# Muscles cramps and twitching



## Tulips (Oct 23, 2010)

Hi

I have no diagnoses and been suffering for 12 years.
I have a lot of other symptoms that can go with throid like hair loss and facial hair growth. Tierd and vitin d deficient. But for the last 12 years I have suffered from severe muscle cramps and spasms all over my body. Face , throat and all over . Same with twitching and a lot of neuropathy like stuff. Pins and needles stabbing etc....

I have had extensive work up my neurology and rhumatology. MRI, spinal tap, emg-ncv, muscle
And skin biopsy. Tons of blood work.
All normal

Except vitamin d deficient and elevated sed rate and always trace to moderate blood in urine.

I had my thyroid levels and org checked and according to it's fine.

My question the ones with confirmed problem with thyroid
Do u suffer from cramps and twitching and especially all over face and throat.
Neuro says since it's all over it defiantly some thing systemTic. But don't know what.

Thankyou
Tulips


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## Tulips (Oct 23, 2010)

I wanted to add besides the cramps and twitching( very rapid cramps and painfull all day in every muscle:-(

I do have the hirgrowth on breAst too and tierd Ll the time. Dry itchy skin. Allergies and eczema.

Herr are some of my results

In. 2010
Free t4 1.22 range .85-1.72
Tsh .94. Range. .35-5.50

In 2007
Tsh 2.47. Range .35-5.50

In 1999
Tsh 1.9 range 0.5-4.7

In 2003
T4 1.3. Range .8-1.8

In 2008
Tsh 2.7 range .30-4.50
Calcium 9.6
Pth 35 range 15-65

In 2010
Vitamin d 1,25 32
Vitamin d 25 hydroxy 12
Pth 25


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## Andros (Aug 26, 2009)

Tulips said:


> Hi
> 
> I have no diagnoses and been suffering for 12 years.
> I have a lot of other symptoms that can go with throid like hair loss and facial hair growth. Tierd and vitin d deficient. But for the last 12 years I have suffered from severe muscle cramps and spasms all over my body. Face , throat and all over . Same with twitching and a lot of neuropathy like stuff. Pins and needles stabbing etc....
> ...


Hi Tulips. I find it interesting that the doctors ran all these tests and MRI and never once ran any antibody tests.

The twitching could be from peripheral neuropathy and depending on how severe, myoclonic seizures both of which can be attributable to autoimmune disease.

Actually, your last thyroid panel looks suspicious because your TSH is low and your FREE T4 is below mid-range indicating that there might be a fast conversion rate going on. T4 converts to T3 which is your active hormone so I am recommending that you get all the little ducks in a row and re-get FT4, TSH and FREE T3. These all have to be done at the exact same time.

Also, I believe you need these antibodies' tests.

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/unders...s/thyroid.html

Here is info on peripheral neuropathy.

http://emedicine.medscape.com/article/1172273-overview

Incidentally, I do think you may be hyper but would only know if you get the testing suggested re FT3 and the antibodies.

I can't see your twitching activity so I don't know if it is myoclonic or not but here is info. And by the way, myoclonic is usually found in Lupus patients. Tests for that would be Anti-DNA, C3 and C4 and you can look this up on the link for lab tests also.

http://www.ninds.nih.gov/disorders/myoclonus/detail_myoclonus.htm

And lastly but not least, low ferritin can cause cramping so a ferritin test would be in order. Ferritin should be 50 to 100; the closer to 100,the better.

Ferritin http://www.thewayup.com/newsletters/081504.htm

You now have plenty of stuff to read this weekend. LOL!!


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## Tulips (Oct 23, 2010)

Hi

I have had pretty detail workup with DNA rhumatology ssa, ssb, smp. C4 was elevated as twice Ana was borderline but the doctor said dosent mean much!! Okay but I have symptoms

I was reading on hypocalcemia and tetany can cause Cramps and twitching
All the info is very confusing
I get fast twitches like pop pen popping and huge thumps to one flickers. I do have the jerks but when relaxed and falling asleep.

Skin biopsy is normal dor neuropathy as is emg/ncv but I do have carpel tunnel.


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## Tulips (Oct 23, 2010)

its so frustrating. as it could be lyme, lupus, to neuromuscular to diabetics to thryoid to malabsorbtion issues.

Had my glucose tolerance test yesterday.
i had celiac panel...negatve
specil antibody test for neuromuscluar ...negative

paraneoplastic panel...negative

i think its some autimmune as i have elevated sed rate.


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## Tulips (Oct 23, 2010)

Andros

U said there is a conversion goin on. What does that mean or indicate.
I feel like a ticking time bomb. I know I have had so many test and this has been going on do so long but I am in so much pain and I feel like something obvious is being missed. And I don't know how to prove it


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## Andros (Aug 26, 2009)

Tulips said:


> Hi
> 
> I have had pretty detail workup with DNA rhumatology ssa, ssb, smp. C4 was elevated as twice Ana was borderline but the doctor said dosent mean much!! Okay but I have symptoms
> 
> ...


Ah, ha!! See, these little critters are hard to catch. They get quiet and then they rebound. This is true of the Anti-DNA and many others as well.

Increased levels of both C3 and C4, in addition
to increased concentrations of C-Reactive
Protein, are linked to acute inflammatory
disease and tissue inflammation.
http://www.beckmancoulter.com/literature/ClinDiag/Bulletin 9282C3_C4.pdf

Something is afoot as evidenced by the mere presence of ANA which of course is only "suggestive."

And that is precisely when the myoclonic jerks occur. When resting. I know because I had them.


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## Tulips (Oct 23, 2010)

My c4 was elevated but not c3 and last time such detail testing was done was in 2005. But since Ana and ssa and ssb have been repeated and show normal

Crp has been normal.
I know somethin is up. Just what I don't know!
Vitamin d down sed rate up. Ana twice borderline.

I will try to get them done again. 
Do you know if the detail rhumy bloo test are expensive as I am about to loose my insurance

Oh gyno did bunch of blood for hormones and testosterone And pelvic ultrasound and that was normal for pcos.

Oh yes I have eczema and allergies... Autoimmune perhaps!

This natupath yesterday put iodine on my skin and said to watch how fast it absorbs in 24 hours and that can tell thyroid problems.
Is that true?
Thankyou


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## lavender (Jul 13, 2010)

I think bloodwork is a much more reliable way to test for thyroid issues. TSH, FT3, FT4, TSI, TPO, Thyroglobulin Antibodies. Except for TSH and one FT4, I do not see that you have had these tested.


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## Andros (Aug 26, 2009)

Tulips said:


> Andros
> 
> U said there is a conversion goin on. What does that mean or indicate.
> I feel like a ticking time bomb. I know I have had so many test and this has been going on do so long but I am in so much pain and I feel like something obvious is being missed. And I don't know how to prove it


T4 converts to T3 which is your active hormone. Because your TSH is low and Because your FT4 is below mid-range in the range, I suspect you may be converting to T3 in excess;hence the low FT4.

http://www.endocrineweb.com/conditions/thyroid/how-your-thyroid-works


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## Tulips (Oct 23, 2010)

Okay ya no antibodies for thyroid has been sone yet. That's next

How was your lupus discovered?

My 2006 test
DNA ab, histone, ssb ssa normal
Sed 58.
Crp 91 range 0-80
Rf negative
Ana negative
C3 179 range 90-180
C4 58. Range 16-47


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## Tulips (Oct 23, 2010)

In 2004

Same test were negative and so was sm/ rnp and normal ck

I do have the moderate blood in urine for years and when I was reading that c4 link u gave on top it mentions nephritis or lupus nephritis but it says level of c3 and c4 would be loow.. So that's confusing
I had ivp and bunch o work by urologist 7 yrs ago and they couldn't figure it out.

Besides the neuromuscular doc says it's something systmetic as it's all over. 
Even in tongue ( twitch) and heat cramps!'

The thing is in 2003 I took flu shot that made my levels of this from 3 to million over night. So I don't know if that made my existing condition worse or what.

Tulips


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## Andros (Aug 26, 2009)

Tulips said:


> Okay ya no antibodies for thyroid has been sone yet. That's next
> 
> How was your lupus discovered?
> 
> ...


W/that C3 and C4, something was rearing it's ugly head at the time.

I always knew I had Lupus but could not get a doctor to acknowledge or run tests. Finally, I found a good doc. She is a rheumatologst/immunolgist. She "suspected" and ran the Anti-DNA, C3, C4. Through the roof.

Let me ask you a question. DNA test, it says normal. Do you know you should not have any Anti-DNA? Do you have copies of these tests where you could show me the result and the range?

A lot of times they will say in normal range and diss the patient when in fact there are many antibodies the healthy person should not have.


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## Tulips (Oct 23, 2010)

You are right. The fact we have antibodies is telling you something. I went to new rhumy earlier this year and she only did Ana. She said we. Only do others I Ana shows anything. I said okay then why the other rhumy ran everything together! 
Plus she said all of this is tere to some level is normal peoe and that seed rate can be high due to my blood in urine (cystitis?) or allergies!!

She said if was pressed to make a diagnosis based in your symptoms I would say lupus. But she said u are not classic and medicTions are harsh to diagnose clinically.
So I need to find a different neuro.
Plus when all this started fir me I live in Connecticut so I always wonder about Lyme. In 2004 the wester blot was done and one out of ten cane back reactive but in 2005 all negative.but a person on Lyme forum told me the fact one was active is clue e ough cause if u never were infected none should ever be active. Yet again docs says it's nothing.

I don't have joint swelling but I do have rash on my sides an back all the time. I showed it to rhumy and she just shrugged it off.

My dna says negative 
Histone says <1.0. 
Range
<1.0 negative
1.0-1.5 weak positive
1.6-2.5 moderate positive
>2.5. Strong positive

Ana negative

Sm//rnp <1.0
range
< or =1.0 negative

There is more I am looking for it.

Basically these were last done in 2005. Yes Ana and sed this year but not the detail

And I wanted doc to do it since I have been flaring worrse then ever since June this year


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## CA-Lynn (Apr 29, 2010)

I am not a doctor but here's what I would do:

Go to the closest university that has a med school. In your case Yale or UConn. Both are excellent. Get a rheumatologist and get a rule-out for polymyositis and dermatomyositis.

That rash could be symptomatic of a connective tissue disease.

Rheumatologists don't typically see polymyositis in regular practice - whereas clinical professors in teaching medical schools will likely have greater experience.

http://www.nlm.nih.gov/medlineplus/myositis.html


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## Tulips (Oct 23, 2010)

Hi

I had a glucose tolerance test 2 hr one and it's abnormal.
Does that help with anything a clue


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## Tulips (Oct 23, 2010)

Hi

Okay I had bunch of blood test done

Ferritin 45 range 10-291
Free t3 2.9 range 2.3-4.2
Free t4 1.22 range .85-1.72
Tsh 1.43 range .35-5.50

Ionized calci 5.2 range 4.5-5.6
Manesium 1.9 range 1.6-2.6
Tpo ab 10 range 0-34
Tsi. 30. Range 0-139


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## Tulips (Oct 23, 2010)

The about thyroid anti bodies test are innnormal range but dosnt it mean something for the fact that o een have some antibodies or will everyone have all kinds of antibodies and dosent mean unless u are really off in numbers


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## Andros (Aug 26, 2009)

Tulips said:


> Hi
> 
> Okay I had bunch of blood test done
> 
> ...


As I suspected; fast conversion rate of T4 to T3. TSI means hyperthyroid. You should have absolutely NO TSI.

Results and Values
What do the test results mean?
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism.

http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html
--------------------------------------------------------------------------------

Not surprised about the ferritin either which could account for twitching. Ferritin should be 50 to 100 and the closer to 100, the better. So, iron supplement would be in order. Talk to your doctor about this. Floridix Liquid Iron is fast acting.

Both the FT3 and FT4 are below mid-range at this time. You are in roller-coaster mode right now. Lots of fluctuation.

I do recommend RAIU (radioactive uptake scan.) As mentioned, TSI is only present when hyperthyroid. So, nodules and cancer need to be ruled out as well as finding out what your rate of uptake is re the hyper part.

As evidenced by TPO and TSI, you do have autoimmune issues.

Thanks for the ranges; much appreciated.


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## Tulips (Oct 23, 2010)

Thankyou for you knowlegede

Here is the thing my gp didn't even want to check my iron. And she Said she is not going to supplement as it's normal!!

Does iron play a role in thyroid

See that's the thing. A lot of my rhumatology work up shows no antibodies!! So when it shows regardless it's in range I would think it means something. I would asse in otherwise healthy people anyibodies shouxldnt be there.

Can I supplement with OTC iron. 
I went to the endocronologist and she Is running the same blood teat except the ferritin.

She said she don't see any thyroid issue and even if anitibodiea come back high u dont need treatment for that and she doubts it would so
Anything for my symptoms

I was shocked!!! Changing endo for sure


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## Andros (Aug 26, 2009)

Tulips said:


> Thankyou for you knowlegede
> 
> Here is the thing my gp didn't even want to check my iron. And she Said she is not going to supplement as it's normal!!
> 
> ...


I am equally as shocked. This is too scary! You need medical intervention. Which came first, the cart or the horse? Hard to say but I do know that most of us w/autoimmune also have low ferritin.

Yes; you can do OTC for the iron but the best thing you can do is buy cast iron cookware and use it. Also eat things high in iron. Like beets, dark green leafy veggies, raisins etc..

Your thinking is correct. Trust your instincts and yes...........you will have to go doctor shopping. Oh,what a shame.

It is to the point where I am just terrified of doctors. I kid you not.


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## Tulips (Oct 23, 2010)

HBA1C Hemoglobin 5.0 % 3.90-6.0

A1C

CH14 COMP XXXXXXXX

METABOLIC

PANEL

NA Sodium 142 MEQ/L 135-148

K Potassium 4.1 MEQ/L 3.5-5.3

CL Chloride 104 MEQ/L 95-110

CO2 Bicarbonate 29 MEQ/L 22-31

GLU Glucose 93 MG/DL 60-100

BUN BUN 14.0 MG/DL 6-23

CREA Creatinine 0.6 MG/DL 0.5-1.4

ALB Albumin 4.4 GM/DL 3.4-5.0

TP Total Protein 7.7 GM/DL 6.4-8.3

GLOB Globulin 3.3 2.3-4.2

TBIL Total 0.4 MG/DL 0.0-1.2

Bilirubin

SGOT SGOT (AST) 14 IU/L 0-37

SGPT SGPT (ALT) 15 IU/L 0-40

ALP Alkaline 70 U/L 39-117

Phosphatase

CA Calcium 9.6 MG/DL 8.5-10.5

FT4/TSH Free T 4 / XXXXXXXX

TSH

FT4 Free T4 1.4 ng/dl 0.9-1.8

TSH TSH 2.0 uIU/ml 0.30-4.50

PTHP PTH, XXXXXXXX

INTACT/CA

PTH PTH, INTACT 37.8 PG/ML 15-65

CA Calcium 9.6 MG/DL 8.5-10.5

TEST Testosterone 53.8 ng/dl 5-80

( total )

TPO TPO Antibody 6.8 IU/mL

< 30 IU/mL Negative

30 -34 IU/mL Borderline

> 34 IU/mL Positive

hi

i had these done by my endocronlogist too within the same week.
but u see my h1ac is towards the high side and always is plus my glucose tolerance was elevated but doctor not worried.


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## greatdanes (Sep 25, 2010)

It's not uncommon to have glucose measurements altered when in hyper state. TSI indicates graves. I am surprised you are so symptomatic with only 30% TSI. Usually if you are at 50% or below you are asymptomatic. I had 99% at one time and didnt have any symptoms, then again everyone is different! You could have something else going on or may be just deficient in a few areas such as VIt D.


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## stranazingarella (Dec 6, 2010)

Please look up Sarcoidosis. You may have neuro-sarcoid, an auto-immune disease.


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## CA-Lynn (Apr 29, 2010)

Tulips,

I don't see your Glucose Tolerance Test results. But your A1C is as normal as it could possibly be. Many people would kill for that reading, me included.


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## Tulips (Oct 23, 2010)

hi

i has my urine 24 hr calium done . i ordered it my self as my doc wouldnt. (private labs)
and it came back loe.

30 range starts from 100

If you scroll up and you can see my other levels. 
please advice me wht to pursue next. still suffering from severe body wide spasms and crqmps

thankyou


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## Andros (Aug 26, 2009)

Tulips said:


> hi
> 
> i has my urine 24 hr calium done . i ordered it my self as my doc wouldnt. (private labs)
> and it came back loe.
> ...


I wish I could help you better. You do have TSI, that indicates hyperthyroid.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

You do have Anti-DNA, C3 and C4 which indicates Lupus as well. You also showed ANA. I went through all your previous posts.

In my particular case, treating the thyroid (Graves'/hyper) has kept the Lupus antibodies very quiet.

Not sure that would be true for you but I wish you could find a doctor to even "acknowledge" the fact that something is going on and offer you some medical intervention.

Now, the thyroid...........let's talk about that. Do you have a goiter? Do you have trouble with your eyes? Do you have edema (pretibial myxedema?) And lastly, are you over active; do you feel hyper, are you sleeping well, do you have arrhythmia of the heart.....................stuff like that?

Most of us who have had hyperthyroid are deficient in many minerals. While they are very important for good health, we need to focus on the "why" part.

I am presuming that you are NOT anorexic? That you do NOT have IBS (malasoprtion syndrome?) That you ARE eating properly?


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