Thyroid UK
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A strange cough and palpitations

Hi all

I was diagnosed with under active thyroid in early feb after a year of going back and forth to my doctors. My TSH level was 18. I went back after a month for a blood test and it had dropped to 4.9 which the doctor said was within normal levels so wouldn't need to change my current dose of 50 mg and they had me for a call back in Novemeber.

At the end of March, I stared with an irritation in my throat, that even now when I shout or sing it makes me cough and constantly feels like I have a pressure in that area which the doctors put down to a viral infection, but and I am now having really bad palpitations ( that are getting more consistent) that make it worse and also occasionally make me feel light headed or that I'm underwater.

About two years ago after a very stressful time at home and work, I was diagnosed with an ectopic heartbeat and put on beta blockers for a short period of time which made me feek dreadful. However, I came off those in 6 months and had never had another episode until now.

I have contacted my doctor and they want me to go back on the bets blockers, but I am really reluctant to do this as I think they are ignoring the other factors .

Help please, I am at my wits end and just want to sit and cry as all I want to do is feel well!

Thanks in advance for any help or advice.


15 Replies

I cough all the time. Doctors - when I used to see them - would listen to my chest and say well, there's nothing wrong with your chest. Of course there wasn't, it was coming from my throat! But that response seemed to tax their brains to an undesirable extent and they would change the subject.

Coughing from the throat is a hypo symptom, as palpitations can be. But, of course, doctors don't know anything about symptoms - especially the more obscure ones. Your dose is too low and your TSH is too high, so it's not really surprising you still have symptoms.

50 mcg is just a starter dose. The idea is to test after 6 weeks and increase the dose. Unfortunately, your doctor obviously knows nothing about thyroid so when he saw your TSH was 'in range', he thought his job was done! Not. Once you are on thyroid hormone replacement, the TSH should be below one. So yours still has quite a way to go.

I don't know if trying to tell your doctor that you feel unwell at that level and still have symtpoms will do any good. You may have to change doctors, or insist on seeing an endo. Or just tell him politely but firmly that you want an increase in your dose and you intend to get it.

Hugs, Grey


I've had a cough for years and it's worse in the evening. So is it actually a sign of being undermedicated? I thought I was medicated until recently but the cough still hung around!

I regularly go for days without using my voice (can be a bit of a miserable cah) so wonder if this could be making it worse.


I'm sorry, I don't know about that. But no dose of medication has ever got rid of my cough. I've coughed all my life. Maybe once you've got it you've got it, I don't know. But a throaty cough is on a lot of lists of symptoms of hypo.

I don't use my voice much these days, either, but I used to. My voice has earned me my living for most of my life. Didn't make any difference to the cough though whether I used it or not.

It's funny I used to cough and cough and people would say - invariably - you ought to see a doctor about that. So I would see a doctor and he'd say oh, yes, you've got a cough! Ha! Even ENTs weren't in the least interested in my cough and none of them knew it was a symptom of hypo. So the cough is still with me. Ho hum.

Hugs, Grey


That's strange isn't it. Presumably you had x-rays done?

Can't believe how many symptoms there are for one illness. I did actually have an x-ray and apparently showed up nothing.

I believe it started from when I was working in front of a large warehouse, had to walk through warehouse several times a day so suspect it was dust etc.


No, no x-rays. The only thing that could be called an examination was when the ENT guy put a tube down my throat -- thereby makeing me ill for a week - and announced that there was absolutely nothing wrong with my throat! Of couse there wasn't. But had he touched me in that area he might have found an enlarged thyroid pressing on the wind pipe? I don't know. But the thyroid is gone now, and the cough is still there.

Of course, it could be due to my asthma. Asthma that doctors have denied that I have for most of my life, telling me I had bronchitis or goodness knows what else, until an allergy specialist gave me a test that triggers asthma attacks. I thought I was going to die! He just laughed and said well, you told me you had allergies but you didn't tell me you had asthma! No, because doctors had been telling me all my life that I didn't have it! Well, I have it, and I think it makes me cough.

But who knows. Really, finding out whats wrong with you seems to be to be just the luck of the draw, just happening to be in the right doctors surgery at the right time to get a diagnosis. It's all very haphazard and very unscientific, but... what can you do.


Hey there...

OK Palpitations can be a side effect of too much thyroxine.. or... have you had a new prescription? different packet... I get palpitations with one brand... don't panic, they won't kill you and if you're stressed about them they could get worse (even caused by stress) so let's ignore that for now and concentrate on the throat.. did your GP feel your Thyroid gland? If not, I would go back and ask them why not, if he/she doesn't feel confident to examine you, perhaps they would like to refer you to a more highly qualified person who will.

It could be swollen thyroid or it could be a recurrent throat infection (also a hypo symptom) or it could be totally unrelated..

So, you need, I would say... a referral to a specialist. I SO know how you feel.. I am on my 4th GP since I was diagnosed and have finally found one that I can talk to.

Write a letter, because if you're anything like me you get too frustrated to do it in person (also a hypo symptom) tell them you are genuinely concerned that your thyroid condition is being properly managed, you want an examination of your thryroid gland and a referral to an endochrinologist (get a recommendation from one of us because loads of them are rubbish as well)... It's a long hard road, buddy, but you'll get there


...palpitations from my understanding are caused by too little T4/T3. The heart is a muscle and needs the active T3 for it to carry out its function correctly. It was an irregular heartbeat that first took me to the docs in 2005 and the observant GP tested my thyroid properly....TSH FT4 FT3 Anti-bodies etc. A scan was also arranged for the same day - nodules revealed.

When I was just on T4 I still had the off blip and was aware of my heart in my chest. Now on T3 only and it's much better although my pulse has increased to around 80 - sometimes over !

May I suggest you have your FT3 tested and it should be in the top third of the range. Also your T4 and the TSH under 1. Your dose is too low.

Also get the Famous Five tested.....B12 VitD Folates Iron Ferritin. They all need to be high in their ranges for optimal health....and to aid in the conversion of T4 at a cellular level. There is a book that was brought to my attention by Red Apple - Thyroid and Heart Failure. It's on Amazon at great expense but you can read through it on screen. It won't take you too long to realise the importance of T3....and the Thyroid in general.

Good Luck with your GP.....we will soon have you sorted !!


I also had a persistent cough which my doctor said was a virus. I had it for several years and eventually realised that it was connected to my thyroid. Sometimes I would start to talk and the first sound to come out would be a small cough which sounded as if I was going to laugh. It was very embarrassing.

Since I have been on Armour I don't get as much. I have made an appointment to see Dr Peatfield so I am hoping that once my dose is correct it will go completely.


I know exactly what you mean! Just want the ground to swallow me up sometimes.


Thanks so much both. I feel like I'm going mad. I have had a definite improvement since I went on the Levo, but have found these symptoms gradually getting worse. I spoke to the triage doctor today after having a full weekend of this and nearly lost my temper because he told me to just get the beta blockers. I have an appointment tomorrow with my regular doctor so will try to get my dose increased. Can any one recommend a good Endo in the Leicester area please as if I'm not successful I will ask to be referred.



Have a look at the "hospital" section at the top of this page to see if anyone else has been to a good hosp in your area.

I suffered with heart palps and missing beats for over a year and when my GP suggested beta blockers and warfarin I told her, in no uncertain terms, that I didn't want a sticking plaster put over the problem I wanted to know WHY I had the palps. Was sent to an endo and he has now sorted me and no more palps. Mine were due to over medication (but the confusing bit is they can also be caused by under medication) and low iron. My palps were also made a lot worse when I was taking sweeteners in my tea and no added sugar juices - mentioned these just in case you have either.

Moggie x


I did forget to say that they did also discovered a vitamin d deficiency and I take 2 25ug tablets a day for that now. Thanks Marz I will also ask what tests were run. The problem I will have is that all of our GPs hate having their diagnosis questioned so need to think how I will word it.

I've learnt more in 20 minutes on here than from my GP and it has made me more knowledgable on what to ask.



Hi! I had really bad palps when my thyroid function was really low. It didn't calm until 175mcg of levo.

Your dose is crazily low, and such low doses suppress the natural output of your thyroid so you then need a full replacement dose.

Re beta blockers, beware this drug actually reduces your thyroid function, probably why you felt so terrible.

I've had this cough and a croaky voice, both when my thyroxine was really low.

I suggest you give a copy of the symptoms list on Thyroid Uk, preferably ticked to help your doctor out. It seems we have to educate them at every opportunity!


I had a strange cough for months, with having to swallow mucus often-I don't know if yours is like that.

To my surprise my GP diagnosed acid reflux, which I had not suspected because I had no oesophagus or stomach soreness. And he was right.

He prescribed Omeprazole, and said I might have to be on it long-term-which didn't feel right. After a week I switched to cider vinegar and honey, and that cleared it after 2 or 3 weeks. I think the cough is a hypo symptom- perhaps the stomach not being energised enough to work properly?


Hi all. I have been today and got my GP to up my Levo to 75. She wasn't keen on the idea but could understand my reasoning. I have to go back in 8 weeks for another blood test. Keeping my fingers crossed that this horrible feeling in my throat goes. Thanks so much form the help. It gave me the push to stick up for myself with my GP x


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