Why Are My Ankles Swollen?

In the last few years, I've had times when my ankles have swollen, sometimes overnight, and the swelling didn't go away. Hobbling around was not only uncomfortable but stressful, leaving me to wonder what had happened.

My overactive imagination focused on worst case scenarios, everything from heart disease to a blood clot. Of course, I didn't consider the number of minor reasons ankles can swell, mimicking over-inflated balloons.

In those instances where I had ankle - and even feet- swelling, I sought medical advice and each time there was a different cause. Based on my experiences as well as feedback from doctors I consulted, there are some basic reasons why your ankles could get puffy and even painful. After going through this checklist, you might want to discuss some of these possibilities with your doctor:

First, has your medication dosage changed?

I've been treated for low thyroid for years but it wasn't until I had severely swollen ankles that I discovered that some people can go from having under-active thyroid glands to hyperthyroid or over-active thyroids. After I was not only put on a new thyroid med but a change in medication dosage, I not only had ankle swelling but my feet turned bright red within a few weeks.

No matter what I did, the swelling would not go down. After consulting with my doctor, we discovered that my thyroid was to blame. Blood tests indicated that my formerly sluggish thyroid had changed to an over-active one. For more information about how the thyroid can cause ankle swelling, check out on line information from the Mayo Clinic, found here .

Are you on new medications or a combination of meds?

If you are on new medications, they could be interacting with your other meds. Yes, a pharmacist should catch this but it doesn't always happen. Also, there are instances where the vast majority of people don't have problems with a combination of medications but you could be among the few who are exceptions.

Again, discuss this possibility with your doctor. Prednisone is one drug which can cause generalized swelling as well as swollen ankles. When mixed with other drugs, these side effects could be even more intense. I've taken Prednisone and experienced facial swelling, as well as in my feet and ankles.

Are both your ankles swollen or is just one ankle and/or foot affected?

After suffering from puffiness and ankle pain which centered on just my left foot area, I consulted my doctor and had a test for both PAD (peripheral artery disease) as well as an ultrasound Doppler test on my leg to check for a possible blood clot. Luckily, I passed both tests with flying colors. However, if ankle puffiness and pain is accompanied by leg swelling and/or redness, call your doctor or get to the emergency room as soon as possible.

You don't need to panic because many blood clots are superficial but it is best to play it safe. It is especially urgent to seek medical treatment if the pain and swollen leg appear suddenly. You may also need a stress test and cardiac ultrasound, depending on your symptoms and doctor's recommendation. These are often done just to rule out the most serious possibilities so don't assume that a cardiac ultrasound is reason to assume you have a life-threatening condition.

Do you walk regularly, often outside and on hot days?

If so, you may notice that your feet, ankles, and even fingers can get quite swollen. If you keep up an exercise program, the swelling may go down as your heart rate improves but some people tend to have puffy feet and ankles after they walk or jog, even if they are in shape. If you've gotten medical clearance to exercise, you might want to touch base with your doc about any concerns but odds are high that the swelling is of minor concern, particularly if it disappears shortly after you stop exercising.

Pregnancy can be a common cause of swollen ankles

Even if you don't exercise, pregnancy can result in water retention. In severe cases, this can cause pre-eclampsia or total eclampsia, potentially serious conditions associated with some pregnancies. Since I've had pre-eclampsia, I know that water retention can lead to severe bloating and swelling which may or may not be accompanied by other symptoms. However, with regular prenatal check-ups, your doctor should know if you are at risk for eclampsia. Perfectly normal pregnancies can cause swollen legs, ankles and fingers.

Sources:

Personal experience
Hyperthyroidism (overactive thyroid), Mayoclinic.com, found here
Peripheral Artery Disease, Mayoclinic.com here
Prednisone and swelling at Drugs.com here