Member Case Study: Tapazole, Grave's Disease and Joint Pain

author : AMSSM

comments : 0

Joint and muscle pains are a known and reported side-effect of Tapazole, and are not particularly dose-related or known to be caused by a particular action of the medication.

Question from titurtle

While building my aerobic base this fall I noticed my resting heart rate had really climbed high and was then diagnosed with Grave's disease (hyperthyroidism). It seems reasonably well controlled with Tapazole but the muscle and joint pain I think is drug related and is pretty harsh at times. I have two HIM's and an IM scheduled for this summer and have too much time and money invested to take the season off. Your suggestions?
 

Answer by Chris Koutures, MD, FAAP
Member AMSSM

Dear titurtle,

Joint and muscle pains are a known and reported side-effect of Tapazole, and are not particularly dose-related or known to be caused by a particular action of the medication. General recommendations for controlling joint or muscle pains such as maintaining adequate hydration, using warmth before strenuous training and cold afterward, and acetaminophen as an oral anti-pain medication can be helpful.

However, consider some other likely possibilities for your pain:

a) Treatment with antithyroid medication like Tapazole can occasionally overcorrect the disease, creating a hypothyroid (low thyroid hormone function) state which can present with similar muscle and joint pains. Thus, check with your medical provider to ensure that your thyroid hormone production levels are appropriate.

b) Overtraining- increasing distance, intensity or frequency of your workout can lead to joint and muscle pains, maybe even more now that your body is recovering and "readjusting" to the Graves disease and treatment. Allowing adequate rest days and increasing only one of the elements (distance, intensity, or frequency) at a time may lead to some resolution.

Now, if the pains are too restrictive, there are other treatment options for Graves disease- both medical and surgical- that can be discussed with your medical provider. Obviously, you would not want to stop any medical therapy without such a discussion, but it would be appropriate to see if the other options might be more feasible for an active individual with triathlon goals in the next summer.

Good luck!

Chris Koutures, MD, FAAP
Member AMSSM
Anaheim Hills, CA
 

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date: March 6, 2007