Carpal Tunnel and Your Thyroid

Trying to ignore tingling or numbness in your hand and wrist?

Ever have a sharp pain shoot through your wrist and up your arm?


   Carpal Tunnel Syndrome (CTS) is a painful progressive condition caused by pressure on the median nerve in the wrist. Some carpal tunnel sufferers say their fingers feel useless and swollen, even though swelling is not visible. The symptoms often first appear during the night, since many people sleep with flexed wrists. A person with carpal tunnel syndrome may wake up feeling the need to “shake out” the hand or wrist. As symptoms worsen, people might feel tingling during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people are unable to distinguish hot and cold by touch. Carpal tunnel syndrome may be due to repetitive strain and CTS is especially common in those performing assembly line work. There are also a variety of health conditions – including diabetes, arthritis and hypothyroidism – that can lead to CTS.

Carpal tunnel syndrome can be a symptom of untreated — or inadequate treatment of — hypothyroidism. If you have carpal tunnel syndrome and have not had your thyroid evaluated, you may want to discuss this with your doctor before you consider an invasive treatment like surgery.

In the U.S., the primary cause of hypothyroidism is Hashimoto’s disease — an autoimmune disease in which antibodies attack the thyroid gland, and eventually slow it down. Symptoms can start long before the slowdown is reflected by the Thyroid Stimulating Hormone (TSH) test but can be detected when a Thyroid Peroxidase Antibodies (TPO) test is included as part of a thyroid workup. Studies show that treatment of patients with normal TSH levels who have Hashimoto’s disease may help lower antibodies, and prevent progression to overt hypothyroidism. Research has shown that restoration of hormone balance, immune system support and dietary changes (such as a gluten-free diet) may lower antibodies, reduce inflammation, and help resolve symptoms in some patients.

The thyroid produces the two key hormones, T4 and T3. T4 is a storage hormone, and its function is to be converted into T3, the active hormone that delivers oxygen and energy to cells, tissues, glands and organs. In a thyroid test panel, the prescriber can choose to include TSH, Free T4, Free T3, and TPO. Thyroid hormone therapy is complicated when the active thyroid hormone T3 is not measured and deficiencies are not addressed. A patient can have a TSH in the “normal reference range” and yet still have low-normal or below-normal Free T3 levels, indicating that she does not have enough active thyroid hormone in her bloodstream. Patients often prefer combination treatments that include both T4 and T3.

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