Frequent injuries when exercising.

[beh1]

I have been hypo for about 10 years, currently on 75mcg levo, and 10mcg lio but drop to 5mcg twice a week, otherwise my heart rate goes up from 60’s to 90’s. TSH 0.01, FT4 16.1, FT3 4.6, both 41% through range. Vit D 85.

I find if I do even pilates, ligaments and bursae get easily inflamed. Eg an ankle the physio said would take two weeks to improve is still lingering a year later. I end up with multiple irritable joints from simple stuff, when I used to be able to exercise freely.

Do people think this is thyroid or just age related? Or vitamin related? As stated above, if I try to increase my dose, my heart goes from normal to super fast, but it’s just so frustrating to be unable to exercise without damaging myself. CRP very low, but highish ferritin(150) so could be some inflammation?

Any suggestions welcome.

[GlowCoach Administrator]

Most people on a combination dose need both FT4 & FT3 at around 70% of range.

T3 should be taken consistently every day to be effective. It works immediately and is not like Levo that is a storage hormone.

Have you tried raising Levo?

Can I ask if you are double jointed or joints more flexible than others might be? You sound like someone who might be hypermobile. See link for diagrams.

ehlers-danlos.com/assessing...

How are your B12 & folate?

What do you supplement with?

[beh1 in reply to GlowCoach]

Thanks Jaydee. I tried 85 levo and 5lio per day but I had a return of fibromyalgia type pain. Realised I needed higher lio, but just can’t take 10mcg every day without heart rate going way up etc.

folate 11.84 (3.89-19.45)

Active B12 88.9 (37.5-188)

I only supplement occasional D at 1000.

But… although not Ehlers-Danlos, I am very flexible and that might well be the issue, combined with the aging body, more worn joints, thinner ligaments. Perhaps just have to be careful etc.

[GlowCoach Administrator in reply to beh1]

If you are very flexible then its likely your connective tissues are the issue.

Have you tried going strictly gluten free? This helps many with hashimoto's. Some also need to go dairy free. This is especially true if hypermobile and may well help yor pain levels.

Your folate could be higher. You could try a good methyl B complex which would further raise B12 as well.

Slightly cheaper options with inactive B6:

amazon.co.uk/Liposomal-Soft...

Contains B6 as P5P an active form:

bigvits.co.uk/thorne-resear...

healf.com/products/basic-b-...

Explanation about the different forms of B6:

helvella.blogspot.com/p/hel...

B complex comparison spreadsheet:

healthunlocked.com/thyroidu...

[Sparklingsunshine in reply to beh1]

I have EDS and niggling injuries have definitely become an issue, if I overdo certain exercises I will pay for it. Had to give up running a few years ago as it was just too hard on my body. I stick to lower impact now like cross trainer, walking, resistance, rowing etc. Plus obviously stretching, proper warm up and cool down. I have found using a daily collagen powder seems to help.

[Sparklingsunshine in reply to Sparklingsunshine]

I noticed that when both FT4 and FT3 were below range in December I felt about 90. I was struggling to get out of the chair as my knees were hurting so much. Since these have improved my knees have stopped hurting.

[beh1 in reply to Sparklingsunshine]

Thank you for your input. I used to do aerobics, now I’m like you and do rowing, cycling, walking. If I do anything too repetitive to build up strength (eg sit to stand exercises) I pay for it.

But, collagen powder sounds fascinating! Could even help my skin if I’m lucky! What brand/ where purchased please.

[Sparklingsunshine in reply to beh1]

I bought it in my local Home Bargains so nothing fancy. I've also got some from Amazon, no specific brand. I take 2 scoops. Also I take plenty of vitamin C as that is involved in collagen production.

[Noona123]

How old are you (as you're wonder if it's age related). I note from a post 8 yrs ago that it took ages for you to be diagnosed with thyroid issues. It could be that a lack of thyroid hormone in the time leading up to being diagnosed meant your muscles weren't getting enough thyroid hormone and consequently they got inflamed. I believe I was undiagnosed for about 3 years and was practically bed ridden by the time I got Levo. I had similar achy muscle problems and 6 months after diagnosis was referred to a Rhumatologist who said I had "Hypothyroid induced myalgia'. I ached all over but he said it wasn't fibromyalgia. Since then, I have ultrasound guided steroid injections into both my hips and shoulders due to bursa problems/ tendinopathy and also one wrist. I can now do pilates again without pain. I also take T3 alongside Levo. The T3 had a miraculous effect on my fuzzy and depressed brain and also, to a lesser extent, my aches and pains. It was the steroid injections that cured them but I had to wait 6 months for an ultrasound investigation. Do you see a Rhumatologist?

[beh1 in reply to Noona123]

Thanks Noona

Yes it took years for me to be diagnosed because my TSH seemed high normal (I now realise) but not high enough to treat. When it reached about 6 they tested FT 4 which was way out of range. By that time I had given up my lovely job. I saw a rheumatologist who said not fibromyalgia (even though another doctor had said it was), and he prescribed amitriptyline which gave me screaming tinnitus. However, like you, the liothyronine thankfully helped enormously at a dose just under 10mcg.

I’m not sure my ligament pain needs injections; it’s just painful to walk upstairs, do certain exercises. There always seems another bit of me that sets off!!

Anyway, thank you for your reply. I think it’s a combo of being flexible and not coping with higher thyroid doses. Going to try supplementing B12 and B9.

[SlowDragon Administrator]

You’re not doing yourself any favours changing T3 dose

Take same dose everyday for 8 weeks then retest

You may be better splitting dose as 2 x 5mcg

Or 3 doses - 5mcg, 2.5mcg and 2.5mcg

Or try 3 x 2.5mcg per day

Meanwhile work on improving vitamin levels

[beh1 in reply to SlowDragon]

Thank you for your reply.

I already split my 10mcg dose into two. However, if I take the second dose too late, I suffer insomnia.

Unfortunately as I have mercury T3, 20 mcg tablets, it’s pretty tough to split them into 4, and impossible to split into 8 so a 2.5mcg dose won’t work. Other brands give me awful indigestion due to excipients.

What I do to even it up: if I get a larger piece I use that on my lower dose days, split if possible.

Believe me, I have tried every which way to get to my sweet spot.

I will work on vitamin levels.

[SlowDragon Administrator in reply to beh1]

I use sharp craft scalpel to cut 20mcg into 4 x 5mcg

(6.30am, 11.30am, 5.30pm and 11pm)

They aren’t always even 1/4’s ……but as I take 20mcg per day that’s easier to manage

If 1/4’s are not equal - I tend to take smaller portions afternoon and bedtime

[Afaghieh]

Hi beh1

I definitely will ask GP to do blood test for RA to be sure.

Good luck.