Slow shallow breathing, hand weakness - thyroid?

[Lotus266012]

Hi I have Hashimoto's and I currently take thyroxine however I've noticed that my breathing has become very slow and shallow.

I'm not on any other medication but I'm on 75mcg of thyroxine per day. My chest isn't hurting with my slow shallow breathing, more than anything it doesn't seem to have made much difference. I also take spontaneous deep breaths as if I'm not getting enough air, but I then revert back into slow shallow breathing again. I hold my breath without realising it for about 10 seconds, take a slow shallow breath in and out, hold my breath again and so on.

Also I've developed weakness in my dominant hand. The pain/weakness doesn't start straight away but when I'm writing or drawing I lose my grip on the pen/pencil. I also get sharp pains in the middle of my wrist and sometimes it's severe enough to shoot into my arm/elbow. Could this be carpal tunnel? I've had this pain for quite some time, about 3 years (before I was diagnosed with Hashimoto's) so I don't know if wearing a wrist splint would help. I didn't even consider going to my doctor the moment I had the wrist/hand pain as I correlated the symptoms with my period/ovulation. Any ideas?

Thanks for any help.

[jemma116]

:) Thank you Lotus.

Sounds like you have both the tendonitis problem and the carpal tunnel problem.  Wearing splints at night will help, because it supports the wrist.

The carpal tunnel runs down the wrist and inside the tunnel is the median nerve in the wrist.  The median nerve provides feeling and movement to the thumb side of the hand, including the palm, thumb, index finger, middle finger, and thumb side of the ring finger (not the little finger). Carpal tunnel syndrome can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers.

You may notice numbness in the palm, thumb, index finger, middle finger, and thumb side of the ring finger;

The doctor may notice on examination that you have a weak hand grip.

The doctor may tap over the median nerve at the wrist that may cause pain to shoot from the wrist to the hand, this is called the Tinel sign.

The doctor may bending you wrist forward all the way for 60 seconds and this will usually result in numbness, tingling, or weakness.  This is called the Phalen test.

The doctor may send you for xrays to see if there any arthritic changes and there are the nerve conduction tests.

Regarding your iron levels, it sounds like the level is border line and hence that is why he has said that your iron levels are low, but not low enough to be classed as being anaemic.  

Parecetamol tablets will be OK for pain.  But I would suggest you mention your hand problem to your doctor and for him to recommend or prescribe any anti-inflammatory drugs.  If you are already on medications, some of the over the counter meds may not be suitable.  Ibuprofen can also cause gastric problems, so should be taken with food, or your doctor may prescribe omeprazole to protect the stomach lining if he prescribes you with Ibuprofen.  I am not able to take it, because my legs swelled and my doctor said that Ibuprofen can cause oedema.

As you are from the UK, the doctor may refer you to the hospital with regard your hand problem.  I got my wrist splints from the hospital and didn't have to pay for them, but with things changing a lot now, I am not sure if the doctor will be able to prescribe the splints for your or not.  It is worth asking about.

You will also need to change how you use your hands.  It will not get better if you continue using them the way have been.  With complete rest they may heal, but it will take time.  Unfortunately even if they heal, you will have a weakness with the wrists and hands.  So do take care, you are much younger than I was when I got my problem.  

Best wishes.

[mkh9]

p.s. I just noticed they found you have Hashimotos. Looks like you are on your way to healing. Like I said it takes a while to get to feeling better. Probably longer with Hashimotos. I'm not sure how they regulate that.
mkh9

[mkh9]

I would be careful with the NSAIDS, I took them for 6 months and got stomach pain and you can get problems from them. It does help for a while. But it does nothing to cure the problem if you have carpal tunnel. It will get the swelling down. I have had tendonitis for  years and dealt with workmans comp. lost my job and career. I kept working and thinking it would go away if I just work a splint and covered up the problem with an NSAID. There is a good book you may want to read. It is pretty detailed. Called Dr. Pascarelli's Complete Guide to Repetitve Strain Injury, by Emil Pascarelli, MD. The physical therapists use it too. It is pretty informative.BTW I'm hypothyroid and also had iron deficiency anemia. I am a clinical lab scientist so I understand the lab end of things. I am taking synthroid and doing quite well. It takes a long time for the brain to get used to the correct level of thyroid. There is a lot of controversy about whether or not to test for T3 andT4 versus TSH alone. On Medhelp I will get blasted if I say test for TSH alone is enough. I am now convinced after reading the New England Journal of Medicine and quite a number of other very good articles and so forth that TSH is quite good enough. I am now feeling quite  a lot better finally after about  6 months of adjustment. I haven't felt this good in years. You can do what ever you feel you need to do this is my opinion as a professional and from my doctors point of view. I have had people trying to force me on here to really force me and message me to go to an endocrinologist and I thought about it. but  after extensive reading my opinion is it is not necessary. You can do what you like. I have been tested for Hasimotos and was negative. As for the anemia have you had a complete blood count (CBC), iron level, ferritin, B12 done yet? If not you should. I suspect your iron level is low. I would be glad to read your CBC, and Iron level and ferritin if you have it but I need your labs normal levels. Sorry to get opinionated but I know I am going to get blasted if I say anything about thyroid, LOL. The shooting pains you have are usually nerve pain. It is possible you have tendonitis like I have. I did have some numbness and tingling with tendonitis. I don't have carpal tunnel. like I said the best way to know for sure is the nerve conductivity test.
take care,
mkh9
take care,
mkh9

[Lotus266012]

Hi Jemma thanks for your answer.

Well, the pain varies at times. On the whole it's mostly sharp and shoots through my wrist and up my arm. Sometimes it's bad enough to shoot into the middle of my stomach. Why this is I don't know. I get pins and needles in the same hand when I'm in bed and I drop my arm over the side of the bed to bring the blood flow back into it. I find that this helps. However it won't help if I'm using it during other times of the day!! So taking NSAIDs might be worth a try.
The doctor has got me on iron tablets - the blood test has come back saying I'm low on iron but I'm not suffering from anaemia.

Your hand problems sound worse than mine and I'm sorry you had to retire due to it. I used to do a filing job myself but I took voluntary redundancy due to thyroid problems so now just looking for something more easy-going.

Thanks and take care

x

[Lotus266012]

Hi mkh9 thanks for your answer.

Taking NSAIDs is probably what I'll do - I've not taken them for the pain I get as I just assumed it would go on its own but since it's recurring I might do that.
I didn't speak to the doctor about the hand problems as he seemed to think I'm still new to taking the thyroxine (3 months into the course today) and he's already aware that I still get tired and have pain in my muscles from the hypo. He's quite concerned that my TSH has fluctuated dramatically and also that the blood test for anaemia has come back with low iron but not anaemia (?). Not sure what he meant by that.

[Lotus266012]

Hi I've only been diagnosed with Hashimoto's this year (Jan 2013) with thyroid autoantibodies at 84,000 with normal range 34,000 or lower.

Although I've been newly diagnosed my TSH has fluctuated over the past 2 years, going from high to low, so I can't honestly say how long I've had it.But my former clinic who identified the high TSH did nothing about it and so I continued to feel rough. I would keep going back there but they weren't willing to discuss the high result at all so I left.
I changed clinics since and the doctor I'm now with is much better, although he himself was rather thrown by my latest blood test result since I've been taking the thyroxine.

Doctor has checked for anaemia but he's said that my iron is low but I'm not anaemic. What that means I'm not sure. He also can't understand why my TSH has fluctuated dramatically either, but I'll be getting a review in 3 months to see how I'm getting on with the new course.

Thanks

[jemma116]

I would suggest you make an appointment with your doctor to check your air ways and your lung function and to make sure that you are not anaemic.

With regard to your hand, that needs to be examined by your doctor too.

The symptoms of Carpal tunnel problems are usually pins and needles in the wrist, hand and some of the fingers (not the little finger).  The hand can go completely dead or have sensations of tingling.  This can happen when sleeping too.

The sharp pains that you are experiencing in the wrist that run up to your elbow and weakness is more likely to be  tenosynovitis and tendonitis.  This is not the same as carpal tunnel problems.  Carpal tunnel problems are confirmed by nerve conduction tests.  Whereas tenosynovitis and tendonitis will be confirmed by  x-ray, ultrasound scan or MRI.

The doctor will be able to diagnose the problem by the symptoms presented, but may refer you for tests to confirm his diagnosis.

Taking pain relief, anti-inflammatories (if you are OK with them), applying an ice pack to your painful arm and complete rest will help to settle down the tenosynovitis and tendonitis.  This is inflammation of the tendon and the tendon sheath that is attached to the bone that causes the pain that you experience when writing.  This condition is very common for people who write, type, do any repetitive work, and sports people.

You can get a metal velcroed wrist support splint (you can get these for the left and right hand and in different sizes, Small, Medium, Large).  The metal part goes on the palm side of the hand and also under the wrist, it covers the hand (not the fingers) and is velcroed into place.  This supports the wrist by keeping it in a straight position allowing the tendon and sheath to recover.  The more you use your hand the worse it will get.  Limit your time when you write.  As soon as you start to feel discomfort in the hand, stop writing.  Any use of the hand, for example peeling vegetables can also make it worse.

As a temporary measure until you are able to get the correct support for your hand, apply a bandage around the hand and up your arm to help give it some support.  

Your doctor may be able to prescribe or give you further advice with regard to the hand supports.

I retired due to ill health many years ago because both my hands, wrists up to the elbows were in absolute agony.  I had conduction tests and there was no carpal tunnel problems.  I was prescribed the metal support splints to wear by the hospital.  Since that time my hands have a weakness and I do still get problems, but no where near as severe as they were originally.  I am not able to do any repetitive work, and when I was filling in a few page form the other day, my hand and wrist started to really hurt again.

Hope you get sorted out soon.

Best wishes.

[castratemeplease]

You are paying waaay too much attention to things and letting anxiety get the best of you if you are noticing your breathing that closely. You can relax it is not a problem unless breathing is associated with chest pain. As for the hand grip issue, it is carpel tunnel. There is a well documented association with thyroid disease. How long have you had hashimotos? If you've had it longer than the carpel tunnel problems it is likely the cause in which case a splint is not going to work and you need to go to a doctor. If you suspect the carpel tunnel is from overuse then a splint can help.

[mkh9]

I don't know what is causing the slow shallow breathing. I would see your doctor about that. The hand weakness does sound a lot like carpal tunnel. You can get tested for it with a nerve conductivity test. If it is positive you can try physical therapy and resting the hand but it may come back. Surgery is pretty successful. However, the only risk are adhesions besides the usual  risks of surgery. Also, it takes about 3 months for recovery and physical therapy after the surgery for each hand.  There is no evidence that wearing a splint will help cure or fix the problem however, it may  help at night if you wake up with numbness. If you do, then you can wear the splint very very loosely so you won't bend your wrist at night. You can take Ibupropin with a large meal but it can cause stomach problems, over time. Any of the NSAIDS. Well, there is one that doesn't but I can't think of the name of it but it doesn't work very well.  I also found that if you have two sinks in the kitchen fill one with cold water and ice and the other with warm water and start putting your arms up to the elbow if you can in the cold water for 30 seconds and then switch to the warm for 30 seconds then back to the cold 30 seconds and so on until 5 minutes are up always ending on the cold water. This helps bring inflammation down. One of my doctors gave me this and it felt good. Ice can also help for short intervals throughout the day. Take rest breaks and don't do repetitive tasks.
Hope this helps.