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What causes muscle twitching while being on Synthroid?

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Posted on Fri, 29 May 2015
Question: I am a 36 year old female. had a complete thyroidectomy 3 years ago and have been on synthroid keeping my tsh extremey depressed. my last tsh was .05. I recently have been experiencing random muscle twitching like when your eye twitches except I get it in random places. could this be sign of hyperthyrpidism. just wanted to make sure it's from that and not from anything neurological.
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Answered by Dr. Binu Parameswaran Pillai (3 hours later)
Brief Answer:
Low TSH

Detailed Answer:
Good day.
Noted your concern. Usually we don't aim to keep TSH so low except in the follow up of thyroid cancer. Hyperthyroidism can cause muscle twitching. Vitamin D deficiency and anxiety also cause muscle twitching. Random muscle twitching occur after viral infection.

Take sufficient calcium and vitamin D. If the twitching doesn't settle, in next few weeks, then you may need to see a neurologist.
Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Binu Parameswaran Pillai (42 minutes later)
My calcium and vitamin d are all good but I noticed the twitching started when my synthroid was upped. They r very random and not isolated to a particular muscle group. What are other common causes of the twitching for my age?? You can see it happening if you look hard enough too like when eyelid twitches.
doctor
Answered by Dr. Binu Parameswaran Pillai (57 minutes later)
Brief Answer:
Fasciculations

Detailed Answer:
Thank you for the reply.
Muscle twicthigs ( fasciculations) are seen commonly in anxiety. It is also seen in electrolyte disturbances ( low and high calcium, magnesium etc), After viral infections ( common), Certain drugs ( particularly anti depressants and anti psychotics), certain neurological disorrders associated with "motor neuron disease".
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Binu Parameswaran Pillai (19 minutes later)
I did have a past brain mri done twice showing white matter disease and neurologist excluded ms upon exam. The only thing found at the time was extremely high antithyroid antibodies through bloodwork. I'm worried. could the muscle twitching be from the medicine/synthroid or should I see the neurologist again?
doctor
Answered by Dr. Binu Parameswaran Pillai (29 minutes later)
Brief Answer:
MRI is non progressive.

Detailed Answer:
If the follow up MRI was non progressive, not to worry. High antithyroid antibody levels has been shown to cause encephalopathy in children ( hashimoto's encephalopathy). But this is uncommon in adults.

If your TSH levels are in normal range, synthroid dose is appropriate.

Well, you may meet neurologist again and get the blood works again. Request for a magnesium level in particular.

I myself had similar twitchings after a viral illness recently. Mainly on eye lids and arms/shoulders. It lasted a month and disappeared. These twicthings become obvious if you concentrate too much on it or if anxious. Physical exertion and tiredness can also worsen this.

May i suggest you something. Engage yourself fully wit family or friends for couple of days in some fun filled holiday activities. You may not even notice these fasciculations if you are engaged in other activities.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1435 Questions

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What causes muscle twitching while being on Synthroid?

Brief Answer: Low TSH Detailed Answer: Good day. Noted your concern. Usually we don't aim to keep TSH so low except in the follow up of thyroid cancer. Hyperthyroidism can cause muscle twitching. Vitamin D deficiency and anxiety also cause muscle twitching. Random muscle twitching occur after viral infection. Take sufficient calcium and vitamin D. If the twitching doesn't settle, in next few weeks, then you may need to see a neurologist. Regards Binu