Breathlessness and hypothyroidism?

[Alice S]

Hello, I am a 22 year old insulin-dependent diabetic.
I had general symptoms of fatigue and slow mental capacities for several months. Any much exertion, eg a 20-40 min walk, resulted in extreme tiredness coupled with shortness of breath (I am not over-weight). My periods had become irregular with increased flow, and hair had started thinning a little.

4 weeks ago my symptoms very suddenly worsened. Extreme fatigue with shortness of breath, unable to do anything much. Also during the last 4 weeks i have had joint aches and hair loss has increased rapidly. As the breathlessness was so bad I ended up in hospital. Scans and x-rays of the chest were clear. Blood tests showed TSH level of 12.6, but Free T4 normal (a blood test just 6 weeks earlier gave TSH of 2.6). The docs put me on 25mg levothyroxine. Whilst i am better than when admitted to hospital i still get bouts of severe fatigue which always come with a degree of breathlessness.

Problem: I believe i am hypothyroid but my GP seems to think that hypothyroidism does not explain my symptoms (particularly breathlessness) and seems to think that i have some form of anxiety, even though i really don't feel that is the case. He does not think the TSH level of 12.6 is particularly significant as the fT4 is normal. He won't refer me to an endo.

Please, can the breathlessness be explained? All the other other symptoms appear to be common one for hypothyroidism and i think my GP is getting it very wrong.
Help?!

[Mark Lupo, M.D.]

Hypothyroid can causes breathlessness - usually the labs are more severe....but first would normalize TSH (0.5-1.5)which may mean more thyroid meds (switch to a brand like synthroid or levoxyl instead of generic levothyroxine) and have the TSH checked every 6 weeks after a dose start/change until goal is reached.  If your symptoms persist after fixing thyroid, then it may be another cause.  

Are you not under the care of an endo for the Type 1 DM?  It think a T1DM pt with hypothyroid is also at risk for other endocrine problems such as adrenal insufficiency (at least ask primary care to check an 8am cortisol and if less than 11 - consider an ACTH stim test).

[Alice S]

By the way, forgot to mention that i have had high thyroid antibodies for about 3 years. As a diabetic i'm routinely checked for it.

[tnt406]

HI IT MOST DEFINETLY SOUNDS LIKE YOU ARE HYPOTHYROID.WITH YOUR HIGH TSH AND HIGH ANTIBODIES LEVEL.MAYBE THE LEVOTHYROXINE IS NOT THE RIGHT MEDICINE FOR YOU.TALK TO YOUR DOCTOR ABOUT TRYING A DIFFERENT ONE.MAYBE DR.MARK CAN RECOMMEND ONE IF HE FEELS IT IS NOT RIGHT.I AM NOT A DOCTOR,ONLY A FORUM USER LIKE YOU ARE.GOOD LUCK,AND TAKE CARE OF YOUR SELF.TNT406

[ShannieK]

Hi, I was glad to see that you added about the antibodies at the last minute, I agree with Tnt, that you TSH level is high and that you are hypo, however, You say you are positive for the antibodies, which means that you have an auto immune disease, which in my opinion, is linked to so many added symptoms of it's own.  I too, have been diagnosed with Hashimoto's disease, and it has been my experience, that I suffer from a wide variety of symptoms, which range from hypo to hyper symptoms, but also have had chest pain and shortness of breath and so on.  I know they are not the typical symptoms, but I strongly believe it is all related, during different thyroid med changes that I go through, there are times when all of those symptoms go away.  If your GP is not willing to refer you to an endo, I would suggest trying a doctor tht will give you the referral, just the fact that your dealing with diabetes, and another auto immune form, I think this is significant cause to be treated by a specilaist, this is just my two cents.  good luck to you, Shannon

[sicntired]

It is my experience that when my ferritin is low I have breathlessness too. Low ferritin is like an anemia and shortness of breath is a sign of that along with weakness and fatigue. Are your lips very pale? Check not iron but ferritin. MAny hypo patients are helped with iron supplements.
Good luck