Deep cracks in heels

[Topes009]

Hi lovely people, I have deep cracks in my heels, is this something with low thyroxine levels or high? Or can it happen with both?

[helvella Administrator]

I don't know if it can happen with high thyroxine levels, but it can most certainly happen with low levels - hypothyroidism.

My heels certainly had thicker skin and cracked far more when I was not treated/adequately treated and has improved.

In the meantime, try foot cream and/or heel; balm. I used CCS products and they helped a lot. (Other products might be just as good or better - I don't have the experience to say anything about them.) Easily found by searching.

[Buddy195 Administrator]

My chiropodist recommended applying foot balm at night and wearing thin cotton bed socks to ensure it remains on the feet.

[Anthea55]

When I get cracks I put antiseptic on the crack, then hold it together with surgical tape (what I call medical sellotape), to cover it completely and pull the edges together. I can then leave it on for several days, including through the shower.

Eventually it heals.

[humanbean]

The skin on my feet improved with B vitamins.

[Topes009]

Thanks all. I always wear socks to bed as have the coldest feet and get cramp if I don’t. Have started using the foot cream again, and hope it settles.

[humanbean in reply to Topes009]

I use a hot water bottle most of the year, even when it is quite hot. Without it I end up with cold feet and cramp.

[Sallybones in reply to humanbean]

me too

[humanbean in reply to Topes009]

I forgot to mention... I need to keep my iron and ferritin levels as close to optimal because of the cold feet and cramp. If I let my iron/ferritin levels drop my cramp becomes a lot worse and prevents me sleeping.

[Topes009 in reply to humanbean]

I have low ferritin, it’s starting to go up but very slowly.

The cramp is awful isn’t it. I also find it makes yoga very hard especially if it’s colder.

[Wired123]

one word of warning, cracked and broken skin can let germs in when walking barefoot and lead to nasty infections. A family member was hospitalised for 2 weeks with cellulitis due to germs entering through cracked heels. Take extra precautions like wearing socks and slippers to prevent any dirt or germs entering

[SlowDragon Administrator]

What are your most recent thyroid and vitamin levels

Which brand and dose of Levo

and still on T3?

what vitamin supplements are you taking

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

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

[Topes009 in reply to SlowDragon]

Latest results were in June

Tsh 0.03

FT3 6 Range (3.8 - 6)

FT4 11.3 range (8-14)

Ferritin 31

Taking T3 5 x2 daily. 75 t4

Take b vit spray, multi mineral, vit d and K liquid and vit c and iron a couple of times a week.

Due another test in December last test was not timed very well as the surgery mucked things up on the first test leaving me no time to get a decent timed test before the appt with the endo

[SlowDragon Administrator in reply to Topes009]

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

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

Was this approx how you did your test

How much levothyroxine were you taking BEFORE adding T3

Free T4 (fT4) 11.3 pmol/L (8 - 14) 55.0%

Free T3 (fT3) 6 pmol/L (3.8 - 6) 100.0%

Ferritin is very low - deficient

Are you vegetarian or vegan

cks.nice.org.uk/topics/anae...

Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

It’s possible to have low ferritin but high iron

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

If taking any iron supplements stop 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

[Topes009 in reply to SlowDragon]

I was taking 100mcg T4 prior to adding T3. The endo initially reduced my dose to 50 which was not great. I don’t feel too bad on 75, he’s reluctant to go higher because of the tsh level.

[SlowDragon Administrator in reply to Topes009]

Well you look like you might need a bit less T3 and a bit more levothyroxine….but it depends on when last dose Levo and T3 were

perhaps negotiate with endocrinologist for 3 x 2.5mcg T3 and 87.5mcg Levo per day?

meanwhile working on low ferritin

[Topes009 in reply to SlowDragon]

Thanks, that sounds like good advice, I was thinking the same. The results prior to that are:

Feb 24.

1st test on T3/t4 comb 75t4 10t3

Tsh 0.08 (0.38-5.33)

Ft3 5.3 (3.8-6.0)

FT4 10.5 (7.9 -14.4)

This was taken before first dose of T3 for the day.

Since the reduction of T4 I have had a lot of bloating and slower bowels, less tolerance to foods that were fine before and also much more extreme jaw clenching, not sure if that’s associated.

I’m also peri menopause so he does tend to blame a lot of symptoms on that, and of course they do cross over.

[SlowDragon Administrator in reply to Topes009]

Many of us on levothyroxine plus T3 find we need BOTH Ft4 and Ft3 at good levels

Far too often levothyroxine is reduced too much

Suggest you increase levothyroxine as next step…..perhaps 87.5mcg 4 days and 75mcg 3 days

[Topes009 in reply to SlowDragon]

Thanks yes, seems to be standard that they reduce t4 massively when t3 added. The initial reduction to 50mcg was crazy low

I’ve emailed the endo and suggested increase of t4 to 87.5 mcg daily and reducing t3 slightly. Will see what he says.

[Seabird4]

I would say yes as prior to being diagnosed with hypothyroidism my heels were like deep gouged crazy paving. I had to glue them together & walk on my toes to prevent the cracks opening. All healed now with meds hope you get the same result