Further advice on solving the burning in my feet please.

[FW23]

Thank you to everyone who has previously offered advice on this website, I’m writing again in need of a little bit more advice. I followed your suggestion, spoke to my consultant, and suggested that initially raising my T4 might help. He sent a second email to my GP and on the 4th April 2024, I began an 8-week trial of 75mcg of levothyroxine. I came down with a particularly dreadful flu, so initially it was difficult to gauge any changes due to the increase of meds.

I have noticed over the past weeks that my 5pm anxiety is much better, my bouts of feeling low are less and I also have more energy. Sadly, the burning in my feet hasn’t stopped but it has lessened (but it is always better at this time of year). My feet don’t burn when I go to bed so I’m able to fall asleep and I’m managing to sleep 6 /7hrs a night. However, they are burning in the morning when I wake up and during the day if I’m in hot environments.

I’m due to see my GP this week and I should contact my consultant afterwards to have a check up. I just need some words of wisdom from you all about what I do next before I speak to them both, so that I know how to respond. Below are my blood results before and after my increase to 75mcg. My TSH is lower but my T3 and T4 don’t seem to have altered much.

17th November 2023 (50mcg Levothyroxine)

TSH 2.51 mU/L 0.27 – 4.20

T4 19.8 pmol/L 11.9 – 21.6

T3 4,0 pmol/L 3.10 – 6.80

4th April increased Levothyroxine to 75mcg

17th May 20 24

TSH 0.49 mU/L 0.27 – 4.20

T4 21.6 pmol/L 11.9 – 21.6

T3 4.1 pmol/L 3.1 - 6.80

Do you think adding T3 might stop the burning? My GP has said that they won’t prescribe T3 and I don’t think they know how to administer it, if I’m honest.

The consultant suggested 5 mgs of Thybon Henning twice a day, morning and afternoon and 50mcg levothyroxine four days a week and 25mcg three days a week. At the time I was on 50 mcg T4 daily. If I now begin taking T3 what do I do about the levothyroxine dose now that I’ve been taking 75mcg T4 daily? I have already purchased Thybon 20 Henning through my consultant. I will have to discuss and negotiate my levothyroxine dose with my GP. What do you think would be an appropriate T4 dose now? Last question, how do I introduce T3 and perhaps a change of T4 dose, should I do this all at the same time or over a few days?

Thank you in advance all for your time, expertise, and support, it's really appreciated.

[SlowDragon Administrator]

17th May 20 24

TSH 0.49 mU/L 0.27 – 4.20

T4 21.6 pmol/L 11.9 – 21.6

T3 4.1 pmol/L 3.1 - 6.80

Was test early morning and last dose levothyroxine 24 hours before test

Do you always get same brand levothyroxine at each prescription

What vitamin supplements are you taking

Looking at previous post with results your vitamin levels look reasonable (but no folate result)

healthunlocked.com/thyroidu...

Your hypothyroidism is autoimmune

Are you on gluten free or dairy free diet

[FW23 in reply to SlowDragon]

Hi SlowDragon, Yes my test was at 9am before meds. I always have the same brand. I've been taking D3000+K2 oral spary and alternating Vitamin B12 oral spray and Methyl Folate 400MCG with Thorne Basic B Complex. My GP didn't do a folate test and Medicheck didn't get a result. I've gtried to cut out gluten but I still have dairy.

[SlowDragon Administrator in reply to FW23]

Personally I would suggest it’s also worth trying dairy free too

Which brand levothyroxine are you using

[FW23 in reply to SlowDragon]

I'm taking MercuryPharma. I'll definitly try to cut out diary.

[SlowDragon Administrator in reply to FW23]

Loads of dairy free alternatives available these days

Even dairy free “cheese” ….passable on shep pie or (GF) spag Bol

[FW23 in reply to SlowDragon]

Do you think I should remain on 75mcg levothyroxine at present and try eliminating dairy and gluten before trialling T3?

[SlowDragon Administrator in reply to FW23]

I would remain on 75mcg

Retest again in another 8 weeks approximately

[FW23 in reply to SlowDragon]

Thank you, I'll discuss the options with my GP. Do you think my T4 level remaining at the very top of the range is ok.

[am111]

Have you checked your B12? Feet can burn due to this also, which is common with hypothyroidism.

[FW23 in reply to am111]

Hi am111 thanks for your reply, I did have low B12 and managed to raise it. I'm still taking B12 so don't think its that.

[am111 in reply to FW23]

Fixing low B12 is not so easy and one can have a low active B12 even while on tablets and even when the serum B12 shows normal. How much and what type of B12 do you take?

I somehow do believe that your issue is B12 related, as this is a nerve problem and nerves can get damaged due to low B12.

[FW23 in reply to am111]

Thanks for repying. My Serum Vit B12 on the 22 April was 763ng/L (160-925) and on the 7th Feb my Vit B12 - active was 132 pmol/L ( 37,5 - 188). My folate is low 14.2 ug/L (2.9 - 50). When I'm not having a blood test I take Thorne Basic B Complex and other wise I take BetterYou Vit B12 oral spray 1200ug. I'm not sure if folate has any bearing on Vit B12.

[am111 in reply to FW23]

Your active B12 is fine now, although it can go down without the supplementation, so recommended to continue. Folate is also fine and not too low. I agree that your problem is probably not due to B12 deficiency, especially since you don't have any other symptoms of it.

[Rita-D]

I had burning feet syndrome, which went away when I increased T4. My GP was clueless about anything thyroid related. I increased myself and all burning feet symptoms went away. I was struggling to sleep and couldn’t perform in my choir because I couldn’t tolerate standing in one spot for 30mins. It was awful. I do sympathise with you.

[Mishymoo22 in reply to Rita-D]

i had horrible burning feet and found it difficult to work i started taking magnesium and vitamin B complex it went away like magic

[FW23 in reply to Mishymoo22]

Hi Mihymoo22 thanks for replying. Yes it does tend to take over your life sadly. My magnesium has always been right at the top of the range or over, I'm going to continue alternating B12 oral spray and B complex. Maybe I need B12 right at the top of the range to solve the issue. Its really heartening to hear of so many members on this sight having had the same issue and solved it. All of the GPs I've seen treat me as if its never been heard of before.

[FW23 in reply to Rita-D]

Hi Rita-D sounds exactly like my issue, standing makes it worse and getting hot. I've increased my T4 to 75msg it's helped my anxiety but my feet still burn. Did your increase ofT4 also raise your T3? My TSH has dropped but my T3 hasn't moved. It's really good to know that there can be an answer to this. My present GP is actually working with me to solve it but the other GPs I've had the pleasure of meeting didn't care. Pleased for you though.

[Rita-D]

I can’t remember. I don’t think it did because I’m now on Combination therapy because I’m heterozygous for DIO2, means I have trouble covering T4 to T3. No burning feet since my T4 was increased.

Hope you get sorted. It’s horrible and no one understands it, so they think you’re just moaning!

[FW23 in reply to Rita-D]

Thanks for getting back to me, just one more question was it definitely adding T4 and not adding T3 that stopped the burning . My T3 hasn't increased and my endocrinologist has recommended adding T3 might solve the issue.

[Rita-D in reply to FW23]

Yes it was definitely increasing T4 that solved the issue for me. I didn’t start T3 until many years later after much argument and private testing.

[FW23 in reply to Rita-D]

Thanks Rita-D

[chrisbuy63]

Hi

I found that taking pantothenic acid vitamin b5 helped get rid of my burning feet.but i do take a multi b vitamin supplement too, so think i sometimes just need a boost, I am on blood pressure meds whic can be the culprit.

Vitamin B5 deficiency is rare, but may include symptoms such as fatigue, insomnia, depression, irritability, vomiting, stomach pains, burning feet, and upper respiratory infections. Groups at risk of deficiency are alcoholics, women on oral contraceptives, the elderly, and people with impaired absorption due to certain digestive disorders. Whole grains are a good source of vitamin B5 but milling can remove up to 75 percent of the B5 content. Dairy products: Egg yolk, milk, yogurt, and milk products. Legumes: Lentils, split peas, and soybeans. Vegetables: Mushrooms, avocado, broccoli, sweet potatoes, corn, cauliflower, kale, and tomatoes. Drugs or Medications that may interfere with or deplete vitamin B5: are- caffeine.- high blood pressure medications.- acid reflux medications.

Hope that helps.

[FW23 in reply to chrisbuy63]

Thanks this is all very interesting, I'm also on blood pressure tablets ( Loartan) which has burning feet, hands and lips as a side effect, although apparently rare. I brought this up with my GP , he's the only one who has listened to me so far and he said that if the added T4 etc doesn't work, he would change my blood pressure meds. I've lots to still investigate thanks to this group and its really heartening to know that so many have solved the problem.

[ThankfulWanyana]

Sorry I'm not able to specifically reply but I wondered if I could follow this please as I also get hot feet? I use a voice recognition programme for typing it could be that there are mistakes that I overlook .

[FW23 in reply to ThankfulWanyana]

Yes of course that's fine with me. Is there anything you need me to do that you can follow the posts?