Hypothyroidism Has A Link With Peripheral Neuropathy

Case Study: A 52 year old women complains of the following-

I suffer from hypothyroidism and over the last few months my left arm has become increasingly weak.

The process accelerated recently (last 6 weeks) during the period when I moved house and was without thyroxine (T4) for three weeks. My left hand now looks like a claw and I think I’m developing a Dupuytren’s contracture. How worried should I be? I’m back on my meds now and have been for the last 10 days. I’m very aware that time is of the essence in dealing with this issue. My hands looked the same 6 months ago!

Possible explanation:

Lets understand this problem that the lady has step by step.

What Is Peripheral Neuropathy?

The involvement of nerves supplying the peripheral organs of the body by any disease process may be termed as peripheral neuropathy. Our hands, legs, foot are the commonest areas to be involved.

Diseases Which May Manifest Peripheral Neuropathy

• Diabetes
• Hypothyroidism
• Nutritional Deficiency
• Severe Vitamin Deficiency
• Viral infections affecting nerves, as Shingles
• Later stages of AIDS
• Chronic Alcoholism

Symptoms of Peripheral Nerve Involvement

• Sensory nerves are the first to get involved, in general. This may give pain and burning over the affected limb or area, as the first symptom.
• This may progress to tingling and feeling of numbness there. You may feel ‘pins and needles sensation’ over the region.
• If progressed further, the motor nerves get involved. These control movements of the limb. So, you may complain of weakness, thinning of limb, restriction of movements, contractures.

Case Explanation

The lady seems to be having long standing Hypothyroidism, that is, her body is not producing enough thyroid hormone required for major body functions.

As she shifted her home and neglected her medications, (that’s understandable, may have happened due to busy time schedules then!), her body survived on very little amount of thyroid hormone present, as external supplements were absent.

This possibly led to water retention in various connective tissues, which pressed upon nerves. Her left arm was pressed excessively and started giving her symptoms.

Discussing Why The Hand Got Affected First

Nerves traversing via our wrist pass through a very narrow tunnel, called Carpel Tunnel. This is only about an inch wide in an adult. So, pressure from surrounding tissues is likely to get transmitted to these nerve really quick.

This happens due to tightness and lack of space in the area.

How Does Hypothyroidism Lead To Peripheral Neuropathy?

This is another question. What exactly happens to your nerves when you are Hypothyroid? The exact mechanism is not clearly explained. However, fluid retention in various connective tissues may be one of the factors.

There may also be a direct link of thyroid hormone and nerve repairs. In utero babies require an absolute ‘Euthyroid Status‘ for proper mental development. A deficiency of adequate thyroid hormone may lead to permanent mental disabilities.

The hormone has been linked with proper myelination, dendritic growth and formation of synapses.

Management

Lady may resume her medications at the earliest. As the hormone gains back its optimum level in the blood stream, most of these effects are likely to reverse back to normal.

This is because fluid retained back would go away, relieving pressure from above the nerves.

Hormone may also help in regenerating the damaged nerves.

However, prolonged pressure over the nerves may lead to permanent damages. So, early intervention is recommended.