Its possible you may have a Hereditary Neuropathy like Charcot Marie Tooth disease. Would discuss with your Neuro as well. In any event, I hope you find some relief.

Thank you for all those who have given me their thoughts about my condition. Just an update - I had MRI of my head and neck, both were
normal. I had NCV and EMG but results are yet to be discussed with my neuro in my next visit. I also had a test for the lower extremity doppler. The technician commented that it was normal. I have essentially been tested which could be the cause of the neuropathy but it all came back normal. Except for my thyroid function test which is a little way off. My primary care physician has been trying to adjust the dosage of my Synthroid (for 3 consecutive times) but it just could not make my TSH normal.

Does anyone in the group has hypothyroidism as the cause of the PN, even with just a little abnormalities? I wish I could find an underlying condition for my PN, at least there is something to cure.

I purchased a guidebook on PN from MediFocus. It says in that book that Levothyroxine is contraindicated with Gabapentin. Is this true?

I am now experiencing much pain in my feet. I barely can stand and walk because of the pain. The burning is really bad as well as the jabbing, lancinating and prickling in my skin.

Thank you all for "listening" to me.. It scares me to death living in constant pain for the rest of my life.

I had terrible PN in my feet when I was hypo...back before my son was born. I also had carpal tunnel --lost 80% function in both hands while I was pregnant.

I didn't get a firm diagnosis of hypo until I had a radioactive uptake test done...which showed a dead left lobe and goiter in the right side. My tests were not severely off either. The isotope was called technicium.

When I started levothyroxine, it was very slowly. 25mg a day for 3 mons and then 50mcg. I stayed at 50 for a while, then we had very severe winter and lost power for 4 days, I had a hypo crisis, which was terrible. Then I was raised to 75mcg, and that seemed to stabilize me and that is where I stay.

Some people with Hashimoto's can fluctuate up and down.
Also people low in iodine intake can not respond properly.
Using a standard kelp product which mostly have 150mcg..each and take 2 a day...may help.

Then there is peripheral conversion issues. People low in zinc and selenium cannot convert T4 to active T3. So if you take levothyroxine, it may not work...since it is inactive, and needs conversion in the tissues.

It can get very complex. Then there is "reverse T3" which is also inactive.

One of the best resources on the net is Mary Shomon:
http://thyroid.about.com/bio/Mary-Shomon-350.htm

There is considerable disagreement among medical doctors on how to deal with thyroid problems. So it is not easy getting this fixed.

Keep in mind you MUST take the same brand of hormone when testing. Things vary even among brand names! Also always take first thing in the morning, on an empty stomach and no food for an hour. Very critical for absorption...just like the B12 and some other drugs that are given in microgram amounts.

]

Thank so much Mrs. D. I had my Total Thyroidectomy in 2007. It took months before I had my thyroid function stabilized. I was on .75mcg for years, until my PN symptoms came last Oct. 2010. Due to my PN symptoms, I had essentially tests related to PN, all came back normal, except the TSH. It was 9.230 (normal range 0.450-4.500). Then, my Synthroid was adjusted to .100mcg resulting to a TSH of 0.078. Then, my Synthroid was again adjusted to .88mcg resulting to a TSH of .162. Now, I am on .88mcg for 5 days and .75mcg for 2 days. Hopefully, my TSH will be normal in my next test. My neuro does thinks that my TSH numbers is enough to cause my PN. You see my PN symptoms are all over my body : pain on both feet; jabbing, prickly and lancinating pains in my legs and arms. As you know, it is very uncomfortable even the touch of a soft materials in my skin. I am taking my Synthroid on empty stomach at 5am, followed by VB12 (methylcobalamine) at 6am at the Gabapentin at 7AM. It is only after taking Gabapentin that I take food.

Do you know if Gabapentin and Synthroid are contraindicated with each other, taken on different times?

I have been to 2 neurologists, both of whom seem to be nonchalant of my symptoms. If they only know/experience the pain, I am sure they would have been more sympathetic.

Again, thank you Mrs. D.

This is the drugchecker at drugs.com

no interaction with gabapentin listed;
http://www.drugs.com/interactions-ch...=1147-0,1463-0

not all drug checkers are 100% accurate or 100% up to date however.

I personally have never heard of this interaction.
Can you link to the place where you found it?

I read it from the guidebook about Peripheral Neuropathy which my husband bought online. ** Under the topic of medications/treatments : Gabapentin is contraindicated with various medications, among others is Levothyroxine
.

Before taking the Gabapentin, I also checked the Drug ** Checker and i was confident that Gabapentiin and Synthroid have no contraindication. But now, i am confused with this new information.

Is your neuropathic pain limited only to your feet?

That may be one of the most confounding and infuriating circumstances with this... condition. I recently read (once again) that there are somewhere in the range of 50 to 100 known causes of PN, some of which are treatable, and some of which resist treatment. Yet after evaluations for all those etiologies are performed, somewhere in the range of 30-70% (guesstimates vary) of all peripheral neuropathies remain idiopathic.

Knowing the cause does not guarantee a cure, arrest, or even a treatment, yet... some people with PN whose cause is never found have still been able to find some relief/improvement.

I'm trying to be a little philosophical about it. I'm going at it kind of backwards, like... reverse diagnosis. Since my cause hasn't been found, I'm looking for/trying things that help/improve my symptoms, thinking/hoping that that may lead to clues in figuring out a cause. If it doesn't, I'll still have improved a bit, and IME, that's easier to live with than the alternatives. I guess for me, getting better is more important than knowing the cause, even if I knew what that cause was.

I don't know if this can help anyone else; it helps me to cope.

Doc

Well, I think it is unusual to be on a low dose levothyroxine product after a TOTAL removal of the thyroid gland.
Usually they start people off at 100mcg to 125mcg.

Thank you for the quote... the grammar? Was this an abbreviated download? When I went there I saw that the abbreviated download was free but a charge for the full book?
If this quote is from the abbreviated one...I think what it is saying is that gabapentin has interactions, and among other drugs, there is levothyroxine (and maybe more with their own interactions). So the grammar is odd IMO in this quote.

Gabapentin is popular because it DOES NOT interact much with other drugs. It is not metabolized by the liver, and so all the enzyme effects on the liver are not present.
This is a further detail on drugchecker at drugs.com
only 5 major interactions
http://www.drugs.com/drug-interactio...&generic_only=

This is the moderate list which is longer:
http://www.drugs.com/drug-interactio...&generic_only=
While this list looks impressive, this interaction is mostly
for the sedative nature and side effects of potential cognitive impairment with gabapentin which are so common for most people.

Levothyroxine does not cause cognitive impairment or sleepiness so it is not on the moderate list either.

Now, one type of interaction with levothyroxine which is possible with some drugs, like warfarin, is the displacement off carrier proteins in the blood. Thyroid hormones are shipped around the body by these proteins and some drugs have more affinity for them than others. So the thyroid hormone may be bumped off its carrier by something else. But I don't see this listed from Drugchecker either. It is possible you are having problems with the proteins that carry drugs. Either you take another drug which is knocking the thyroid hormone off resulting in poor distribution, or your body is low in protein from diet or some other reason, and the hormone cannot be distributed well, because of that.

So with the added detail of your total removal of the gland, then the kelp/iodine suggestion would not work for you. That only works if some gland is present.

Yes, I have PN in my hands too. It was very acute at one time, and now is only minor. I control it with wearing carpal tunnel braces when needed. It tends to flare with fluid retention or overuse of my hands (computer, gardening, stressful tasks).

The type of PN that comes from HYPOthyroid conditions is mostly compressive in nature. Hypothyroid situations, result in the deposit of a type of tissue in the body, at the wrists and
ankles, and this compresses nerves and causes pain, numbness and/or loss of function. When I was pregnant the additional hormones created a severe compression at my wrists, and EMG showed 80% loss of function. This resolved to my old levels after I delivered my son.

By the time I was finally diagnosed, my feet were pretty numb.
During my titration up in dosage over the months, they "woke up" and tingled alot until most of the numbness is gone. I still have some residual numbness in the middle toes of each foot, but the doctor would not go higher with the levothyroxine because of my TSH at 1.5-2. It varies in that range now.

I think my husband got the complete guidebook as he had to pay for it.

I started on 100mcg after my thyroidectomy, however, it had to be adjusted several times in the course of several months until my TSH stabilized at 75mcg. It was during the onset of PN symptoms that myprimary care physician requested for the TSH test (that was in October 2011) to look for the underlying conditions (among other several tests I have been through for the past 4 months) and since then, my TSH has not been normal.

Other than Synthroid and Gabapentin, I am taking VB12 (Methycobalamin), Vit E, Vit. C, Multivitamin, Selenium, Glucosamine, Omega 3,6,9, Metamucil and Calcium. I take my Calcium 5 hours after I take my Synthroid.

Out of desperation and frustration of the pain, I am considering of participating in a cllinical trial for peripheral neuropathy but there has been no recent trials that I could see online. My neurologists dont know either.

Does Gabapentin work well with Cymbalta? If yes, does Cymbalta work well with Synthroid?

Thank you Mrs. D!

In your readings, did it enumerate the list of 50-100 known causes of neuropathy, just additional information.

I like your philosophy in coping with the pain. While reading your post, i was trying to relate it to myself. I really dont have extraordinary diet or activities that I could think of knowing which aggravates the pain or gives me relief. I dont smoke nor drink. I eat relatively healthy food. I used to walk 5 miles a day until the onset of my neuropathy in October 2011. My symptoms came suddenly. Now, I do moderate stationary bicycle. I dont know if stationary bicycle will aggravate the nerves.