Hyperthyroidism, sometimes referred to as an overactive thyroid, is a condition in which the thyroid produces an excess of thyroid hormone (thyroxine), usually as a result of autoimmune disease. Nerve pain, or neuropathy, is most often associated with hypothyroidism (or underactive thyroid), but occasionally it is experienced by patients with hyperthyroidism. Treatment of nerve pain associated with hyperthyroidism involves managing the symptoms as well as treating the underlying condition.
There are several different kinds of neuropathy, but according to Dr. Tarakad S Ramachandran of State University of New York the kind of nerve pain that is most associated with hyperthyroidism is polyneuropathy. Polyneuropathy is a type of peripheral neuropathy, which describes pain in the peripheral nervous system. The peripheral nervous system is made up of the nerves that are outside of your brain and spinal cord (these nerves are called peripheral nerves). With polyneuropathy, several peripheral nerves fail or malfunction. Although neuropathy is experienced by 31 to 65 percent of hypothyroid patients, according to Dr. Ramachandran, it is rare in hyperthyroid patients.
The first symptoms are usually pain or tingling (“pins and needles”) in the feet and hands. Numbness may also occur. Eventually, the pain usually spreads up the arms and the legs. In the long term, sensitivity to touch, coordination problems and even paralysis are possible, depending on which nerves become affected. Symptoms may come on gradually, or they may appear suddenly.
There is no specific test for neuropathy. Your doctor will make a diagnosis based in your medical history–including your hyperthyroidism–and symptoms. Other tests, including blood tests for thyroid function and vitamin B12 levels, nerve biopsy and electromyography, which detects electrical discharges that your muscles produce, may all help with diagnosis, but only make up part of the picture. Your doctor may diagnose your neuropathy based on your symptoms and hyperthyroidism without any further testing.
According to the Mayo Clinic, the first line of treatment for nerve pain is to treat the condition that is causing it. In the case of hyperthyroidism, there are a few treatments your doctor may use. Thyroid-suppressing medication, radioactive iodine therapy and in severe cases, surgical removal of the thyroid are all options. Every patient responds to thyroid treatment differently, so your doctor will work closely with you to monitor your progress and determine which treatment is the best one for you.
Managing the nerve pain is the other piece of the puzzle in terms of treatment. Over-the-counter painkillers may help, or your doctor may prescribe a stronger pain medication. Lidocaine patches for localized pain relief also can be used. Anti-seizure medications have shown some promise in alleviating nerve pain, according to the Mayo Clinic. If your symptoms are interfering with your life or you are having difficulty dealing with the pain, your doctor may also prescribe antidepressants.