Thyroid Function and Neuropathy

Thyroid irregularity can cause strange and unexplained pain. I say irregularity because, as I have often explained to my patients, hyperthyroidism, or an overactive thyroid, is a variation of hypothyroidism. Hyperthyroidism is a cry for help from the thyroid. It often overproduces thyroid hormone when it is beleaguered and under attack, often from antibodies, until it can no longer produce, which is hypothyroidism. There are many ways irregular thyroid function can cause pain, but I will focus on nerve and muscle pain.Our nerves and muscles work together to regulate movement. Therefore, any alteration in thyroid hormone regulation will affect the neuromuscular system. It can present as pain but also as a lack of control and fatigue. In addition, you can feel tingling, heat, cold, wetness, and numbness. There can also be muscle weakness, which usually comes with stiffness, cramps, pain, and fatigue.

These symptoms are so common that studies over the past 50 years have associated neuromuscular symptoms with 80 to 100% of hypothyroid patients. Nerve and muscle pain may appear with more classic symptoms of hypothyroidism, such as being cold and having metabolism issues, or pain can be the only clinical manifestation of thyroid dysregulation.

All the textbooks on thyroid function that I have read always stated that irregular thyroid function can cause pain and that people with unexplained muscular symptoms should be screened for thyroid issues. Think of all of the women who have been diagnosed with fibromyalgia and treated with antidepressants and anti-seizure medications but not investigated for hypothyroidism beyond a TSH test. 62% of patients with fibromyalgia were found to have thyroid function problems, and 40% of patients with Hashimoto's thyroiditis had fibromyalgia— for those who were tested for thyroid function issues. How many people weren't tested and prescribed painkillers and antidepressants? Publications on fibromyalgia peaked in early 2011, but the cause of fibromyalgia still baffles medicine. Even though the cause is unknown, the first line of treatment is the prescription of powerful and often addictive psychoactive medications, antidepressants, antipsychotics, anticonvulsants, and painkillers. These treat the brain as if the brain were the cause of the pain.

In the movie Cake, Jennifer Anniston is not supposed to be suffering from fibromyalgia, but she is in constant pain and addicted to painkillers. Undiagnosed hypothyroidism can lead to the same condition. Primarily, middle-aged women are diagnosed with fibromyalgia. This is the case with hypothyroidism and depression as well. The pain can affect one nerve, several nerves, and even cranial nerves. Cranial nerve dysfunction can cause palsy when part of the eye or mouth droops, hearing loss, and tinnitus. The most common manifestation is carpal tunnel syndrome, with its tingling, numbness, and pain in the arm, hand, and fingers. I've seen many people who had carpal tunnel surgery when they could have instead been treated for hypothyroidism to resolve the pain. My mother had tarsal surgery and went to a podiatrist, who then performed painful surgery on her feet. There was nothing wrong with her feet. She was finally diagnosed with Hashimoto's a decade later.

Everything slows down with thyroid dysregulation—and so is nerve conduction. A nerve trying to send a signal with difficulty creates not just pain but also weird sensations. Unfortunately, there can also be demyelination— multiple sclerosis and Guillain-Barré syndrome are both related to hypothyroidism. Hypothyroidism causes ataxia, which is the name for a grouping of disorders that causes loss of coordination and problems with balance, walking, speech, and swallowing. Someone may be diagnosed with early-onset Parkinson's but may be hypothyroid.

Muscle weakness and motor control problems are associated with Parkinson's. The symptoms are primarily due to delayed relaxation of reflexes. That delayed tendon reflex is a classic test of hypothyroidism, usually performed by tapping the Achilles tendon with a small rubber hammer. The more the person has low thyroid hormone levels, the slower the reflex.

First described in 1897, hypothyroidism causes Hoffman's syndrome, where muscle tissue becomes engorged by liquid. Glycosaminoglycan accumulation causes the swelling. The tissue is enlarged but weak. Glycosaminoglycans bloat the muscle tissue. Since hypothyroidism slows all function down, so is calcium uptake. Reduced calcium uptakes make fast-twitch muscles act like slow-twitch muscles, commonly seen in the ithe gastrocnemius muscle—behind the calf (cramps at night, anyone?) and deltoid and trapezius muscle—was shoulder surgery suggested?)

What turns up on blood tests, if anything turns up on blood tests, is a high level of serum creatine kinase. Muscles can also have glycogen accumulation, mitochondrial disruption, and muscle necrosis in severe cases. Many of my patients have asked me why they cannot build muscle. Glycogen accumulation reduces the ATP for muscle contractions and increases lactate. In this case, you cannot exercise and feel miserable trying.

What can you do if you suffer from pain? As an osteopath, I have found that reducing inflammation will significantly help eliminate tissue congestion around the nerve path. Reducing inflammation will allow proper nerve conduction and ensure nervous tissues get the nutrition they need. I seldom see vertebral compression or misalignment in joints in patients who come to me with pain. While any compression or impingement will cause pain, reducing inflammation by eating a carnivore diet is a longer-lasting treatment than repeated adjustments. I finally had to ask myself why people returned with the same misalignment after adjustment. Sometimes, muscles contract to protect areas of the body that are weakened by chronic inflammation. Removing foods that cause inflammation includes removing anti-nutrients and foods that overstimulate the nervous system. Of course, the thyroid directs all healing and energy conduction in the body and all nervous system tissue. So if a carnivore diet has helped somewhat, but only partially, I recommend investigating thyroid function.