If you have thyroid gland issues and your legs are swollen, you may be searching online for answers to some or all of the following questions:
- Why do my legs feel heavy?
- Why are my legs restless at night?
- Why do I have leg cramps all the time?
- Why do my legs feel weak when I walk?
- Why are my legs always swollen at the end of the day?
- Why, when I wake up in the morning, do my legs take time to get moving, hurt, and feel tingly?
If these questions are familiar to you, you may be relieved to know that they sound familiar to us, too, because we hear them all the time from patients struggling with hypothyroidism — a disorder of the endocrine system in which the thyroid gland doesn’t produce enough thyroid hormone.
Unfortunately, doctors who practice conventional medicine often miss the connection between swollen, achy, tired legs and the thyroid gland. Or they suspect thyroid, order some blood work, and conclude from the lab results that the thyroid isn’t responsible.
Or they start the patient on thyroid medication, but the problem persists. Then, patients are usually told something along the lines of, “You need to eat less and exercise more.”
If you or a loved one have to contend with these issues, it’s important to know what’s going on and how it can be properly diagnosed and fixed.
According to the American Thyroid Association (ATA) — the world’s leading professional association of medical specialists dedicated to education and research to improve thyroid disease prevention, diagnosis and treatment — more than 12 percent of the U.S. population will develop a thyroid condition during their lifetime, an estimated 20 million Americans have some form of thyroid disease, and up to 60 percent of those with thyroid disease are unaware of their condition.
Recognizing the Signs of Low Thyroid Hormone
The thyroid gland is a butterfly-shaped organ located just below the larynx (voice box). It is part of the endocrine system — the body’s chemical (hormone) messaging system.
Although it is relatively small, weighing only about 25 grams, its performance impacts every cell, tissue, and organ in the human body by regulating the body’s metabolism — the process by which the body extracts and uses energy from food.
Your thyroid gland produces two important hormones — T3 (Triiodothyronine) and T4 (Thyroxine). If it’s not producing enough of both hormones, you suffer from a condition called hypothyroidism. Symptoms of hypothyroidism include the following:
- Carpal tunnel or Tarsal tunnel syndrome
- Constipation
- Depression
- Dry skin
- Elevated blood cholesterol
- Enlarged thyroid gland (goiter)
- Fatigue
- Heavier than normal or irregular menstrual periods
- Hoarseness
- Impaired memory
- Increased sensitivity to cold
- Joint pain, stiffness, or swelling
- Muscle weakness, aches, cramps, tenderness, or stiffness
- Numbness or tingling in the extremities
- Puffy face
- Restless legs (involuntary leg movement when sleeping)
- Slowed heart rate
- Slowed reflexes
- Stubborn weight gain
- Swollen extremities (legs, feet, arms, hands)
- Thinning hair
Why My Legs?
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 as peripheral edema.
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 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.
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 the 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’s the Solution?
The solution starts with a thorough evaluation of your thyroid and other factors that may impact thyroid health and function. Here’s what we do at BioDesign Wellness Center to diagnose and treat hypothyroidism:
- 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. At BioDesign Wellness Center, we add the following tests:
- 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.
For more about the thyroid gland and how we treat health issues related to thyroid dysfunction, check out our two-part series on Restoring Thyroid Health.
At the end of the day, like your aching legs, you shouldn’t have to live with pain and discomfort. Integrative approaches to healthcare, like those offered at our Tampa functional medicine practice, are designed to help you discover what’s going on and then restore and optimize your health and well-being with a personalized healthcare plan.
If this sounds like the type of care and treatment you deserve, please call our clinic at (813) 445-7770. In addition to visits at our Tampa clinic, we offer telehealth visits as well.
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Disclaimer: The information in this blog post about the thyroid gland is provided for general informational purposes only and may not reflect current medical thinking or practices. No information contained in this post should be construed as medical advice from the medical staff at BioDesign Wellness Center, Inc., nor is this post intended to be a substitute for medical counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.