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An underactive thyroid is rarely a cause for neuropathy, but it can be if the condition is left untreated for too long. The best way to treat peripheral neuropathy in patients with hypothyroidism is with hormone replacement therapy and good nutrition.

Peripheral neuropathy is a disease where nerves that should carry messages between the brain and spinal cord and other parts of the body fail to work properly. Underactive thyroid is not a common cause, but it left untreated for too long, it can cause peripheral neuropathy.

Underactive thyroid can be a cause of peripheral nerve dysfunction. Even though this connection has to be researched more, it's a well-known fact that underactive thyroid can cause water retention — which can in turn lead to swelling that might press peripheral nerves.

This mostly happens around the wrists because nerves in this area go through a lot of soft tissue that is prone to swelling, which can lead to one or more nerves being pressed. This condition is known as carpal tunnel syndrome and it's rarely caused by an underactive thyroid.

Research has found that being overweight or obese is among the top risk factors for carpal tunnel syndrome in people suffering from an underactive thyroid. If you have peripheral neuropathy, you might feel burning, prickling, tingling and even pain in the part of the body affected by the nerve damage.

These issues can be annoying, and cause not only physical but psychological damage to the patient. If you have or suspect of having underactive thyroid and feel awkward tingling in your limbs, make sure to speak to your doctor because peripheral neuropathy comes with many serious consequences such as metaboli​c and toxic damage to the body.

You need thorough testing

Finding the cause of peripheral neuropathy is the most important part of disease management. Some causes besides underactive thyroid can include nutrient deficiencies and diabetes. This is why it's important to get a correct diagnosis, which should include clinical and laboratory testing, as well as a nerve biopsy.

The condition can affect large and small nerves, and various nerve types such as sensory, motor, as well as autonomic nerves. Peripheral neuropathy is rarely caused by underactive thyroid, but if your hypothyroidism is left untreated for too long, it can damage nerves and prevent carrying information from brain throughout the body.

A person might need an MRI scan, an x-ray, various nerve and blood tests to confirm peripheral neuropathy. Treatment and cure depend greatly on correct diagnosis. Patients are able to recover from it as long as their nerves are able to regenerate.

Treating peripheral neuropathy in patients with underactive thyroid

If inherited, peripheral neuropathy can't be treated, but if acquired due to some other health complication, it can be improved over time. Regarding hypothyroidism-related peripheral neuropathy, the best approach is to tackle your underactive thyroid and its symptoms with hormone replacement therapy (levothyroxine), which often improves the symptoms of peripheral neuropathy as well.

Levothyroxine (Unithroid and Synthroid, among others) brings your hormones back to a normal range, which often helps with many symptoms such as tingling, numbness, and pain, and helps with nerve regeneration as well, the most common symptom of peripheral neuropathy.

Physicians often prescribe over-the-counter drugs such as nonsteroidal and anti-inflammatory drugs to minimize inflammation. Ibuprofen is among the most common NSAID medications prescribed to tackle inflammation, and it's quite safe and well-tolerated among patients. NSAIDs rarely react with other medications, and don't affect levothyroxine absorption.

If you have neuropathy, the best way to ease the symptoms is to rest your hands. You can also apply cold to the affected area. A brace is another common recommendation when it comes to easing the symptoms of peripheral neuropathy. Braces and splints keep wrists in a good position and prevent compressing the nerves.

If OTC medications fail to ease your symptoms, your doctor can recommend steroid injections, but this happens rarely as most people find hormone replacement therapy combined with NSAIDs very helpful.

If everything fails, surgery is an option as well, especially with patients who have carpal tunnel syndrome. Surgery gets rid of the bones that are pressing on the nerve. Surgeries that are often performed are:

  • Anterior transposition of the ulnar nerve
  • Cubital tunnel release
  • Epicondylectomy

Maintaining a good body weight minimizes stress on the nerves, and exercise strengthens your body. Make sure to get plenty of exercise, but discuss what you should and shouldn't do with your physician. Stretching your arms and wrists can relieve a lot of tension as well:

  • Move your hands around ten times in both directions. This is done to relieve muscle stiffness.
  • Roll the shoulders five to ten times forward and then backwards. This helps your shoulders relax.
  • Stretch your arms out as wide as possible and hold them like this for at least ten seconds.

Living a healthy lifestyle is an important part of treatment for both hypothyroidism and peripheral neuropathy. When it comes to healthy habits, recommendations for this involve:

  • Staying away from any cramped positions.
  • Avoiding toxins and chemicals.
  • Consuming a diet rich in fruits, veggies, whole grains, vitamins and minerals.
  • Make sure to ingest enough vitamin B12, as it plays an important role in keeping our nerves healthy. Some foods rich in B12 include meat, fish, eggs, low-fat dairy products, as well as fortified cereals – a source good for those that don't ingest animal products.
  • Avoid alcohol and cigarettes as much as possible. Tobacco constricts blood supply to blood vessels and prevents nutrients from food to enter the bloodstream and nerves.

  • Duyff RF, Van den Bosch J, Laman DM, van Loon BJ, Linssen WH. Neuromuscular findings in thyroid dysfunction: A prospective clinical and electrodiagnostic study. J Neurol Neurosurg Psychiatry 2000,68:750-5. Tonner DR, Schlechte JA.
  • Neurologic complications of thyroid and parathyroid disease. Med Clin North Am 1993,77:251-63.
  • Photo courtesy of SteadyHealth

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