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Sore muscles and leg cramps are common in people who have underactive thyroid, but it's possible to ease the symptoms with medications and a few lifestyle changes.

Muscle pain and spasms are frequent in people with hypothyroidism. This isn't a reason to worry too much as it can be improved by taking your hypothyroidism therapy. Muscle aches can sometimes be more profound, but these scenarios are rare.

Muscle weakness is sometimes evenly spread all over the body, but most people feel it in the upper legs, or arms and shoulders. People with this type of muscle discomfort can find it hard to brush the hair or perform simple tasks such as walking.

Pain might be accompanied by the increased levels of creatinine kinase (CK), which is an enzyme that increases its amounts in cases of an injured muscle, but the connection between the amount of this enzyme and the level of pain that someone goes through might not be related. 

In rare cases, an underactive thyroid can lead to Hoffman's syndrome, a serious disorder characterized by enlarged or hypertrophic muscles, severe weakness, and pain, as well as a fast breakdown of the muscle tissue (rhabdomyolysis). Rhabdomyolysis is commonly triggered by hypothyroidism and performing some kind of strenuous exercise regimen such as Crossfit. Certain prescription drugs can cause these problems, especially statin (used in the treatment of high cholesterol).

Some studies have suggested that low levels of thyroxine (T4), which occur in people with an underactive thyroid, can cause oxidative metabolism that initially leads to pain and discomfort in the muscles. Learning about your condition and the connection between hypothyroidism and muscle problems can help you understand your situation better and hopefully overcome the pain.

1. Learn about other possible causes for muscle pain

Muscle pain is a common trait of many other conditions and it doesn't have to be related only to underactive thyroid problems.

One possible cause of muscle discomfort is rheumatoid arthritis (RA), and the symptoms are similar to that of hypothyroidism-related muscle aches. RA attacks your own body — it can make your connective tissues and joints weak and extremely painful. It's good to eliminate other possible causes for your muscle ache first, before assigning them to the underactive thyroid.

The crucial move towards feeling better is finding the root cause of your pain.

2. Try hormone replacement therapy

After someone starts the hormone replacement therapy, most symptoms caused by hypothyroidism such as pain and cramping in the legs that were bothering them improve after a while. Levothyroxine is the most common drug prescribed to people with an underactive thyroid.

To stop experiencing pain and stiffness of the legs caused by hypothyroidism, a patient will probably have to wait for a few weeks, sometimes even a couple of months. It's important to stick to your medications. If thyroxine (T4) doesn't help, ask your physician to increase your dosage, or to add triiodothyronine (T3) to the existing therapy.

3. Nonsteroidal anti-inflammatory drugs

Doctors commonly prescribe nonsteroidal anti-inflammatory drugs (NSAID) such as ibuprofen (Advil, Motrin), and naproxen (Aleve) to people with hypothyroidism for their problems with muscle pain. Drugs like paracetamol, also called acetaminophen (Tylenol) are also prescribed and indeed help with muscle pain.

It's recommended to be careful with NSAID medications if you take them for a long time. If taken for too long, muscles can get immune to them and lose the power to repair.

Certain inflammatory drugs like meclofenamate and salsalate can change the amount of thyroid hormone concentrations. Knowing these things can prevent possible problems and unneeded treatments.

There are good anti-inflammatory drugs such as naproxen, ibuprofen, and indomethacin that don't affect the levels of any of your hormones. NSAID medications don't react with levotyroxine and don't affect how it is absorbed by the body.

4. The RICE method

This has nothing to do with consuming rice. RICE is an abbreviation for Rest, Ice, Compression, and Elevation. It teaches us how to be responsible and ease the ache with a few easy steps. This method not only reduces pain, but it decreases swelling and fastens recovery. This technique is commonly suggested by physicians and therapists to ease sports injuries, but it's also useful in the treatment of hypothyroidism-induced muscle and joint pain.

5. Try low-intensity exercises

To feel better and reduce symptoms of hypothyroidism such as weight gain and joint aches, it's recommended to workout at least a few times per week. It shouldn't be anything too strenuous; a light workout that lasts 20 minutes to an hour is often enough to speed up your metabolism.

It's recommended that you choose some easy beginner workouts if you have pain in any area of the legs. Elliptical and stationary bike are better options than treadmill when it comes to join or knee pain. Swimming is great for people with muscle or joint aches because it's a low-impact workout, and water serves as a cushion for your weak joints.

It's recommended to warm up a bit prior to a workout. It was once believed that you should stretch your muscles well before working out, but research has shown that stretching isn't beneficial. In fact, research has found that stretching doesn't offer any important benefits, neither before nor after a workout.

6. Try some mind-body techniques

Techniques such as yoga or meditation have shown useful when it comes to stress reduction and relaxing the muscles. In fact, relaxation exercises have a positive impact on every aspect of our health, mental and physical. Practicing them also reverts the damaging effects of stress.

There are many techniques that are good for the mind and the body that you can try to relieve your stress and get rid of your muscle aches. Some of them are yoga, meditation, deep breathing exercises, as well as rhythmic activities. It can be anything that gets you moving — including walking, dancing, or garden work.

7. Include more magnesium in your diet

Magnesium is recommended as a tool against cramps and muscle pain because it relaxes muscles and normalizes their contractions. Magnesium is commonly used against back aches, tension in the muscles, and as a medicine against cramping in the legs.

Hypothyroidism comes with many other issues, and one of them is constipation. Magnesium can help to relieve constipation. Even though you can find magnesium naturally in many food sources, it's often not enough. Best sources of magnesium are green vegetables such as broccoli, spinach, and peas, as well as:

  • lentils
  • potatoes
  • celery
  • avocado
  • pineapple
  • beetroot
  • bananas
  • brown rice
  • whole grains
  • nuts
  • seeds

8. Try Bathing in Epsom salt

Epsom salt is a sulfate of magnesium, which makes it great to bathe in. Some doctors even recommend Epsom baths to relieve muscle aches instead of using nutritional supplements of magnesium. It makes sense because it's a known fact that magnesium can be absorbed through the skin.

Epsom baths are quite relaxing because magnesium promotes serotonin production, and serotonin is a “happiness” hormone. Magnesium also increases your energy levels without making you hyperactive or anxious. A lot of patients with underactive thyroid recommend using Epsom salts in a bath and swear that pain in their muscles and the headaches have decreased, so there's nothing to lose if you try.

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