# Shortness of breath!!



## visc (Feb 22, 2014)

Hey guys!

I've been on treatment for about 6 weeks now and for the past few days I've been progressively short of breath.

My last results from three weeks ago were,


TSH 4.17 (.27-4.20)
FT4 1.3 (.9-1.7),
T3 127 (80-200).

Here is a snippet from my symptom log:

3/11/14
1239pm
Short of breath and faint feeling.
400pm
Very tired and sore feeling
729pm
Really tired and sore. Hands feel swollen/stuff but aren't. Legs feel sore. I didn't do anything more than a small walk today.

3/12/14
742am
Sore legs(calfs and feet), Stiff hands, Tired, Tinnitus
115pm
Sore legs, eyes, right elbow, hands/feet, Tired, Tinnitus
235pm
Muscles feels sore like I've worked out but didn't.

3/13/14
Last night I had many dreams and wake ups. I was also very sweaty. Urine looked like I was dehydrated. 
300pm
Slight headache, slightly tired. Muscles no longer sore. 
317pm
Blurry vision and headache
542pm
Headache is worse. Not tired or sore. Will rest a bit.
900pm
After resting my headache lessened. Going to be bed exhausted.

3/14/14
200pm
Walked up three flights of stairs, fast heart rate, lightheaded-ish, kinda out of breath (went away quickly)
1100pm
Short of breath feeling. Happens when I stretch or try to slow my breathing down.

It feels as though I need to take a breath a few seconds(3-4) after I've taken a breath, not normal for me. I'm sitting down right now and haven't done anything strenuous. I stretched again and felt out of breath.

I'm a 21 year old male and diagnosed with Hashimoto's. I'm going to get an ACTH test and I'm afraid to have that done... I've been dealing with symptoms my doctors had said were from anxiety. Now after being diagnosed and feeling slightly better after treatment, I'm having annoying and somewhat perplexing symptoms.

I can't get much sleep because I have very vivid and disruptive dreams. I wake up sweaty and sometimes out of breath (rarely and more recently, its a new symptom). I also have muscle twitching and this strange icy hot sensation so now I think I have some other comorbid condition...

I've called my endocrinologist but because of a snow storm in the North East of the United States, I was forwarded to an on call doctor who brushed me off and said to wait to see my doctor. He did reassure me that I didn't need to go to the hospital.

Could the medication be causing this? My PCP didn't believe 50mcg of Synthroid would bring my TSH from 15.27 to 4.17 in three weeks. I think its kinda unusual too... I had relatively high antibodies as well.

I'm really convinced my symptoms suggest something more and this breath thing had gotten me frightened. I don't even get spring break this week, my uni's is next week. But on monday I will call my Endo and see if I can get an appointment with my PCP.

I wrote my PCP this email:

Dear Dr,

I had a rough nights sleep 3/15/14. In my research of sleep disorders I came across sleep apnea. I found a connection between apnea and Hashimoto's with a frequency of 46%! (http://www.ncbi.nlm.nih.gov/m/pubmed/22785371/) I think I could benefit from a sleep study and would like to arrange one.

The symptoms I had were vivid dreams, sore achy legs, dry mouth, sweating, and waking up short of breath. I woke up frequently and poorly rested.

As I type to you I have muscle twitching, strange body temperature sensations (icy-hot), and raging tinnitus. Although it might be to soon to say(~6 weeks), I believe something more is going on besides my thyroid condition.

I haven't been doing well in school because of my inability to sleep well. So I'm requesting arrangements for further tests and a sleep study. Hope your weekend was/is warm and refreshing

Sincerely, 
Visc

EDIT: The sleep issues are not new, I've had them since I've started having symptoms about two years ago. They've just progressively gotten more intense.

EDIT: When I mean sore, I mean I feeling like I worked out at the gym all day.


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## CA-Lynn (Apr 29, 2010)

Assuming a good blood workup has been done and found to be normal, I definitely would look towards anxiety-related issues. While there is documentation of a correlation between OSA and Hashimoto's, the survey sample size in the study that I'm aware of was relatively small.

Enter these numbers in the search engine and likely you will come up with the study: "22785371"

You might consider the relationship between OSA and anxiety, which is just as high as OSA and Hashimoto's. You can enter "PMC3181635" into your search engine for this.

So which is it? The questions you need to ask yourself are: When did the sleep apnea start? When did I have symptoms of Hashimoto's. Was I anxious before ANY of this started?

For consideration: You more than likely have psychological resources on campus to facilitate discussion of anxiety triggers and learn coping mechanisms. Check them out.


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## visc (Feb 22, 2014)

CA-Lynn said:


> Assuming a good blood workup has been done and found to be normal, I definitely would look towards anxiety-related issues. While there is documentation of a correlation between OSA and Hashimoto's, the survey sample size in the study that I'm aware of was relatively small.
> 
> Enter these numbers in the search engine and likely you will come up with the study: "22785371"
> 
> ...


Well I definitely have some anxiety. But Its always after the symptoms never before. You would expect I developed a little anxiety from suffering for almost 3 years. The anti anxiety meds do not work, and I already practice meditation. Good suggestions!!

I'm just puzzle why these new symptoms occur. They are intermittent some of the time. But things like being really tired or the paresthesias tend to go on for long periods.

Could this be something medical? Anyone else experience this?


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## burdette2004 (Oct 29, 2013)

Have you ever had your adrenal function checked? It can cause issues with sleeping and extreme fatigue. There are also so many other things that can cause issues too. So many things like to piggy back with Hashimoto's. Hopefully when you can get in to see your doctor, you will be able to get some answers.


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## Swimmer (Sep 12, 2013)

Hi, a lady who I know who no longer has a thyroid, told me that when she has been overmedicated (when her thyroid dose is too high) her breathing starts acting up -- it may be an extra breath here or there. It is very strange - but that's what signals her that it's too much.

For me, on synthroid/tirosint, my breath also became strange - to the point of having a very heavy chest where I felt like an elephant was sitting on it... Couldn't get a breath - (heart attack symptom) and I'm a VERY HEALTHY individual - eat healthy, swimmer, etc. 10 days on the medication... Bad effects while on it. (At first when the strange breath symptoms started, my endo told me to go to my regular doctor about the breathing. The thought would have been - sleep apnea? The answer -- NO. This condition was specifically related directly to the medication. My endocrinologist had me immediately stop the medication (only ten days in) after this and some other symptoms. Stopping the medication made all of these symptoms go away. My endocrinologist reluctantly put me on armour thyroid (which has been really wonderful. I am back to myself - more and more!)

Definitely call your endocrinologist. Six weeks is the time when synthroid/levothyroxine etc. is supposed to have "peaked" or reached it's high spot (high level) meaning it is finally built up in your system.

One more thing: Worry/anxiety are a symptom of thyroid problems. I was a worrier for quite some time. When I learned this, I was able to say - that worry is a symptom -- understanding that - I was able to view it as a symptom and literally set it aside - set aside worry/anxiety. Whenever it crept up I could view the situation. It helped me immensely and I no longer have a problem feeling anxious or worried -- unless it is a rare occasion, something normal that I 'should' be concerned about. I hope that looking at it this way will help you as well.

Instead of thinking of being worried, rather, think, my cardiovascular is now off since taking the medication - talk to the nurse (your endocrinologists nurse) be sure to be clear that this is a NEW effect since taking this NEW medication. Now don't worry, realize, that the doctor can simply have you cut your medication in half - but you need to be very clear about the symptom.

Also -- there are other things that correlate with the muscle pain - for some - it is simply that they don't have enough magnesium. Before you change this - talk to the endocrinologist... Eat a banana... Make sure you drink all the water you need -- there may be simple answers for you.

Get good answers, proceed with wisdom & from the doctors instructions. I suspect everything will turn out great


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## LKAustin (Aug 15, 2013)

I have pretty severe heart palpitations related to Hashimoto's. Your symptoms sound worse than mine, but it can't hurt to be checked out by a cardiologist. Mine had me wear a monitor for 24 hours and did an ultrasound. They found a slight murmur and noted that I was having palps (which make you feel out of breath), but said neither were dangerous and recommended I avoid caffeine, stress, alcohol, sudafed, and get plenty of sleep. If you take your pulse and you feel your heart skip, you may be experiencing palpitations. That doesn't sound like it would explain everything but maybe a start? And I agree with Swimmer - hydration helps with everything.


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## bigfoot (May 13, 2011)

I can tell you that right before they diagnosed me with Hashi's, I was pretty active, despite already being hypo and taking 50 mcg of T4 (which I now know wasn't enough). Gym, short hikes, biking, long walks with the dog, etc. All of a sudden I could barely walk around the block, got very winded and out of breath, and was exhausted from basic tasks. I knew something wasn't right. Once they bumped up my T4 dose, my exercise / cardio tolerance improved over time.

The night sweats, anxiety, dry mouth, tinnitus, achy muscles, neuropathy, disruptive sleep, etc. all sound familiar. I am a firm believer that many of these can be tied into hormones (thyroid and otherwise) or autoimmune issues, because when my thyroid and testosterone medications are optimized, they simply vanish. Beware that doctors and specialists do not know everything. Each will have their own knowledge and opinions. They may dismiss many of your signs & symptoms outright. The best thing you can do is take the relevant info from each one and focus on your health goals. For example, I had strange rashes on my arms before being diagnosed as hypo. Multiple docs could not figure it out. When I started thyroid meds, poof, the rashes were magically gone within a day or two. No explanation -- I'm a firm believer that there is a lot that we do not understand about the body.

*Since you are a young guy, the doctors really need to turn over all the stones and look for answers here. No excuses.* You need good doctors on your team that you are confident in and are willing to listen to your concerns, even if you both don't agree on everything. Simply putting you on something like an anti-anxiety med or a sleep med is not going to address the root problem(s). It gets you out of their office, and it might help in the short-term, but long-term it doesn't fix anything. Even things like low testosterone or high estradiol in males can cause very bad anxiety, let alone many of the other things that you are mentioning.

My humble suggestions:

- The usual CBC, CMP, liver labs, and A1C if they haven't been done already.

- Check for low Vitamin D-25, B-12, and Ferritin.

- Test for low testosterone, free testosterone, SHBG, and E2 estradiol (should not be high in males).

- If low testosterone is present, "why?" needs to be looked into *before* treatment.

- TSH, Free T3, and Free T3 are a minimum for ongoing thyroid monitoring and titrating meds.

- TPO Antibodies, Thyroglobulin Antibodies, and Thyroid Stimulating Immunoglobulin (TSI, *not* the same as TSH) if not already tested.

- Thyroid ultrasound for a baseline.

- Check adrenals with 24-hour urine or saliva collection, broken into different time periods. ACTH is okay, but is only a snapshot in time. You need the big picture.

- Test catecholamines (epinephrine, etc.).

- CRP and Sed Rate labs.

- Overnight sleep apnea study.

- Cardiologist consult to verify heart is OK.

- Celiac Disease and gluten sensitivity testing (not the same thing).

- Check for any food or environmental allergies, heavy metal toxicity.

Something else to add -- if your doctor is treating you by monitoring just your TSH, save yourself the trouble and go elsewhere. You need a doc who is going to think outside the box from the get-go, and not just with the thyroid issue. Trust me, I languished for years in the medical establishment. I only wish someone had pulled me aside and told me this stuff a long time ago!

Please do let us know how things are going with an update.


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