Breathlessness and rib cage pain: I am at a loss... - Thyroid UK

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Breathlessness and rib cage pain

zerendipity profile image
18 Replies

I am at a loss. For a couple of months I have experienced breathlessness and painful rib cage. Breathlessness lasts for about an hour and feels as if my lungs aren’t big enough. I find myself gasping for air trying to take deeper breaths. It is usually accompanied by sore and tight rib cage - sometimes ribs hurt for a day or two and then I get an episode of breathlessness, sometimes breathlessness comes first but there is no specific order.

I have noticed that physical activity - especially walking - seems to always trigger sore ribs and breathing problems. I am not overweight, I was very fit before this issue but now cannot exercise regularly.

My doctor had me do a breathing (lung function) test with methacholine and concluded that I do not have asthma. Also, by listening to my heart and lungs she concluded that I am fine.

So I guess I am just imagining that my chest is tight and burning sore when I gasp for air. Any ideas where or what to look for now that I have to go private with this issue?

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zerendipity profile image
zerendipity
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18 Replies
Marz profile image
Marz

How are your Iron levels ? Also Ferritin - Folate - B12 - VtD ?

Saya85 profile image
Saya85

Agree with marz

I had so many breathing issues and feeling like I'm yawning and sighing all the time and tight chested and can't breathe well until my b12 and iron were sorted

It's recently come back again but I'm also now pregnant so I'm thinking my iron levels have dipped again and it's been 2 months since my b12 injections

I do also get pressure on lower rib cage and bone and feel as if I have pressure on it

MichaelJH profile image
MichaelJH

I had chest pain and breathlessness, prior to my bypass, with the slightest exercise. In my view the best check is an exercise ECG. A resting ECG can be of limited value IMHO!

gigitheweegie profile image
gigitheweegie

Oddly enough, I have the exact same thing. I’ve been on a starter doze of Levo for 3 months now and after 6 weeks I developed these symptoms too.

( I was convinced I had thyroid cancer and it had spread to my lungs as I was waiting on an ultrasound scan to check a swelling in my thyroid )

Going from out in the cold to inside where it was warm was tough and it almost felt like a panic attack. I’ve since had a scan and biopsies which have proved fine but what did show up was excess stomach acid and a hyatus hernia. Reading up on it, the symptoms do fit.

Still to see the doc for a discussion regarding treatment with PPI’s but I can’t help but feel it’s a knock on effect of the Levo or it’s fillers.

SlowDragon profile image
SlowDragonAdministrator in reply to gigitheweegie

Starting dose of 50mcg - bloods should be retested after 6-8 weeks

Insist on blood test ASAP

Dose increase in 25mcg steps until TSH is around one and FT4 towards top of range

Low vitamins can badly affect thyroid function

Essential to test vitamin D, folate, ferritin and B12

PPI is for high acid

Most hypothyroid people have low stomach acid

Hundreds of posts about low acid on here

PPI often lowers B12 and/or magnesium

gigitheweegie profile image
gigitheweegie in reply to SlowDragon

Thanks slowdragon, I questioned the specialist from endoscopy as I felt my stomach acid was weak (after a few times the acid had come up after a burp... ) he said he recommended a PPI for the amount of acid I had, not the strength. ? Thoughts?

Unfortunately having had the breathing difficulties after 6 weeks and thinking the worst my doctor thought I was anxious as a result of being over medicated so ordered new bloods. TSH was around 3.8 and my doc insisted we keep on 50mcg for another 2 months before re testing.

She seemed to think I may have been gently suffering for some time and didn’t want to over medicate early on. She also thinks 3.8 is good as it’s within range and would risk heart problems if it was less than this so you’ll know what I’m up against. I’ve read before on here what tsh should be when on Levo, you mentioned it in my first post. I know bloods should be tested after 6 weeks and increased accordinngly but it’s just baby steps with her at the moment. Bloods at doc last week, TSH still 3.8 and fT4 of 15 (range 12-26)

Appointment not till mid jan to re-negotiate Levo, discuss thyroiditis seen on ultrasound scan and PPI request from gastroscope.

Thanks

(Apologies for hijacking someone else’s post!)

SlowDragon profile image
SlowDragonAdministrator in reply to gigitheweegie

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

All thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

NICE guidelines saying how to initiate and increase. Note that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine

cks.nice.org.uk/hypothyroid...

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

Low stomach acid can be an issue

thyroidpharmacist.com/artic...

drmyhill.co.uk/wiki/hypochl...

scdlifestyle.com/2012/03/3-...

pulsetoday.co.uk/clinical/m...

gov.uk/drug-safety-update/p...

gigitheweegie profile image
gigitheweegie in reply to SlowDragon

Now I’m bamboozled after reading one of your links. I’m not sure if I have Hashimoto or not. Tell me your thoughts, Both my doc and medichecks tests show I don’t have antibodies (but then I’ve read that you can have it and not necessarily have antibodies) the radiologist said I had “background thryoiditis” Does this mean I do have Hashimotos?

I felt mine was a knock on from pregnancy but 2 and a half years later I’m still suffering (mildly). Both my auntie and grandmother had hyperthyroidism (and then were sent hypo after radiation treatment) and my dad has only recently been diagnosed hypothyroid. (Not sure if he has antibodies or not, he just takes the pills the doc requests and no questions asked!)

Could it be Hashimotos after all?

I was also tested for gluten problems about 3 years ago and was told I was fine. Going gluten free is such a challenge I’d rather avoid if I don’t have Hashimotos but if it is then I’m willing to embrace it.

SlowDragon profile image
SlowDragonAdministrator in reply to gigitheweegie

Many on here, even without Hashimoto's, find gluten free diet helps. Others try it, and find no improvements

I would suggest trying it....eventually

But first you need to get dose of Levothyroxine increased. That's most important. Also highly likely you have low vitamin levels that need improving

Give GP printed copies of these NICE guidelines

NICE guidelines saying how to initiate and increase. Note that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine

cks.nice.org.uk/hypothyroid...

Also this recent guidelines

New NHS England Liothyronine guidelines November 2018 clearly state on pages 8 & 12 that TSH should be under 1.5 when on Levothyroxine to be adequately treated

sps.nhs.uk/wp-content/uploa...

Suggest you see GP and request 25mcg dose increase in Levothyroxine and vitamin D, folate, ferritin and B12 testing

If GP refuses to increase Levothyroxine, insist on a referral to endocrinologist of your choice

Email Thyroid UK for list of recommended thyroid specialists after Jan 3rd so that you know which endocrinologist you wish to see

please email Dionne


tukadmin@thyroiduk.org

Low stomach acid is direct result of being under medicated

As to wether you have Hashimoto's. If vitamin levels are very low it suggests gut involved and it's more likely.

gigitheweegie profile image
gigitheweegie in reply to SlowDragon

Thanks slowdragon. I am upping the vitamins as we speak. The only thing which was low on the medichecks tests were vitamin d. The rest were all in range (but on the low side) so as you suggested at the time I’ve started on supplements.

Will email thyroid uk as suggested in the new year.

Thanks for your help x

SlowDragon profile image
SlowDragonAdministrator in reply to gigitheweegie

Just looked at your original post

B12 and folate may need improving too.

Low vitamin D affects B vitamins

drgominak.com/sleep/vitamin...

Clare1971 profile image
Clare1971

I felt the same , kept blaming my thyroid / medication . After lots of tests they have discovered im going through peri menopause.. it’s awful

KT77 profile image
KT77

Gasping for air is very much low iron symptom. I had that all the time. Also muscle spasms around rib cage is either low iron or vitamin D. The last time I had those pains I took vitamin D and the pain was gone in 2 days. Hope this helps.

Part of my hypothyroid symptoms have been "Air hunger". mine hasn't been nearly as severe as yours, but still unpleasant. I had asthma as a child, and at first I thought it might be coming back, but an inhaler had no effect.

Eventually I phoned the doctor, after being too weak, (the bus stop is only a few hundred yards) to go to town to meet friends. Thankfully I was given an increase in Levo, and haven't been that bad since.

Of course, there are a lot of other possible causes for such chest problems, but being hypothyroid certainly doesn't help!

zerendipity profile image
zerendipity

Thank you all for replying! I was freaking out thinking of MS hug or a serious heart issue. I have had several ECG-s over the last couple years and also a heart ultrasound; last week had a finger prick blood test for infection to rule out pneumonia.

I must insist on iron testing because it seems as the only thing that makes sense. My B12, folate, vit D and other micronutrient levels are perfect (perfect according to advice given here on HU) and have been so for a while. Iron levels though have been very difficult to up, I believe it’s an absorption issue as all women in my family have this problem. To be honest I wish I could find a place for an infusion because the supplements make my stomach hurt so much and cause digestive issues. I have tried several iron supplements but I have not noticed a difference in side effects. I take it with vit C.

gigitheweegie profile image
gigitheweegie in reply to zerendipity

I use better you iron spray. It’s fab as it is absorbed sub lingually

zerendipity profile image
zerendipity in reply to gigitheweegie

Ooh, thanks for the suggestion, that’s something new and I’ll have to try it 🙂

Peachykeen1 profile image
Peachykeen1

Me too, you aren’t alone

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