Hypothyroidism
Hypothyroidism occurs when the thyroid gland produces less thyroid hormone in the body. Many symptoms indicate an underactive thyroid in the body. But one of the symptoms that people with hypothyroidism complain about is foot pain and swelling. Before we talk about the treatment of foot pain, it is better to know more about these symptoms. These symptoms appear in the following ways and cause discomfort in a person:
- Feeling of heaviness in the legs
- Restless legs
- Leg cramps
- Feeling of weakness in the leg while walking
- Swelling of the legs
In the rest of this article, we will talk about the cause and relationship between hypothyroidism and leg swelling and how to get rid of it.
How does hypothyroidism lead to foot pain and swelling and restlessness?
Hypothyroidism was originally referred to as myxoedema or myxedema — myx meaning “mucus” or “slimy substance” and edema meaning “swelling.” We commonly refer to swelling of the legs, feet, arms, or hands peripheral edema. High thyroid TSH levels were found to be significantly associated with painless bilateral limb swelling. Peripheral edema is the technical term that refers to swelling of your legs and feet, but also swelling of your arms and hands.
Myxoedema is primarily the result of a buildup of mucin (also called glycosaminoglycans or GAGs), which form the extracellular matrix that fills the spaces between tissues in the body. Mucin is a spongelike jelly that holds our organs and tissues in place and protects them against compression.
Hypothyroidism causes a rapid accumulation of mucin, which causes the swelling, stiffness, weakness, and pain. This swelling may occur in the legs and feet, arms and hands, belly, or face. It results in thick, rubbery skin that you can’t pinch and lift like normal skin. And it doesn’t push in easily when you poke it with your finger. Left untreated, hypothyroidism leads to systemic swelling, and the entire body can become waxy, pale, cold, and doughy with thick, dry, swollen skin.
Swelling that affects the nerves results in numbness, tingling, and impaired reflexes.
The weight gain associated with hypothyroidism is a combination of slowed metabolism and water retention due to the buildup of mucin. Eating less and exercising more may help with the weight gain from a slower metabolism, but it will do little or nothing for the weight gain associated with mucin buildup. In fact, most of the weight loss that patients experience after being successfully treated for hypothyroidism is due to the excretion of excess water stored in mucin.
What factors lead to the exacerbation of swelling associated with hypothyroidism?
Other factors that contribute to swelling associated with hypothyroidism include the following:
- Low basal body temperature: Hypothyroidism is associated with low body temperature, which causes the body to retain fluids.
- Reduced blood circulation: Low thyroid reduces blood circulation, so fluids accumulate in the extremities.
- Poor kidney function: Your kidneys filter your bodily fluids continuously. Low thyroid is associated with a decrease in the glomerular filtration rate (GFR), which results in accumulation of fluids throughout the body.
Keep in mind that swollen, achy legs are associated with other health conditions, as well, such as cardiovascular disease and diabetes, so be sure to get a thorough medical examination. If your doctor doesn’t provide a solution that works for you, get a second, third, fourth, and fifth opinion about your thyroid. It can take some time and many trials to find a doctor who knows how to conduct a thorough examination and provide an effective treatment protocol.
What is the solution and treatment for foot pain?
The solution starts with a thorough evaluation of your thyroid and other factors that may impact thyroid health and function. Some of these treatments include:
- Thyroid sonogram: When called for, we order a thyroid sonogram, which is an ultrasound that checks for nodules and inflammation.
Complete thyroid testing: Many healthcare providers are conducting incomplete thyroid testing — they test only for thyroid stimulating hormone (TSH), T4, and T3 uptake. But the following tests need to be added:
Reverse T3 shows how much active thyroid hormone you are getting rid of. It’s normal for your body to shed some thyroid hormone as a waste product. If you’re doing that excessively — usually in the context of inflammation — you can feel bad even on medications. Knowing this can help us identify and address the underlying issue, usually resulting in increased energy and decreased pain.
Thyroid antibodies can help determine if you have Hashimoto’s thyroiditis (autoimmune thyroid). In this case your thyroid is not the only problem and working on your immune system will be advantageous.
Total and Free T3: T3 is the active form of thyroid hormone.
- Thyroid hormone therapy: Depending on the test results, we may need to prescribe specific types of thyroid hormone. For example, if T3 is low and you’re already on Synthroid or levothyroxine, an addition of T3 hormone can resolve lingering issues.
- Nutrient evaluation and supplementation: We check your vitamin and mineral levels and address any nutritional deficiencies. Low levels of magnesium, iodine, selenium, or B vitamins can contribute to restless legs and other symptoms. Knowing what needs to be supplemented can make a big difference in how you feel and heal.
- Sex hormone testing and treatment: Having too much estrogen and not enough progesterone can contribute to thyroid symptoms. We address any imbalances with bio-identical hormone replacement therapy, which is safer and more effective than using synthetic hormones.
- Cortisol testing and treatment: Cortisol mediates various metabolic processes and has anti-inflammatory and immunosuppressive properties. Excess or insufficient cortisol can contribute to thyroid symptoms. We have various treatment options to restore healthy cortisol levels.
Guided by your test results, we can create a personalized plan that seeks to restore thyroid health and function, addresses other related health issues, and relieves the swelling, pain, and discomfort.
