I'm low thyroid and was getting a lot of foot cramping on the swim. My endocrinologist recommended taking magnesium. I also take Vitamin D every day on her advice. The cramps cleared up, although it could just be that I've increased my distance and gotten used to these longer swims.

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Sharon McN
@IronCharo
#TeamZoot
Clif Bar Pace Team 2003-2018

Ask her about your thyroid hormone (T3 & T4) levels. If they are in normal range or high, your thyroid hormone replacement (levothyroxine) is excessive because your TSH is clearly too low. You may now have HYPERthyroidism. If so, your cramping is probably due to that. Titrate the strength of levothyroxine to achieve normal T3 & T4 levels. Don't be concerned about TSH until it exceeds 4.4. Actually, athletes with poor leg strength and persistent muscle cramps associated with low TSH (but normal thyroid hormones) often find a happy compromise with TSH up to 10.0.

Thanks Sharon. I will ask Dr about that and start. My cramping issues are not isolated to just the swim. They are almost all day and most muscle groups.

Thanks Pedalhead. I am taking 3gr of Armour Thyroid/day. It is a natural thyroid medication and has all the "T"'s. I am thinking and hoping the same thing you are which is I may be a little Hyper now.

TSH levels are a very personal thing. To say that 0.5 is too low is not correct. I function best between 0.3 and 0.7 and I know this from 27 years of work on dialing my dosages around my activity levels and keeping a detailed journal that includes notes on how I am feeling every day. I too am on Armor (3 grains as well). My untreated level of TSH was as high as 237 before I got started down this road back in the 90's. Are you experiencing night sweats, rapid heart rate for no reason during the day, fitful sleep (insomnia) and irritability? Those are better indicators of a hyper state than cramping. In fact, cramping is a symptom of HYPO, not hyper. If it were me I would drive my levels closer to 0 with a half pill extra on Sundays (with docotr's buy in) and see if that helps.

While I don't have an easy answer for your cramping, I can tell you its most likely not your TSH levels.

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Dave Stark
dreamcatcher@astound.net
USAC & USAT level 2 certified coach

I was having similar issues for the last couple months. My calves, arches and toes would severely cramp, sometimes just from wiggling my toes. I finally went to the doc last Monday and what showed up on the blood tests was pretty eye opening:

Low magnesium(not surprising)
Severe Vitamin D deficiency. Levels should be over 50, mine is 15.
Low alkaline phosphatase. This is highly unusual, but marks a significant protein deficit.

I also have bone pain in my feet that I assumed was simply sore feet from 70+ mile run weeks. This is from the D deficiency.

I waited waaaaay too long to go to the doctor, since cramps are often regarded as benign and most peoples answer is your lacking salt, potassium, training etc.

I would request a complete metabolic panel done.

Thanks Karma...I like your journal idea. I am not having night sweats, rapid heart rate or any irritability but I do have trouble sleeping. I have to take something every night to get to sleep. Great info.. Thanks again.

Thanks Zanne E. More great info. I will have Dr do that. Thanks again.

Convince your doctor (perhaps by demonstration) that the muscle cramps, unlike the typical exercise-associated cramps, can be induced. Mention whether you notice any loss of muscle strength. My guess is that she will want to investigate your electrolytes, and with a little encouragement from you, also your thyroid hormone levels. You might tactfully tell her you've learned from the literature that TSH levels around or below 0.5 indicate subclinical hyperthyroidism, even when fT4 and T3 are in the normal range. [Thyroid medication is prescribed for over 70 million Americans. Optimal doses are not fine-tuned for most of them.]

Would I need to fast prior to a complete metabolic panel? I am going to Dr early in the am and if I would need to fast I would like to get the blood work done asap. Thanks.

An overnight fast is unnecessary before blood sampling unless the chem panel will include glucose and triglycerides. Both fasting and unusual meals can alter your normal metabolic panel. Some hormones can be altered by a prolonged (>10-12 hrs) fast. Take your meds on schedule.

Not sure where you're getting your ranges from. As of 2003, the American Association of Clinical Endocrinologists (AACE) says the range is 0.3-3.0. My personal experience shows I'm FAR better off at the lower end of that scale. If I had a TSH of 10, I'd never get out of bed.

http://thyroid.about.com/...yroid/a/newrange.htm

I have found that a TSH of 0-1.0 works best for me. The closer to 0 the better.

My point to OP was be concerned that his T3 and fT4 levels are normal. Too many docs increase thyroid hormone replacement (usually levothyroxine) to push TSH below 4.5. When fT4 and T3 are in the normal range, values for TSH below 0.5 reflect "subclinical hyperthyroidism." New guidelines were published last week: Annals of Internal Medicine 2014 Oct 28 early online.