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Old 05-31-2005, 09:41 AM   #1
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Has thyroid treatment relieved your muscle/joint pain and fatigue?

My first really intolerable symptom of thyroid disorder was severe muscle/joint/soft tissue pain. It began 16 years ago, when I was 5 months pregnant. The docs never even checked my thyroid, and I was dx with "Fibromyalgia" by a Rheumatologist. I knew that there was more going on, because my thyroid was swollen and painful, and had been for 2 years, but a previous thyroid test 2 years before was normal, so they didn't check it again.

Anyway, I've suffered from what I call "Total Body Throb" for so long that I worry that now I've been properly dx, FINALLY, that the symptom won't go away because I've had it for so long. My sister began having the same symptoms a couple of years ago, but her doc spotted her thyroid disorder almost right away, put her on Synthroid, and within a few months, her pain all went away. I've been treated now for over a year, and have had no relief at all - I'm beginning to despair that I've just been in pain too long to ever get relief.

I'm on 120mg. Armour/day (90mg. AM, 90mg. PM), .75mg Biest (Bio-identical Estradiol/Estriol), and 400mg/day Progesterone. I feel better in some ways (better cognition, sleep better), but still have overwhelming fatigue and pain. Had my labs done last week, and don't have the results yet, but even with my results perfectly within upper 1/3 or range, I still felt horrible.

Has anyone with LONG -TERM muscle/joint pain found relief?

Thanks,
OraEtLabora

 
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Old 05-31-2005, 11:20 PM   #2
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Re: Has thyroid treatment relieved your muscle/joint pain and fatigue?

That 400 mg. per day of progesterone is HUGE. Not sure where you are on the peri/meno spectrum, but the balance between estro & progesterone needs to be continually adjusted as one matures.

You are taking .75 mg of bio-identical estro? Has your blood level been measured to determine that your plasma level is sufficient. Some routes & formulations of bio-identical administration yield only 10% increase in plasma. Add to that the fact that most Bi-est is about 70% estriol, the weak estrogen, which is metabolized within 12 hrs., and you will see that your effective dose of estradiol is quite small, esp. in relationship to that whomping 400 mg. of progesterone.

Progesterone does a couple of things that might be affecting your situation. First, it really can whack down your free T4 by pushing conversion to free T3. You say your labs are in the top third of the range ... I'd want to be sure that included the free T4.

Furthermore, a progesterone overdose/imbalance itself can cause mega joint pain. It can also predispose women to depression, mess w/neurotransmitters in the brain, and affect pain perception.

Perhaps there is a specific medical reason for the high-dose progesterone. But many docs just rx the one-size fits all. There are some docs who believe that progesterone is a wonder hormone that cures all ills; this just ain't so.

If there is a chance that you can do a trial on lower-dose progesterone, you might see whether that has any effect on your joint pain. You might ask your doc if you can try, say 200 mg. or even 100 mg. per day of progesterone. In the natural cycle our bodies only manufacture progesterone for 2 weeks of the month, except during pregnancy.

Something to think about.
Good luck!
Lor

 
Old 06-01-2005, 12:39 PM   #3
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Re: Has thyroid treatment relieved your muscle/joint pain and fatigue?

I don't know about thyroid treatment relieving the muscle pain, but I found out that female hormones CAUSED it for me. I've never been on hormones and I'm 45, with regular periods all my life. We took fertility pills(both my husband and myself) to get pregnant twice, and the third child popped up all on her own. Then had a tubal ligation. Been feeling hypo for the past 6 years but numbers never looked bad, plus I'm one of those few who doesn't tolerate thyroid meds. A few months ago, my gyn suggested I get on a three month dose of birth control(the vaginal ring-can't remember the name!) and after a week, I quit it. I couldn't sleep, I was more stomach-bloated than my usual, and my muscles just ached like I had never experienced before. After a few weeks everything went back to my normal(hypo-feeling!) self, but was I glad it was not absolutely necessary for me to be on birth control. That kind of told me that maybe fibromyalgia is female hormone connected, along with thyroid. Or that the female hormones alter my already Hashi system to an even worse state. Of course, my blood levels never go out-of-range, but I don't tolerate the meds anyway, so it does my no good to try and see if it helps.

By the way, I've eaten goitrogens, etc. and down the road feel worsening hypo symptoms, such as more tiredness, dizziness,and more, but I've never had the muscle aches like I did with the female hormones. So, it's doing something different than just making me more hypo!

Karen

 
Old 06-01-2005, 07:46 PM   #4
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Re: Has thyroid treatment relieved your muscle/joint pain and fatigue?

Lor,

You've brought up some points that are of concern to me - thank you. I was not comfortable with the high dose of progesterone (400mg), and especially after getting my lab results back today. I'm sure the doc will lower it now back to 200, where it was before. He upped it because I was having such severe surgical menopause symptoms, and he wanted it to build up quickly. I was also supposed to double my dose of bi-est to 1.5mg (the ratio is .5 Estradiol/.25 Estriol), but after only a couple of days, I was experiencing breast tenderness, so I quit. I don't believe now that my Estradiol was too high, though, because the blood work I got back today showed 15 (range is 10-37 for menopausal women). It's my fault the ratio is so messed up! Might it have been that I was just waking up some receptors that have been dormant for a long time?

The progesterone level was almost 28, which is way too high for menopause, and way too high for the amount of Estradiol my blood work showed. You might be right on the money with the high progesterone being the cause of the increase in my joint pain (it's unbearable, and was never this bad!), and I've also become severely depressed. My other results were:

TSH 1.18 (0.47-6.90 mcIU/mL)
FT4 0.93 (0.60 - 1.70 ng/dL)
FT3 2.8 (2.3 - 4.0 pg/mL)

I was taken off all my hormones by the traditional docs when I had the total hysterectomn/oophrectomy 9 weeks ago, and was off my thyroid for almost 5 weeks after the surgery, which is why it is so low - I've only been on the Armour for about 4 weeks now. He was trying to build me back up to my pre-surgery levels, when I felt really good, but I wanted to take the thyroid very slowly, as I was having some heart palps.

Thaks so much for your input! You know so much about this stuff. Would you recommend I take the Biest and the Progesterone at the same time, too? And, should I take them only certain days of the month? I'm not sure it's a good thing to take them every day, like I do (my doc does it that way).

Karen,

Thanks for your help, too. I've suspected, too, that my "Fibromyalgia" is hormone related - it has worsened so much since menopause hit, and then since I had the hysterectomy it's been horrible. But, as you and Lor pointed out, it could be because I'm on too high a dose of progesterone. I've had the muscle aches since the 5th month of my pregnancy, (that was 16 years ago), and so I knew it had to be hormonal. I've since learned that was when my Hashi's got so bad it began to manifest in symptoms I couldn't ignore any longer.

I've stopped the progesterone, at least for about a week, until I see the doc again. I'm sure he'll put me back on 100 or 200 - that might even be too high, but at least I wasn't having the severe joint pain.

Thanks again!

Theresa

 
Old 06-02-2005, 09:53 AM   #5
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Re: progesterone

Hi Theresa,

If you haven't done this already, pls. ask your doc what is the purpose of the progesterone. Usually the prog. is given post partial-hysterect., to protect the lining of the uterus. But your whole shebang is outta there. ... perhaps that point has eluded your doc, so many women get partials ... or I may be totally out to lunch here. I'm not a doc. But you do deserve to understand why you are taking the progesterone.

About timing, some docs want you to take prog. full cycle -- but then you can usually do half the dose of those who take it for only 2 weeks of the month. As far as time of day ... progesterone makes some women groggy & so they take it at night. BUT, again ... that's assuming it's a reasonable rx.

You may do better w/the hormones when your free T4 pops up. Thyroid hormone helps all of your other hormones to get into the cells better.

Have you been ckd for anemia recently? Not a bad idea, what with being off your meds for a spell, going through major surgery, & who knows what before the surgery. I'd also consider supplementing subling. B12, or getting that ckd if it hasn't been done recently.

Since you've had a total w/oo, have they ckd your testosterone level? If that is low it also will contribute to fatigue & depression.

Best wishes,
Lor

Last edited by elmhar; 06-02-2005 at 09:58 AM.

 
Old 06-02-2005, 02:09 PM   #6
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Re: Has thyroid treatment relieved your muscle/joint pain and fatigue?

Thanks, Lor, for your valuable input.

I've been taking bio-identical hormones since about September, 04, for severe menopausal symptoms, and osteoporosis. I am now taking the progesterone to build bone, and to protect against breast cancer, and since my last bone density in May, my osteoporosis is actually reversed. Still some osteopenia in the left hip and spine, but so close to -1 T that I'm sure it will be further reversed. This fact totally amazed the technician, who told me she rarely sees such improvement. It's my understanding that things like Fosomax can reverse osteoporosis, as it did in my sister's case, but it is not from building new bone, as is the case with progesterone. Anyway, that is the main reason my doc gives it to women who have had total hysters/oophrectomies - he says they still have breasts and bones to protect.

Also, prior to the hyster I was on Pregnenolone, DHEA, and Testosterone. I became pretty overstimulated, growing hair on my face and losing it on my head, and tons of acne, so he took me off those things prior to my surgery. He is now just trying to take it slow by not adding any other supplements until I have been stabilized somewhat with the biest, prog, and Armour. I think he has discovered that I am hypersensitive to medications, even natural ones, and can take them only in tiny amounts to gradually build up.

I was checked in the hospital for anemia, several times, and am surprisingly not even close to anemia. B12 is extremely high, as is my Folate, which also surprised me. I feel really good today, just having been off the Progesterone for 2 days (today and yesterday), so I really think that was a lot of the problem. I did not have this problem before my surgery, when I was taking only 100 (and sometimes 200mg/day).

Another thing I have recently learned is that higher doses of estrogen can have pain killing effect. My doc's been after me to double my biest to 1.5mg, as I said, and I did that for awhile, and had almost no joint pain! I had to stop, though, because my breasts were getting so sore. BUt, as I said, it might have been just some receptors awakening, and might have gone away had I stayed on that amount. But with the imbalance I now have between Prog/Est (I understand the ratio should be 200:1), it makes sense that my joints are aching so much.

I've been having a problem with recurrent Thrush, oral and the other place, and that also might be the fault of too high progesterone. Also, my adrenals are fatigued, and I've been taking 5mg Cortef in the AM and 5mg in the PM. Haven't noticed any benefit yet, in the way of energy. My AM saliva and blood cortisol levels were very low, they peak in the afternoon, and then fall to below normal at night. This probably explains why I perk up a little in the afternoon....

Thanks again for your help. Like I said, I am already feeling better, just having skipped my progesterone for 2 days.

 
Old 06-02-2005, 03:51 PM   #7
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Re: Has thyroid treatment relieved your muscle/joint pain and fatigue?

A month ago I thought I was going to die with all the aching I had. After two weeks of a reduced dose of thyroid, I called and told them that every joint in my body ached and was stiff---and that now my back was becoming affected. They increased my thyroid and most of the aches and pains are gone---but I know it affected my back in some weird ways.

 
Old 06-02-2005, 06:18 PM   #8
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Re: Has thyroid treatment relieved your muscle/joint pain and fatigue?

Thanks, shellshocked. I am so sure the aches and pains I've suffered for 16+ years were due to low thyroid, but since I've only just begun treatment (since Dec. '03), I wonder if the pain will ever go away. I'm glad to know that your pains went away after increasing your dose. My sister had the same thing, and the pain went away in a few months. But I've been like this for many years, so I wonder, will it take years of being on thyroid before my pain goes away? Or, will I never find relief? It seems that everything else that goes wrong with my body these days (menopause) manifests itself in more pain - and I'm only 51. What will I feel like at 70?

 
Old 06-02-2005, 06:22 PM   #9
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Re: Has thyroid treatment relieved your muscle/joint pain and fatigue?

All of my pains also went away after about 2 or 3 months. The pressure I had behind my eyes is also gone. Maybe you just need more time.

 
Old 06-02-2005, 06:38 PM   #10
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Re: Has thyroid treatment relieved your muscle/joint pain and fatigue?

annemy,

How long did you have the aches and pains before beginning treatment? For my sister, it was about a year before they dx her with low thyroid, and it took a couple of months for her pain to disappear. I haven't seen any improvement at all - yet. It gets really discouraging, because I think that since it's been so long, my body will never recover.

It's funny, but the index fingernail on my right hand was always split, for as long as I can remember. At least back to the 8th grade, the nail would split clear back to the cuticle, and never grow together. It looked like I had smashed it, and I was always trying to hide it because people would always say "What did you do to your fingernail?" Now, I've noticed that it is growing together, and is almost totally whole!!! I never guessed that the split fingernail was from my thyroid! Now, I wonder if, since that was probably the first sign of my thryoid disorder, (37 years ago!!!), the last sign of my thyroid disorder (the pain) will be the last to go. Just a thought....

Thanks for your input.

 
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Old 06-02-2005, 10:16 PM   #11
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Re: Has thyroid treatment relieved your muscle/joint pain and fatigue?

OraEt,

You and your doc are quite on top of the hormones. Thanks for sharing about the progesterone & the bones/osteo. I had forgotten about that connection.

You are right about estro & pain ... I think it may have to do w/how it affects the brain & neurotransmitter receptors. Not sure, but it seems more central than peripheral.

Best wishes,
Lor

 
Old 06-03-2005, 08:11 AM   #12
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Re: Has thyroid treatment relieved your muscle/joint pain and fatigue?

Keep us posted.

 
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