unexplained dyspnea

[leemarie717]

I am an RN, have asthma and hx of histoplasmosis. Approx. 7 weeks ago I started feeling extreme dyspnea with normal daily activities. I otherwise felt healthy and well. About the same time I started on Levoxyl 0.025mg for newly diagnosed hypothyroid. All cardiac and pulmonary tests have been normal. I have a hx of SOB on exertion with my asthma, but never with performing normal daily activities. I've been on disability and am beyond anxious to find out the cause so I can get my life back. All labs are normal, other than my TSH, which was greater than 7.8. I did have a recent repeat TSH and antithyroid for Hashimoto's (awaiting the results). I feel since all other tests have been negative, maybe the structures in my neck should be looked at. Iam wondering if possibly my thyroid could be pressing against my trachea. Actually I am grasping at straws to get to the bottom of this. I do feel this "sensation" in my neck. I don't have a great descriptive word for how it feels, but sometimes it feels as though there is something "wrapped around" my throat, although I don't feel like I am choking, just short of breath. I have also had a dry cough and some hoarseness since this began seven weeks ago. No fevers, no other symptoms to speak of. I've been under the care of my primary MD and pulmonologist. Would you recommend an endocrinologist as well and do you feel my symptoms could be thyroid related? Thank you!

[Mark Lupo, M.D.]

a flow-volume loop (spirometry) will see if there is external compression on the trachea (as would a CT scan).  If you have asthma, I am sure you have had spirometry so you could confirm with that doc if the flow-volume loop is negative for compression.

Would also conisder a trial of H2-blockers or proton-pump inhibitors (yes, even if there are no GERD sx) as this can cause these same sx.

The TSH seems high and treatment as well as antibody testing seems appropriate, but my best guess would be that unless there is a large goiter causing compression, the choking/dyspnea is not likely thyroid.

[Janmei]

From an experienced speech pathologist's view:

Considering you are SOB and have a feeling of something in your neck, and are experiencing vocal hoarseness, I would recommend you see an ENT and be examined using endoscopy.  You might be experiencing some vocal fold dysfunction or have a growth on or around your vocal folds.  A good view of your vocal folds might also show evidence of gastroesophageal reflux.  Aspiration of refluxed material can occur without you knowing it, especially at night, and can cause the symptoms (SOB, coughing, hoarseness) you described.  It can also exacerbate your asthma symptoms.  Good luck.  

[jd2]

hi
i also have a feeling of something pressing on my windpipe - not constantly - sometimes for hours at a time every day, othertimes short bursts, and othertimes it won't happen for a week.
i have hashimotos thyroiditis.
i know this probably doesnt help much but thought it might help you to know that other people have a similar problem.
i reckon it's got something to do with thyroid, although my docs dont.
there are lots of previous posts on here about breathing difficulties and swollen thyroid glands etc... i suggest having a read through them!
oh yeah and if your tsh is 7.8 you should really get treated!

[Nikki72505]

I understand completely how you feel. I also have Hashimotos thyroiditis. For about 8 months I've been short of breath during my everyday life. I also have a feeling of have something stuck in my throat and diffuctly swallowing. I've also lost weight, from 167 to 109, yet all my tests come back normal. It's frustrating but hang in there. Good luck!