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What Causes Numbness In Toe And Fatigue After Total Thyroidectomy?

Posted on Thu, 6 Nov 2014

Question: I'm female, 41, 5'5", 184lbs. Gave birth to 3 babies, ages 17, 16, and (a little surprise) 3. No miscarriages. Total thyroidectomy for papillary/folicular cancer, and Hashimotos thyroiditis. Did XXXXXXX treatment. TSH levels are good - I get checked every 6 months. No signs of cancer recurrence after 5 years. No gallbladder - removed because of severe pain. No spleen because of a questionable growth - benign. No appendix. I take levothyroxine, and atorvastatin. Paternal grandmother had breast cancer, Paternal grandfather had diabetes and strokes. Dad had heart surgery a couple years ago. I eat healthy most of the time, very little white flour products or breads. Typical breakfast is granola and greek yogurt with fruit and chia. Typical lunch is a salad with a protein, sometimes with a whole grain-something. Dinner is usually veggies and protein. Walk on treadmill almost every day for at least 30 mins. I recently started taking multi-vitamins regularly, extra B12, Cal-mag-zinc & D at bedtime. Acai supplement for an antioxidant, and omegas. Drink plenty of water throughout the day. For about 2 months now I wake up with numbness and tingling in my toes. Mostly feel it on the right foot. My muscles ache all the time, knees ache, and I have bone pain. If I add any pressure on my shin bones, or sternum especially, it's super painful. I feel week, and tired most of the time. I have general anxiety. Had a brain scan about 5 years ago because of migraines. Brain looked good. Migraines went away with time. I have weird heart flutters on occasion, ever since my thyroid was removed. Before my last pregnancy I had a herniated disc in l4-l5 l5-s1, which resolved with pregnancy. Any idea for the toe numbness, and overall fatigue, and bone/joint pain? Thanks!!!

Answered by Dr. Dr. Sudhir Kumar (1 hour later)

Brief Answer:
Osteoporosis and VitaminD3 defeciency can be cause

Detailed Answer:
Hi,
Thanks for your query.

I'm Dr. Sudhir Kumar,

After going through your query I concluded that you have got total thyroidectomy done nearly 5years back. Due to removal of thyroid along with it probably also parathyroid also got removed. So you are lacking thyrocalcitonine and parathyroid hormones. This resulted in disturbance of calcium and phosphorus metabolism.This may have resulted in osteoporosis causing bone pains which are typical of osteoporosis. Second you may be having deficiency of vitaminD3. Tingling and numbness signifies neuropathy possible cause can be diabetes,Vitamin 12 deficiency and herniated disc.

So I want you to do following test :-
1.Bone mineral density test to see status of osteoporosis
2.Vitamin D3 test
3.Vitamin B12 test
4.Blood sugar fasting and PP to rule out diabetes
5.MRI lumbar spine to rule out herniated disc

Furthermore I will advise you consult endocrinologist as there is disturbances in hormones such as thyrocalcitonin and parathyroid hormones.You are already on treatment and taking thyroxine and many vitamins . I will advise you to take supplementation of VitaminD3 if it low and analgesic such as diclofenac for pain relief. If Bone mineral density show osteoporosis then parathyroid hormone may be taken after consultation with endocrinologist.
You can discuss with your treating Doctor about it.

Hope I have answered your query.
If you have any further questions I will be happy to help.

Wishing you good health.
Take care.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Dr. Sudhir Kumar (46 minutes later)

Thank you for the information. Any thoughts on the heart flutters? Sometimes it's strong pounding, and other times it's only little off beat rhythms. It happens randomly. Would that be related to osteoporosis, or any deficiency that you mentioned?

Answered by Dr. Dr. Sudhir Kumar (29 minutes later)

Brief Answer:
Can be caused by levothyroxine.

Detailed Answer:
Hi,
Welcome back .

After going through your query and follow up query I want to say that heart flutter is known to be caused by drugs used to treat an under active thyroid, in your cases it may be due to levothyroxine. It is probably not related to osteoporosis or any deficiency. Other matter has already been discussed.You can discuss with your treating Doctor about it.

Hope I have answered your query.
If you have any further questions I will be happy to help.
If you do not have any clarifications, you can close the discussion and rate the answer.

Wishing you good health.
Take care.

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj