After over a year of reactive tendinitis in both my upper and lower body, through this group I have only just discovered that thyroxine directly affects collagen synthesis (necessary for tendon repair).
It's been so disheartening getting nowhere with my physical discover, despite rest and physio, if only there had been some internal communication between departments.
Hopefully, thanks to this new information, I am in a better position to see improvements and can get back to enjoying a more active lifestyle once again.
Thank you for posting this interesting and informative paper Huxtable . Very interesting to me as I have had Rotator Cuff and Medial Meniscus problems in the past. Also feel very 'arthritic' at the moment.
You're welcome, it's all news to me and it shouldn't be really.
In my last physio appointment, when I mentioned that I had given up almost, after 10 months of not very enjoyable recovery work and little progress, they asked rhetorically whether I was really interested in making a recovery at all, which was very upsetting and disrespectful I felt. Since reading this paper I now understand that it was a very ignorant remark to make also.
I do feel let down by the lack of interdepartmental communication and being left feeling like I just wasn't trying hard enough to physically recover, when the truth is that my T4 levels have been in the bottom 1/3 of the accepted range and my TSH has been above 4 the entire time.
Now that I am getting more clued up on optimisation (vitamins, minerals etc) plus the fact that my dose has been increased for the first time in years, I am feeling a faint sense of optimism creeping in, not just for my mental wellbeing but now for my physical problems also.
If there's room for improvement in your thyroid health management, maybe you could see some of the physical benefits from increased collagen synthesis also. Fingers crossed.
My thyroid levels are good and most of my vitamin and minerals are also at optimal levels. I have been supplementing for quite a few years now and regularly private testing. I do have back problems - mid-slip LR4 and LR5, which NHS so-called Physio has made worse, so it is back to my private Physio/Osteo. I am also on NDT, which has made so much more of a difference than being on T4/T3. I shall definitely look into the collagen. So thank you for this information.
I am also suffering with numerous & frequent tendonitis flares in elbows, knees, shoulders. My thyroid levels are adequately medicated according to TSH, T4 & T3. Are you able to advise if there is anything else I can do/take to assist with the tendon issues? I'm pretty active & these injuries restrict & get me down. I have seen a physio who without prompting suggested that there may be an autoimmune/inflammatory thing going on due to the number & frequency of injuries. She suggested oestrogen may help? I'm post menopausal, no HRT (yet)
You ever tried an exercise or foam roller before and after exercise. Before the pandemic I was going to the gym and was really getting into lifting weights.
My trainer suggested getting one as they are very good at increasing circulation, relaxing tight muscles and tissue and loosening knots of tension. They can be a tricky to use at first but I've found them very good.
A lot of top athletes and footballers use them and physios often recommend them. Be warned they can actually be quite painful if you've got a sensitive spot. You can buy them online for under a tenner. Also I've found collagen supplements can help with aches and pains from exercise.
I have Ehlers Danlos, a genetic condition where I don't make enough collagen, so I have very stretchy skin and joints, I'm what used to be called double jointed. Great when I was a gymnast, not so great as a 50 plus year old. I just use collagen powder from Amazon, whatever is on offer. And mix it with a bit of milk. Vitamin C is also responsible for good collagen levels, supplementing that might be a lot cheaper.
I understand how much of an impact tendon health can have on wellbeing, mentally and physically, tough that it's happening regularly for you.
Psychologically, although I admit this can be difficult at first, I have found it a bit easier getting through this time by developing my ability to be vulnerable and reach out to people when I need help. If there's no one in your life already that you would feel comfortable talking to, I think communities like this are great, but verbal communication can be more therapeutic. I have experienced a lot of mental anguish having gone from being able to go to the gym most days and cycling every day to living a mostly sedentary life for the past year, verbally talking to people, using helplines if necessary, have helped me through.
Physically it is harder to say. My recent T4 measured 9.6 (range 7.9 - 14.4) and TSH was 4.8 (range 0.38 - 5.33) so you can see how there might be collagen synthesis issues, being as I have had tendonitis in both arms for a year and something similar in both hips for 10 months and no recovery, despite rest and physio protocols.
If your levels are fine I'm not sure what to say, other than, if you're super active, maybe there weren't adequate initial periods of rest and recovery for the tendinitis to repair to a level where it was no longer reactive? This is my first lived experience of tendon health issues, so I'm mindful of what I say, but the general gist of the recovery work I have been doing in the gym is about finding optimal load for tendon repair, which is a much lesser load in my experience compared with standard strength training.
What is your FT4 and FT3 like ? From my own experiences having high FT4 caused me shoulder pains amongst many other symptoms eg dry mouth tired and wired etc. The Frees have a lot of clues as to why one is experiencing hypo/hyper symptoms.Best Wishes.
I'm so sorry that your Dr limits your vital thyroid markers to be tested that are so helpful for your well-being. Hypo/hyper symptoms can sometimes over lap. If you are dosing with T4 only it's still very important to test FT3 to see how well you convert your T4 to T3. Other wise you don't know if T4 or T3 is need to be added/tweaked. That is if your T4 dose is enough for your needs. You might need to add some T3 to your T4 . From my personal experiences I need enough T4 for my T3 dose. You might want to move on to a new Endo that tests the FT3 FT4 Vitamin D , B-12/folate, Iron /Ferritin.
Thanks, I think this is going to be a bit of a journey of discovery and may take time for me. I am an NHS patient in the UK, not a private one, so the there may be some limits on what kind of information I can get access to. I am grateful to have experienced at least some benefit so far, simply by adding a high quality B12 supplement to my daily regime. In my last conversation with a GP I was told that having a TSH level of 4.8 was fine, which makes me unsure of how well doctors understand thyroid health.
I managed to secure a 25mcg thyroxine increase (which I am only now, having educated myself, taking fasted and without other meds/caffeine) and have been put on 200mg ferrous sulfate daily, how soon do you think I should be asking to have bloods retested?
yes , a bit more communication (and curiosity) between different specialisms in medicine would be good.. and no doubt save the NHS a ton of money.
The lack of education of GP 's on the subject of thyroid hormone actions in ALL tissues is a big problem.... as is so much of the research data since about the 1980's ? , when TSH test became the dominant method of diagnosing and monitoring thyroid treatment...and so there are loads of research papers suggesting 'thyroid isn't associated with 'x' because it included people like you who's 'treated' TSH was 3/4...they are then included in the euthyroid group because their TSH ( the only thing recorded) was 'in range' .. when in fact their hypothyroidism may not have been adequately treated at all... so sub-optimally treated hypothyroidism could actually have been associated with whatever the research was looing at.
I have read this article before and even mentioned it to my earlier Endo’s after my thyroidectomy because I suddenly developed debilitating tendonitis throughout my entire lower body and they didn’t even flinch all they said its not related your adequately replaced your blood test say so. I ended up later on seeing and orthopedic for sudden horrendous knee pain and Achilles Tendonitis and was told my xray on Achilles shows spots of calcification and still the Endo’s did nothing with this information and I have suffered with debilitating tendon issues for the past 5 years….I’m much better today but Im on 2 biological drugs to make this happen because I was also diagnosed with PSA that also attacks tendons double disaster.
Im going to print this out for my current Endo who I never mentioned this to before and Im sure his reaction will be the same!
This disease has ruined my health and the doctors don’t even care all they see is $$$$ when they see me ….. Can’t make money on a healthy person!
This is madness, sorry you've had to go through all that. Saw my physio yesterday and asked whether she was aware I had a thyroid condition and she said yes. When I mentioned the fact that poor thyroid function prevents proper collagen synthesis, necessary for effective tendon repair, she said that this was something she did not know anything about and didn't want to comment. This is the same person that questioned my commitment to recovery when I said I felt like giving up after 9 months of following unsuccessful rehab protocols..
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