Could thyroid be the cause of foot and ankle edema?

[Panya]

Hi, I am getting quite worried about increasing swelling of my feet and ankles and just wonder if it could be related to my hypothyroid condition. Does anyone else have experience of this?

I have had a tendency to swollen ankles for 20 years but some years ago was told my heart and kidneys and leg valves were fine and that it 'could be any number of conditions'. In other words, I have no idea what causes it. It is getting worse though.

I was diagnosed hypothyroid 4 years ago (though I think I was developing it at least 10 years previously) and am currently on 100 Mg Levothyroxine.

Awaiting recent thyroid blood tests but they've always been mid-range and considered fine.

I am going to go to the doctor about the swelling but it would help if I had foreknowledge about whether my thyroid condition could be related. Obviously I am wondering if upping the T4 could maybe help. Or whether I may need to get my T3 checked?

While I'm here..... I am puzzled by why - if my T4 levels are fine as the Doctor says, my daily body temperature is still way below normal. Seems odd?

[TiggerMe Ambassador]

A full thyroid panel is the way to go, low core temperature suggests you may have low fT3 due to low conversion possibly because of low iron, Vit D, B Vits etc or DIO2 gene

We have chatted about mucin here... healthunlocked.com/thyroidu...

[Buddy195 Administrator]

When medics say ‘fine’, ‘within range’ or ‘normal’ you need to be mindful that this may not be ‘optimal’. Definitely look to test FT3 and FT4 in addition to TSH, plus key thyroid vitamins ferritin, folate, B12 and vitamin D. When you have the results post them in the forum for comment and advice, adding ranges in brackets (as these can vary between laboratories)

[greygoose]

What is mid-range? If it's your FT4, then you probably need an increase in dose, because most hypos need it higher than that. If it's your TSH then you are very under-medicated. The idea of thyroid hormone replacement is to bring it down to 1 or under. Always best if you can give us the exact numbers: results and ranges.

I've probably been hypo since I was about 8 years old, and had swollen feet/ankles/calves for most of my life. It is more than likely due to thyroid because doctors have never been able to find any other cause. And water-retention is a common hypo symptom. Even when treated optimally - i.e. all other symptoms have gone away - it can be difficult to get rid of the water-retention.

am puzzled by why - if my T4 levels are fine as the Doctor says, my daily body temperature is still way below normal. Seems odd?

Not odd at all. Sometimes temperature control never returns to normal and body temprs remain low. No-one ever believes I have a fever because that's when my temperature is what they see as normal. Otherwise, it's low!

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[jgelliss in reply to greygoose]

GG your Spot On. Thank you for confirming what I personally went through as well for years without Dr ever diagnosing me with thyroid issues.

[waveylines]

Swelling of my feet and ankles is usually a sign I'm a little under treated for my thyroid. I need my thyroid hormone levels (ft4 & Ft3) to be in the top third, Ft3 higher still to feel well and to avoid feet swelling. I tweaked my dose not long ago and found myself running to the loo for a days or do... Clearly needed the increase! You can check your thyroid hormone levels with a home testing kit that you send off to the labs. Details on Thyroid uk website.

One proviso, in very hot weather towards the end of the day I still get some swelling. I think that's heat related, not thyroid.

[SlowDragon Administrator]

Suggest you get FULL thyroid and vitamin testing done

If results are “mid range “ you’re likely not on high enough dose levothyroxine

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

 

For full Thyroid evaluation you need TSH, FT4 and FT3 tested 

Also both TPO and TG thyroid antibodies tested at least once 

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 

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 

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 that all thyroid blood tests early morning, ideally just 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...

Only do private testing early Monday or Tuesday morning. 

Link about thyroid blood tests

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

Symptoms of hypothyroidism 

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

Tips on how to do DIY finger prick test 

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee 

And consider trying dairy free…..this might reduce leg swelling

[bellk]

my ankles are no longer puffy since been on good dose of Liothyronine, had been puffy for years.

[Bertwills]

Definitely a symptom for me before I raised my T3 with liothyronine. Recently I noticed that my ankles were swelling again in the evening., I raised my dose by 5mcg & the swelling has gone away.

I’ll be testing with Medichecks again soon to check but I think that I needed an increase as I’d stopped taking LDN for awhile. LDN boosts the effectiveness of thyroid hormones for many.