Weak and easily fatigued muscles, linked to hashimotos?

[Hopetoheal22]

hello kind and wise people,

I would love to know if there’s any connection between weak, easily fatigued muscles and Hashimotos? I’m in my mid 40s with hashimotos for last 8 years, I have weak arm and leg muscles, and they tire very quickly. I tend to be low in iron. I take T4 and T3 and bloods are generally at higher end now. Having blood test in two weeks. It’s really frustrating as I want to get fitter and stronger but tire so easily and often feel weak. I’ve got young kids and am always on the go, also cycle on e bike, walk, swim but always tired, particularly exhausted after lunch and for the rest of the day!

Any thoughts and advice on building stamina and muscle (I’m aware of the need to strength train at my age) gratefully received thank you 🙏

[GlowCoach Administrator]

Your profile is a little out of date. What are your latest results for TSH, FT4 & FT3, also vitamins?

What are you supplementing with?

How are you treating your low iron?

We need good levels of key vitamins for our thyroid hormone to work well.

[Hopetoheal22 in reply to GlowCoach]

Hi Jaydee, thank you for your quick reply. I’m having a review by the endo in two weeks with blood tests so I can post those results then. Re iron, I eat red meat, chicken liver and occasionally take iron supps but usually forget those! I take vit C, D, fish oils and magnesium daily. Diet pretty good.

Is there a link between hashimotos and weak muscles? Just get tired muscles so easily even though I think I’m quite fit. Perhaps I just need to push myself! 💪

[GlowCoach Administrator in reply to Hopetoheal22]

Usually if optimally treated then weak muscles shouldn't be an issue unless you have ME or dysautonomia or possibly low vitamin levels.

You haven't mentioned B12 or folate and low levels of those could cause weakness possibly.

The thing with being hypo is you dont absorb vitamins as well as you should, so regardless of good diet you can still get low vitamin levels.

What was your most recent ferritin level?

[Hopetoheal22 in reply to GlowCoach]

Thank you Jaydee for your helpful answer, I’m having blood tests in two weeks so I’ll request to have all those tested and post here when I get them. Thank you

[JumpJiving in reply to Hopetoheal22]

Might be worth getting an early morning (8-9am) cortisol blood test done as well. Whilst weak muscles can have many causes, low cortisol is one possibility, and those with Hashimoto's do have an increased chance of also having Addison's. Hopefully not in your case, but worth checking - ideally with the blood test done before seeing the endo

[Hopetoheal22 in reply to GlowCoach]

Found some blood results from April this year, having new tests this month. I don’t feel any different so maybe levels haven’t changed.

HGB 123 (115-157)

Ferritin 55 ng/ml (13-150)

b12 382 pg/ml (197-771)

vitamin D roche cobas 140 (>50)

T4 16.2 (12-22)

T3. 5 (3.1-6.8)

( I take liothyronine and levothyroxine)

TSH less than 0.014

[GlowCoach Administrator in reply to Hopetoheal22]

The glaring problem in your vitamin results is that you are B12 deficient. What has your GP said or done about this. Likely this is your biggest issue currently.

Are you vegan or vegetarian? If not:

B12 - do you have symptoms of B12 deficiency? The reference range for B12 is very wide and cut off point too low. theb12society.com/signs-and...

If you do then you should discuss this with your doctor for further tests for Pernicious Anaemia.

If not, then start with a methyl B12 sublingual spray or lozenge for a week, then add a good B complex. Once you run out of the separate B12 just continue with the B complex.

cytoplan.co.uk/vitamin-b12-...

amazon.co.uk/Better-You-Boo...

B complex suggestions: 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...

[Hopetoheal22 in reply to GlowCoach]

Thank you for your reply Jaydee, I’m so sorry, I made a typo! My B12 is actually 382, so hope that’s an ok level? I do eat meat and animal products . Don’t think I have specific symptoms of low b12

I’ve amended the results above, sorry!!

[GlowCoach Administrator in reply to Hopetoheal22]

Optimal for a serum B12 is 500++ so yours is still low although not as terrible as the typo. As I said before, even with the best diet we can still get low vitamin levels being hypo as gut function is affected.

Suggest you still follow my recommendations as above.

[Hopetoheal22 in reply to GlowCoach]

Thank you Jaydee, that’s really helpful. I usually told I’m ‘within range’ so these things don’t get flagged. Thanks again, I’ll look at your recommendations

[GlowCoach Administrator in reply to Hopetoheal22]

Doctors get no training in nutrition and will telll you you're fine even if just 1 point above bottom of range! I'm sure that supplementing will help your muscles.

[Hopetoheal22 in reply to GlowCoach]

Crazy that doctors get no nutrition training!

I’ve got a B12 spray and separate B complex so will restart those. Do I have to take them well away from my thyroid meds? Thanks so much for your help

[GlowCoach Administrator in reply to Hopetoheal22]

Best taken in the morning as can be stimulating, an hour after Levo.

[Hopetoheal22 in reply to GlowCoach]

Oh brilliant thank you. Yes I took it a couple of times later in the day and was so wired I couldn’t sleep! That’s why I stopped taking it I think!

[GlowCoach Administrator in reply to Hopetoheal22]

I've made that mistake too so if for whatever reason I havent got it down me by 2pm then I skip that day. Just take with breakfast and all should be good.

[Jefner]

alas fatigue is a classic symptom with Hashi's and it can be debilitating for me sometimes. Can't think of an easy solution tbh but if you are low in iron then that will have a dire effect on your energy levels. If you work on getting those optimal you should feel better

[Hopetoheal22 in reply to Jefner]

Thank you Jefner for your helpful reply, any tips for increasing iron levels please? Any supplements you recommend? I eat chicken liver and red meat, and lots of iron rich foods, but my levels don’t tend to increase much. Supplements have caused some tummy discomfort in the past so I tend to avoid them.

[TiggerMe Ambassador]

I'd suggest getting your sex hormones checked as it could well be peri-meno, I didn't regain muscle strength until I sorted my HRT with a significant improvement sorting out my low testosterone

Edit... just looked at your bio

Latest bloods in July 2022

Testosterone 0.2 (0.2-1.65) 👈

[Hopetoheal22 in reply to TiggerMe]

Thank you TiggerMe, that’s very helpful. I started HRT last year and it’s helped a lot with sleep, mood and fewer aches, but sadly not muscle strength. Started testosterone a few months ago as you’re right, well spotted, it was very low. Having it reviewed soon. But sadly haven’t noticed any improvements in muscle strength, still feel very weak and tire quickly physically. Wondering if I just need to get on with strength training?!

[Dahliasanddaisies in reply to Hopetoheal22]

Have you had your thyroid bloods checked since starting HRT? Some women find they need an increase once on HRT. Hopefully you'll get some answers when you've had your appointment in a few weeks x

[Hopetoheal22 in reply to Dahliasanddaisies]

Thank you Dahliasanddaisies, that’s a good point. Haven’t had them checked for a while so be interesting to see if HRT has affected them. Yes hope the results shed some light, thank you

[TiggerMe Ambassador in reply to Hopetoheal22]

Forgive me I'm sure we have discussed HRT not so long ago... looks like it's the low iron holding you back... is your Vit D still optimized?

Just looked back at your last results and your fT4 was on the low side...

[arTistapple]

Absolutely definitely. Can strike any muscle or group of muscles. Even the heart muscle. Common in arms and legs particularly.

[Hopetoheal22 in reply to arTistapple]

Thank you arTistapple, yes arms and legs are exactly where I feel it mostly but yes can be other parts too! Sometimes feels like general all over weakness or like I’m not getting enough oxygen in my body 🤷‍♀️

Any tips on what can help other than optimising vitamin / thyroid levels? thank you so much

[Dahliasanddaisies in reply to Hopetoheal22]

This is exactly how I feel but my thyroid hormones are not yet optimised,.so I really hope it goes away when I am!

[Hopetoheal22 in reply to Dahliasanddaisies]

I’m sure optimising your thyroid levels will help enormously, really hope you can do that and feel better soon , it’s very frustrating!

[arTistapple in reply to Hopetoheal22]

Crikey Hopetoheal (great tag and speaks on behalf of me too) no unfortunately I don’t have any tips because that’s where I am too with skeletal and heart muscle issues caused by hypothyroidism.

Yesterday after advice from TiggerMe i took a female hormone blood test. I am well beyond menopause but now at the stage I will try anything. No endo seems to want to treat me because of the heart stuff (long story) but I am still trying!

The oxygen description I am very familiar with. In all muscles. However it’s never cut any ice with medics. They so lack any kind of vision or signs of any visual capability. It’s like talking to a wall.

Good Luck with optimising your treatment.

[Hopetoheal22 in reply to arTistapple]

I’m so sorry arTistappple, very frustrating for you. The heart stuff must be very hard and might explain the lack of oxygen feeling as heart pumps it around the body. Are your iron levels ok? Be interesting to see how your female hormone levels are, maybe HRT could help but I’m no expert! Are your thyroid levels optimised? And vit D, B etc? Are you able to do gentle exercise? I find it helps. Also I’m going to try deeper breathing as mine is very shallow which probably doesn’t help! Good luck and hope you get help and feel better 🤗

[arTistapple in reply to Hopetoheal22]

It’s awful for all of us. Allegedly such a simple condition to treat! Honestly the shallow breathing is part of the symptom picture. It’s not an ‘in your head thing’. It’s real. The muscles can just no longer respond normally. It’s not that you have a lung condition. It’s slow muscles. Slow most things if truth be known. That children’s writer that I can never remember the name of, discusses it on the Thyroid Trust podcast. He is now an ‘advocate or ambassador’ for them.

Everything optimised last time I checked BUT I definitely have high ferritin which may be related to inflammation. It’s a relatively new concern for many illnesses symptomatology. I can’t eat sugar or ‘additives’ as …..

Anyway don’t we have a lot of weird things to deal with. Doctors don’t know the half of it!

[Hopetoheal22 in reply to arTistapple]

Ha yes! They say oh just take the meds daily & that’ll treat it but it’s a very complicated beast that just keeps on giving isn’t it 😬 this forum keeps me sane as otherwise you are led to believe it is all in your head! Sorry about the high ferritin, I’d never heard of that as a problem or linked to inflammation. Inflammation seems to be linked to everything doesn’t it

Oh the thyroid trust podcast sounds good thank you, I’ll look for it.

[buddy99]

This is how it was explained to me (and made sense): Autoimmune disease causes systemic inflammation which in- and decreases depending on circumstances. With high inflammation the proximal muscles especially (thighs and upper arms etc.) can be flooded with cytokines and react with swelling which in turn inhibits circulation so that nutrients can't get replenished sufficiently and waste can not be transported away sufficiently. The muscles get weaker, less responsive and can also start to hurt. There is a whole list of things that can be done, from Ashwagandha to Zumba, that bring this inflammation down. And the challenge is to find out what works for each individual. I would say that optimizing thyroid hormones is #1 on my list, then diet, light exercise, stress reduction and supplements as needed. All the best.

[Hopetoheal22 in reply to buddy99]

That’s really interesting and helpful thank you buddy99. I notice I feel much better when it’s warmer and I’m active and sweat a lot, I wonder if that’s getting rid of the waste. Would one see the swelling? I will keep working on your list too thank you, it’s very similar to mine 😄

[buddy99 in reply to Hopetoheal22]

No, one would not usually see the swelling. I do get regular massages and my massage therapist often notices knots in my thigh muscles when I struggle with inflammation.

[Hopetoheal22 in reply to buddy99]

Oooh any excuse for a massage, that’s a great idea, so pleased it helps. Interesting about the knots / inflammation connection. I am often very knotty in my back and shoulders & my legs always ache, particularly my thighs, better after stretches

[buddy99]

This is the info I have: Inflammatory cytokines (proteins that signal inflammation) stimulate collagen production in connective tissue. Excessive collagen (which is usually produced in healing processes) can cause fibrosis (replacement of functional tissue architecture with excess fibrous connective tissue), which stiffens muscle tissue and can result in adhesions (knots) where fibers adhere to each other in a way that restricts movement and flexibility and can cause pain. This, too, makes sense to me.

[arTistapple in reply to buddy99]

My trainer used to break up these adhesions. It did help but it would not stop happening. It was too expensive for a few hours relief to keep up. I hoped upon hope, proper thyroid treatment would help. However lousy treatment remains, as do the mucsle issues.

My guess was that mucin, (hypothyroidism) which acts like glue in the muscle fibres was the cause. It clearly was not permanent as it really felt ‘normal’ after massage. It was just temporary though. Probably kept me going for many years before I knew I was hypo.

[arTistapple in reply to buddy99]

Yes same process as in the heart - plaque. However there is a paper which states this can be dealt with by T3. Only the guy who wrote it (or gathered the information) won’t treat me!

[buddy99 in reply to arTistapple]

Well, that's a downer! Why will he not treat you?

[arTistapple in reply to buddy99]

Politics? However he quotes the blockages! His own paper says this can be reversed by thyroid hormones (T3). However he does not have the courage of his own convictions to treat me. I have not said that in my appeal but if I am refused, I will pinpoint this and ask the question. There is a later paper which is even more explicit. A really good breakdown by ThyroidPatientsCanada.

[buddy99 in reply to arTistapple]

Ahhh, politics! My best endo was a "victim" of that. She constantly got called in to the College of Physicians and finally closed practice and went to the U.S. It is a shame how good medicine is blocked by other interests than helping patients. So sad and discouraging.

[Hopetoheal22 in reply to arTistapple]

I’ve been feeling much better since starting T3. I get it privately and it’s worth it. My T3 level finally dropped off range and endo agreed I could take it. It should be a readily available option as it’s the more active hormone

I hope you get the help and treatment you need

[Katarina60]

This might not apply to you unless you are overweight and carrying a lot of the fat on your stomach, which may be a sign of insulin resistance - something that often develops with hypothyroidism/hashi's. This happened to me and so I became prediabetic. My hba1c has now returned to normal aftermonitoring my blood glucose and sticking to a low carb diet and now I have a lot more energy, massively improved muscular performance, less pain in the joints and, of course, I have lost a lot of weight.

[Hopetoheal22 in reply to Katarina60]

Thank you for your reply and well done Katarina, sounds like you’ve made amazing health changes. My weight is ok but interesting to learn about the link with insulin resistance and hashi’s. I think probably I need to eat fewer carbs and sugar as I do notice I don’t process it as well as I used to, feel like I get blood sugar crashes but can’t be sure unless I monitor I guess

[Hopetoheal22]

Hi, I hope you’re all well. Here are my blood results following on from my previous post.

I’d be so grateful for any thoughts. Endo is happy with these and to be fair they are pretty good for me, but I feel exhausted and very physically weak and having some palpitations. I take 100mcg levo and 15mcg liothyronine daily. Hashimotos, 45 year old taking HRT too. Should I be concerned about the antibodies, or that’s normal with hashimotos? Or even without?

Any advice gratefully received! Have a lovely weekend 😊

Blood results HGB 115 (range 117-157)