The Connection Between Chronic Pain and Fibromyalgia & How to Treat it

Is your intuition telling you that your hypothyroidism or Hashimoto's is causing your chronic pain?

​I've got news for you:

Your intuition may be right.

Low thyroid hormone can potentiate musculoskeletal pain that can be misdiagnosed as fibromyalgia. 

Even more important than that is many providers (and patients) don't understand how to correctly diagnose, treat or manage pain and fibromyalgia related to hypothyroidism. ​

In this post, I'm going to talk about how hypothyroidism causes chronic pain and fibromyalgia, how to correctly diagnose the condition and other treatments that may help or benefit patients who suffer from this debilitating condition. 

To understand how this works you really need to understand the concept of Tissue Level Hypothyroidism...

More...

The Connection Between Hypothyroidism, Chronic Pain, and Fibromyalgia

You probably know that your thyroid helps to control the metabolism of your entire body but did you know that it also has many more functions than just that? 

It's common for patients who are hypothyroid to gain weight, but one of the other (many symptoms) of hypothyroidism includes chronic musculoskeletal pain.

In fact, it's not uncommon for hypothyroid patients to present with back pain, joint pain or multiple tender points deep in their muscular tissue (1).

While hypothyroidism can cause chronic pain and a fibromyalgia-like syndrome this doesn't mean that ALL cases of fibromyalgia and chronic pain are due to hypothyroidism. 

​That being said...

If you have either condition (chronic pain syndrome, fibromyalgia or chronic fatigue syndrome) you absolutely should have your thyroid checked out.

And I don't mean a cursory glance at your TSH, I mean a complete thyroid panel and thorough workup that includes ALL thyroid lab tests including markers for autoimmune thyroiditis. 

I hear patients all the time respond that their thyroid is "fine" only to find out upon closer look it's anything but fine. ​

Before we talk about how to correctly diagnose thyroid issues we need to talk about how thyroid hormone can cause chronic pain and fibromyalgia. ​

  • Bottom line: Hypothyroidism can certainly cause and potentiate chronic pain and fibromyalgia. Standard blood tests and standard "interpretation" of thyroid lab studies is insufficient to correctly diagnose the problem. To properly evaluate for this condition you need a complete set of lab tests and proper workup. 

Download my Free Resources:

Foods to Avoid if you have Thyroid Problems: 

I've found that these 10 foods cause the most problems for thyroid patients. Learn which foods you should absolutely be avoiding if you have thyroid disease of any type. 

The Complete List of Thyroid Lab Tests:

This list includes optimal ranges, normal ranges, and the complete list of tests you need to diagnose thyroid hypothyroidism correctly!

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Tissue Level Hypothyroidism Explained

​So what can cause "normal" thyroid lab tests but all the symptoms of hypothyroidism?

This condition is known as tissue level hypothyroidism (2).

Tissue level hypothyroidism

Tissue level hypothyroidism may explain why there is a widespread dissatisfaction with standard thyroid treatment and standard thyroid replacement therapy with Levothyroxine or Synthroid

​It turns out that there are many patients currently being treated with thyroid hormone and yet they still have all of the symptoms of hypothyroidism, including chronic pain, hair loss, weight gain and weight loss resistance. 

​So what is tissue level hypothyroidism and how does it cause these symptoms?

Tissue level hypothyroidism is the idea that you as the patient might have "normal" blood levels of thyroid hormone but due to a number of factors (including inflammation, weight gain, medications, chronic illness, etc.), that thyroid hormone can't get into the cells to do its job. 

So it remains outside of the cell in the bloodstream making it look like your thyroid function is fine but in reality that thyroid hormone is almost inactive. 

This is also known as thyroid resistance and it is probably one of the most commonly missed thyroid conditions due to how thyroid diseases are diagnosed. 

Standard laboratory tests can only measure what is happening in the bloodstream. 

But...

T3 conversion booster results

When it comes to thyroid hormone, we don't care what's happening in the bloodstream because thyroid hormone has to get into cells to do its job. 

Thyroid hormone is active when it travels through the cell membrane and directly attaches to the nucleus to what's known as a nuclear receptor (3).

From there it directly changes your DNA, in a process called genetic transcription, and causes an increase in metabolism, changes in proteins and an increase in oxygen consumption (4).

Pretty cool, right?

This means that in order to properly check if thyroid hormone is working, we really need to look at both the blood levels of thyroid hormone and markers to see if it is actually working in the cell. 

One of the best ways to do this is by looking at the complete thyroid blood panel

  • Bottom line: It's possible for you to have "normal" levels of thyroid hormone floating around in your blood but that hormone is only active IF it can get inside your cells and turn on genetic transcription and change your DNA. Some patients have "normal" blood levels but that hormone can't get into the cells to do its job - this is known as tissue level hypothyroidism. 

The Complete Thyroid Blood Panel

The only way to correctly diagnose and identify tissue level hypothyroidism is with a complete thyroid blood panel.

This panel is designed to not only evaluate how much thyroid hormone is floating around in the blood but also evaluate if the tissues and cells are getting enough thyroid hormone.

The complete thyroid blood panel you need to use if you have Chronic pain or Fibromyalgia:

Complete thyroid blood tests image
  • TSH: Should be less than 2.0 - this helps determine how much thyroid hormone is influencing pituitary function
  • Free T3: Should be in the upper 50% of the reference range (patients with fibromyalgia and chronic pain often have VERY low free T3 levels)
  • Reverse T3: Should be less than 15 (the higher your reverse T3 and the lower your Free T3 the more symptoms you will have)
  • Free T3/Reverse T3 ratio: Should be greater than 0.2 when you divide both numbers (Chronic dieting leads to thyroid resistance and can worsen thyroid function)
  • Total T3: Should be in the upper 50% of the reference range (usually in the 130-150 range
  • Sex Hormone Binding Globulin: In women, this should be between 70 to 80 (This protein is secreted from the liver when thyroid hormone is present and active so it can be used as a surrogate marker for thyroid tissue levels) 
  • Thyroid Antibodies: Should be as close to 0 as possible (high levels may indicate autoimmune thyroiditis and inflammatory conditions) 

When most providers and Doctors check thyroid function they are usually checking just the TSH. 

Without the other markers and the "optimal" reference ranges it is difficult to truly diagnose tissue level hypothyroidism.

I hope now you can see why many patients are told their thyroid function is "normal" and yet that is not true at all.

  • Bottom line: If you have chronic pain or fibromyalgia make sure you get the complete thyroid blood panel and you evaluate your thyroid function based off of the "optimal" reference ranges. 

The Link Between Fibromyalgia, Chronic Pain, and Hypothyroidism

Chronic pain and Fibromyalgia frequently accompany each other, however, no one seems to understand the exact connection.

But, if you look at the symptoms of Fibromyalgia and Hypothyroidism side by side you begin to see something very interesting:

Fibromyalgia and Hypothyroidism present with almost the exact same symptoms...​

There are several studies to show this (which we will go over below) but first I want to talk about a researcher named Dr. Lowe who put this all together for us. ​

He linked tissue level hypothyroidism as one of the main causes of Fibromyalgia. And he did this through a concept known as 'deductively formulated theory'.

This method of problem-solving takes all of the competing theories that cause a disease and by the use of mathematical analysis pumps out the hypothesis that is most likely to be correct (this is the same logic that Albert Einstein used to come up with his hypotheses - like the theory of relativity (5)).

Not only did he link the two conditions together he also showed us how to effectively treat and even reverse Fibromyalgia and chronic pain symptoms through various research studies and even case studies. ​

Through his research, he found that the majority of patients who have fibromyalgia either have undiagnosed hypothyroidism or they are being inadequately treated with LT4 containing medications. 

His research showed that in order for patients to have complete remission of their pain most of them needed the active form of thyroid hormone known as T3. 

This can be assessed through routine blood work but it is not often ordered by most physicians. 

For this reason, you may need to specifically ask your doctor to check your free T3, total T3 and reverse T3 levels in order to accurately assess if your body has sufficient cellular thyroid hormone available. 

​As a quick primer: 

T4 is the inactive thyroid hormone that must be converted to T3 to become active <---- This is what most Doctors prescribe for patients​

T3 is the active thyroid hormone that turns on genetic transcription, increases metabolism and helps thyroid patients feel better <---- ​Most Doctors do not prescribe this medication but many patients with chronic pain and fibromyalgia may need it

Dr. Lowe's data showed that approximately 2/3 of patients improved on Natural Desiccated Thyroid Hormone (Medications like Armour thyroid, WP Thyroid, and Nature-throid) and another 1/3 required higher doses of T3 only therapy (Liothyronine or sustained release T3) to get symptomatic improvement. 

While thyroid hormone that contains T3 (triiodothyronine) was very important to treating and reversing fibromyalgia, it wasn't the only therapy required to get complete remission. 

We will go over the rest of the treatment below, but first, let's talk about some of the symptoms you might be experiencing if you have tissue level hypothyroidism. 

Symptoms of Tissue level Hypothyroidism & Fibromyalgia

As I mentioned previously blood tests are not 100% accurate in diagnosing hypothyroidism which leads to many undiagnosed and/or mismanaged patients. 

It turns out that using the combination of symptoms in combination with blood tests makes diagnosis much more reliable. 

Before the widespread use of TSH testing most patients were diagnosed by symptoms alone and their medication was also titrated based off of their symptoms.

​While there are hundreds of symptoms of hypothyroidism there are a few that remain very constant among patients who share both fibromyalgia and hypothyroidism which we will go over below: 

#1. ​Chronic Fatigue

This is the kind of fatigue that is debilitating. The kind of fatigue that keeps you from doing normal activities like household chores or going out. 

Patients frequently tell me that after they go out to do something simple like shopping they are almost bed bound for 1-2 days.

Chronic fatigue is both a symptom of hypothyroidism and fibromyalgia, but how are they connected?

2 ways: ​

Thyroid hormone is involved in the production of Dopamine.

Dopamine helps your body to determine how much energy it is going to use and low levels have been associated with obesity (6).

If you have low levels of thyroid hormone you will have low levels of Dopamine which will result in the symptom of Chronic Fatigue.

Tyrosine is a precursor to thyroid hormone and dopamine

Thyroid hormone helps your body convert Tyrosine to Dopamine, Norepinephrine, and Epinephrine.

You may know some of these hormones as adrenaline (7) which helps to set the metabolism of your body and is required for the "fight or flight" response.

​The second way hypothyroidism causes fatigue is through decreased consumption of oxygen and thus decreased production of ATP. 

ATP is created in the mitochondria of your cells, if you have low production of ATP you will have the subjective symptom of fatigue. 

Thyroid hormone is involved in the metabolism of oxygen and oxygen consumption is required for proper ATP production.

#2. Weight Gain, Weight Loss Resistance & Inability to Lose Weight

Does it feel like you are constantly gaining weight, despite eating healthy or even exercising?

Many hypothyroid patients and fibromyalgia patients have difficulty with weight loss even though many of them are already restricting calories and exercising frequently. 

This isn't a normal condition and it can be mediated through low levels of thyroid hormone in the body. ​

Under normal circumstances, thyroid hormone helps your body burn fat by increasing the effectiveness of lipolytic enzymes (8)(enzymes that break down fat).

When thyroid hormone is low, these enzymes are also low resulting in the inability to break down fat molecules - making it almost impossible to lose weight.

Thyroid hormone upregulates lipolytic enzymes and helps burn fat

(Thyroid hormone increases enzymes that help you burn fat and when thyroid levels are low your cholesterol increases and your metabolism will slow down)

In addition, thyroid hormone is involved in mediating your basal metabolic rate or resting energy expenditure (9).

In other words, thyroid hormone helps regulate your metabolism. 

Patients with hypothyroidism frequently feel like their metabolism is damaged and may gain weight even when eating 1200-1500 calories per day (sometimes even less).

In order to fix this metabolic damage thyroid hormone must be replaced. ​

#3. Hair Loss

Many patients with fibromyalgia have symptoms of hair loss and/or hair thinning. ​

It is well known that thyroid hormone is required for both hair growth and proper pigmentation (10).

​Now hypothyroidism isn't the only cause of hair loss but it is definitely one of the more common causes. 

Chronic stress itself can lead to hair loss and let's face it: having fibromyalgia is stressful​. 

But hypothyroidism is still a leading cause. ​

Not only that but low thyroid hormone ​leads to low stomach acid which leads to nutrient deficiencies that make hair growth even more difficult. 

Deficiencies in zinc, B12, and iron cause both hair loss and are made worse by hypothyroidism. 

Thyroid hormone is responsible for hair growth and pigmentation

(Low thyroid hormone leads to hair loss by itself but also leads to deficiencies of nutrients required for hair growth - it's a double whammy)

Just realize that replacing these nutrient deficiencies is a necessary and important part of reducing symptoms of both fibromyalgia and hypothyroidism. 

#4. Muscle Tension, Trigger Points & Muscular Pain

​Tender points in the muscles are common in fibromyalgia. 

These tender points are caused by abnormal contractions in the muscular tissue that stays contracted over long periods of time causing changes in the fascia and potentiating pain. 

In order to relieve the pain the tissue MUST relax, and in order for muscular tissue to contract, there must be enough energy in the form of ATP. 

Remember that thyroid hormone is required for proper ATP production?

In order for muscles to relax your body must produce ATP (11)(the energy currency in your body).

​What you may not realize is that contracting your muscles does not use energy, it's the relaxation portion that requires energy. 

Consider this as an example:

When someone dies all of their muscles contract and they become "stiff", this is known as rigor mortis (12).

The reason for this contraction is due to a lack of energy production.

The same thing is happening (to a smaller degree) in certain muscles in patients with chronic pain, fibromyalgia, and hypothyroidism. 

This inability to relax your muscles results in trigger point formation and muscle tension/pain (13).

Treating these trigger points and tender points are required for relief of pain and we will go over that below. 

#5. ​Delayed Relaxation Phase of Deep Tendon Reflexes

This symptom you may not even realize you have, but it can be a VERY sensitive marker for diagnosing tissue level hypothyroidism. ​

When tissue levels of thyroid are low it results in the inability of your muscles to relax quickly which causes a slow relaxation phase when checking deep tendon reflexes (14).

Your reflexes have been tested whether you realize it or not:

Testing of the deep tendon reflexes happens when your Doctor hits your knee with his reflex hammer and your knee automatically "jumps".

Patients with a low amount of thyroid hormone in their tissues have a slower response to the relaxation portion when this reflex is tested (15).  

This can be easily tested and there are even machines to help with the diagnosis. ​

How to Treat & Reverse Fibromyalgia & Hypothyroidism:

These recommendations come from treating many patients with both chronic pain, fibromyalgia, and hypothyroidism. 

You can see an example of a case study in a patient with chronic pain who had a complete resolution in her symptoms, lost 40+ pounds and reversed her diabetes here. ​

This treatment works (provided your symptoms are due to hypothyroidism) and has the potential to help many patients if done correctly.

For the best results make sure to follow each of the recommendations below - doing just one or two of them will not lead to long-lasting, significant results. 

Step #1: Get on the right type and dose of thyroid medication

For most patients, this means using some form of T3 thyroid medication. 

The majority of patients are already on T4 only medication (such as Synthroid, levothyroxine or Tirosint) but in order to ensure that tissues are getting enough thyroid hormone, you will need T3 added to your regimen.

If you have a diagnosis of hypothyroidism you can follow these steps:

  • Add T3 (in the form of liothyronine or cytomel) to your existing medication - you can ask your provider for this medication (this is probably the easiest way to get T3)
  • Switch from levothyroxine to NDT ---> this may be difficult but some providers are willing to do it. Make sure you follow this dosing guide if switching
  • Temporarily (or permanently) switch to T3 only medication <--- this will be the most difficult to get but probably the most effective

If you don't have a diagnosis of hypothyroidism then I recommend these steps: ​

Step #2: Exercise to tolerance

The important part of this step is to find the maximum that you can tolerate and exercise to that point. 

This will vary depending on your energy level, your weight, and your metabolism.

If you can only exercise for 5-10 minutes once per week, then that's fine. On the other hand, if you can tolerate 20-30 minutes several times per week then you should do that. 

Focus on taking your body to its limits and exhausting the targeted muscle group of both glycogen and energy.

This can be done most efficiently by utilizing the idea of high-intensity interval training or high-intensity strength training (16).

Both exercises provide benefits over the traditional "cardio" type workouts where you sit on the treadmill for 45-60 minutes a few times per week.

The more intense your work out the better it is for muscular tissue, energy levels, and your hormones.

It also provides a boost to weight loss. ​

Step #3: Eat a real, whole food, nutritious diet

Diet is an important part of treatment and the basics should include real, whole and nutritious food.

The macromolecule breakdown of your diet should be tailored to your body, your activity level and other specific medical problems you may have.

Real whole food diets include diets like whole30, the paleo diet and even nutritional ketosis.

You can find more information about how to pick your diet in these posts:

If you are new to the idea of changing up your diet take it slow but use the recommendations in the articles above to help get you started.

Changing your diet will be required for optimal health. ​

Step #4: Manage muscular tension with these recommendations

​As we discussed previously treating and "releasing" the tender points seen in fibromyalgia and chronic pain are required to reduce symptoms. 

Treating these tender points involves several therapies but universally some sort of mechanical force will be required to get rid of them.

I recommend and have used all of the following therapies for patients with fibromyalgia:

Studies have shown (21) that various types of massages improve quality of life in patients with fibromyalgia. 

Whatever you decide to do just make sure you remain consistent with the therapy while doing the other treatment recommendations. ​

Step #5: Replace nutritional deficiencies

​Most people nowadays have some vitamin and nutrient deficiencies as a result of chronic stress and poor nutritional diet. 

Replacing these nutrient deficiencies is a vital part of the healing process and in most cases is required to thrive.

Hypothyroid patients (and fibromyalgia) are susceptible to certain nutrient deficiencies that may potentiate chronic pain and fatigue.

For instance, studies have shown (22) that fibromyalgia patients tend to have a low mineral content via hair analysis. 

You can read more about the list of nutrients that hypothyroid patients need to function optimally here.

Below I will also go over the most important nutrients required for energy and to reduce pain & inflammation:

  • B complex vitamins <---- B vitamins (specifically B6 and B12) are required for proper energy production and replacing them may improve energy levels and reduce fatigue. When replacing vitamin B12 make sure to consider B12 shots if you have issues with absorption. 
  • Zinc & Selenium <---- Zinc reduces inflammation and is required for proper immunity, it also helps boost T4 to T3 conversion and helps the thyroid function optimally.
  • Iron <---- Iron deficiency leads to hair loss, decreased energy and even shortness of breath. Low levels are seen in patients with hypothyroidism, but be careful when supplementing not to get "too much". You can follow iron storage in your body by assessing your ferritin level. 
  • Krill oil + Astaxanthin <---- Omega 3 fatty acids help to reduce inflammation (23) and provide relief to patients with joint pain and chronic pain syndrome. 
  • Bottom line: Replacing nutrient deficiencies is a necessary part of recovering from chronic pain and fibromyalgia. Make sure to target your nutrient replacement to targeted deficiencies based on lab tests. 

Conclusion

What's the main takeaway here?

If you are suffering from chronic pain or fibromyalgia, and you also have hypothyroidism, then there may be a connection between the two. 

Due to how hypothyroidism is managed, however, your physician may not be aware of this connection and you may not receive adequate treatment. 

It appears that chronic pain can be made worse by low levels of circulating thyroid hormone. 

The treatment for this condition is to use thyroid medications which contain both the active T3 and the inactive T4 hormones. 

To ensure that you are getting enough thyroid hormone you need to get a full thyroid lab panel and look specifically at the concentrations of free thyroid hormone in your blood. 

Once you have this data you can then determine how to proceed with treatment!

In addition to using thyroid medication, you'll also want to focus on repleting any lost nutrients, using a proper exercise routine and on eating a healthy and nutritious diet

All of these things, when combined, may help to relieve your pain. 

Now I want to hear from you: 

Are you suffering from chronic pain and/or fibromyalgia? 

Have you been able to overcome your symptoms?

Do you also have hypothyroidism?

Let us know what worked (and what didn't work) for you so we can further the cause and help as many people as possible. 

Leave your comments or questions below! 

References (Click to Expand)

This post was most recently updated on January 17th, 2019

Dr. Westin Childs

Dr. Westin Childs is a Doctor of Osteopathic Medicine. He provides well-researched actionable information about hormone-related disorders and formulates supplements to treat these disorders.He is trained in Internal Medicine, Functional Medicine, and Integrative Medicine. His focus is on managing thyroid disorders, weight loss resistance, and other sex hormone imbalances.You can read more about his own personal journey here.

286 thoughts on “The Connection Between Chronic Pain and Fibromyalgia & How to Treat it”

  1. Hi this has been great information for me as I was diagnosed with chronic fatigue 8 years ago I hardly eat I’m constantly on the go and in exhausted and never lose any weight so going to get myself tested thank you

    • Hey Susan,

      I’m glad you found it helpful! Make sure you get the right tests, but more importantly make sure they are interpreted correctly. Thyroid resistance is behind the scenes in many patients with these symptoms and can be easily missed if the reverse T3 isn’t ordered.

      • I have been sick for many yrs. The Dr’s I have seen in the past have not been much help. They just say I have chronic pain, fibro or to take vitamins B12 & D3. They say I probably have fibro, but when I get copies of my medical records they have never put it in my records. I have been told for years that I have hypoglycemia, but when I check with a glucose meter my levels are always normal. I have a tumor on my thyroid that measures 5.8 and they only did an ultrasound, they just tell me not to worry about it, they have never biopsied it and don’t tell me to come back to have it checked again. I feel so bad I feel like I am dying. I have no energy and have all the symptoms of having a thyroid issue. How do I get a Dr to listen to me? I have found a lab that I can pay cash to have the test done without a Dr ordering them. What test do I need? It is expensive so I don’t want to have test done that are not needed. I feel so desperate to find help. Ilene

        • Hey Ilene,

          You’re in a tough spot. I wouldn’t even recommend that you spend your own money on expensive lab tests because your doctors aren’t going to change their treatment. If the doctors knew how to interpret and treat those lab values they would have ordered them to begin with. The fact that they didn’t is very telling.

          Your best bet is to look outside of the insurance model and find a doctor that is aware of the conditions you have and knows how to treat them. I only know of a handful of people (out of thousands) that have been able to find a doctor in the insurance model that has been of any help.

          Bottom line: don’t waste your money on expensive labs hoping that your doctor will somehow see the “light” and start treating you correctly. It won’t happen.

          • Hi thanks for your advice. How do you find this doctor you speak of I have tryed several doctor. All seem to not hear what I’m saying. I live in North Carolina. I have weight problems fog brain, fatigue, muscle aches. No one listens. Being sent to neurophysiology. So frustrated.

          • Hi Phyllis,

            Unfortunately I don’t have any recommendations to give you. The only way a physician knows this information is if they study it on their own, it’s not standard knowledge.

          • If you haven’t found a doctor yet, I can recommend Beverly Goode in Raleigh. She is an osteopath and hypothyroid herself — and very thorough. However, be forewarned she will be urging you to make lifestyle changes including supplements 🙂

          • I also have had a life time of weight battle had many thyroid test dr always says in normal range I had gastric bypass loss only 50 lbs while always eating rt only to go back to diet dr put me on phentrimene and loss another20 lbs seems abnormal to me to have to do this

        • Ilene,
          If you cannot find a doctor to take you seriously, you need to take your health into your own hands. This is what I did and I feel so much better for it.

        • Have them do test RBI. That’s the only test it would show up my thyroid problem. Tumor and thyroid removed. Take 300 m daily. It goes crazy a couple times a year and dose is increased.

        • Please change your Endo! For 7+ years Kaiser was tracking a nodule on my thyroid, they did do 2 biopsies that came back negative (if you don’t hit the right spot it will be negative and my dr. Was the one to do it, not a dr. That this is all they do) I changed insurance and seen a new Endo, had ultrasound and biopsy. Came back positive for rare thyroid cancer, Medullary, it’s incurable and my doctors believe I’ve had cancer 7+ years. There is a simple blood test to find this cancer, Calcitonin and CEA. KAISER never did this even though I had the only symptoms for it (diaherrea and flushing). With a nodule that big you must biopsy it!

          • Hi Colleen ~ Thank you for sharing. I also had a nodule that was being tracked for 10yrs. After 2 FNA, they both came back negative but also said that they don’t know what’s around the biopsy site and suggested I have a thyroidectomy (which I regret). So you had 2 biopsies by your first doctor but then you went to an endo and they also did a biopsy and they found cancer, what was different between the biopsies your first doc did versus the new endo?

          • The first was done by my regular Endocronologist the one where I was diagnosed was done by a pathology lab in Pasadena, CA where the dr. Only performs these biopsies. I forgot what they are called but this is his only job.

        • PLEASE see another dr. For your nodule, you need a biopsy! Several years they were (Kaiser Permenente) watching mine and even had a biopsy done by my Endocronologist (you should have it done by a dr. Who only does biopsies, they have experience and know how to do it) my biopsy (2 of them ) were negative. I got new insurance and seen a new Endo, I had new ultrasound that led to getting biopsy which was positive for a very rare form of thyroid cancer, Medullary Thyroid Cancer. When I found out they only had to do 2 blood tests (calcitonin and CEA) to know this I was extremely upset. This has been growing for 7 years. I had to have thyroidectomy and a central and left neck dissection. This was 2 years ago. It’s incurable. I am stable for now but had a suspicious lymph node on my ultrasound. Need a biopsy. Listen to your intuition you sense something is not right go find a dr. To do the right testing.

          • Wow this is where I am. Kaiser biopsy done twice now and ultrasounds. Diagnosed with multiple thyroid nodules being benign. My TSH is at the high end…yet I have no energy, extremely dry skin, Fibromyalgia.
            Not sure I trust what they are telling me.

        • Hello,

          When I read your post it sounded just like ME, last year. I am not a doctor but the past 4 years I felt as if I was. You could possibly have a parathyroid tumor In your neck. You can be tested for this but you need to STOP taking vitamin D for 3 or more days, it will suppress your PTH. I was tested when I was taking Vit D and it came back normal, a false test result. Then I found Dr. Norman’s site, I stopped my Vit D and it came back high and my calcium was 11. You also need a bone density test. Please go to parathyroid.com this is were I figured out my lump in my neck was and I had my surgery there, they are the best. If you have high calcium, low vitamin and a lump in your neck, you need to test your PTH. BUT STOP taking your vitamin D. I hope this post will find you.

    • I then researched Selenium and decided to give it a try. I have only been taking it for a few days and will have to wait to see if this proves my hypothyroidism and associated aches and pains.

    • Very informative. I have fibromyalgia chronic pain disorder soft tissue disorder. I am always fatigue. Low energu. Mu doctor keeps telling me there’s nothong wrong with my thyroid. What do I do?

  2. A friend sent me this link through Facebook. Question: I had my thyroid removed several years ago due to it being three times the normal size and Hasimoto’s disease. I am of course on thyroid replacement, bus still ha e chronic pain and exhaustion that comes on without warning. Will these things that you mention and write about help some one without a thyroid gland?

    • Hey Lissa,

      Absolutely. If you are on a T4 only medication then your body will still have to convert that hormone into the active T3, and in the setting of any of the problems I talk about you may ultimately turn that right into reverse T3. Bottom line is that these recommendations will definitely help even without a thyroid gland.

  3. I found this article interesting. Is it possible to only have pain in one area?] I take Armour 120 mg and 15 mg and have disabling calf pain that comes on suddenly. The pain can last from a day to months, which renders me unable to stand or walk. Arthritis, blood clot, vein diease, etc are negative. I am unable to lose weight and gaining since 15 mg was added. My rheumy wants necular muscle doctor to run tests to see if calf muscle is resisting magnesium. I refused since I feel problem is thyroid related. Unfortunately doctors in my area do not test R-T 3.

    • Hey Tee,

      It is possible, but unlikely. I have a number of patients that I have successfully treated with conditions similar to yours. In some cases it’s been post herpetic neuralgia, in others it’s been related to venous stasis or arterial disease. Bottom line is you need further evaluation by a good doctor.

      • Thanks for responding. My calf pain comes and goes. I can have it for several months one year and not again for several years. MS tests were negative, but vitamin D level low. My D is 50 now. I was told I had measles, but not chicken pox. I didn’t get chicken pox or shingles when my children had them for a month or afterwards. However, the chicken pox blood test my doctor ordered was positive. I don’t know whether to believe the results since I tested positive for Sojourn a year ago and negative this year. This blood test can show a false positive, which is why a lip biopsy is recommended. I was researching NatureThroid and came across a consumer site where hundreds of patients taking Armour complained of leg etc. pain like mine and reported their symptoms to drug manufacturer. Their pain subsided when switched to WP or NT. My doctor switched me to 130 mg of NatureThroid last month and said she may need to adjust dose. I was taking 150 mg of Armour prior to switching. I felt wonderful the three days I took NT. Probably due to Armour still in my body, and took nose dive after 5 days. After falling asleep while eating celery with greek yogurt on Easter, I decided to increase NT. I started by adding 1/4 tablet of 130 mg NT to my daily dose. I was better in the morning and wiped out by afternoon. The calf pain returned too. Today I took 130 mg plus 1/4 tablet of NT in the morning and 1/4 of tablet at 1 pm. No calf pain even after swimming laps for an hour. ( I have been a lap swimmer for over 20 years.) I am glad my calf pain is gone, but unhappy that I gained 7 lbs in a week. I have been taking thyroid medication for 50 years and told my thyroid no longer exists. I go for blood tests next week. My doctor only does TSH and Free T 3 and 4, vitamin D, adrenals, cbc. I haven’t found a doctor in my state that does R T 3 tests. I took it upon myself to take 100 mg of B 6. I already take a multivitamin with minerals, D and magnesium. I get selenium from Brazil nuts, sunflower seeds, etc. and C from veggies and fruits. My zinc and iron levels are good. I was raised eating fresh foods and continue to eat this way. My exercise, sleep and relaxation are fine. I didn’t start gaining weight, develop fatigue, etc. until doctors changed my thyroid meds. I am tired of gaining weight, fatigue, pain, and looking like an old woman instead of thin, energetic, etc. self I use to be. I looked for NP in my area. The one listed is so far away, I would need to move to see her. I don’t know what type of doctor to look for, but seeing another endo is out.

        • Hey Tee,

          It can be tough finding someone who understands the thyroid, but keep looking! I would also recommend that you check out your other hormone levels as well. They could definitely be contributing to your overall health. Generally speaking, doctors that practice functional medicine can be helpful – as long as they can prescribe medication.

          • Hi Dr. Childs:

            I wanted to update you on my condition. I began taking selenium and zinc with NT. My calf pain subsided, mobility and energy increased. I even lost a few pounds. It is a relief to be able to move without walker. My physical therapist is floored by the change.

          • Hey Tee,

            That is great news! I’m happy for you 🙂 Most doctors don’t know what’s possible because they don’t even try!

        • My dr. Won’t do RT3 either but she did do a Reverse to T4 (better than TSH,it shows what your body is actually taking in. it showed I’m normal 1.2 where the TSH showed I was hyper .32)

  4. I am in the same boat as Lissa I had my thyroid removed two operations. Now I have fibromyalgia. I am exhausted after doing the slightest thing I struggle to keep weight on and most days my pain is unbearable.Most days I feel like I have done 10 rounds in a boxing ring and then hit by a bus. Night times I dread as the pain increases and insomnia. I take 125 mg a day of Levothyroxine 120 mg of MST and 2700 of Gabapentin

    • Hey Tracie,

      Most post thyroidectomy patients feel terrible. Your thyroid naturally pumps out T4 and T3 in about an 80/20 ratio. When doctors give you back replacement hormone they almost always leave out the T3 – which usually makes patient feel terrible, gain weight and develop symptoms of hypothyroidism.

    • For fibromyalgia if you are not on opioids then ask your dr. About trying Low Dose Naltrexone, if you are on opioids then ask about ULTRA Low dose Naltrexone (helps with fibromyalgia pain and doesn’t block your opioid sensors). Google about it you will find a lot of positive info. There is also a new blood test (most rhumatologists don’t believe in it but the science backs it up). Fm/a you can contact the research company directly and have it done https://thefibromyalgiatest.com

      • I take Naltrexone 4.5mg 2x a day for fibromyalgia. I feel it saved me because I was in so much pain & I was surely taking too much pain medication. I still have pain but not like without Naltrexone and lyrica together.
        I am very interested in this article and I will be looking into it more but I am not sure my gp will go for the idea and depth that she will have to look. Im my best advocate and I will get a definite answer. Thanks for the information!

        • No problem, I’m glad you found it helpful! I have many patients who have had significant improvement on LDN. Not everyone does, but when it works it tends to work well.

  5. Hi,i had hypo after my son Was born,then years later went hyper due to a Multi nodule Toxic goilter,so had meds for two years then had 500 of radio iodine theapy,then Was in loads of pain,3 yrs later they said i had fibro,ive Seen 4 endos to date all say no thyrod issues,so when my neck swells up and goes hot Just before a flare up,Also if i take vit d (Im low at 53) my joint pain Is through the roof and Im weeing all the time ,they said no parathyroid Prob,Im not On Amy thyroid meds,i did take ndt i got up to two grains but It didnt make a diff,Also weight gain through the roof 3 stone why does Mo one belive me,Also tested positive for hla b27 Gene too,esr,rhemo factor 10,crp eleivated,i Just want my Life Back,ive had to give Up two Jobs,i cant Do even 1/3of what i used too,if i Do too much i pay for It the next day,Sometimes two days,this Is not living this Is Just exsisting

    • Hey Sue,

      All endocrinologists practice medicine the exact same way, so no matter how many you go to you will always hear the same thing. I wrote a post about it here so you can get an idea of what you’re facing: https://www.restartmed.com/thyroid-lab-tests/

      The truth is that you aren’t likely to ever find help in the insurance model of medicine (that means through your GP, PCP or endo’s).

      • Endos do not even want to talk about treating with T3. They look at you like you’re an idiot. “I’ve never heard of that,” was the last response I got. The one doctor, that did treat the way you described, left the area.

        • That tends to be the case, if you want to get the help I am talking about here you will generally have to look outside of the insurance model.

  6. Hi my daughter 17 has hypopituritsm undiagnosed for 14 years. She is now on levroxine 100ml a day but has chronic pain and is now in a wheel chair they have said it’s cfs but I’d really like to know what you think regarding her thyroid
    Many thanks
    Rachel

    • Hey Rachel,

      She could be suffering from persistent tissue level hypothyroidism, but I would have no way to know for sure unless I saw her as a patient. I take a very comprehensive history and do extensive lab work with each patient to get to the root cause of their problem, but it can take some time and digging to get there.

      I find most hypo pit patients (like post thyroidectomy patients) are usually under treated and feel terrible.

  7. Very informative, I have a 5cm complex cyst (goiter on my Thyroid)…all standard test reveal my levels are normal, however in recent months i have patches of Vitiligo under my arms and on my stomach, I am wondering if this is maybe all tied into Hashimotos and that maybe one day, one of my GPS will actually do a test for me, I have mentioned it but my GP says they arent connected.
    Any thoughts

    • Hey Dawn,

      Lots of thoughts! 🙂 It’s not about ordering the right tests it’s about interpreting them correctly. I would take a look at this post here so you can get a better idea: https://www.restartmed.com/thyroid-lab-tests/

      I see this in a lot of patients who try to ask for the “right” tests, and when they get them they are told they are all “normal”. Asking for the right tests is just the first part, interpreting and taking action is 90% of the puzzle.

      To answer your question, yes, hashimoto’s and vitiligo are most likely related and signs that you have an underlying immune issue because both of these conditions are autoimmune based.

  8. I have had hashimoto hypothyroid for 30 years and been on levo for all that time but have still had all symptons, 3 years ago insisted on referal to endo and lots of tests and mri scan was diagnosed with hypopituitarism with adrenal insufficiency ( now steroid dependant) growth hormone deficiency (now inject daily) meds are 100mg levo and 10mg T3, 25mg hydrocortisone daily, 0.3 growth hormone, adcal and self bought vitamins as recommended by ‘Stop the Thyroid Madness’ book. I still have chronic fatigue and take Tramadol for my chronic aching joints. My life is now a daily struggle as having to rest most of the time and constantly have low iron store or anemia. I have bought NDT from Canada but nothing changed have no idea what to do next. Oh and also struggle with weight despit having no appetite at all as have no smell or taste for last 10 years.

    • Hey Linda,

      Medication is only one piece to a much larger puzzle. When I treat patients (and in order to get them better) you really have to look at EVERY body system and hormonal system. This includes nutrient deficiencies, gut health, detox capacity, inflamamtory levels, hormone levels, etc.

      Just taking NDT is not likely enough to help your entire condition.

      My best recommendation is to find a functional medicine doctor near you for further help, if you don’t have one close you may need to drive to see one.

    • All comments are moderated before they are public to ensure that no one is spamming or being inflammatory to other people 🙂

  9. Hi I sent a message but it is not here. It said my message was waiting moderation? what do this mean please and why it has not been answered?

    • Hey Linda,

      It takes some time for me to see and reply on all of the comments. Your comment does have an answer now 🙂

  10. Thanks for an interesting and easy to understand article. I wish more doctors understood this!

    I was diagnosed with hypothyroidism end of 2011. Due to one reason or another, it was about 4 months before I started taking Levo. During this time my lifestyle changed a lot and I think I “crashed”. I thought I had fibromyalgia but was still in denial about being hypo. Eventually I realised I needed help and started taking Levo. The pain reduced, but didn’t disappear. In fact, I think I crashed again a couple of years later, going from a gym junkie to someone who barely left the house.

    Then I discovered Natural Dessicated Thyroid, a gluten free diet, and I learned about the inflammatory effect of night shades (esp tomatoes and potatoes).

    Now I feel like I have a life again. There’s still a way to go, but making these changes changed my life!

    • Hey Kris,

      Thanks for your comments! I’m glad that you were able to identify and target the triggers of your pain! It really can be that easy once you know what to look for – though I’m sure the journey was a difficult one.

  11. This article was enlightening. I was seen by an endocrinologist, she did an ultrasound, blood work and 2 biopsies. I have multple nodules on my thyroid, which are visable. The bloodwork came back normal and the biopsies were non-cancerous. So, I was not treated at all. I have 9 out of 10 hypothyroidism symptoms. I have no insurance and can’t financially push for more testing/answers. This article explains that some of the other issues I have been having are most likely linked to the thyroid issue.

    • Hey Kelly,

      I’m glad you found it enlightening! There are many things you can still take action on including: diet, supplements, exercise, stress reduction and improved sleep. I would start with these until your situation allows for more advanced testing. Good luck!

  12. Thank you for this article. I was diagnosed with hypothyroidism years ago and was put on Levo but then taken off by my primary care doctor because my blood work was normal. As of today I am completely desperate in so much pain, mental fog, muscle fluttering I can’t take it. I will be headed back to my Dr. as soon as possible after reading this.

  13. I have EDS and am hypo w hashi. A few years ago I lost 80 lbs (clean eating – getting chemicals and processing out of my diet and exercise) and felt so much better. It use to take me 10 minutes just to get out of bed because of the pain. Now I spring out 🙂 Lately I have not been fitting in my workouts (still maintaining a healthy weight) and have noticed my over-all pain returning. I feel like I’ve aged 30 years in the last 2 months.

    • Hey Heidi,

      EDS is a tough one. In general the same rule applies (regardless of the disease): remove processed foods and chemicals from the diet, eat whole and nutritious foods, replace nutrient deficiencies (some diseases exacerbate underlying deficiencies), exercise to tolerance based on your fitness level, remove stress and improve coping mechanisms, continue to detox!

      The one thing I would trial is physical work – this could be in the form of accupuncture, massage therapy, vibration therapy, etc. I’ve seen good results with these modalities when used in conjunction with the above.

      Keep up the good work!

  14. I HAVE HAD HYPOTHYROID FOR 20 PLUS YEARS.RECENTLY DX WITH SJURDRENS SYNDROME.CHRONIC PAIN DUE TO OSTEOARTHRITIS AND ? RA., HAS TAKEN ME AWAY FROM EVERY THING.DOC,S ARE AFRAID TO INCREASE MY MED BECAUSE I WILL BECOME ADDICITED.MY T3 LEVEL GOES UP AND DOWN AND IT SEEMS TO BE HIGHER WHEN THE PAIN IS THE WORST.CAN YOU HAVE RA AND YOUR RH FACTOR BE NORMAL?WHEN ONE MD DOES NOT KNOW WHAT TO DO,THEY SEND ME TO ANOTHER MD.MEAN WHILE I AM STILL IN THE WORST PAIN AND HAVE TO WAIT FOR MONTHS TO SEE THE NEW MD.I WENT TO THE ER ON EVENING BECAUSE MY FOOD WAS SWELLED AND VERY PAINFUL.THE MD TOLD ME THAT I COULD NOT GET PAIN RELIEF DUE TO MY ALLERGIES AND WA ALREADY ON MS CONTIN.MY FOOT IS BROKE AND I CAN NOT GET MEDICATED.I GUESS THEY THINK I AM DRUG SEEKING.I AM AT A TOTAL LOSS AND GETTING DEPRESSED.ANY SUGGESTIONS?

    • Hey Alice,

      Persistent hypothyroidism can cause and potentiate chronic pain, but it doesn’t necessarily mean it is the cause of all chronic pain. Your T3 levels can go up when you are in worse pain due to elevated reverse T3 levels – this combination of lab values usually points to thyroid resistance.

      The first place to start is with a complete and full thyroid evaluation (plus other functional chemistry tests) to evaluate where you stand. I would caution against staying in the conventional system, however. You are not likely to find a Doctor who will agree with what you are reading here in that model.

      You can see an article I wrote about here which goes over how to actually test for hypothyroidism: https://www.restartmed.com/68-of-the-most-commonly-reported-signs-and-symptoms-of-hypothyroidism/

  15. My doctor finally put me on 5mg of Cytomel 3 times a day along with my Synthroid and it made a huge difference! I am also a huge advocate of probiotics!!! My life has improved tremendously since making these changes.

    • Hey Lori,

      That’s great news! I’m glad you were able to find a doctor to work with you. And I agree with you on the probiotic point. Sometimes small changes like that can make a HUGE different on your overall health.

  16. I’m 43 and lost my thyroid due to cancer 21 yes ago.thr pain I feel daily makes me hate my life. I’ve begged for help and begged for consults. Instead he runs a TSH on me and then just prescribed me 50 mcg of levo. Mind you I have no thyroid and have been taking 200mcg for 15 years. Won’t address my pain my fatigue or concerns. I’m 208 lbs. Only 5’5″. And gaining. I can’t afford to pay for things out of pocket. So my reality is pain and suffering everyday until I die. Which will be soon I fear. I’m glad some patients have you and feel better! Thanks for trying to help so many of us that suffer!

    • Hey Melissa,

      I’m sorry to hear about your situation! I wish that this type of medicine was more widespread, but unfortunately it is not. You may want to look for a new doctor who is more willing to work with you.

    • Hey Toni,

      I don’t know of any data suggesting that thyroid plays a role in plantar fasciitis. In my experience it’s usually a consequence of degeneration and/or inflammation caused by insulin resistance – or at least I should say most pain goes away completely when we treat insulin resistance.

  17. I have had hypothyroidism since age 4. I have been treated on and off most of my life with either synthroid or levothyroxine and a few times with armour. I had surgery in January of this year on my knee, a arthoscopy for arthritis and torn meniscus and it seems to be taking so long to heal. I keep hearing lose weight to ease the pain. I have tried to lose weight most of my life and my endo’s just do not listen to me when I tell them I have no energy, can’t lose weight, pretty much have at lesst 150+ symptoms associated with this disease. I have been ignored or discouraged into presenting information I’ve found that could help me and I’m getting really ticked off. There are few specialists in my area and I have state insurance so going to another state for treatment is out of the question. I’m 55 and tired of being tired! My doctor poo poo’s my request for testing for leaky gut, told me probiotics are not necessary, etc. I don’t want to live the rest of my life miserable, and unable to enjoy what I can do.

    • Hey Annette,

      I’m sorry to hear about your situation. It can be difficult to find a doctor who takes insurance and also understands how to actually treat the thyroid, but keep on looking! Most functional medicine doctors do not take insurance, but some do. You may have some luck by searching out friends who have had successful treatment.

      • I was curious to know whether my healing is being hindered by my thyroid condition. How would I ask my current doctor to test for deep tissue thyroid probllems?

  18. Hello, I had my thyroid out last year. I am on levothyroxine only. Doctor says I do not need a T3 med because the Levo will convert. Does that sound right? If someone doesn’t have a thyroid do they need both T3 and T4 meds? thx!

    • Hey Lisah,

      T4 doesn’t necessarily convert to T3 the way most doctors think it does. Beta blockers, anti depressants, inflammation, obesity, insulin resistance (just to name a few) all reduce the conversion of T4 to T3. You can read more on how to increase free T3 levels here: https://www.restartmed.com/increase-free-t3-naturally/

      Most people do feel much better on a combination of T4 and T3.

  19. Hi, I had half of my thyroid and the isthmus removed July 2015 due to a large hurthle cell nodule which thankfully turned out to be benign. Pathology did reveal a smaller papillary carcinoma elsewhere in the lobe. It was considered low risk with no further treatment. My TSH was 1.4 in 2014 and since the surgery has risen to 3.8. I am sure I am experiencing symptoms of being hypo. The t4 and t3 were also reported within normal reference ranges. I am extremely fatigued and am in pain. Sometimes I’m not sure if it is joint or muscular. My hair is dry and brittle. I have had ongoing weight issues for the last couple of years. Lately I have gained a few kilos really quickly.I am glad I stumbled over your article and am going to investigate further. I really feel I need some hormone replacement.

    • Hey Debh,

      I definitely think it’s worth further evaluation! Just make sure you find the right doctor who is willing to order all of the tests.

  20. My son is 21 and for last 5years have all symptoms you’ve listed except weight gain he had thyroid tested and came back ok I have celiac so he got tested did not show he had it but he does feel a little better avoiding gluten I was wondering if you think he could have thyroid issues his uncle and other realities have thyroid problems my son also has some excema.

  21. How do you make sure it is going to your cells, I never imagined it would tear my world upside down, so complicated and impossible . So frustrated, I take 65 mg of nature thyroid and 44 of synthroid once per day. I don’t know how to k ow if it is getting to your cells. I take Adrenotone plus and DHEA every day for high cortisol levels along with vit d, b12 and iron , a progesterone cream. I was DX with hosimotos thyroiditis which is an autoimmune disease , all my levels can never get optimal, my TSH is low while my T3 is normal but T4 is low, my reverse t3 is around 10. How do you get a perfect world??? Just want my hair back. Any help you could give I would be over joyed!! I can’t lose weight!! Imy body aches , I just want my hair back. My scalp seems inflamed on top where losing the most hair? Help, I pray God puts me in the hands if someone who can cure me. Thanks again!!

    • Hey Robin,

      There are a few ways to check: basal body temperature attempts to measure your metabolism which is influenced by thyroid hormone, you can check sex hormone binding globulin which can give you an idea of tissue levels in the liver, and/or you can check delayed deep tendon reflexes with specialized computer techniques. These should be used with blood tests to get to a diagnosis and help guide treatment.

  22. I have had a hyperthyroid for 12 years 2 years ago I got diagnosed with hypothyroid my weight flushuatse up and down I take my med. I want it taking out the Dr I seen said it’s to late for that my hair falls out so much I’m always cold and tired can u please tell me what I can do to take some of the pain away if I can’t have it removed please

  23. This is very interesting, thank you for the help you give! I was just talking today about hashimoto’s and fibromyalgia. I wonder if I really have fibro or if the pain is thyroid related. I’m on synthroid and cytomel. I had sinus surgery in November then a rare bacterial infection then viral infections, and I think all the antibiotics and prednisone threw things out of whack. Afterwards I developed severe pain in the front area of my left hip which makes it hard to even stand up by night time. Also pain in my back in right rib area, and swollen hard upper abdomin. I have costochondritis for many years in sternum, so I wonder if it’s in other areas too causing the pain, but with all the prednisone I’ve been on it seems that would’ve helped if so. I was seeing a functional medicine dr prior to surgery and was doing ok then. I’d love to know any thoughts or suggestions. I’m getting concerned that it’s still getting worse. Plus my glucose, A1C and insulin is suddenly high, pre diabetic range. I could go on forever, sorry!

  24. Hi,I am wanting to know if there is a link between hypothryoid and nuropithy. Have been diagnosed with it and I am not diabetic. Thanks Kathleen

  25. Thank you for writing and sharing. I spent years with a “normal” tsh despite waxing and waining hypo and hyper symptoms. Endocrinologists, Rheumatologists, and GPs diagnosed and treated many thyroid-related ailments, but insisted my thyroid was fine and never tried thyroid replacement. After a serious trauma, a pain management doctor suggested giving Armour a try. He felt, despite normal labs, that the fibro pain was actually hypothyroidism in the tissues. It worked! Within weeks, there was surprising improvement. He incorporated supplements, encouraged yoga, and helped me more than any other specialist ever has. I went into remission, but was ultimately diagnosed with Graves years later. I’ve since had a total thyroidectomy and have struggled with finding appropriate care. I spent three years unsuccessfully begging multiple doctors to prescribe NDT instead of Levothyroxine, all while fibromyalgia symptoms returned with a vengence. Ultimately, I did something completely out of character and decided to self medicate with Nature-Throid. Once again, NDT worked. I’m healthy, active, and happy! Now, not only are my labs normal, but so am I. I pray your shared knowledge will help others suffering needlessly, just as the pain management doctor helped me. Physicians, like you, are giving many much needed hope. You’re changing lives! Bless you!

    • Hey Elle,

      Thank you for the encouraging words and thank you for sharing your story. Unfortunately many other patients are in a similar position but they may never get to the bottom of their issues because the “standard of care” is actually standing in their way. Good for you for finding what works and doing it!

      • Hi Doc,

        I posted yesterday and my story is similar to Elle’s. I love your response–SO spot on: “standard of care” is actually standing in the way!

        I just read a previous post (after posting a question of my own to you on basal temp testing. Since I started very recently, I have intuitively and simultaneously increased my Armour from 1 grain to 1 1/2 grains. I’ve had enough tests and experience with functional and non-functional doctors to become familiar with the facts of what I and everyone NEEDS, no matter what level of autoimmunity we’re at: clean, gluten-free & grain-free, ORGANIC autoimmune Paleo style food choices, exercise and stretching to tolerance, keeping toxins out of your body, mind and lifestyle as much as humanly possible, plus endless unable to mention in this post details relating to all of our individual nuances. Thanks Doc for exercising your positive passion for listening to folks like me. Compassion put to action is therapeutic in and of itself!

  26. Was diagnosed 2 years ago with Hashimoto take T3 and T4. Still have fatigue, joint and muscle pain and 100 pds in weight gain. So discouraged!!!

    • Hey Christine,

      I hear ya, many people believe T4 and T3 combinations to be miracle medications but they aren’t. You still need to do some digging to get to the root cause of the problem. Check your leptin and insulin levels (and sex hormones if you are menopausal).

      • Very well written information. It will be helpful to everyone who utilizes it, including myself. Keep doing what you are doing – looking forward to more posts.

  27. Hey there I suffer a great deal with muscle tension assumed it was stress then a friend introduced me to a hypothyroid group on face book a lot of people suffer from different things
    I feel like I suffer everything: (. I only c my thyroid dr once a year and showed her things she should check as far as levels go she said all that wasn’t necessary I’ve actually been having issues with my menstruale cycle she says that it’s not thyroid related what do you think? Any body clomplain about that? Thoughts, suggestions???

  28. I have a question I had my thyroid removed back in 2005 and I being in synthroid since then I started with chronic pain muscle joints hair loss weight gain fatigue depression anxiety all kinds of stuff so anyway I asked my Dr if I could try armour so she did some blood work to make sure she will give me the right dose she had recently adjust my synthroid but I still didn’t feel good at all even my lab work came back normal so I asked what if I had hoshimotos she tested me and said it was negative so my question is what or how do I know if my pain is not frybromilagia? Or how ever its spelled how do they test for that? My pain comes and goes but when it stays is bad and I notice I feel a Lil better eating gluten free or no cokes or junk food so ive try to help myself not sure what else to do

    • Hey Faby,

      You need someone who actually knows how to test and treat your thyroid issue to figure it out. If your doctor is basing your dosing off of your lab tests they are doing it wrong.

      You also need a full workup to figure out the cause of your issues including comprehensive blood chemistry panel, hormone levels, gut evaluation, inflammatory markers and nutritional status. Unfortunately, it’s never as easy as just changing one medication and feeling 100% better.

  29. Good afternoon, this has been a great article for me, as I recently attributed a knee problem to my thyroid, since recently requesting that I truly need T3 added,and finally got it, in 5 days I have lost 4 1/2 lbs adding the t3 and cutting out gluten.
    I have regular manipulation visits and have been diagnosed with fibermialga as well as I have hashimotos and hypothryroidism. I have been attributing the joint and muscle pain to my thyroid for sometime and when my knee MRI came back with just inflammation, that told me, this is my thyroid. I am working on healing my gut and diet change as well as the new t3, hoping for success as this is a long road.
    I am really glad to be following your information now. If you have other suggestions, I would love to hear.

  30. How can I get my primary care physician to read this article and do these tests? He thinks that I make up the pain I am in. I have had my thyroid take out with papillary cancer and Hashimoto. Do I still have Hashimoto if I no longer have a thyroid? I currently take 200 mcg levothyroxine.

    • Hey Peggy,

      Ordering the tests is just the beginning, most doctors don’t order the tests because they don’t know how to interpret them. So even if you can convince them to order the tests it may not mean anything unless they are willing to treat you!

      Yes, you can still have hashimoto’s after thyroidectomy as this procedure never completely removes 100% of the thyroid.

  31. I’ve been hypo for 13 years, taking Levo for the first 12. 3 years ago I was under enormous stress of a parent’s death and subsequent estate. I became I’ll with pneumonia, shingles and depression and anxiety. My body soon began to ache. My muscles and joint pain accompanied my fatigue and exhaustion. To make a long story short…after 1 1/2 years I finally found a care giver who would listen. After research, I began on Nature throid, low dose naltrexone, gluten free diet, proper supplements and Flourish probiotic. My lab numbers are optimal, my pain is gone, my life has returned and I’ve lost 40 lbs. My hypothyroidism, chronic fatigue and fibermyialga are under control. I educated my NP with STTM book and tons of info on LDN and thyroid labs. One piece of advice…educate yourself. READ

    • Hey Jolene,

      Thanks for your story! It’s great to have that kind of perspective, and your experience is similar to most of my current patients.

  32. I suffer from Fibromyalgia,and Sjogrens disease..my fatigue is horrible..but I also have a stomach condition that doesn’t allow me to have any raw fruit or vegtables..I have hair loss and just about every symptom you listed..I take b12 injection monthly and my Vitamin D level is low so I supplement.. How do I get my doctor to test me for this..

    • Hey Jodi,

      If your doctor hasn’t tested for it by now there’s a good chance he/she probably never will. It’s likely easier to find a new doctor than it is to try and force an old doctor to learn new tricks.

  33. I had my thyroid taken out in 2007 because of cancer have done iodine twice and have been to to many Drs to count they have never been able to get my Ths lower that 100 right now it is at 437 on 300 mg of lyvo in the last year my arms have gone numb and now my legs are also doing it I even went to the mayo and they just told me that it must be cause I’m not taking my lyvo lol!!! That is just funny to me that someone would willingly put themselves in as much pain as I am in daily!!! So what are your thoughts will trying some t3 help even though my Ths is not any where near normal ?

    • Hey Kandace,

      Adding T3 should help to lower your TSH, but as always you will need to monitor it closely if you or your doctor choose that route. I have found that it provides relief to many patients in a similar condition as yourself.

  34. Hi Dr. Childs, I have been trying to get help for years, the past 4 years have been life changing for me. I have all these symptoms, extreme fatigue, severe pain, joint inflammation,gained over 30 pounds this past year an I eat pretty healthy, am cold all the time, moody, depression,etc…… My mom,sister, and brother all have hypothyroidism. I have had all kinds of thyroid blood work over the years and they always come back within normal range. I really believe that is the source of my problems but I can’t get anyone to listen to me. Is there anyway that all my problems are due to my thyroid even tho my labs always come back normal? Would love to hear back from you. Please help!!!

  35. I have been on synthroid for 46 yrs. Current dose 225 mcg daily. Have had fibromyalgia and cronic pain for 25 year and ssd since 2002. Nothing gives me much relief. Used to get tp injections every 2 mos til developed type 2 diabetes in 2003. Can I take these supplements with synthroid

  36. Almost everyone that I know that has FS has thyroid problems too. I was diagnosed with hypothyroid at age 17, and FS around 19 I’m almost 65. I had to have a parathyroid gland removed in 2004 and I’ve been tired since, tired and in pain. Nothing helps. I made this connection myself about 15 years ago. I ask my doctor to take me off synthroid and try armor and he said no. When I ask why all he would say is it’s pig it’s unclean. Not fair it’s my body what’s wrong with giving it a try?

    • Hey Yvonne,

      Good question, I would look for a doctor willing to prescribe it because it can make a big difference for certain people.

  37. I was diagnosed 20years ago. I have low iron, chronic low blood pressure, fatigue, headaches ect.. Had an issue w my cortisol and it was very complicated but the endo said everything was fine but I don’t believe that. How do I get the specific tests done right because I know regular doctors tests arent accurate from what I’ve been reading.

    Thanks

    • Hey Stephanie,

      Don’t waste your time trying to get your doctors to run the tests you need, if they didn’t order them to begin with they aren’t going to know what to do with the results anyway. And you need cortisol binding globulin to tell the whole story about your serum cortisol levels, if you didn’t get that you can’t say for sure what is going on with your cortisol levels.

  38. Try the Hotze Health and Wellness Center in Katy, TX. (It’s near Houston.) I have Hashimoto’s and several other health issues. They don’t just treat the bloodwork. They treat the symptoms. In other words, even if your thyroid numbers are “normal,” if you are tired, losing hair, ect., they will adjust your medications and supplements until you feel better. I’m still in the “adjustment” phase, but I’m already feeling better with cortisol and hormone supplements, in addition to Armour thyroid, vitamins, etc. Unfortunately, they don’t take insurance; but they do have a monthly payment plan.

    • Hey Cindy,

      I’m glad it’s working for you! It can definitely take a while to adjust medications and supplements.

  39. I was diagnosed with Fibro about 3yrs before I got the Hashimoto diagnosis. Until I started seeing a Naturopath I always felt tired, in pain, migraines, and the pain meds that the Rheumatologist put me on weren’t working. I decided to take my Heath more seriously and found a Naturopath I had a 3hr initial consult with Naturopath and extensive lab work. With all that info I found out there was a lot going on inside of me. The 1 thing I’d ask my GP about every year was “do I have a thyroid problem.” turns-out i was correct, I had Hashimoto disease . The test that the GP did always showed me on the HIGH SIDE of normal for thyroid. So cut to 1 1/2 years later my Hashimoto is in remission, I am on 1 pain med instead of 4 and except for a few flares of Fibro through out the year I feel great and finally losing weight!! The fist full of supplements I take did the trick, i have been religious about taking them 3 time a day!! Here’s my list of supplements I can’t live without. Thyrosol and Thyroid Support, 2xday, D3 1xday, B12 2x, Magnesium Malate 3x, and 1000mg of Fish Oil 2 of those 3x (6 all together). I’m not without pain any day but I can get through my day not feeling like I want to go right back to bed, I excerise by walking, yoga, or swimming. I was in to much pain to do any excerise before. I am a Flight Attendant so my hours of work are messed up but I can manage it without total collapse. Thanks for this article and all the comments people write. So very HELPFUL!!!

  40. I too suspected a thyroid problem, but all doctors who tested my blood said no. I’ve had Fibro over 20 years now, but got lucky 7 years into it and discovered a supplement which is nothing but plant sterols and sterolins. Within a month most of the pain was gone and I could sleep again. 2 years of regular trigger point work plus massage and my trigger points finally calmed down to only an occasional flare of the trigger points. I was also diagnosed about that time (by bone marrow) that I was totally lacking iron, so I sometimes have difficulty telling whether my lack of energy is from the fibro or lack of iron, or laziness. Or age. But I don’t hurt anymore and my endurance is SO much better, no more days after of not being able to move after exertion that I am nothing but grateful. I so wish tho that regular doctors didn’t rely solely on standard bloodwork and gave credence to their patient’s intuition.

      • Thank you. I’d really like to follow up with your thyroid recommendations tho, hopefully sooner than later. And I’m really impressed with your trigger point observations. After I got better I became a Massage Therapist, and from my experience and observing my clients who have fibro, I totally agree with you. I do wish that more fibro people, who are in the pain phase, knew that deep tissue massage is NOT what they should get. It’s what we think we want, but it does more harm than good. My suspicion is that deep tissue massage causes the muscles to produce/use ATP, which is much more beneficial being used for movement, rather than being used up getting a Massage. I’m so glad that there are some medical professionals like you actually taking this seriously and getting fibro sufferers real answers now. Thank you!

  41. This info was so intresting. My Dr. Has done lab work n tests have come bk negative for thyroid,but I do have fibromyalgia n am in so much pain. Have gained weight, hair thinning,cnt sleep,etc. So I ll b sure to talk to her some more. N any suggestions n ino u can send me would b appreciated.

    • Hey Rose,

      Just make sure that she is ordering all of the thyroid lab tests. That means: TSH, free t3, free t4, reverse T3, thyroid antibodies and sex hormone binding globulin.

  42. Hello,
    I have had chronic back pain since age 21. But since I got pregnant with my second child at 30 I started having ” pain attacks”. After birth
    I was sent to a rheumatologist and they found no explanation. I was inflamed everywhere but no arthritis or genetic markers for autoimmune even though family members do. That Doctor quickly dropped me as a patient saying to see a oncologist and he couldn’t help. I have been taking cybalta which masks it but still have attacks. Also he said that he was no comfortable with how my thyroid looked. No one seems to want to help. What do I do?

    • Hey Joelle,

      You will need to look for a local Doctor who can help sort out your thyroid. I don’t know if it is causing your issues but it is most likely contributing. Specialists like rheumatologists and endocrinologists are not likely to be of much help, unfortunately.

  43. Ive been diagnosed with fibromyaligia its been 6 yrs and the pain is horrible i take lyrica trazadone and naproxin ive tried so many pills im tired i need to find a way to get relief plz help plus always tired and no energy i want a life where i can do thibgs and go places but with this its impossible

    • Hey Stacy,

      Unfortunately I’m unable to help unless you are a patient of mine. You might have luck searching for someone local who practices similarly, however.

  44. Hi Dr. Childs,

    I have been hypothyroid for the past 35 years. For 32 of those years I was on .112 mcg of synthyroid. Through the the years I developed chronic pain in joints, and trigger point areas, tight muscles, head fog, exhaustion from the start of the day. After struggling for all these years I changed to a natural doctor and she put me on 90mg of Armour thyroid. My symptoms all stayed the same except for the head fog. It went away and I felt like me again, just with all the pain. My levels were all over the place over the next to years, ranging from 1.0 to 8.5 and never once did she change the dose. Now I decided to see an endocrinologist and she switched me back to .125mcg of Synthyroid. And added 5mcg of Liothyronine. now, my pain level is 50% better but my energy is at its lowest. I’m struggling to get up in the morning and really having to push myself to do anything. It doesn’t get better through the day either. Just got blood work back T4 Free 1.5 ng/dL, TSH 0.054. Any suggestions?

    Thank you, Wendie

    • Hey Wendie,

      Unfortunately you probably won’t get to the dose you need seeing an endocrinologist or naturopaths. You’re heading in the right direction but it sounds like your body needs more T3.

  45. Hi

    Thank you for this. Very interesting. I have chronic pain. (Nerve damage in jaw due to bad infection and chronic migraines ) I have been put on liothyronin to help but still in pain what ever medication specialist put me on. I do not know what to do next.I tried every thing to vitamins/ Hypnosis/ deep tissue massage and acupuncture. I am waiting for the results of my brain scan to decide what nerve damage there is to decide treatment. I knew there was a link but no medical profession knew it. Thank you

    • Hey Anne,

      No problem, typically when I say patients need T3 I mean they need up to 50-75mcg per day type of doses. Most doctors give patients in the 5-10mcg range.

  46. I have had hypothyroidism for 22 yrs and on levothyroxine. I have had severe fibromyalgia for 18 years. Recent lab tests show my THS at 0.8, but T- 4 is normal. Dr doesn’t think I need to adjust meds. Would natural thyroid meds be better to bring up my numbers and ease up on the pain, spasms and hair loss?
    I am about to lose my job due to being unable to function enough to be there. I have difficulty walking and have been extremely dizzy and hurting in places not normal for me. It is affecting my connective tissue really bad. Help please!

    • Hey Tami,

      Unfortunately for chronic pain and issues like you have you will most likely need the prescription strength thyroid medication, supplements are not likely to significantly boost your thyroid function by themselves.

  47. I have been fighting Hashimotos and Fibro for 3 years now. You are on to something for sure. I figured that same thing out and told my doctor my theory. I am on T3 only. My problem however is due to an extreme case of Hashitoxicosis, I am limited to how much T3 I can take. I take a METHAMIZOL to block my thyroid from producing but it doesn’t stop it entirely. I still have fibro-flares of extreme muscle pain when I encounter triggers … Mainly STRESS… and also when I cycle hypo to hyper my joints are affected. The brain fog, fatigue, and emotional symptoms have just become a way of life for me with no relief. Would you have any insite into my unusual case?

  48. Hello and thank you Dr Childs! I’ve been diagnosed hypothyroid but my Drs won’t treat me because I’m still in the “normal” range on blood tests. My latest issue is horrible pain in my hip joint and thigh. The joint hurts after only mild activity and if I stand too long or walk too much I become unable to move without severe pain. I recently had a hip x-ray which shows lucency and osteophytic spurring on the acetabulum and femoral head. I also had a similar issue in my shoulder joint but that never had an x-ray.
    Is it possible these are related?
    Thanks,
    Theresa

  49. I have fibromyalgia.l, diagnosed in 2006. For the past two years it has been getting worse and new symptoms have appeared. I show every characteristic of hypothyroidism. Yet all my blood work comes back normal. My Endo is worthless. She believes lab results are black and white. She recently diagnosed me with secondary hyperparathyroidism. The reason was because one of the blood tests fell one point out of range. She blamed it on the fact that I had gastric bypass. If I didn’t have gastric bypass 19 years ago and have felt fine up until now I would have accepted the diagnosis. However I simply can not. I have gone to at least 20 doctors this year. I know something is wrong yet they have all made me feel like a hypochondriac. I feel like I am in a no win situation with these doctors.

    • Hey Carrie,

      It might be time to look outside of the traditional insurance model to get better care, all conventionally trained doctors will look at you the exact same way and that is a huge part of the problem.

  50. I have been diagnosed with Hashimoto’s recently, although I think I’ve had it for years. My doctors finally decided to have an antibody test done and it came back positive. I have fibromyalgia, spinal stenosis and other disc problems causing chronic pain. I just started NDT at 1/4 grain and I feel like my body is flaring up from it (pain all over) although I haven’t noticed an increase in heart rate. I should add that a lot of my symptoms before starting NDT are hyperthyroid ones, such as a fast resting heart rate (99), sweating alternating with cold, insomnia, etc. I do not feel much fatigue either, like a lot of hypothyroid people. My free T4 and T3 were at the lowest normal and my Reverse T3 was at 12. My hair is falling out more and more every day and I’ve gained about 10 pounds but that’s probably due to inactivity. My question is whether this dose is too low start out on and when should I increase it? How do I know if NDT is adversely affecting me or if my body sees it as a “foreign substance” and produces more antibodies? Also, I will be starting low dose naltrexone soon to help with all of the above once I get the thyroid meds sorted out. Thanks for any help you can give with this.

    • Hey Kate,

      Your case is quite complex, I would recommend you seek out a provider who understands your situation to help you further.

  51. I have all those symptoms, my doc tells me it’s just diabetes though and refuses to check for anything else. I recently showed an abnormal thyroid blood test and he rechecked it and said it was fine, but I’m not getting better so what do I do ? Most doc’s don’t take medicare and medicaid and that’s the 2 insurances that I have. I want someone who heals holistically without all the pills cause they have such bad side effects and I’ve already felt that. What do I do?

      • What kind of doctor do I need to see and I will do that, because I always keep my weight within 5 pounds and it’s still climbing it went from 160 to 230 without me changing eating or routine and that’s not normal. Thank you for letting me know that’s what I need to do, that helps more than you know. Thanks, Peggy Driscoll

        • No problem! Unfortunately, there is no specific Doctor that learns this stuff in residency meaning they have to teach themselves this info which can make them somewhat difficult to find.

  52. I am 56 yo female. I have struggled most of my life with weight. Even tho i have been plant based almost no oil..processed…salt or sugar i have still been gaining weight. My basil temp runs about 95 to 96. My pulse around 55. My cholesterol numbers high but recently started coming down with addition of magnesium oil. My bp spikes at times. In feb my tsp had gone from 3 to 4 in 6 mo. My free t3 was 2.4 and free t4 also normal. I have started adding lugols iodine and vit c..atp co factor..selenium. i also inconsistantly take b12.i have read i should take 1/2 to 1 tsp of Real salt to help with iodine detox. What are your thoughts on this?

  53. Dr Westin, my name is Ken. I was undiagnosed with Lyme for twenty years due to unreliable bloodtests. I found a LLMD and received pulsed abx treatment in 2015. I was still left with muscular skeletal issues. I found I was iodine deficient after consuming higher level of iodine foods and water while on vacation in the Gulf side of florida. It sent me into an extreme hypothyroid condition. I started taking I/O PLUS IODINE supplement in march 2015. It helped some but I found I have severe trigger points in all areas of my body. I’ve been told I have chronic fatigue, fibromyalgia, MS and chronic lyme. I have studied my fascia release and made good progress with release. I am considering switching to Lugol’s iodine supplement and also using it transdermally in baths along with dead sea salt.
    I have not been able to convince my doctors to give me minimum dosage of Armour thyroid. My thyroid results fall within normal ranges so they refuse to treat.what do you recommend I do to get someone to give me treatment ?

  54. I was diagnosed with Chronic Fatigue at the age of 20. I have had the symptoms of fibromyalgia since age 18 but was not diagnosed until I was in my 30’s. I figured out on my own that I was hypothyroid also. Submitting a list of symptoms to my PCP, I persuaded him to put me on Synthroid even though my TSH was normal. Within 2 weeks, my eyebrows began to grow back in. Synthroid helped some of my symptoms, but not all. Eventually, my TSH levels tested low, even though I had been on Synthroid for years. I asked for Armour Thyroid and have been on it for about 6 years now. I am a bit more sensitive to it and can tell when my levels are slightly high, causing palpitations, and I back off of it for a day or two. My fatigue, dry skin and fibro pain are fairly constant to severe. I don’t have a regular exercise schedule, though I used to, due to multiple injuries (I don’t know if it’s related, but I seem to injure myself more easily than most.) But with fibro, movement is essential to keep the stiffness at bay. I eat whole foods, but do crave sweets and that is something I continually have to work on. I am now 65, having lived most of my life with this. Both of my daughters have many of the same symptoms (ages 28 and 41) and the same difficulty get diagnosis or treatment. The oldest just started on Armour Thyroid last month and has noticed increased energy, less dry skin and less hair loss. (Her TSH was normal also). Thank you for the information, which I found helpful.

    • Hey Diane,

      No problem, I am glad you found it helpful. Getting treatment can be tough and complete remission may not be possible, but even a reduction in symptoms by 50% I would call a win and a step in the right direction.

  55. I have been dealing with thyroid problems for over half my life. Hyper to hypo & then Hoshimotos eventually having a total thyroid lobectomy. I suffer from severe, chronic pain. Sitting, walking, lying down is all very painful. Some days worse then others. I am always tired since I am not able to sleep well because of the pain. I am at a loss.

    • Hey Margie,

      You should have your T3 (total and free T3) levels evaluated and treated if low, many patients in your situation have low T3 syndrome at least contributing to their symptoms.

  56. I have been diagnosed with fibromyalgia and thyroid I can not get anyone in my area to help me. I have such sensitivity to touch I feel bruised on the sides of my legs and arms and the pain in between my shoulders and my hips is terrible. I have been told that my thyroid levels are perfect taking Levothyroxine. I have been dealing with this for 13 years with no help other than being told if I had gastric bypass it would help. I do not believe this is all do to weight issues and if I did not hurt all the time I could exercise. Please tell me what to do next I am completely discouraged

    • Hey Ann,

      If you have absolutely no one to work with then you need to change what is in your ability to control: diet, lifestyle and stress. If you haven’t already adopted a whole food diet (paleo, whole30, nutritional ketosis, etc.) then that would be your first step. You can also then try various supplements as well. If you’ve done these things and still have no improvement then unfortunately your only option will be to find someone who can help you by searching outside of the insurance model (Doctors who focus on hormones generally are cash only).

  57. Thank you so much for all of the information. In have Fibromyalgia, In remission from Rheumatoid Arthritis, Diabetes, Osteoporosis in one hip, Osteoarthritis, Chronic Fatigue Syndrome and over weight. I recently started Nature Throid although my levels were normal my doctor felt because of the CFS I needed to take it. She also tested my harmone levels and started me on Biote Pellets. I do have more energy and, although I had Sinus Surgery, feel like I can breathe better. Also find I sleep better. I am having trouble losing weight but hopeful that will improve. I also have SVT and PVC’s. Hoping to get off of some of my meds eventually. Once, again thank you for the information.

    • Hey Eleanor,

      Thanks for the comment and I hope you found it helpful. I’m glad to see you are improving on the new medication, hopefully the improvement continues.

  58. Hi, love the long, concise article. One thing I’m wondering…if a person uses Selenium, and other important minerals, might they not improve conversion and not need added T3? And when I added T3 my hair loss drastically increased, although I felt so much better. Not sure where to go from here…

    • Hey Brenda,

      You can boost T4 to T3 conversion somewhat with the use of zinc and selenium, but that won’t necessarily work for everyone.

      Some hair loss after starting T3 often occurs but is usually transient and self limited.

  59. I felt terrible on synthroid. After lots of research, i wanted to try cytomel (t3) only and my GP agreed to let me try. I felt tons better. However she sent me to a endocrinologist and she refused to just do t3 and has me on a low dose of cytomel. I feel bad again. I can’t find a doctor who will treat me with t3 only and /or find one that will prescribe more than 5mg BID. Where can I find a dr. That will treat with t3 only and in correct dose? I have also recently heard about low dose naltrxone and really want to know more about that.

    • Hey Heather,

      The unfortunate truth is that most thyroid patients are being mismanaged and could potentially feel so much better if they found someone to help manage their condition. In my experience it’s almost impossible to find someone to correctly manage your thyroid inside the insurance model (the reason has to do with the standard of care). You’ll have much better luck if you pay cash because these physicians are less bound by time and standard of care. LDN is also great and something I prescribe frequently, you can learn more about it here: https://www.restartmed.com/naltrexone-weight-loss/

  60. Hi
    I am so glad that I found your write up. I found out almost 4 years ago that I have non toxic goiter . Been trying to get my regular doctor to send me to a specialist . He only does what he said is the require testing . A few months ago I found out I have fibromalgia , also Iodine deficient. and I am gulten sensetive as well. My SHGB is 37 ,TSH 1.68 Free T4 1.0 Reverse T3 30% T4 8.1 Vit D 25 . Sorry that I am unable to post the rest of my results . But I want to Thank you for most eye opening information.

    Sincerely ,Tama

  61. Hi Dr Child’s. I was wondering if I could get a copy of this article sent to me so that I could print it to bring to my doctor. I was diagnosed with Fibro 20 years ago and have hypothyroidism for which I am on a low dose of Levothyroxine. I have not had extensive thyroid testing done. My hair is falling out at an alarming rate. My skin is very dry, my nails are dry and brittle. I have been taking 10,000 mcg of Biotin daily for several years to no avail. I hope it will be possible to get a copy of this article as I think it will be very helpful. Hope to hear from you soon.

    Sincerely,
    Sandra

    • Hey Sandra,

      You can print the article from your browser or use the share function and more options to find a printer friendly version.

  62. I have been on thyroid medicine for 22 years. About 5 years ago, I started having muscle pain, especially when trying to sleep. It has gotten so bad that I can only sleep 3 or 4 hours a night. I am fine when I’m up and active, but even to sit and rest causes my muscles to start aching. I take .88 mcg of Levoxl daily. I am having difficulty losing weight which was never a problem before. I thought you article was very informative. What exactly should I ask my Dr. To prescribe for me? Would it be something in addition to the Levoxl or a completely different medication.

    • Hey Shawn,

      It’s important to consider that muscle pain isn’t always from hypothyroidism (that is just one of the causes). It’s fairly easy to experiment to determine if your muscle pain is from your thyroid as increasing your dose should reduce the pain. If it doesn’t then it may be related to something else.

  63. I have just been diagnosed with hashimoto’s and had a scan that showed my thyroid is not working at all, my antibodies are 1374, my TSH is 17.73, Free T4 is 0.97 and T3 is 0.1, I am currently on 137 synthroid, any ideas on what I can do to help me out? I am always tired, have a hard time concentrating and in constant pain. Thank You

    • Hey Cindy,

      I would start with the recommendations in this post, you can also find lots of information about supplements, diet, etc. on my blog for further help.

  64. Very enlightening info you’re providing!

    My thyroiditis was diagnosed in 2006. Much later I learned it’s autoimmune. I also have severe multi-chemical sensitivities.

    What do you think of basal body temperature testing first thing in the morning and then other times in the day to gauge hypo status? I have been feeling super-hypo recently.

    I’ve long had low basal body temperature, blood pressure, no reflexes in the doctors knee test, horizontally ridged and thin fingernails, one eyebrow is shorter on one side, inflammation, mood issues, plus countless other classic hashi symptoms that, over the years, have come and gone, based on lifestyle, ETC. I’ve tried T4, Armour and WP. Not all at the same time, you know 🙂

    Having been to countless doctors of all types over the years, I’m wondering if DIY basal temp moderating could be helpful. If so, how? Having read and followed directions carefully, my results range 94-96 degrees in the morning. Six hours or so later it goes up around .8 degrees. Recently, it has reached above 96.9.

    Thanks again for the amazing blog as mainstream healthcare is unable to sufficiently test all of us with autoimmune disease.

  65. Hello. Thank you for all above info. Been suffering from chronic muscle pain 18 mths. Hashimoto and multiple nodules 5 yrs but bloodwork always said “within range”. I’ve fought with Drs that maybe this isn’t my normal range as we had no beginning numbers to work from. Nodule was stable until past yr and it started growing fast. Just had half thyroid removed with egg size nodule. Bloodwork CH50 high for 2 yrs. Most recent Parathyroid Hormone H 77. Thyroid Peroxidase Antibodies H 23. Calcium increasing over past 6 months 9.5 to 9.8 to now 10.2.
    Total protein 7.0 6 mths ago to H 7.9 now. T3 free 2.9 T4 Free .91 TSH 1.564 vitamin D 29 C4 was H 46
    Any guidance appreciated .

    • Hey Denise,

      The best thing you can do is find someone who understands what I’m discussing on this page to help you further, fighting with physicians is never recommended and will only lead to frustration on both sides.

  66. I have had fibromyalgia for over 25 years I was managing it very well until a nodule was found on my thyroid in December of 2016 they removed my thyroid and put me on the levothroxine 175mcg once a day in the morning what you have. Said about t3 is so true I have been so sick they just say my hormones are taking along time to up take in my body it is not working it feels like my fibro has come on with a vengeance like 10 times worse my life is terrible I am always sick and in pain I do like my Dr but does not know what to do he is Dr Noel Stibor at Star Valley medical center in Afton Wyo 83110 I am 66 years of age I am afraid I will lose this connection so I can show it to him please help me I need your help or send your info on email and can show him please I so agree with what you are saying help me . Pam Fournier

  67. Finally, a doctor who understands.! was diagnosed with hypothyroidism and fibromyalgia simultaneously 25 years ago when I was in my early 40’s. I have always believed there is a connection between the two. I’ve seen many doctors over the years who have prescribed different strengths of Synthroid. I have also taken Armour Thyroid .I have frequent lab test (TSH) as well as T3 and T4. I never ” feel” as if I’m on the correct dose.. The FM is wicked and I suffer with migraines daily. My endocrinologist is near retirement and I have asked for a complete blood panel over the years and he assures me that my dosage of Synthroid at the time is appropriate. I have tried to press the matter but I get brushed off. What should I do? I have no quality of life.. I’m so sick and exhausted all the time.. The body pain can be unbearable and the migraines rule my life.. I am desperate and about to give up on ever having someone connect the dots.. Please help me.. Help all who suffer from this debilitating illness..

    • Hey Kathy,

      The best thing you can do is look for a provider who understands thyroid function. Usually PCP’s and endocrinologists are not the ones to prescribe the right type and dose of medication, and yet patients tend to stick with these providers despite how they feel.

  68. I had my thyroid removed last year with a positive cancer (papillary) biopsy. I am exhausted beyond belief. Used to be extremely energetic.I am currently taking Fluoxetine for my fybro and 137 Levothiroxine . My calves cramp when going a 6 step stair I am forgetful and gained weight. What can i do

    • Hey Monica,

      I would start with the recommendations listed in this article, if those aren’t working then I would have a complete thyroid panel.

  69. My naturopath has had me on Naturethroid 2 grains for the past 6 years. Before that I went through a “thyroid storm” on Synthroid from a conventional medicine doctor. Currently, Naturethroid @ 2 grains keeps the TSH around 1.0 which, for the most part, makes me feel best. I am also on “Meyer’s cocktail” IV therapy plus glutathione, plus a vitamin D shot (I don’t have a gallbladder any more). My TPO was 1300 two years ago. I was prescribed low-dose Natrexone @ 2 mg which brought the level down to 638. Eliminating raw milk brought the TPO 380. I have routine complete thyroid labs studies (in order to refill the Naturethroid Rx). Currently, he is mainly concerned about the TPO not coming down lower because all the other thyroid labs are optimal. I have many food allergies, sensitivities, and intolerances: all grains, eggs (white and yolk), nightshade vegetables, beans, milk products, and most nuts, so you cansee my diet is very limited. I keep track of my calories (carbs, fats, proteins, salt, and sugar) and water intake and exercise on a daily basis. Calorie intake is around 1100 per day. Walking for 40 minutes is about the only strenuous exercise I can do. I have more pain if I carry something while walking. I used to run 5 miles every other day for 12 years in my 20s, but at age 32, fatigue, aches and pains, and HUGE weight gain started abruptly. I had to stop running, and then I became pregnant. After the C-section, I was even more exhausted. I thought it was from the anesthesia still in my body. There was no mention of my TSH being out of wack at that time. I wasn’t diagnosed with Hashimoto’s until age 54 when my hair started falling out, facial skin peeling, chest pains/heart palpitations, MRSA boils resistant to all antibiotics, and could not get warm even on 106-degree+ temperatures during the Arizona summers. A conventional medicine doctor put me on Trimethoprim and sulfamethoxazole which did nothing for the boils. I would sit in the car with the windows rolled up to try to get warm. I had a woman lawyer set up a will for me because I thought I was dying. She recommended a naturopathic doctor. He put me through eight UBI treatments which cleared up the boils, and all my lab results returned negative for Staph thereafter. I was free of boils after fighting these for two years. I was no longer having long bouts of bronchitis. Even though that naturopathic doctor moved to Canada, I now see my current naturopath in Scottsdale. I have been to myofascial release therapists and this only provides temporary relief. My daughter’s roommate at ASU in Tempe is from India. She recommended that I drink heated coconut milk with 1 Tbs turmeric, 1/2 tsp grated ginger root, 1/4 tsp Saigon cinnamon, 3 peppercorns for the muscle pains…or to prevent colds and flu. This has given me pain relief on a daily basis. I have to drink it every day,otherwise the pain flares up in the wrists, upper arms, neck, shoulders, posterior ribs, and hip sockets. I don’t add honey because I am afraid of developing diabetes (family history). I recently read an article about lectins contributing to inflammation, but lectins are in everything. I haven’t talked with my naturopathic physician about this article yet. It seems the highest levels of lectins are in the same foods I have allergies/sensitivities to. I must be lectin resistant.

    I await your comments.

  70. Dr. Childs,
    This is extremely interesting information. I am wondering if all of this still applies if the thyroid has been completely removed, as well as having gastric bypass: BPD with a duodenal switch. How effective will this therapy work with the malnutrition aspect? Exactly what kind of physician should be seen if the Endocrinologist doesn’t take this seriously?
    Thank you very much for this info and for any additional information you can provide for these specific hurdles.

    • Hey Skye,

      Yes, the same principles apply if you are post thyroidectomy. Most of the time you will have to look outside of the insurance model if you want to get the type of care you see on this blog.

  71. Thank you for this article. I have taken levothyroxine for many many years and have al the issues you talk about. I asked a dr.once if I could have fibromyalgia and he laughed. I have serious skeletal issues and always have had, especially my spine. Drs blame all my pain and fatigue ln my lower back. That would not cause pain in my hands, arms, fingers, ankles, elbows and knees. I am on prolia for severe osteoporosis and I have osteoarthritis and possibly RA, but does not show on blood test, only high sedimentation rate. I am 5’5″ weigh 121 lbs. and will be 72 next month. What can I do to encourage my drs to check this out. I am too tired to ever go anywhere or do anything in mu house. My pain is constant, usually several things hurtin at once. Always my back and the rest varies. Hope you can reply. Thank you for teaching me this information.
    –Sharon L. Childs

    • Hey Sharon,

      You won’t be able to convince your current set of doctors to change how they think/evaluate you. Instead, it may be worth it to try and seek out someone who is more willing to listen and act on your concerns.

  72. I was diagnosed with hypothyroidism in ’96 and with Fibromyalgia in 2002. I had always felt that these two somehow had something to do with each other. I’m also bipolar and feel like this goes along with Fibro and thyroid issues. I’d like to know your thoughts on this. I thought I heard the doctor say something about depression in his interview but for some reason I can’t get that video to play again.
    Thank you

    • Hey Angie,

      Yes, there is a connection between thyroid hormone and bipolar disorder (and depression). Several studies have shown treatment with T4 even with normal thyroid doses to be effective. In addition studies have also shown that high doses of T3 only help patients with bipolard disorder even when they are resistant to multiple medications: https://www.ncbi.nlm.nih.gov/pubmed/19215985

  73. I do not have a thyroid, anymore, due to thyroid cancer. I am hoping to be two years, cancer free, very soon. I have extremely sore feet, ankles, and wrists, shoulders, and that’s about it. My feet are high arched…but I go to bed with foot pain and wake up with foot pain. I also am short a parathyroid, due to my surgery, so I suffer with very low calcium. Any tips? I am on my feet a lot, at my job and I also have a toddler, son. I enjoyed your article.

  74. I had a gastric bypass in 1982 that had to be revised 3 separate times. I lost 135# but now have regained and lost several times and now am about 50# from my highest weight again and can’t seem to lose no matter what. I have large fluid retention issues taking large doses of diuretics even though my BP has always been normal or even low before put on the diuretics. I can gain or lose 10-14# withing a day or 2. After trying to blame my weight on my thyroid..which was always “normal”, I gave up on that and low and behold I found myself hypothyroid with weight gain, hair loss, low energy. I was place on Levothyroxine for several years and in the course of moving and trying to find new MDs in new areas, I had run out of meds and had been off of them for sometime before we got settled and found a new MD. My TSH was now “normal” as was my Free T4 so was kept off the meds. I still have symptoms of hair thinning and weight gain and weightloss resistance but MD will not do anything else. I also have secondary hyperparathyroism with levels in the high 300s but changes frequently. I also have a “cyst” on my thyroid found by ultrasound so was sent to and Endo. He does a few tests and says see you in 6 months but I get no answers. I finally questioned him more on my last visit and he became VERY defensive, almost nasty, stating this was his specialty and if I didn’t like him to have my primary follow me. I also have very low vitatmin D levels and am on RX dosages of D3 and calcitracin, as well as B12 shots depending on how low can be as often as weekly. These are being attributed to the gastric bypass which I know will affect those levels. I have also had to have 2 separate rounds of iron infusions with Hgb in the 8.0 range and has been stable for last couple years but now in down to the low level of normal with a drop of over 3 gms in past year. I feel like I am being ignored by the MDs and don’t know what to do. We live in a small town now so not a lot of options for treatment. Nothing is being done about the thyroid cyst and when I question the Endo about it he gets nasty telling me that is his specialty and who am I to criticize him. I was only asking a question. I am so frustrated, especially with the weight gain and inability to lose. I have done just about every diet known includng weight watchers in which I lost 60# but I was quite ill with diarrhea for 3 months and ended up with pancreatitis which is now resolved and the whole 60# came right back on. Where do I go from here??? How can I go about finding an Endo that will answer my questions and DO something?

  75. I no longer have my thyroid due to possible cancer. I am currently taking 88 synthroid. I also have fibromyalgia and arthritis in all joints. Can they still check all those levels since I no longer have a thyroid?

  76. Where can I find a list or name of a provider who will agree to do these tests and treat with the treatments you describe?
    I’ve searched for years – requested full thyroid panels and been denied when my TSH comes back “normal”.
    I was diagnosed with FM over a decade ago, the flare ups, pain, and body seizes are unbearable at times.
    I just want to be treated but cannot find a provider….please help.

  77. This is excellent information about fibromyalgia/hypothyroidism. I want to tell everyone…Don’t give up on finding a doctor to help you! After 10 years and 8 different doctors I have finally found one who goes beyond the conventional (TSH) testing, listens to my symptoms and has helped my tremendously. Look for a thyroid specialist … you will most likely have to travel some distance and pay out of pocket. Hope this helps!

  78. I am going to my doctor today to get my blood work back on my thyroid. I am currently taking 250mcg of synthroid daily and I have no relief from the pain. Was DC with fibro years ago but I have yet to find a doctor willing to treat the pain. I am taking a copy of this to my doctor and I am going to ask her to run these tests. I pray that I find some relief so I can get on with my life

  79. Dear Dr. Child’s,
    I just tried sending you an email. It was lengthy but basically asked if you are still treating patient in Arizona? If so, how can I get an appointment?
    I’m suffering horribly & the docs I’ve seen are doing nothing for my Hypothyroid. I just found out after waiting 2mths to get my lab results my levels were high & this so-called office person had no idea what TSH even meant! The doc was out 6 weeks for paternity leave as his wife had their first child yet he had no one available to see patients while gone!
    My symptoms are a combo of chronic pain from 2 injuries plus recently diagnosed with OSTEOARTHRITIS & Hypothyroid just within this last year!
    Before accidents I was extremely healthy never sick quite active & worked out always. Since really
    relocation from AZ to Kennewick WA it’s all fallen down around me!
    Please please Dr. Child’s is there anyway you can fit me in as a patient? I can’t go through much more
    especially zero sleep which has me beyond exhausted all the time! I need your help!

  80. Thank you so much for this info I have been looking hard at this for awhile now. I asked my Dr. If I should use iodine supplement and she laughed and said no and would not do a full thyroid exam. I have fibro and hypothyroid and a fatty liver I have not worked in 20 years. I am not sure about liquid iron but will try. Thank you again could you tell us what kind of Dr. we need to go to for help with this.Mine thinks all is fine ivam losding my hair bad, I go out once every two weeks, I have no energy can barely get through the grocery store, I stopped pain meds and muscle relaxers after 20 years my husband is ill and I need to help him but well you get the picture. Sorry I talk too much but help would be most greatful. Debbie

  81. I have a question. I don’t have a thyroid anymore. Had to be taken out because it quit working and I had spots of cancer on it. I need to lose weight and it is impossible for me and I have fibromyalgia and hypothyroidism. Can I be helped?? I have a lot of health problems and I’m just 48yrs OLD. I’ve done CNA work for 25yrs and have done a lot of lifting and now I have 3 pinched nerves, arthritis, stenosis, 2 Ruptured discs in my lower back, spurs in my hip and arthritis. So, I need to lose weight bad… You have any suggestions? Thank you,Pam C.

    • Hi Pam,

      Yes, you can definitely be helped, but how much is always unknown. Patients in your current standing generally get at least 50% improvement in pain when following my recommendations (some more than others obviously and some less).

  82. What if I have a dr who treats my thyroid well, have taken NDT or T3 only (to reduce RT3) but my SHB is always very high. It’s around 169. Dr says this is due to using HRT for surgical menopause. Does that mean despite good thyroid levels that it’s just not being used correctly? How can I fix this? I am chronically exhausted and have fibromyalgia with 16/18 trigger points confirmed. ANy advice appreciated. I do have good levels of B12, omega 3, d3, etc.

      • So if SHBG is increased from taking thyroid hormones and estrogen and you need both – does that mean the thyroid never reaches the tissue correctly? Or what is the answer? Do I just ignore high SHBG levels? Have read that testosterone can bring it down but no luck so far. I am replacing all missing/deficient hormones except DHEA.

        • Hi Fig,

          You may need estrogen and thyroid hormone but you don’t want high SHBG because by definition it is binding up your sex hormones.

          • Please tell me what needs to be done then. I don’t know how to reduce SHBG. Surgical menopause necessitates HRT and Hashimoto’s results in thyroid replacement. My drs do not advise on how to lower SHBG but I don’t seem to process thyroid replacement as normal people do. Thanks.

  83. Hello i found this to be very helpful. i have suffered chronic left pectorial muscle pain since Jan 2012, left trapaizoid pain same time length. A combination of different types of headaches to include migraines 31+ yrs siezure disorder diagnosed in 2008. Lipoma brain tumor diagnosed in 1998. Depression 2000, suicidal 1988, bi- polar, multiple personalities, audio, visual hallucinations, insominia, brown circles around eyes, puffy bags under eyes, sore throat, raspy voice swollen vocal cords, sores and swollen tongue. lack of appitite, no sex drive, no desire for self hygiene. i also have muscle cramps and swollen joints. I have been diagnosed with sub clinical hypothyroidism but since my labs came back normal in dec 2017. the Doc wont listen when i tell them that something is wrong. Please advise

  84. My wife has had thyroid cancer and therefore her thyroids removed. She takes levothyroxine but after 5 years is still struggling with fibromyalgia and constant pain. She is always cold and her energy levels seem to be at an all time low. She is on a surprisingly low level of thyroxine considering her weight, height, age etc of only 100ug. Her GP has said that this amount keeps her within a normal range but I feel her deterioration is profound. What would you suggest is these circumstances please? Your post is extremely interesting and quite the eye opener. Many thanks.

    • Hi Stephan,

      The single best thing you can do for her is to find a practitioner who shares these philosophies. The conventional approach will be insufficient to help her.

  85. My name is Danielle,
    I have been diagnosed with Hypothyroidism for over 32 years at age 16. About 5 years ago, I had an ultrasound of my thyroid and it was not detected. The Dr. Was unable to find it, no other follow up was done for that.
    I have had chronic pain in my neck, low back and sciatic nerve for about 10 years.
    I have an autoimmune disorder called localized Scleroderma on my back since age 14.
    I was recently diagnosed with Fibromyalgia by my Rhumatologist.
    My thyroid levels have never been consistent.
    I have been on high doses of Levothyroxine for all of these years.
    I am finally being referred to see an Endocrinologist in late May, 2017.
    My chronic pain is debilitating and my only real successes each day are waking up my kids for school and preparing dinner.
    The rest of my time is spent in bed and in great pain and frustration.
    Thanks for any recommendations or advice.
    Danielle ~

  86. It’s like this article was about me! Been on every dose of Levothyroxine and feel awful. Dr refuses to discuss any other med. Devastating fatigue, pain, blurred vision, insomnia, weakness, extreme intolerance to heat, foggy headed, trouble with balance and the list goes on. I virtually have no life and can’t do even the simplest of things.

  87. I have hypothyroidism and I also have fibromyalgia and right now my thyroid is not functioning right I have went from 225mcg to 165mcg my muscles are absolutely killing me right now. They are as hard as a rock but some of them are stretched to far. My muscles feel like they are drying up. My stupid doctor thinks I’m her crazy mind that I want pain pills, I don’t want her stupid pain pills I want her to listen to me and help me find out y my muscles are doing this. Will you plz help me. Where
    do I go to what do I do. She isn a thyroid specialist should I have her to send me to one?

  88. My name is Victoria, I was diagnosed with low Thyroid around 2006, I have been on 15 mg of NDT, 3 x a day for 11 years. I also have low blood pressure, and my skin has been itchy in areas of my back between my shoulder blades, and on my abdomen for about 25 years (it was diagnosed as neurodermatitis) and nothing helps stop the itching feeling. My skin has turned brown in those areas caused by constant scratching. I have also had an itchy scalp and oily dandruff ever since I was a child. I am stating all of these symptoms because they might be related to Low thyroid.

    These might be other possible symptoms of Low thyroid:

    I started getting hip pain about 20 years ago, but it is not arthritis (I was diagnosed as bursitis – with an unknown cause). I got severe tendonitis in my forearms 7 years ago, which took a year to recover from, but re-occurance happens when I use my arms in strenuous circumstances. Just last year new symptoms started: pain in my sacrum, and lumbar region, and my hip pain was worse. And while walking around several hours a day, while on vacation, my lower legs started to hurt. I thought it was shin splints, but then both my entire lower legs began to hurt, calves, tendons, everything, and there is a lot of pain at night just from the pressure of the mattress on my legs. Physical therapy has not improved the situation.

    I want to get my thyroid function tested again, according to your protocol series of tests. Every time I get a thyroid test (which is not the series that you recommend – just a simple thyroid level test) to see if I need to change the formula, my thyroid level looks normal, but my symptoms say otherwise. My question is – before I get tested should I get off of the NDT(for a week or more?) and the bio-identical estrogen and progesterone, in order to get an accurate reading, or should the tests be taken with those supplements in my system?

    • You should look into adrenal insufficiency… especially when you say you have areas of brown skin and pain in your sacrum and lumbar region (SI pain is commonly associated with adrenal issues). I had similar and did lots of PT which didn’t help, once low adrenals were addressed, have not had any more SI pain. Low blood pressure is another low adrenal symptom as are fatigue, nausea, weight loss, etc.

      I don’t see why you would get off your thyroid meds (dangerous) or hormones to test levels. You just usually skip the morning NDT dose before the blood draw and take it after labs are drawn.

      • I had my adrenals tested and the test said they were fine. Is there also a different series of tests that we need to do for adrenals that the doctors don’t know about?

        • Did you do the saliva testing for adrenals? Where you collect 5 samples in one day and mail in for analysis? That’s the gold standard for adrenal testing vs a single cortisol level done via bloodwork. Many alternative drs or D.O.s will order this for you. Or you can order yourself online.

          • Hi Fig,

            Salivary testing for cortisol is not the gold standard. Urinary testing for cortisol and cortisone metabolites is much more effective at establishing cortisol levels in the body. You also have to understand that a normal cortisol test, even a normal urinary cortisol test doesn’t indicate that your cortisol status is indeed normal. There are receptor level issues that can cause resistance syndromes which are virtually undetectable with our current assays.

          • Dr. Westin, you didn’t answer my previous question about your recommended series of tests for hypothyroid.

            I take NDT for low thyroid. My question is – before I get tested should I get off of the NDT(for a day, a week or more?) and do I also need to get off the bio-identical estrogen and progesterone I am currently taking, in order to get an accurate test readings, or should the tests be taken with those medications in my system?

            Also, for the the adrenal test, if none of the tests are accurate, not even the urinary one that you suggest, then how do know what protocol to use to treat low adrenals?

          • I already know the tests that you recommend. My question is, do I get off of my NDT medication before taking the tests, and if so, for how long do I need to be off of NDT before taking the tests?

          • There is no need to stop taking your medication prior to your tests, but when you take your thyroid hormone in relation to those tests depends on your physician. In some cases I like to see the tests 2 hours after taking medication and in other situations I like to see a 24 hour result – it just depends.

  89. How is the testing done? Multiple times/day? I haven’t heard of urine testing for cortisol. Please tell me more about resistance syndromes…. I am intrigued…

  90. I had to have my thryoid radiated in 1981. My physicians always just put me on t4 only explaining that if those levels are normal than it is converting correctly. I still have all systems compounded with fibromyalgia digestive issues such as gastroparesis. Horrible weight gain and dealing with severe fatigue. I switched over to natural thyroid thinking that it was the way to get all my correct hormones. I took a dive. Now my thyroid is pronounced and undergoing cat scan. And went back on synthetic thyroid. Tired of hearing all of this is in my head. It is not normal to feel like this I am determined to get to the bottom of it. Very interested in your information.

  91. I have asked my Dr to check my T3 and Dr refuses. I have been on thyroid replacement for over 30 years and 1year ago was finally diagnosed with fibromyalgia. I have a service dog and no energy to do the things that I love. Kathleen

  92. Hi Dr Child’s. Read your article and it is so me. I am hypo and also have fibromyalgia. My question to you is I try and take the Nature Thyroid meds but then my whole body is in worse pain. I tried 5 different thyroid meds and they do the same thing to me. What causes all of the pain with thyroid meds. When I first took it for 1 month I was fine then it just got worse. All over body pain and fatigue. I work with a Naturopath Dr also just trying different things. I also have side effects taking vitamins also. Help please

  93. I have debilitating fatigue and muscle pain. My endo has tried twice to add cytomel to my synthroid and I have not been able to tolerate it. My heart races and I have emotional (almost feel crazy) reactions. How else can I get my ft3 levels up to relieve my symptoms??

  94. I have had hypothyroidism for almost 20 years and changed over to natural thyroid medication because I was just getting worse. Since changing over last Christmas, I have noticed dramatic change and improved fatigue and have stabilised gut problems by being really restrictive in my diet. But I have noticed increasing muscle tightness, aching and joint pain. I did have RT3 out of balance but I think that came good after changing over. I was just about to see a specialist about this increasing muscle stiffness and pain and am curious about treatment options, any additional testing and management approaches. My iron has always been good, I take iodine, selenium (Brazil nuts), zinc and vitamin C (or I end up with continuous colds). I have been endeavouring to up the exercise but end up with chronic muscle overtightness, trigger points everywhere and still decreasing flexibility. I roll muscles, use tennis ball for trigger points and do a variety of stretches but I just cant seem to get improvement. Would appreciate any suggestions or explanations.

  95. Hi, thanks so much for the great article and thankyou also engaging with all the various post commenters. I know from firsthand experience there are many confusing and contradictory views around this topic.

    Could I please get your opinion? I have had pain now for about 1.5 years mostly noticeable in fingers and toes but have had tight tendons / muscles in legs for a few years now. Last year I had my right shoulder pretty well tighten up in pain that I couldn’t use it (not frozen shoulder apparently) Both physios told me that they felt my muscles were not reacting to treatment as they should and they felt I had a systemic issue.
    I was sent for barrages of test and despite no markers the rheumatologist tried methotrexate and plaquinal just in case but to no effect. Brain fog and fatigue kicked in earnest late last year.

    At the start of this year (2017) they finally tested tsh which was mildly elevated at 7. Exercise was getting really tough to do by then and pain afterwards was huge. Was told to stop all exercise at that point.
    I was Started on thyroid usp (dedicated extract) and muscles (triggers etc) have improved since then (according to Physio) however the pain has not. If I work around the house for 60 mins I will be in pain for days (as an example) (I used to ride 200 miles / week and run 2 x half marathon/ week so this is not normal)
    I’ve been to 5 doctors with responses ranging from ‘ your numbers are fine’ to ‘I don’t know what’s wrong what do u want to do’.

    Most recently I think I have found a good doctor (who listens thinks and cares) and am trialling a combination of desicated thyroid extract and t3 ( four weeks so far)

    My question .. (after all that (sorry)).. given that pain was my first symptom and I suspect I have had a slow progression to hypothyroid (hashimoto actually) how quickly / slowly could it take for pain to subside?

    Thanks
    Martin

    • Hi Martin,

      If your pain is related to thyroid function then it should improve over 4-8 weeks after starting T3 medication. Usually pain is multifactorial, however, and does require more than just thyroid hormone replacement.

      • Ok thanks.

        When you say multifactoral do you mean something like rhumertoid arthritis or something less perminant? Could you recommend where to start looking for this at all as I suspect this may be my case?

        Thanks
        Martin

        • Yeah, or secondary to other hormone imbalances, nutrient deficiencies, systemic inflammation, etc. The best place to start is with a complete set of labs and a full history which will require a knowledgable physician.

  96. I have fibromyalgia and hypothyroid. How do you ask your Dr. About running complete panel for hypothyroid. My levels have always been in normal range. Never knew about having more test.

  97. Hi, I have lost the texture of food and partial taste, my jaws ache when I chew and have to stop and rest. a neorologist did blood work and found that my thyroid is to low it was at 16. something, then my regular doctor stated I was at 13 so today I had an ultra sound and will be seeing a thyroid doctor. currently i have lost about 30lbs, I have alot of energy except my back neck and lower back is were I usually have pain, is this common with hypothyroidism.

  98. The chronic pain was the reason I could no longer work. The pain had first started in my feet – it took it a very long time to develop, and then it abruptly became EXCRUCIATING almost overnight. I had to give up most of my physical activity and switched to yoga, gave up wearing high heels, and could no longer do some of my most favourite things to do (walking, dancing, shopping, looking at art in galleries, and attending museums and concerts).

    Then it was my arms. The never-ending nightmare made it impossible to work on the computer or write.

    Then it was my back.

    The latest one is my many times-broken tailbone: the actual trauma had happened around 25-30 years ago, but the excruciating pain only started 2 years back. Now I can’t sit for very long even with a special cushion, despite regular cortisone shots and heavy opiod painkillers 🙁

    Now, while all the drs are willing tonprescribe painkillers, they were completely baffled and helpless when it came to the debilitating fatigue that started 3 years ago and has been keeping me bed-ridden for 6 to 8 months at a stretch. Finding Dr.Izabella Wentz’s documentaries on Hashimoto’s has been a gods-sent eye-opener. I immediately started on her recommendations and – voula! – am no longer bed-ridden! Turns out, it wasn’t just fibromyalgia for me, just as I suspected all along. However, here in Canada they don’t do the full, proper thyroid panel, and my physician still regards all, y new-found wealth of info with a mix of dismissive irritation and skepticism.

    Do you have any ideas how I can get help from a thyroid-knowledgeable US doctor like yourself?

  99. I have been hypothyroid since 1978 -79. I was diagnosed as having depression, becoming a sleep walker/eater, and several other ridiculous conditions. I gained 40 lbs. in a month or two without changing my diet. I had all the classic symptoms of hypothyroidism but because my blood test came back as low-normal as possible, the doctor dismissed the idea that I had hypothyroidism. When I returned to the USA after living in Japan for 3 years, my best friend took me to see her father, who was a famous doctor and had known me since I was 6 years old. From across the room he said “Your thyroid died kid!” He ran more tests and diagnosed me as being hypothyroid and put me on Synthroid. I lost all the weight I had gained, my dry skin cleared up, my hair become fuller, my mood improved radically and I felt wonderful, energetic, happy, my old self.

    I am adopted but found my biological parents in 1981 and my mother, grandmother, aunts and female cousins all were hypothyroid.

    Things were fine until 2000 when my new PA decided that he thought my Synthroid dose was too high. I was asymptomatic but he started lowering my dose.

    I had quit smoking in Nov. 1999, was turning 52 in Feb. 2000 and probably was starting to go through menopause. I had a partial hysterectomy at 41 but still had my ovaries.

    As my PA lowered my dose of thyroid I began to put on weight without changing my diet. Within six months I had gained 80 – 90 lbs. Fast forward to 2017, I have never lost a lb. no matter what I try, I have hypothyroid symptoms, plus I have no energy, I am always tired, have very aggressive osteoarthritis that I has destroyed my hands, knees, hips, feet, neck and back. I have had bilateral total hip replacements, back fusion and the Hallux in both feet have been operated on and need to be fused in the near future. Both knees are bone-on-bone and need replacement and both thumbs need surgical intervention also. I was an Orthopaedic nurse years ago.

    I am virtually a “couch potato” because even water exercises, we have an inground pool, or trying to walk, makes my body ache for days. I was always active so this makes me very unhappy. I see an endocrinologist and have the “normal TSH & T3” labs done. My T3 was very slightly elevated, so we had a discussion about possibly needing to reduce my dosage. I asked them to please leave my dose the same and when it was retested 3 months later it was in the normal zone. Help! I have no idea what to do anymore.

  100. So glad i came across this site. All the years of my symptoms in one article.
    This gives me hope of a “NORMAL” life.
    Thank you

  101. I am 46 yrs old. I have always been told I was hypoglycemic.around 13 yrs ago, I had a car crush me, from a standing position. I suffered a broken back,left leg , having to have a fusion of t11 and 12, with rods,screws,etc.also a rod from knee to ankle,screws etc. I found out that my neck was fractured also, but my back was priority. I have been in chronic pain so much.but I can’t believe these injury’s can be this bad.another Dr found out that I have a hyperthyroid,way bad. I have tried to get the pain Dr to believe I hurt so much, but I have been told I need to see a shrink. I have panic attacks, I have fast heart rate, I sweat, and I’m so tired I can’t do anything with my kids. I hate going to the pain Dr to get told I need to do with out pain meds, and try to not be so nervous about everything.wow.please contact me and I want to get you to send me information about the thyroid and I want to share with my Dr. The signs are there. I feel like death sometimes.other times I am tired and hurting. I hope you get the world to realize it.Many blessings to you.

  102. Thank you for all of this information I have been on medic e since was 20 I’m now 52 I just went to my family doctor and she only did 3 of these test and I told her my synthroid should be upped so she did put it up. My question is I have an endocrinologist should I see him for these others test. I live in Florida and it’s so hard to find a good doctor.

    Thank you for your time

    • Hi Sandy,

      You could try going to an endocrinologist. In my experience it’s more about who you go to rather than what kind of specialist you go to.

  103. Hi. I was diagnosed with hypothyroidism AND Hashimotos disease last year. I’ve been taking Levothyroxine 75 mcg since. I’ve been doing a gluten free diet, eating meats and vegs and fruits. The last 2 to 3 weeks I’ve had tremendous pain in my legs from my hips to my feet. They just hurt/ache. Nothing gives relief. I just some of the comments here and I read your article. I was just wondering your input on this. Thanks for your time.

  104. Great article!I had 1/2 of my thyroid removed about 15 years ago, due to a nodule that was getting large, but biopsy was negative. Since then I’ve had fibromyalgia and have been taking meds for pain. I have a neurologist who gives me Tramadol for pain, and my regular PCP said all of my thyroid blood results are fine. I gained weight, have chronic fatigue, hair loss, all of the symptoms, by my thyroid is fine. When I mentioned your article to my doctor, he said, they are usually trying to sell,you something. No doctor will help me. No one believes my pain is real. I’ve been called a pill-popper, and suggested that I’m fat and lazy, and If I only lost weight, I wouldn’t have pain. It’s very frustrating when no one can help you.

  105. hi Doc, I have observed lot of acidity and gastric problem after I started to take levothyroxine. In my country i do not get other meds, I have to depend on levothyroixine and its causing lot of acidity and gastric problem, If i miss to take the tablet one day , i have not problem

  106. Thank you do much ! I tried so many things over the past 20 years…With several treatments. ..money. .. and therapeutic advice from different people /doctors/etc.

    But your blog is so true! It helped me to feel so much better!!!

  107. I had my thyroid removed is 12/2006 due to cancer. I am taking synthroid. I have chronic throughout my whole body. When you were mentioning muscle tightness you hit the nail on the head when describing my pain. Can a complete thyroid study be done when there is no thyroid?

  108. Hi!

    This information is super interesting to me. I was diagnosed with Hashimotos disease in March, but at the point I was not feeling any symptoms. Within the last month, I’ve been experiencing shooting pains all over my body – they predominantly started in my chest. I went to a cardiologist to check everything out and my EKG is normal (I’m supposed to be going back for a stress test in January). Since the onset of these pains started, I’ve now been experiencing them all over my body (arms, legs, shoulders, wrists, ankles, neck, etc.). Do you think there is a connection between Hashimotos and the pain I’m experiencing? I have not been on medication for my thyroid condition as my endocrinologist said it was manageable without taking anything at this point. So far, all of the doctors I have been to have dismissed the pain I’m having as anxiety, but I really do feel like there is more to this. I appreciate your help!!

  109. Also – one thing I failed to mention in my original post is that I am also a vegetarian. I was curious if you have seen a link with people with autoimmune diseases reducing symptoms by eating meat.

  110. Dr. Childs

    Wow. Just wow. This explains so much and confirms many of the things I have been doing right but still symptomatic. Brief history: Long term care giver to each parent. Health suffered from the stress. Diagnosed myself as most likely hypothyroid in 2014 and confirmed by blood tests. Had to fight for ND thyroid med. My endo is sort of the test TSH and adjust meds kind of doc. Continued heavy supplementation on my own, streamlined my diet while getting back to H.I.I.T. despite a degenerated ankle which was shattered in a 1984 MVA – and kept learning.

    Earlier this year I was diagnosed with anemia leading to MGUS. (Another strange story.) Nauseated for years and suddenly lost 18 pounds from ‘pseudo-anorexia’ and hard training. Finally found a GI doctor who agreed to test for SIBO. Bingo! 5 of 5 conditions I figured out I had. Started eating better again and absorbing my food. Felt almost 100%

    As soon as the temperatures turned cool, chronic pain hit with a vengeance! My PCD suspected fibromyalgia. On 12/11/2017 (my 55th birthday – people still think I’m 38/40) had initial consultation with a ‘pain doctor’. She explained how complicated figuring out the root cause(s) of chronic pain can be. So, of course, I began my research almost immediately.

    Providence lead me to your site. Virtually everything matches my experience. In my senior year in HS I wondered if I was ATP deficient. My senior picture looks like I’m 12 years old and I was tired since the 7th grade. This semi-scrawny-ness has followed me into manhood. Tissue Level Hypothyroidism explains it all – including ‘normal’ blood levels in my young adult life.

    The only thing not mentioned in your article is the rapid onset of joint pain in both my thumbs’ and great toes’ first joints possibly being related to TLH. I am serum negative for inflammatory markers, but my anti-inflammatory supplementation may have masked these. What do you think about this as a co-morbidity?

    As you may have perceived, I am very proactive about my own health, have been called ‘savvy’ by at least a couple of physicians, fired one and fired BY one (probably for those same characteristics). There is a reason why your information found me (or vice verse) and I felt compelled to both thank you and let you know that your detailed article with hyperlinks is a game changer for my last hurdle over chronic pain toward the health, wellness and longevity finish line – and instrumental to a new beginning! You ROCK, sir.

    • Hi Joel,

      Glad you found it helpful and thanks for sharing your story!

      In regards to inflammatory markers… I don’t pretend to assume that serum markers that assess for inflammation are perfect and what I mean is that there are plenty of patients that probably have low grade inflammation, perhaps at the cellular level, that don’t lead to spikes in serum markers. In addition and as you suggested, it’s also possible that certain supplements may mask the elevation of these markers which may cloud the picture.

  111. This is very interesting. My sister shared it with me. Our mother had chronic fatigue and fibro symptoms for years and we both do. Every point on my body feels like a bruise.

    I have been diagnosed with Hashimotos and take 30mg Armour. Dr. says that has it under control but I am exhausted, and in pain all the time and gain weight at about 1200 calories per day. I followed a keto plan of 600-900 calories per day and lost weight but would stall out if I got over 900, only to gain it back.

    I want off daily pain meds. I want brain fog to stop. I want energy and to feel good. I will check out your suggestions.

    Thanks

  112. This is the most informative article i have ever read. this sounds like a road map of my health. I suffer from debilitating pain, everyday. No energy, and an additional 40lbs that wont go away. I also suffer from potassium and magnesium defiencies.

  113. Me and my mom basically have same symptoms. Sounds like we have that. Do you do the testing or can you recommend one around tulsa Oklahoma

  114. I was diagnosed with hyperparathyroidism and had parathyroid surgery. I also have fibromyalgia. Is this connected to hypothyroid? After surgery the doctor said I would be great. I wasn’t. I have never been on thyroid medicine. How do I find a doctor who will do a full panel test like this?

  115. hi there, I am currently waiting to see my primary care dr who is also an osteopathic dr, but I had my obgyn do a thyroid panel, and these are the numbers I got back. She thinks my levels are fine, but every bit of research I’ve done since getting the results yesterday say that my numbers are not fine, and there is definitely something else going on.

    I also was diagnosed with Fibromyalgia 9 years ago, and that was only after 2+ years of seeing dr after dr and all of them saying they had no idea what was wrong with me. This post gives me hope and gives me things to tell my dr about tomorrow when I go to my appointment. I’ll also be bringing with me to that appointment a list of roughly 100 or so symptoms that I have had consistently for at least 10 years.

    here are my thyroid labs numbers.
    TSH = 1.980
    TRIIODOTHYRONINE,FREE,SERUM = 3.1
    THYROID PEROXIDASE (TPO) AB = 10
    T4,FREE(DIRECT) = 1.03
    CORTISOL = 8.2

    thank you,

    Maeve

  116. I have no thyroid due to cancer I take 225 mcg a day I have gained about 70lbs.since 2013 I have all these symptoms. I have endocrinologist should I be asking to be given t3 also? I need help really bad!

  117. I know I have hypothyroidism. My doctor tried me on synthroid and cytomel and I couldn’t take them. Made my heart rate go through the roof. She put me on progesterone and estrogen supplements and Endocrine supplements. I also developed stage three kidney disease. My left hip hurts so bad I can hardly walk on it. I told her and she said I didn’t have fibromyalgia. How do you test for it? Is it safe for me to take a T3 additive? If so which would you recommend?

  118. I have been diagnosed with hypothyroidism for years and cannot regulate it with medication. I’m currently on 150mcg of levothyroxine daily. I have been in constant body aches and pain for years. I’m only 40 years old, can’t lose weight. Please help!

  119. Thank you for such a great informational article. Have have struggled with many of these symptoms for over 16 years. In the last 4 months I have found a functional medicine doctor who has helped me turn the corner towards healing and better health. It’s only the tip of the iceberg. I feel 85% most days and look forward to getting closer to 100%. Life is becoming a joy rather than a struggle.

  120. Thank you for this post and other’s, especially about b12. I found them informative and very interesting. I have hypothyroidism and used to do really well on Synthroid alone. Now I take Synthroid and Cytomel, and even though my bloodwork looks good, I feel like the medications are not working anymore. I switched to Tirosint 2 weeks ago but don’t feel any difference yet. I recently found out that both medications are available as injections. Do you think injecting both would be more beneficial, since it would get directly into the blood? I would really like to know your thoughts on that. Thank you.

  121. Hi and thank you for your wonderful, informative posts.
    I am wondering if you know anything about chronic pain and Hashimoto’s? I was treated for hypothyroidism for several years with levothyroxin; then since 2010, with Naturethroid. In late 2015 I was tested using full panel and found I had mildly elevated antibodies (126) which my doctor diagnosed as Hashimoto’s. TSH normal all those years but now is at 2.63. I have suffered with chronic pain since my 20s; I’m 66 now. No one was ever able to help me with the pain except for the chiropractor, and doctors that prescribed NSAIDs which I finally took minimally for about 7 years before the onset of Hashimoto’s. Ruined my gut! So now I’m on Naturethroid and Levothyroxin, I follow Izabella Wentz’s protocol (diet, etc) and the pain has recently worsened. Can you point me in a good direction? Thanks!

  122. Hello,
    Thank you for confirming my theory. I was diagnosed with Hashimotos and juvenile thyroiditis when I was 11, and have had chronic pain and other anti inflammatory diseases since then. Including, fibromyalgia and CFS. I have always thought they were connected. It’s hard to get the medical field to accept this. Now maybe I have some hope!

  123. Dr.Childs
    Maybe this can help me.When I was 25 I had hyperthyroid, so I took a radiation pill to kill my thyroid out. At 48 years old, I’m now on a dose of 224mcg daily, with fibromyalgia, and major chronic pain with joint pain also the contracting muscles.I use a Tens unit to relieve some of the pain but doesn’t work very good, I currently take 60mgs of Cymbalta for the pain. I’m also very obese due to the lack of energy, can barely make it through the day.I don’t eat a lot usually dinner is my only meal.My life has changed drastically due to the low energy level I have, grocery shopping is absolutely excruciating for me. Any more recommendations that I could use, to help me feel “NORMAL”?
    Thanks so much for this very informative article.
    Shelly

  124. I do have high rt3 and all these symptoms you discuss even though my labs are optimal in tsh, ft3&ft4. My endo and I have tried adding cytomel several times, but I can’t tolerate even the tiniest amount. What else could I try beside a t3 med? I also could not tolerate Armour.

  125. I am a 50 years old female diagnosed with Rheumatoid Arthritis 2 years ago but have had symptoms for at least 20 years. I was taking methotrexate and Cymbalta, as well as infusions of Remicade, nothing worked for me. All my pain was from my waist down and certainly not something I can stand. The only treatment that has been successful has been the taking of RA herbal remedy I purchased from Best Health herbal center. I now wake up every morning without pain. I have been pain-free period for more than 4 months. I have regular blood tests and do not experience any of the side effects of taking the herbal remedy. Thank God this works for me. I feel great!.

  126. This article makes so much sense!! I have to go back in a few weeks for follow up lab work and I asked my doctor to add the complete thyroid panel to the list!

  127. Dr.Childs,
    I read your article and I get it because I’m living with debilitating pains but my recent test below my Endo keeps saying Im hyper and my thyroid levels have NOTHING to do with my 16 months of body pains. I did not have this level of pain until I lost this thyroid. I do supplement with zinc,Selinium,B12, Magnesium and Vit D I get no relief (I have chronic immune disease) Psoriasis and Im currently under treatment with Stelara NO DOCTOR seems really familiar with the biologic medicine and how it could be affecting my thyroid treatment.

    Do my numbers really reflect HYPER like I said earlier I don’t feel any symptoms of hyper BUT my Endo keeps calling it Silent hyper symptoms…. I WISH MY Endo would be silent. I’m currently on 100mcg synthyroid and 15mcg Cytomel SHE WANTS TO REDUCE my synthyroid to 88mcg and leave cytomel alone…. can you give your thought to this? For me it’s a NO since I did med reduction 2 months ago and Im more crippled with pain then before.

    Medical issues: Thyroid cancer and ovarian cancer(14yrs ago) w/chronic immune disease (psoriasis)….Sorry long winded I can’t fix my weight if I can hardly move and Endo is apparently deaf…..Thanks again.

    FT3 (2.0 – 4.4) 2.980

    FT4 (0.93 – 1.7) 1.23

    TSH (0.27-4.20) ……0.076 (L)

    Reverse T3 (9.2 – 24.1) 19.3

  128. Hi Dr Child’s, I just saw a comment from Grace and there may be something in it that I have been wondering about too.
    My short (Hashimotos) story is that noticed that in all my rt3 blood tests that my t3/rt3 ratio was always around 15 (I believe 20 is optimal). This is even when my t3 is in the mid normal range and t4 is at the bottom of the normal scale (10 (range 10-20) I am on NDT and still experience constant pain.
    I had been taking all the usual supliments (zinc, selenium ETC) And s omeone suggested that selenium can also assist rt3 conversion?

    So I recently went off selenium as an experiment (in the last week) and even though my t3 and t4 numbers havnt materially changed my tsh went from 1.4 to 5 in five days.
    Can you explain what is happening here at all?

    Should we be checking before we automatically supplement with things like selenium?

  129. Please recommend someone in Surprise, Arizona for me. I was on Armour Thyroid & Levoxyl, when I lived in Okla. & Colorado. But when we moved to South Carolina, it was like they don’t recognize Thyroid. They took me off of Armour and put me on just levothyroxine. I’m 70, and I was on Armour for years and felt great.

  130. Hi there,

    Thank you so much for this information!! I have Hypothyroidism, Fibromyalgia & my ferritin levels are 14. I started running 2 years ago & really struggle with my energy levels but also get pain in what I thought was my hips but I think its from weak glute muscles, according to a physiotherapist. I just feel absolutely exhausted and get so drowsy. I just want to feel good and run but cannot at the moment due to feeling so awful, and the pain I’m getting.

    I’m definitely going to request these tests from my GP as my TSH levels appear to be normal but they do vary but always stay within the ‘normal ranges’. Thanks for the info!!!

  131. I am 44 year old woman of previous excellent health diagnosed with fibro three years ago and underactive thyroid six months ago. I am 5 foot two and weigh around 7 and a half stone. Symptoms include chronic pain and tender points, tinnitus, dry skin, hair loss, brain fog, cluster migranes, ibs and palpitations and high resting heartbeat I have difficulty gaining weight which is confusing as normally it is the other way with an under active thyroid. I only take paracetamol for fibro, eat well but need to cut refined sugar out completely, I take q10, 5htp, b6, magnesium and zinc daily as well as evening primrose. I am active every day. I was put on levitheroxine but only took this for one month as I began to gain weight rapidly. I wish to resume thyroid meds but am afraid of level of weight gain adding to my list of symptoms.

  132. [email protected] I am hypothyroid. I’ve tried over six T-4 medications. With and without T-3. I’ve taken Dr. Lowes Thyroid Gold. My problem is I’ll be in optimal range and feel horrible for 10 months. Then I’ll get a break and feel great for 4-8 months. Then bounce back to feeling horrible. I’ve not had a full year of feeling decent in over 7 years. I’ve gone as long as 10 1/2 months with no desire to do anything. My Doc does the full panel T4, T/4 free, T3 etc. I’ve been tested for adrenals. Tried gluten free. Nothing has been of help. I take Colloidal minerals, Vit. D3, B complex. Any advise would be greatly appreciated.

  133. My rT3, T3, and SHBG are 18.9, 3.8 and 36.1. I asked my endocrinologist to prescribe me T3 but he told me that would shut down my TSH.

    • Hi Alex,

      T3 does not shut down the TSH and it can be dosed appropriately to avoid TSH suppression. It is true that T3 is more powerful than T4, but that doesn’t mean it can’t be used or that it’s necessarily harmful.

      • Dr. Westin, please pardon my hijacking of this conversation, it applies well to my situation.

        On the weight of the information you provided about muscle pain and supplemental T3 I asked my Endo to prescribe it for my chronic pain, tight cramping muscles and nagging fatigue. She would not accept a copy of your article and flatly refused to prescribe additional T3 alone on the basis that some of her other patients became psychotic from it, which I interpreted as ‘they became manic’. She did up my dose of ND Armor Thyroid a tad, which only slightly increased T3 along with T4. This doesn’t help much if I am not converting well!

        Back home, I asked for a referral from my PCP for a second opinion at another clinical venue, but they don’t accept thyroid patients on the basis of second opinion. There may be a third venue I could try.

        My questions are, 1)How does one find and get an appointment with a doctor who is agreeable to a patient’s legitimate requests for T3?

        2)Are there foods and supplements which aid or stimulate natural production of T3 in the body and subsequently ATP at the cellular level?

        3) Does low T3 along with low ATP levels contribute to greater susceptibility to injury, e.g. knee ligaments,and slower healing from relatively low intensity exercise?

        4)What *really* is the likelihood of becoming “psychotic” when titrating the optimal level of Cytomel (or whatever the current brand of T3 may be)? Frankly speaking, and a bit tongue in cheek, it would likely take quite a bit to only push me into hypo-mania, and that might actually be a good thing.

        Thanks for any insight you may provide.

        • Hi Joel,

          I have some resources that you can use here to try and find a knowledgeable doctor but just realize it can be quite difficult: https://www.restartmed.com/thyroid-doctor/

          In regards to your other questions:

          1. You might have luck increasing T3 using substances contained in supplements such as these (but they aren’t comparable to T3 medication): https://www.restartmed.com/product/t3-conversion-booster/

          2. I’m not sure if low cellular energy would increase susceptibility to injury but it’s plausible.

          3. There really isn’t a likelihood that T3 causes psychosis, in fact, it’s often used to treat bi-polar disease when all other medications have failed: https://www.ncbi.nlm.nih.gov/pubmed/19215985

          It’s also used to treat depression to improve cognition in cases of treatment-resistant depression: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5451035/

          If anything, it will likely improve cognition and mental clarity (not the opposite).

          This is a classic case of a physician who hasn’t spent time in the literature and is practicing based off how they were taught probably 15+ years ago. The more you push these physicians the harder they push back against you, however, so showing them the literature usually is futile.

  134. I was initially dx as Graves disease and was ablated which only partially worked, have ALL the symptoms of hypothyroid but bloodwork shows me ‘normal’do you recommend the name of a thyroid supplement?

  135. • Hello, Dr。 Childs,Thank you so much for the information. I am a long-time patient with hypothyroidism and muscular/joint pain/tender points. I have been taken synthroid 112ug a day for many years but still tired, cold, pain, catch cold/flu all the time….I have been taken Reserve(a Resveratrol formula) and lost some weight, reduced edema, gained some energy, but still not as healthy as other people.
    • In the meantime, I have allergy of my nose/sinus/eyes, feel like have infection/inflammation all the time, for most nights I feel cold/warm alternatively or at the same time. And the tongue is red and sore. nose easily blocked or watering/sneezing, and throat sore often. …
    • Are the inflammation and allergy are caused by hypothyroidism too? What should I do? Thank you so much for your help! It will be highly appreciated.

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