Hands and Feet pain

[jjames66]

ive got an under active thyroid. Is it common to get painful hands and feet in the hot weather

[SlowDragon Administrator]

Sore feet and plantar fasciitis common if under medicated

Carpal tunnel wrists also

How much levothyroxine are you currently taking

How long on this dose

Do you always get same brand levothyroxine at each prescription

Do you have recent thyroid and vitamin results you can add?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies

Do you have autoimmune thyroid disease?

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally before 9am and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

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

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/wp-content/up...

[Jomo2021]

I had sore hands and feet and joint pain in a range of joints. When it didn’t clear up on the full dose of Levo the GP referred me to rheumatology and it turns out I have psoriatic arthritis- another autoimmune condition. I would mention it to the GP

[Batty1 in reply to Jomo2021]

I developed psoriatic arthritis after my thyroid was removed …. What a living nightmare!

[Hidden]

Burning feet was one of my first symptoms. It has definitely got worse in the heat.

[helvella Administrator Thyroid UK in reply to Hidden]

When people post about the feeling of burning, especially of feet, I quite often post this link.

It is getting on a bit but nonetheless it does give an overview of the causes of burning feet.

Burning feet syndrome

racgp.org.au/getattachment/...

racgp.org.au/afp/200312/200...

The following might also be of interest:

Burning Feet

webmd.com/diabetes/burning-...

Riboflavin (vitamin B-2) and health

academic.oup.com/ajcn/artic...

[Batty1 in reply to helvella]

I have burning tops of my feet diagnosed by neurologist with small fiber neuropathy without a cause (still laugh at this) no cause really… Im not diabetic “yet”.

[SarahJane1471]

Thanks for this helvella this is really interesting as it kind of links to my post about buzzing veins and radd link to small fibre neuropathy. I’m stop my b complex to see it it helps….. I also have burning feet…… but the article mentions bvit deficiency as a possible cause 🤦‍♀️All very complicated isn’t it 🤷‍♀️

[helvella Administrator Thyroid UK in reply to SarahJane1471]

I think the B vitamin of possible concern is B6 - and the precise form (vitamer) might well be of importance.

Some time ago, I mentioned that the form in which we take vitamin B6 is important. I think I linked to this paper:

Toxicol In Vitro . 2017 Oct;44:206-212.

doi: 10.1016/j.tiv.2017.07.009. Epub 2017 Jul 14.

The vitamin B6 paradox: Supplementation with high concentrations of pyridoxine leads to decreased vitamin B6 function

Misha F Vrolijk 1 , Antoon Opperhuizen 2 , Eugène H J M Jansen 3 , Geja J Hageman 4 , Aalt Bast 4 , Guido R M M Haenen 4

• PMID: 28716455

• DOI: 10.1016/j.tiv.2017.07.009

Abstract

Vitamin B6 is a water-soluble vitamin that functions as a coenzyme in many reactions involved in amino acid, carbohydrates and lipid metabolism. Since 2014, >50 cases of sensory neuronal pain due to vitamin B6 supplementation were reported. Up to now, the mechanism of this toxicity is enigmatic and the contribution of the various B6 vitamers to this toxicity is largely unknown. In the present study, the neurotoxicity of the different forms of vitamin B6 is tested on SHSY5Y and CaCo-2 cells. Cells were exposed to pyridoxine, pyridoxamine, pyridoxal, pyridoxal-5-phosphate or pyridoxamine-5-phosphate for 24h, after which cell viability was measured using the MTT assay. The expression of Bax and caspase-8 was tested after the 24h exposure. The effect of the vitamers on two pyridoxal-5-phosphate dependent enzymes was also tested. Pyridoxine induced cell death in a concentration-dependent way in SHSY5Y cells. The other vitamers did not affect cell viability. Pyridoxine significantly increased the expression of Bax and caspase-8. Moreover, both pyridoxal-5-phosphate dependent enzymes were inhibited by pyridoxine. In conclusion, the present study indicates that the neuropathy observed after taking a relatively high dose of vitamin B6 supplements is due to pyridoxine. The inactive form pyridoxine competitively inhibits the active pyridoxal-5'-phosphate. Consequently, symptoms of vitamin B6 supplementation are similar to those of vitamin B6 deficiency.

Keywords: Neuropathy; Neurotoxic; Pyridoxine; Supplements; Vitamin B6.

Full paper is, unfortunately, behind a paywall:

pubmed.ncbi.nlm.nih.gov/287...

In the paper, they define mega doses as > 50. And the low doses at which negative effects have been noticed being as little as 2. The conclusion of the paper says:

In conclusion, the present study strongly indicates that the neuropathy observed after taking a relatively high dose of vitamin B6 supplements is due to the vitamer that is used in the supplements, namely pyridoxine. The inactive form pyridoxine competitively inhibits the active pyridoxal-phosphate. As a consequence, the paradox arises that the symptoms of vitamin B6 supplementation are similar to those of vitamin B6 deficiency. Vitamin B6 supplements are used by a large number of people. The safety of vitamin B6 is debated and recently EFSA has lowered the upper limit for vitamin B6. The question is whether lowering the safe dose for vitamin B6 is the solution. Remarkably, even at relatively low dose, vitamin B6 supplementation has given rise to complaints. Our study indicates that the toxicity of vitamin B6 is not only determined by the dose, but by the vitamer in which it is taken. Perhaps it might be better to replace pyridoxine by pyridoxal or pyridoxal-phosphate as vitamin B6 supplements, which are much less toxic. In this way, the vitamin B6 paradox may potentially be prevented.

I'd rather play safe and avoid any pyridoxine in supplements.

[SarahJane1471 in reply to helvella]

As always you come up with great info. So does Thorne basic b have pyridoxine?

[helvella Administrator Thyroid UK in reply to SarahJane1471]

Here's the label from an advert/website:

Label from Throne Basic B

[SarahJane1471 in reply to helvella]

Is pyrodoxal the same as pyridoxine?

[SarahJane1471 in reply to SarahJane1471]

I’ve answered my own question 🤦‍♀️🤣. The study suggests using pyridoxal as it’s less toxic. But I may try without for a while and see if it stops SFN and burning feet