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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for persistent cramps in the legs and hands

Answered by
Dr. Shehzad Topiwala


Practicing since :2001

Answered : 1663 Questions

Posted on Wed, 8 Mar 2017 in Thyroid Problem and Hormonal Problems
Question: Good evening! I am a 67 y.o female that had my thyroid removed about 18 months ago. I take 0.100 mg of levo . I also take supplements i.e. multi vit for 50+ woman, magnesium, vit D, calcium, glucosamine, B-complex and 81 mg aspirin. I do have cramping several times a week and sometimes several times a day. The cramping is in my legs, toes and hands. Almost daily, my tongue and lips are numb or at least have a pin prickle sensation--typically in the eve. I exercise 3-4 times weekly and generally, I would state that I am in very good health. Before being dismissed by the endo, (about 8 months ago) I told him of the symptoms. My blood work however apparently was OK, Had some more routine blood tests in the Fall and my family Doc did not change the levo dosage nor request a follow-up so, I am assuming that blood work was again OK. However, I am getting concerned about the ongoing cramping and numbness--should I be?

Answered by Dr. Shehzad Topiwala 42 minutes later
Brief Answer:

Detailed Answer:
Sorry to learn about your bothersome symptoms. These can be a result of various reasons, some of which could be:

low blood calcium
low blood vitamin D levels
abnormal blood electrolyte levels
abnormal thyroid levels
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)

None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Shehzad Topiwala 1 hour later
Thank you. I have had all of the blood tests including Vit D , done in the Fall and pretty much fell within the normal range. However, I did not have the specific thyroid tests done. So, thank you, I will follow-up with the physician.

I am not concerned about fasting--I am pretty compliant.

Thanks, again.
Answered by Dr. Shehzad Topiwala 20 hours later
Brief Answer:
Best wishes

Detailed Answer:
for good health
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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