supplement for a few months and see if it helps.

[Lindsey13 in reply to jimh111]

Many thanks! The ref levels are in brackets. Will try the supplements

[Lindsey13 in reply to Lindsey13]

Sorry, the ref levels for the FT3 are 2.7 - 5.27. FT4 are 0.78 - 2.19

[jimh111 in reply to Lindsey13]

I should have specified, I had a bit of tunnel vision and focussed on fT3, fT4. Your combined fT3, fT4 are rather low. I know your TSH is lowish but sometimes the pituitary doesn't perform as well as it should do. I would ask for enough levothyroxine to get your fT4 around the upper quartile and see if your fT3 comes up. At the moment it looks like you are a bit under-medicated and this will affect your intracellular magnesium levels.

The proof of the pudding will be if your hormone levels are a little higher and magnesium supplementation resolves your muscle twitches.

Your doctor could do a Chvostek Sign test to assess your magnesium status, they can wear a glove so there shouldn't be COVID worries.

[SlowDragon Administrator in reply to Lindsey13]

Your Ft4 and Ft3 are both very low

Have you had dose increase in levothyroxine

[Lindsey13 in reply to SlowDragon]

No. I think the doctor believes that because my TSH is low, then I’m fine

[jimh111 in reply to Lindsey13]

Your pituitary is not responding adequately to your lowish fT3, fT4 and so TSH cannot be used as a marker of thyroid status. Your doctor needs to look beyond the TSH. TSH can be very useful but it is not always reliable.

[jgelliss]

It can be very debilitating your symptoms. From my experiences when I had muscle twitches/spasms even if my calcium tested fine I still needed to add a bit more calcium /magnesium/boron and B-12 to feel my symptoms resolve. Do you also take some Mineral Complex ?

Wishing you fast resolutions.

[Lindsey13 in reply to jgelliss]

I am about to start. Thanks so

Much

[jrbarnes]

This is my current situation except that my T4 levels are 1.7 and T3 is 2.6, same reference ranges as yours. My TSH dropped from 1.4 to .76 so that TSH is not a reflection of what's going on. My Dr also didn't give me an increase. He wanted to decrease. If you can find another Dr it may benefit you. I started having spasms in my neck, twitching, peripheral neuropathy, carpal tunnel, toe pain, lifting toenails.

[Lindsey13]

Did you increase or decrease?