can Liothyronine cause muscke pain even if levels aren’t high?
Liothyronine muscle pain: can Liothyronine cause... - Thyroid UK
Liothyronine muscle pain
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Jaydee1507Administrator
Its more likely not enough T3 thats causing muscle pain. That and less than optimal vitamin levels.
You posted your B12 which was less than 500 so you would benefit from a B complex.
B complex suggestions: Slightly cheaper options with inactive B6:
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Contains B6 as P5P an active form:
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Explanation about the different forms of B6:
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B complex comparison spreadsheet:
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Most people need vit D as well, sometimes ferritin needs improving.
When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins.
Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...
There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
Only do private tests on a Monday or Tuesday to avoid postal delays.
hi
My Vit B12 was 409 Gp gave me a B12 jab.I tajevfolinic acid with i
VitcD 199
Ferritin 116
RBC under range
Copper zinc ceuroplasmin all good in range
I cannot taje anything tgst is methylated so dobyiubhavexaxsuggestuoj if a b conokex tgst not methylated and does not contain folic acid or methylfolate?
These are my last 2 results with 24 hr gap from last dose to test - note I increased T3
17/1/24
Last dose 8am previous day
100 Levo plus 25mcgs T3
Tsh <0.03 (0.35-4.74)
Ft4 12.2(9-19)32%
Ft3 4.26(2.6-5.7)53.55%
Add 20% 5.11 80.97%
18/3/24
Last dose 8.30 previous day
100 Levo plus 30mcgs T3
Tsh <0.03 (0.45-4.74)
Ft4 11.2 (9-19) 22%
Ft3 4.27 (0.45-5.7) 73.27%
Add 20% 5.12 89.16%
This is a methyl free B complex: dolphinfitness.co.uk/en/see...
All B complex's contain folate of some form or another otherwise its not a B complex. The one I have linked is not a methyl form of folate. Why do you not want to take folate?
Did you allow 8-12 hours for the T3 before the test?
Your FT4 is too low. Both FT4 & Ft3 need to be around 70% on combi treatment.
Over time you probably need to drop T3 very slightly and add in more Levo.
I don’t want any folate as I’m taking folinic acid.
I left 24hrs from last doses both taken first thing in the morning the day before.
I can post resukts of when I was on 125mc t4 and 20t3 15t3 or 25t3
All my tests are done first thing in the morning with a 24hr gap
Thank you for replies
Then you could stop taking the folinic acid and replace it with the methyl free B complex.
So your FT3 is a false low result due to being 24hrs from last dose so your actual level will be much higher than what it is showing.
Testing FT3 recommendation is to split your dose the day before into around 3 equalish portions and take the last portion 8-12hrs before blood test is due.
I’m not allowed to take any other form of folic acid as I’m in daily chemotherapy and can only tahe fokinuc acid to go with my daily chemo drug
You could always ask your doctors if the form of folate in the product I mentioned as OK.
it says it’s folic acid in the one you recommended.
I’m not allowed that or methylfolate
it should be as it says folinic acid same as what I’m taking . Mine is 800mcg losenhges
I did try to explain I’m only allowed to taje folinic acid with my chemo medication . Not folic acid .
Can you look at these which are various doses of t4 & t3 as trying to get numbers right
Folate 4.0(3.0-20)
B12 614 (180-640)
Platelets 245
24/12/19
day. test at 8.10am
Ferritin 66
Saturation 17
Vit D 83.4
Ferritin 103
Transferrin sat 22.0
Transferrin 28%
Iron 15.3
TIBC 70.3
UIBC 55.1so
8/20
Home Test 8am (10 weeks Levo only) Monitormyhealth-nhs lab
Tsh 1.32(0.27-4.2)
Ft4 17.6(12-22) 50.91% range
Ft3 3.4(3.1-6.8) 8.11% range
Levo only 125mcgs last dose 8am previous day
This was 2week Accord brand 2 week’s ACTAVIS
Ranges are different !!!
20/08/20
Tsh 1.53(0.35-4.94)
FT4 14.9(9-19)59% range
FT3 3.8(2.6-5.7)38.71% range
125mcgs Levo only. Last dose 8am previous day 2 weeks ACTAVIS 12 weeks Levo only
Felt horrible for a week now.
Seeing Dr Lee Tuesday 25th August
Bp 101/71 on records pulse 80
26/10/20
125mcgs Levo 10mcgs T3
Last dose 8.10am previous day
TSH 0.09 (0.27-4.94)
Ft4 13.8 (9-19) 48% range
Ft3 3.8 (2.6-5.7) 38.71% range
(+20%=4.56 61.29% range)
Saw Dr Lee and he said increase T3 to 15mcgs .
22/01/21
125mcgs t4 plus 15mcgs T3 ( started 15mcgs 7/11/20)
Last dose 8.30am previous day
Tsh <0.03 (0.27-4.94)
Ft4 16.6 (9-19) 76%
Ft3 4.1 (2.6-5.7) 48.39%
Add 20% = 4.92 74.84%
Been feeling bit anxious
Hadn’t been having tea as had sore tongue
05/02/21
From Monitor My Health
125mcgs Levo plus 15mcgs T3
Last dose 8.15am previous day
Tsh 0.01 (0.27-4.2)
Ft4 15.5 (12-22) 35.%
Ft3 4.4 (3.1-6.8) 35.5%
Plus 20% 5.28 = 51.82%
2/3/2021 - monitor my health
125 Levo plus 15mcgs T3
Last dose 8am previous day
Tsh 0.01 (0.27-4.42)
Ft4 17.7 ( 12-22) 57%
Ft3 4.3 (3.1-6.8) 32.43%
Adj +20% 55.68%
2/3/2021 NHS surgery
125 Levo plus 15mcgs T3
Last dose 8am previous day.
Test 8.15am
Tsh <0.03 (0.35-4.94)
Ft4 14.7 (9-19) 57%
Ft3 4.0 (2.6-5.7) 44.59
Plus 20% adj 4.8 70.06%
27/05/21
Hospital blood test
125mcgs Levo plus 15mcgs T3
Last dose 8.15am previous day
TSH <0.03
Ft4 14.9 (9-19) 59%
Ft3 3.9 ( 2.6-5.74) 41.40%
Add 20% 4.68 66.24%
03/06/21
Surgery at 8.30
125mcgs Levo plus 15mcgs T3
Last dose 8.25 previous day
TSH <0.03 (0.35-4.94)!
Ft4 15.5 (9-19) 69%
Ft3 3.9 (2.6-5.74)41.4%
Add 20% 4.68 66.24%
Prior to starting Oestradiol ( Oestradiol was <37 )
B12 615 ng(180-640) change in range from (150-883)
Folate 5.3 ug(3.0-20) had been using 800mcgs folic acid spray since 14/15 March but not few days prior to test
31/08/21 tested 8.10am
Cortisol 349 (150-600) was using estrogen here so could be why it’s lower than before
* Range: 150 - 600 nmol/L
* Date:31 Aug 2021 14:56:00
* Location:Haematology Department (Worthing)
* Comments:Reference range refers to 9am cortisol and assumes established circadian rhythm. In a well patient cortisol levels above 400nmol/L make adrenal insufficiency unlikely. Midnight and post dexamethasone <40nmol/l.
*
31/08/21 test 8.10am
Tsh <0.03 (0.35-4.94)g
Ft4 15.3 (9-19) 63%
Ft3 4.4 (2.6-5.7) 58.06%
Add 20% = 5.28 86.45%
100mcgs Levo 15mcgs T3
1mg Sandrena
Last dose 24hrs prior
22/11/21
125mcgs Levo plus 15mcgs T3
Tsh <0.03 (0.35-4.94)
Ft4 12.8 ( 9.0-19) 38%
Ft3 4.8 ( 2.6-5.7) 70.97%
Add 20% 5.76 100%
Oestradiol 112 on 1mg Sandrena
Folate 11 (3-20)
B12 think it was 450 so started supplementing
Bp 138/98 at surgery
Pulse 96
14/02/22
125mcgs Levo + 15 T3
Tsh <0.3(0.35-4.94)
Ft4 14.6(9-19) 56%
Ft3 4.2 (2.6-5.7) 51.61%
add 20% =5.04 78.71%
1.5mg Sandrena
Oestradiol here was 619
Platelets 380
09/05/22
125mcgs Levo +15 T3 last dose 24hrs before test at 8am
Tsh <0.03(0.35-4.94)
Ft4 11.4(9-19) 24%
Ft3 4.6(2.6-5.7)65.62%
Add 20% 5.3 84.38%
1x100 patch 3 1/2 weeks
Oestradiol here 169
24/06/22
125mcgs Levo plus 15mcgs T3 test 8.25am last dose 24hrs
Tsh <0.03(0.35-4.94)
Ft4 12.5(9-19)35%
Ft3 3.7(2.6-5.7)35.48%
Add 20% 4.44 58.6%
2x100 patch
Estradiol 736 5 weeks 2x100 patch
Cholesterol 5.07
Adjusted 31/7/22
TSH <0.03 (0.35-4.94)
Ft4 14.6 ( 9-19)
Ft3 4.1 (2.6-5.7)
5/9/22
150 Levo plus 15mcgs T3 last dose 8.20 previous day
TSH <0.03 (0.35-4.94)
Ft4 14.1 (9-19) 51%
Ft3 4.3(2.6-5.7) 54.94%
Add 20% = 5.16 82.58%
100 Estradot patch 242
11/11/22
150 Levo 15mcgs T3
Last dose 24hrs previous day
Tsh <0.03 (0.35-4.94)
Ft4 14.1 (9-19) 51%
Ft3 4.3 (2.6-5.7) 54.94.%
Add 20%=5.16 82.58%
100 Everol patch
100 progesterone (Utrogestan)
1/8th testogel sachet
21/2/23
150 Levo 15 T3 at 8am
Last dose 24hrs previous day
TSH <0.3 (0.35-4.94)
Ft4 16.8 (9-19) 78%
Ft3 4.52 (2.6-5.7) 61.94%
Add 20% 90.97%
Was on 75 Everol 100mg progesterone cream
Increased Hydroxycarbamide now
13/3/23 Monitor My Health
150mcs Levo plus 15mcgs T3
Tested at 7pm 11 hrs after dose
Tsh <0.01 (0.27-4.2)
Ft4 20.1 (12-22)81%
Ft3 5.8 (3.1-6.8) 72.97%
Increased dose of Hydroxycarbamide.? Is the higher ft4 pushing up platelets as they were 464
13/06/23
150 Levo 15 T3 last donse 8.40am previous day. Test was 8.40
Tsh <0.03 (0.27-4.74)
Ft4 20.7 (9-19) 117%
Ft3 4.51 ( 2.6-5.7) 61.61%
Add 20% 5.41 90.85%
Was using 15mg cbd patches (2 patches 36hrs prior to test - 1 patch day of test)
27/6/23
Tsh <0.03 (0.37-4.74)
Ft4 16.3 (9-19)
Ft3 not done as this test was requested by Dr Laurie
Ferritin 124
Platelets 376 ( had lowered t4 dose and this is on 2 HU sat & sun)
15/9/23
Tested 09./09/23 Genova
Levo 125mcgs plus 15mcgs t3. 24hrs gap
Last dose 8.20 previous day
TSH <0.01(0.40-2.50)
Ft4 16.22(7.86-14.41) 127.63%
Ft3 4.6(3.8-6.0) 36.36%
Rt3 0.57(0.14-0.54)
Ratio 3.5
Add 20% to ft3 5.52
78.18% 17/1/24
Last dose 8am previous day
100 Levo plus 25mcgs T3
Tsh <0.03 (0.35-4.74)
Ft4 12.2(9-19)32%
Ft3 4.26(2.6-5.7)53.55%
Add 20% 5.11 80.97%
18/3/24
Last dose 8.30 previous day
100 Levo plus 30mcgs T3
Tsh <0.03 (0.45-4.74)
Ft4 11.2 (9-19) 22%
Ft3 4.27 (0.45-5.7) 73.27%
Add 20% 5.12 89.16%
it could be not enough T3. What are your levels and TSH. Under or over medicated can feel very similar with certain symptoms.
17/1/24
Last dose 8am previous day
100 Levo plus 25mcgs T3
Tsh <0.03 (0.35-4.74)
Ft4 12.2(9-19)32%
Ft3 4.26(2.6-5.7)53.55%
Add 20% 5.11 80.97%
18/3/24
Last dose 8.30 previous day
100 Levo plus 30mcgs T3
Tsh <0.03 (0.45-4.74)
Ft4 11.2 (9-19) 22%
Ft3 4.27 (0.45-5.7) 73.27%
Add 20% 5.12 89.16%
The B complex I recommended does contain folinic acid. I'm not sure if we are muddling up names of folate.
The trouble with all these blood results is that if you are taking your last dose of T3 24 hours before the test then all the FT3 results are false lows.
30mcgs T3 is a high dose. I would think, looking at your previous results that 125mcgs Levo + 15mcg T3 might be closer to where you need to be but only change one thing at a time.
I looked at the link you sent me on the M free b complex and it said folic acid ???
I was told to leave 24hrs to get ft3 result then add 20% to it to get a real result
I was told to leave 24hrs to get ft3 result then add 20% to it to get a real result
Suggest you retest now for real results
T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test
Just TSH, Ft4 and Ft3 test - £32
monitormyhealth.org.uk/thyr...
10% off code here
thyroiduk.org/testing/priva...
I’ve done this before with mmh and there was hardly anyvduffetence.
here’s where I split it before m13/3/23 Monitor My Health
150mcs Levo plus 15mcgs T3
Tested at 7pm 11 hrs after dose
Tsh <0.01 (0.27-4.2)
Ft4 20.1 (12-22)81%
Ft3 5.8 (3.1-6.8) 72.97%
Increased dose of Hydroxycarbamide.? Is the higher ft4 pushing up platelets as they were 464
so what should I do?
This is the label of the B complex I suggested. It contains folinic acid, not folic acid. I wouldnt suggest anyone takes folic acid.
Suggest you drop T3 by 5mcgs and do try and test as per protocol which would then more accurately show your stable FT3 level.
Methyl free B complx
so would I increase t4 now tob125mcgs and drop just 5mcgs t3?
When you say follow protocol for testing do you mean test 12 hrs after last dose of T3?
Can it bevtgecT3 that have been giving me these muscle pains for many years ?
I’m trying to message you Jaydee1507 but it won’t let me??
Can you message me please 🙏🏿
see above resukts to Jadydee1507 above ⬆️
It looks to me like you’re on too much T3 as your TSH is suppressed. Too much can cause all sorts of symptoms. I try to keep my TSH and levels just within range.
I thought when taking direct 🇦🇽T3?that tsh is always suppressed?
My TSH is not suppressed. I take T3 5mcg twice a day 8hrs apart. I also take levothyroxine liquid 68mcg a day which I also split. My t3 is usually 85% ‘after’ taking meds. And T4 around 50%. I believe splitting helps reduce spiking. Not everyone has suppressed TSH on T3. I aim for a healthy persons levels and TSH. TSH around 1.00 and T3 and T4 not over range.
for a lot of people that will happen , but not for everyone.
for a few (like mcpammy) it is possible to feel well with TSH in range ( just) while taking some T3
( mind you mcpammy had highish TSH levels when on levo alone ..whereas someone else who already had very low TSH on levo is more likely to end up with TSh below range or even supressed once they include some T3)
I have had this situation for over a decade incapacitating me at times … I think the FT3 is something to persue if you have low levels I struggled to shift mine regardless of taking Liothyronine (T3) for a year as everything else went beserk. I had some improvements at first but it was short lived … I probably need more but I couldn’t get it prescribed due to other blood tests (TSH🙄) going under range.
I have however since found I have pelvic gynaecological conditions adenomyosis & endometriosis (pelvic cavity and bowel) along with being perimenopausal so it’s something to consider… mine wasn’t painful periods and abdominal discomfort so was always overlooked as orthopaedic problem (seen few orthopaedic consultants and had MRIs not much found) it was only as on hrt and abnormal bleeding ticked few boxes now for additional investigation and was finally looked at although had abnormal bleeds for many decades but GPs just didn’t follow up this could of saved me years of agonising pain and incapacity wasnt like I hadn’t told them dozen times.
Really annoys me that we are always seen as the same and that’s not the normal pattern of things, we are all different non of us will have same circulating hormones and genetics to have same blood chemistry at various stages so it’s bizarre we should be the same, so anything is possible in my book … this closed minded mentality is dismissing so many people that don’t present in same way as others …so my conditions were discounted along the way…my coeliac disease wasn’t “normal” symptoms but it’s now thought there’s many like me with no digestive problems with coeliac disease just malabsorption as damaged through not getting diagnosed early due to lack of symptoms. I always think it’s best to be tested for this if have autoimmune conditions and symptoms of anything that’s not going away regardless of text book Drs preach about…, did have skin nerve issues but always passed off as one of those things after exhausting others stuff.
Very frustrating as we age it’s more or less passed off as being normal aging process at 50 odd… I have 91 year old father in law who has better mobility it’s quite ridiculous and lazy for Doctors to disregard and not investigate it puts added pressure on rest of family to have to pick up more chores and for some more financial problems.
Advocate for your own health and don’t be fobbed off, you know your body better than GP reading off screens 80% of the time now ticking boxes as NHS are so strapped you have to fulfill certain criteria before it’s looked at when most Drs know there’s some underlying issue but do nothing until you have the problems on the screen… no provision for preventing… just waiting until they can write a prescription.
Sorry for rant I have wasted many years re my health and enjoyment with being incapable of walking at times when should have been having my best life whilst otherwise healthy and I don’t want others getting stuck in same situation.
Thank you so much for your reply
has anything helped your muscle pains?
I’m in process of shutting my hormones down which has had some benefits so far … I had always attributed it to thyroid and low FT3 and obviously I do have we now know rogue immune & hormones so have to investigate this before doing anything else.
Mine came on in bouts I’d be ok then it progressively became worse then lower key pain but more often so as approaching menopause we are thinking it’s more likely gynaecological issues…hrt balanced them more but abnormal bleeding so had Hysteroscopy along with biopsies, 2 polyps removed and now coil to help adenomyosis.
It still doesn’t address the low FT3 but have enough on with this to battle on with endocrinologist again… I think getting all your bloods optimal not just in range is key and lowering that TSH to under 2 and for most under 1 is helpful… I did find my recovery and well-being better under 2 TSH.
Magnesium is helpful along with good Vitamin D levels
Try and keep diary of symptoms see if any patterns occur.
I had sensitivity to fillers in medication (Levothyroxine) and supplements so try to keep to one brand… or at least record if notice changes shortly after starting things if can’t get same brand and if you do have flares with different brands tell GP /practice pharmacist and get brand of meds that suits you best.
Are you on any other medication - statins known to cause more problems than cure for some, it might be an idea to look at anything else that you are taking.
Of course if pre/peri/post menopausal try hrt.
Balancing my hormones definitely helped but still with cycles I had problems… blood sugar balanced is a good start too… drives a lot of things people seem to disregard other hormones but all interrelated really.
Hope you find some breakthrough what your cause is sooner than later 😊
I’m 71 and now just use estrogen patch as had hysterectomy 38 years ago.I akwats jeep to sane brand of T4 Accord. Always keep to Mercury Pharma T3.
My Vit D levels are optimal at 199. Ferritin 116.
Low RBC always but haematologist says I’m not anemic as my other iron levels are good.
I take Hydroxycarbamide for blood cancer. I tahe warfarin for blood clotting. Have multiple clots in both lungs since the 2nd vaccine.
I taje magnesium glycinate abd nag malate.
Woukd you like to see various results with the different doses I used?
You might ve able to figure what I’m doing wrong.
Always leave 24hrs from last doses of t4 abd t3
I briefly read side effects of your medication and itcan cause muscle aches maybe mention this to GP/Pharmacist
I wouldn’t be able to advise regarding your results of blood tests… I’m not medically trained on my opinion from experience and we are so very different
Another area to look at …How is your Folate and B12.
As we age it’s harder to absorb…my mums just gone onto injections at 83 as she is on blood thinners and heart meds but really tired and achy she’s hypothyroid due to heart medication causing it… her levels over 6 months were going deficient.
I asked my haematologist 9 years ago if this medication can cause muscle pain & he said definitely not.
I’ve asked a few more times and told the same.
My B12 was 409 (150-640) but go have me B12 anyway. I’m supplementing with 800mcgs folinic acid as it’s the only one I’m allowed to take with Hydroxycarbamide.
My Vit D is 198 as I supplement.
Ferritin is 116 .
I’ve had Hydroxycarbamide increased 3 times in the last year too. These pains have hit so much worse
Magnesium is 0.98 top of range 1.0
cancerresearchuk.org/about-...
I’ve only read what say here about it and states it does along with no energy or strength a bit further down…maybe print this out and show those who don’t say it does… unless I’m looking at wrong drug. 🤷🏻♀️
It's possible that your FT3 is too low, not the other way around.
but T3 is still 73% 24 hrs after last dose (therefore it will be significantly higher than that for much of each day) so i would think that low T3 is unlikely to be the problem here .
fT4 is relatively much lower .. i'd say it would make more sense to try and get these levels more balanced.
How can I do that please .
I can post various results with various doses over time .
These muscle pains have become so bad
basically by taking a bit less less T3 and a bit more Levo , but others can advise better than me on adjusting t3 doses and timelines .. as i don't take it.
Jaydee will probably come back with some suggestions for your next course of action.
i'd say reduce T3 by 5mcg and add 25mcg levo, wait 6/8 wks, then retest to see where you are. (preferably using adjusted dose timings for the next test ~ so your last dose T3 is 8-12 hrs from test, and last dose levo is 24hrs).
Can you link me to jaydee please
I put all my resukts above but here again are the last 2 this year
17/1/24
Last dose 8am previous day
100 Levo plus 25mcgs T3
Tsh <0.03 (0.35-4.74)
Ft4 12.2(9-19)32%
Ft3 4.26(2.6-5.7)53.55%
Add 20% 5.11 80.97%
18/3/24
Last dose 8.30 previous day
100 Levo plus 30mcgs T3
Tsh <0.03 (0.45-4.74)
Ft4 11.2 (9-19) 22%
Ft3 4.27 (0.45-5.7) 73.27%
Add 20% 5.12 89.16%
these are my last two results. Please note I increased T3 for the second test but left t4 the same.
17/1/24
Last dose 8am previous day
100 Levo plus 25mcgs T3
Tsh <0.03 (0.35-4.74)
Ft4 12.2(9-19)32%
Ft3 4.26(2.6-5.7)53.55%
Add 20% 5.11 80.97%
18/3/24
Last dose 8.30 previous day
100 Levo plus 30mcgs T3
Tsh <0.03 (0.45-4.74)
Ft4 11.2 (9-19) 22%
Ft3 4.27 (0.45-5.7) 73.27%
Add 20% 5.12 89.16%
What I don’t understand is WHY has ft4 gone down when I didn’t change the dose & ft3 has only gone up 0.01 when I’d increased it by 5mcgs.
What am I doing wrong. ? I reduced T4 over a few months as my rt3 was high at one point and ft4 was over range then too
SeasideSusie ?
Very sadly SeasideSusie passed away a few mths ago. We all miss her advice .
omg no!!!! I’m so sorry. She was always so helpful. Is Clutter still here ?
I haven't seen clutter reply to anything for many yrs,,, but i no idea why she is no longer active on here. If you want to see someone last replies , click on 'members' .... search their name .. go to their profile page.. click 'replies'.
p.s jaydee has replied earlier on this post, near the top.
post about susie here: healthunlocked.com/thyroidu...
Hey there, I have a similar issue now after increasing t3, my ft3 is 70% range after 19 hours of my second dose (i took my first bigger dose 24 hours before the test).I have these weird arm pains I never had before and very tense muscles in legs especially, like I need to move them. My ft4 is 35% ans didn't have any pains when taking the dose once daily with less t3 in the mix.
Did you change anything as of yet? Any relief?
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