Teeth clenching again after slight reduction in thyroid medication

[Somersetter]

I was doing well on 75mcg thyroxine and 17.5mcg liothyronine. I have the DIO2 polyrmorphism (heterozygous).

Last blood test results from February this year (I followed the protocol for blood tests).

TSH is always suppressed (<0.02) even when I once tried reducing T3 to 10mcg for 6 weeks before test (and felt terrible - tired, achey, clenching teeth, irritable and very depressed).

Free T4: 13.3

Free T3: 5.7

I am constantly asked to reduce liothyronine (was originally on 20mcg) and had reduced to 17.5mcg which wasn't too bad. I still felt quite well.

Then pressured to reduce to 15mcg (I have some osteoporosis in one hip). Since then I have started teeth clenching and grinding again, which had stopped when I was finally prescribed liothyronine in addition to thyroxine in 2014.

My jaw has begun to ache and my teeth are bad enough after all the decades of bruxism in the past.

So far I haven't found papers on hypothyroidism and teeth grinding (there seem to be plenty on hyperthyroidism and teeth grinding!). If anyone knows of any, please let me know so that I can show them to the endocrinologist - they just don't seem to believe patients when they report symptoms.

I did find mention of teeth grinding and hypothyroidism from 2 years ago (a Slow Dragon post), but no link to references.

[greygoose]

Reducing your T3 isn't going to help your osteoporosis. If anything, it could make it worse! If the range for that latest FT3 is 3.1 - 6.8, then it's only about 70 % through the range, which isn't high. But I suppose your doctors are only looking at the TSH? Well, TSH has nothing to do with bones. That's not the cause, either. Most likely culprits are sub-optimal nutrients and advancing age - although I'm not saying you're old! It's just that at 60 we can't expect to have the bones of a 20 year old. Doctors don't seem to understand that.

I'm afraid I can't help you with the teeth clenching, but it wouldn't surprise me at all if it was a hypo symptom. Most nasty things are!

[Somersetter in reply to greygoose]

Thank you so much for your reassuring reply (yes, I am old, but still go running 🏃‍♀️). Yes, that is the range (I forgot to put it on). I'm not overly worried about my bones

[greygoose in reply to Somersetter]

Not as old as me, darling! lol I'm 80, and never been running in my life! It's just something I've never been able to do.

You may not be worried about your bones, but it sound like your doctors are, and that's why they want to reduce your dose.

[Somersetter in reply to greygoose]

Yes, greygoose, and probably worried about the extortionate cost, too (I came across a Scottish NHS table specifically showing how much money the NHS could save if they stopped prescribing T3).

Thank you for the interaction, it is heartwarming ❤️

[greygoose in reply to Somersetter]

You're welcome.

[jgelliss in reply to greygoose]

GG I agree with you. I don't convert my T4 to T3 well and I was advised by my dentist to get night guards. I didn't not connect at the time that thyroids are involved with biting down hard on the teeth. It's very much connected. My personal experiences.

[Somersetter in reply to jgelliss]

Thank you for your reply, jgelliss. I am aware of clenching my teeth during the day and keep trying to stop it...I think night guards are the next step...

[jgelliss in reply to Somersetter]

I agree with you. But try to revisit your thyroid dose as well.Best Wishes.

[CreakingGate47]

palomahealth.com/learn/tmj-...

Above link is useful. TMJ is a useful search criterion as this is often caused by Bruxism (clenching / grinding)

It’s worth remembering that the biggest cause is stress and anxiety - and of course stress are anxiety are close friends of hypothyroidism.

I have horrific pain from TMJ and atypical face pain - caused by bruxism. It’s known to be a cause of migraine too.

Hope this helps

[Somersetter in reply to CreakingGate47]

Thankyou Creaky, for taking the time to reply. It is very interesting to see they have found a connection with Hashimotos and mandibular problems . There is a link to a study about it, too, which I will read after a good night's sleep.

I do get stressed now and then, so I do 10 minutes mindfulness every night before bed (I have to use a warm eye mask, so I listen to a relaxing meditation on YouTube ).

I'm so sorry to hear that you suffer such awful pain. That must be a source of anxiety and stress in itself and I do hope you are able to find something to relieve it.

With me it's an ache in the upper jaw and my poor back teeth are badly worn down (one good dentist told me years ago that I must grind my teeth judging by the state of them).

Do take the best care of yourself 🤗

[CreakingGate47 in reply to Somersetter]

You too …. Somersetter 🤗

[SlowDragon Administrator]

Free T4: 13.3

What’s the range on Ft4

Do you ALWAYS test 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

and what are vitamin levels

Are you on gluten free diet and/or dairy free diet

[Somersetter in reply to SlowDragon]

Hello SlowDragon,

Thank you so much for your reply.

Yes, I followed your protocol to the letter for that test.

I’m supposed to be having a blood test for bone, including D3 (was severely deficient, so I supplement) but had to ring for the test form as they forgot to enclose it with yhe letter. NHS haven’t offered a full blood test recently. (Can’t afford private at the moment). Last (and only) ferritin test was 39 ug/l (range 10 to 291) but that was in January 2023). I took an iton supplement for a while, but have stopped as unsure of best supplement to take.

I take a bone complex supplement with additional K2 Mk7, omega 3, vit B12, I’m careful to follow a highly nutritional diet, as I’m already restricted (I follow a 100% gluten free diet as have coeliac disease and cannot tolerate any amount of gluten and dairy free as vegan apart from occasional egg from friend’s pet chickens).

When I’ve repaid my loan I’ll probably look for a private test.

It was one of your posts from 2 years ago that inspired me to ask more about hypothyroid teeth gringing 😄❤️

[SlowDragon Administrator in reply to Somersetter]

So if vegan/no red meat you need full iron panel test

As confirmed coeliac GP should be testing these and vitamin D, folate and B12 at least annually

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 3-5 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Vegetarian option

healthunlocked.com/thyroidu...

epigenetics-international.c...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary

ncbi.nlm.nih.gov/pmc/articl...

Low Iron implicated in hypothyroidism

healthunlocked.com/thyroidu...

[Somersetter in reply to SlowDragon]

Thank you so much for your advice and all the useful links. I did seem to feel better after a couple of months taking 14mg iron, but stopped a few months later due to concern over taking too much.

I get a bit confused over ferritin and iron, red blood cell count, haematocrit etc. (haematocrit 2023 was at top of the range). I will see if I can get as many of those recommendations as possible tested with the gp, because 2023 is the most recent.

I will also save all the information in the links you have provided so that I can make use of them when finances permit private testing.

You have been so kind and helpful, SlowDragon. Very much appreciated ❤️

P.S. The research article on low ferritin is particularly interesting - and I will definitely order some of the epigenetics liquid iron sulphate next payday 🙂🙏

[Beads]

I can’t remember if there were papers discussing hypo and teeth grinding a couple of years ago, but we had quite a lengthy discussion about it. It appeared that quite a large number of us wear what my dentist calls bite raisers (mouth guards) overnight to stop our teeth being worn away from grinding.

[Somersetter in reply to Beads]

Hello Beads,

I’m going to ask my dentist about a tooth guard. It was never suggested by any dentist 🫤

I will keep trying to find some evidence of yhe connection to show the endo x

[humanbean]

Do you take magnesium? If you don't I would suggest it might be helpful. It helps muscles to relax. Low magnesium can cause tetany. There are other possible causes of the condition too.

en.wikipedia.org/wiki/Tetany

Muscle cramps can be caused by low levels of various electrolytes, of which magnesium is one.

en.wikipedia.org/wiki/Cramp...

en.wikipedia.org/wiki/Elect...

Some years ago a member of this forum reported that she reduced the severity of her TMJ by improving her Vitamin B12 and folate levels. (She may have cured it completely but I can't remember that level of detail for sure.)

I should mention that I have suffered from bruxism most of my life. I've also had times when I couldn't relax my shoulders and that problem was reduced by taking a small dose of a potassium supplement.

I suffer much less from cramp when I keep my iron levels and vitamin D levels up.

I should also mention that I'm very nervous about increasing my calcium levels. Calcium often gets mentioned in connection with cramps, tetany and similar conditions. However my calcium level is always high in range when tested so I don't supplement it. I'm worried about calcium ending up lining my arteries.

[Somersetter in reply to humanbean]

Dear humanbean,

Thank you for taking the time to reply with useful information. I do take magnesium as it is part of the bone complex supplement. I also take high dose vitamin B12 (hydroxycobalamin) and my folate levels are high.

I do take calcium and D3 (I was severely deficient in vit D) and to make sure calcium goes to my bones and not my arteries I take K2 Mk 7. Although my blood levels of calcium are within range, I can't help thinking the body takes calcium out of the skeleton in order to maintain the blood levels, so not sure I trust blood levels completely.

I think you are right about needing iron. My ferritin is at the bottom of the range. I stopped taking iron because I was worried about overdoing it as I'm not obviously anaemic, but SlowDragon's link to a study saying ferritin levels should be over 100 is convincing me to start taking iron again (will buy some on payday).

I'm interested in your mention of potassium. I only have to consume a tiny amount of salt to become incredibly thirsty and wonder if there's a link there. I do eat a banana every day, but that might not be sufficient (I will research it further).

Thank you again for your kindness and help ❤️

[humanbean in reply to Somersetter]

If you want more info on potassium, this link is worth reading :

drmalcolmkendrick.org/2013/...