Fasciculations in both legs

[Airmed]

Hi,

Have been on T3 mono 40mcg per day (45 in winter) split into 3 doses since 2011. Have had no problems only benefits. Started with muscle twitching, fasciculations in both legs around a month ago. GP carried out a multitude of blood tests. Of course my TSH is suppressed at 0.04, free T3 is 4.3 range 3.9 - 6.8. Last dose T3 taken 3 o’clock day before bloods at 08.40.

B12 = 433 range 180 - 2000

Folate = 8.43 range 3 - 20

Ferritin = 151 range 13-150

GP has suggested that I drop 5mcg of T3 to see if this is the cause with possibility of reducing further. I have told her will drop 5 but reluctant to drop further due to SVTs which stopped from almost daily while taking T4 to very occasionally on T3.

Having bloods repeated in 6 weeks to see if any change

Has anyone got any experience with this or advice please. Thank you

[TaraJR]

I had these before I started T3. At every dose increase or decrease I've never noticed a change in them.I used to take antihistamine often (the old type that make you sleepy) to help me sleep better. I haven't taken any antihistamine since early August, and my fasciculations have gone to almost nothing.

Think I've read that they can be caused by low B12, or maybe low ferritin/ iron. Someone else will know.

I'd be very reluctant to reduce T3 to try, as it's sometimes hard to get an increase prescribed again..

Oh another thing I've noticed.. i use my laptop on my lap. It's quite heavy, not like a tablet. That definitely has an effect on my legs.

[Airmed in reply to TaraJR]

Fortunately on winter dosage so happy to accommodate. First sniff of SVTs and that’s it. I don’t like taking any meds and thought I had experimented well enough to get it balanced, hence the need for a slight tweak in the winter months. GP seemed ok with that to be fair. But I do understand where you are coming from. We’ve all been through the mill regarding T3 especially mono and a natural distrust of their motives.

[humanbean]

I would suspect low magnesium and/or low potassium but there are other possibilities.

The worst fasciculations I ever had occurred on a day I was having severe chest pain and ended up in hospital with a suspected heart attack. Lots of blood tests were done including potassium, and I got a copy of my blood test results (lucky me - I did have to ask) at the time I was discharged (no heart attack). It turned out my potassium matched the bottom of the reference range. It has never been that low before or since.

I think the chest pain I was having was caused by low potassium. After all the heart is a muscle too.

I take potassium bicarbonate powder as a supplement sometimes - a level quarter of a teaspoon in orange juice to disguise the taste.

Improving magnesium has also helped muscle spasms, twitches and cramp too. I take magnesium citrate powder in orange juice too, but there are quite a few options for magnesium supplementation.

There are other possibilities - low iron/ferritin (iron stores), low vitamin D, low sodium (i.e. salt)

Some links mainly about potassium that may be of interest :

drmalcolmkendrick.org/2013/...

en.wikipedia.org/wiki/Elect...

academic.oup.com/eurheartj/...

forums.phoenixrising.me/thr...

youtube.com/watch?v=8kI98hD...(Not working as expected?)

Problems caused by low sodium :

healthunlocked.com/thyroidu...

academic.oup.com/eurheartj/...

Links about magnesium :

drjockers.com/best-magnesiu...

afibbers.org/magnesium.html

[Airmed in reply to humanbean]

Thank you for info. Lab didn’t test for manganese. Not sure why but will ask GP after repeat. Said on results ring lab if you want us to test as holding sample which seems rather silly to me. Will have a look at this

[humanbean in reply to Airmed]

Magnesium and Manganese are two different minerals. I know nothing about manganese. I was writing about magnesium.

There is no point in testing magnesium. If you look at Table 2 in this link :

ncbi.nlm.nih.gov/pmc/articl...

it shows you how magnesium is distributed in the body. Less then 1% of the body's magnesium is in the blood stream. The body prioritises magnesium in the blood and will steal it from elsewhere if the blood levels run low.

So, someone with enough magnesium in the blood could still be deficient in the soft tissue, the bone, the muscles...

It is safe to supplement magnesium without testing as long as the doses are sensible and the kidneys function adequately so they can expel any excess.

[Airmed in reply to humanbean]

Thank you. Not sure what GP wanted manganese tested for. Good to know about magnesium though.

[greygoose in reply to Airmed]

Perhaps he confused manganese with magnesium. They know nothing about nutrients, and tend to get confused.

[SlowDragon Administrator]

Last dose T3 should have been after 8.30pm night before test

On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test

If anything you might need dose increase in T3

Have you tried adding small dose levothyroxine alongside?

Eg starting on 25mcg

What vitamin supplements do you take

B12 and folate need improving

No vitamin D?

Are you supplementing vitamin D with K2 and magnesium?

[Airmed in reply to SlowDragon]

Thank you for info.

I don’t take any supplements apart from Vit D prescribed by endo for osteopenia.

[SlowDragon Administrator in reply to Airmed]

How much vitamin D

What was most recent result

Aiming for vitamin D at least over 80nmol

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

2 good videos on magnesium

healthunlocked.com/thyroidu...

[Airmed in reply to SlowDragon]

Wow. Some serious reading to be done. Thank you for info. I take 800iu per day. Haven’t tested for it but will ask for it to be done. Should do on NHS as Vit D on script due to osteopenia.

[SlowDragon Administrator in reply to Airmed]

Highly unlikely high enough dose vitamin D

That’s a dose for a well mouse 🐁

Test and see what your current level is