Breathing Problems mimicking asthma

[Leslie4455]

Dear Dr. Lupo,
  We are trying desperately to help our 19 year old daughter with her thyroid issues.  She is a College swimmer and has been hypothyroid since age 9.  She has been hitting the "wall" in her races so we had a breathing test done.  She also has times when she experiences a tight chest for no apparent reason.  The breathing test showed what appeared to be airway inflamation (she improved her small airway lung function by 51% after taking an albuterol type drug).  As a child she had been told she was asthmatic however we discovered that she had a deviated septum (this was surgically corrected 2 years ago) and removed Cytomel from her treatment plan which -helped the breathing issues considerably.  Now the complication when she takes the asthma medicine she swims AWFUL even though she says her chest isn't so tight. It seems the asthma medicine is working against her. Could her Hashimo's disease be the real source of her breathing issues?
She has also gained a considerable amount of weight - she is now gained 15 pounds despite intense exercise.  Her last Thyroid test showed a TSH of 1.49 (in the past we have kept her around 1.0).  Her current dose is 125 mcg. of Levothroid.  The last Doctor we sent her to stated that her levels were normal despite how she feels & weighs.  I am now desperate to find an endocronologist who treats the patient; understands the demands on elite atheletes; and perhaps knows about breathing issues.  She currently attends school near Pittsburgh.  We would appreciate any suggestions or additional information.  Several current articles indicate that hypothyroidism can actually be induced in atheletes by undereating in relation to the body's calorie/ work load- this can occur in as little as four days.

Sincerely,

L. Treece

[Mark Lupo, M.D.]

Could consider discussing a re-start of cytomel.  Otherwise, the levels look fine and there is not much more fine-tuning that can be done from a thyroid standpoint.  The asthma however may require more attention.

[ChitChatNine]

With the inflammation and 51% response, did they put her on any inhaled or oral steroids at the time or now?  I'm not a Doctor but wonder about an Advair type of medicine .. my daughter swims on high school level and finds she needs to take Advair during the swim season.  Long acting bronchidiolator + inhaled steroid. She has mild chronic asthma but is well maintained with meds as needed.

She has silent asthma; the type you don't wheeze and sometimes hard to diagnose but causes inflamamtion and breathing issues.  

All these albuterol type inhalers make her jittery and quite anxious for about 45mins after she uses them .. nebulizers, too.  Sometimes a change in brand of the asthma meds helps ... some have issues with the preservatives and Xopenex works better thru the inhaler which as I understand is in a more pure form .  Have they considered Singulair?

Just wanted to add my comment on the asthma.  I am certain Dr.Lupo will have much to add .. great question.

C~