Thyroid and swallowing problem

[Mel38]

I am a 29 year old female and have been on a low dose of levothyroxine for 3+ years for hypothyroidism. For the last three months I have had difficulty swallowing and was told by a specialist that I have oral phase dysphagia, although they haven't been able to diagnose the cause. I have also been having the pre-thyroid medication symptoms again; fatigue,lack of concentration, losing my hair, complete loss of appetite. I have lost 23 pounds over the last few months and have a constant feeling of pressure in my head and side of my face.
My blood work has shown the following: First test in August: that my throid was low, then two weeks later: normal and then a third blood test a few weeks ago testing TSH T3 and T4 showed some of the levels as high and some low. (apologies that I don't know that levels off hand)
I have been feeling increasingly worse and can't concentrate at work or home any longer.My GP says it could take weeks to see and endo specialist but I feel so poorly that I don't think I can hold out that long.
If anyone could please tell me if these problems (the swallowing and the funny thyroid) are related, and if there is anything at all I can do, I would be so grateful.  

[zachslp]

The numbness, etc in and around the mouth can CAUSE dysphagia (especially oral stage), but the reason for the numbness is usually something neurological, etc. (i.e. brain injury or Bell's Palsy, etc)  HOWEVER, I have been thinking about your case and wondering why you'd be having these difficulties.  If you are having a goiter or enlarged thyroid that is invading other tissues in the laryngeal area (throat), it could be affecting a cranial nerve that loops down from the brain and into the throat area (laryngeal area).  Pressure on this nerve (maybe from thyroid issues) could cause some swallowing problems.  Have you had any xrays (or similar) of your thyroid and/or throat?  If not, please request that your endo order them... I believe that dysphagia is not directly related to hypothyroid unless there are some anatomical reasons... you need to figure those out.  If the anatomical reasons are not found out, you may want to explore some neurological reasons.  Good luck!

[Bets18]

A related discussion, thyroid removed-swallowing problems was started.

[Mel38]

Thanks to all of you for your feedback-I really appreciate you taking the time :) It was indeed a SLP who said I have the dysphagia (thanks for thinking of it!), but we did also do a gastroscopy to rule out reflux and strictures.(those tests were negative) I now have a referral to an endochronolgist so hopefully if this is thyroid related, he will be able to help me.
I am still continuing to have all the same symptoms but I have had two recent incidences of numbness around my mouth and the right side of my face. It disappeared within a few hours and I felt ok otherwise (Zach: are you able to tell me if this is  common with dysphagia?)

Again, my thanks to all of you for offering suggestions- Its been very useful to me!

[jamesie]

About 3 years ago I suffered from this same symptom. My specialist was adament that my Thyroid had only increased minimal amounts. After pressing him he did an ultra sound. He was amazed that the area was so grey ( whatever that meant) after that he referred to a speach specialist. I then had to go to the hospital for a Video Fluroscopy. It was neat to see myself eating & swallowing these foods. It was obvious to the tech that I struggled with it, but no solution. Then referred to an EENT, nice hose stuck down my nose into my throat... Hmmm no solution.. Referred to another EENT.. That referred me back to my Thyroid doctor who by then researched that patients can actually feel pressure pushing on the frontal part of the neck & throat feeling hence hard to swallow. I have Hashi's & am here to tell you that this can be a long road but be persistant!

[Pie Face]

Have you been checked by GI for laryngeal reflux or gastric reflux which may be affecting your swallowing?

[zachslp]

Wow, what a story!  The pressure from an enlarged thyroid would push against laryngeal muscles that are used in swallowing.  However, the patient mentioned someone told her she had "oral phase" dysphagia (swallowing problem).  That's the stage where we chew our food.... did you have any difficulties in that stage? (The difficulties you report seem to be in the pharyngeal stage... the stage where our swallow reflex "kicks in" and then pushes the food through the throat).  Just curious.  Good luck!

[zachslp]

I have been dealing with hypothyroid for a long time myself, but actually your post stood out to me because I am a Speech Pathologist that deals with dysphagia (swallowing disorders).  I have not heard of dysphagia being caused by hypothyroid, unless there may be a goiter that is pushing on some muscles in the larynx.  However, you said you had "oral stage" dysphagia... that is swallowing problem related to the stage of swallowing when we chew our food and form it into a "ball" that we send down (this is compared to the "pharyngeal stage" when the "ball" of food goes into the throat area and down into the esophagus).  If you are extremely fatigued, that could cause weakness in the oral muscles (lips, tongue, palate) which could cause some difficulty.  When you said a "specialist" diagnosed your dysphagia... was that a speech pathologist?  If not, you may consider asking your doctor to order a speech pathology evaluation for swallowing.  I may not have helped any here, but it might be a start.  Good luck!

[Mel38]

Sorry- I forgot to add that when I was first diagnosed with hypothyroidism, my GP at the time told me that blood work showed it was actually my pituitary that was underfunctioing, not my thyroid. I don't know if that is affecting or causing teh problems I am currently having...Thanks again

[Mark Lupo, M.D.]

I doubt the swallowing is thyroid related unless there is a significant goiter -- thyroid ultrasound would help.  I usually do a swallowing study to help sort this out.  The goal TSH on meds is around 1.0 -- make sure your labs are in range.