Persistent cough - advice : Hi there I have had... - Thyroid UK

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Persistent cough - advice

Jessycat profile image
13 Replies

Hi there

I have had a cough now for about 8 weeks. It’s almost a throaty cough, I’m not really sure how to explain it. About 2-3 times a day I will start coughing and I can’t stop, I find it really difficult to breathe, like my throat has closed. I quite often end up being sick, bright yellow bile.

I have looked online and seen people mention nodules on the thyroid. I’m under active and waiting to see an endocrinologist.

I went to my doctor and all she said was you need to see endo and offered me antibiotics despite saying there was no infection so I refused.

Just wondered if anyone else has experienced this.

Thank you

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Jessycat profile image
Jessycat
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13 Replies
SlowDragon profile image
SlowDragonAdministrator

Your previous post shows you're extremely hypothyroid despite being on 200mcg Levothyroxine

healthunlocked.com/thyroidu...

Persistent cough can be due to lactose or dairy intolerance. Extremely common with autoimmune thyroid disease

Dairy intolerance also often substantially increases the dose of Levothyroxine required as it's poorly absorbed

Lactose intolerance is very common with Hashimoto's

ncbi.nlm.nih.gov/pubmed/240...

Lactose intolerance was diagnosed in 75.9 % of the patients with HT

read.qxmd.com/read/24796930...

These findings show that lactose intolerance significantly increased the need for oral T4 in hypothyroid patients.

Have you recently had brand change in Levothyroxine?

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though Teva is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet.

Omeprazole likely not helping either. But you must not stop taking suddenly.

Most hypothyroid patients have LOW stomach acid

Jessycat profile image
Jessycat in reply toSlowDragon

Hello. No brand change for the levo. I also stopped the omeprazole a while ago. I weened off them. I’m seeing an endocrinologist at the end of the month. I just cough so often and end up being sick, it’s draining!

SlowDragon profile image
SlowDragonAdministrator in reply toJessycat

Suggest you try strictly dairy free

What brand of Levothyroxine are you currently taking?

Jessycat profile image
Jessycat in reply toSlowDragon

Mercury pharma!

SlowDragon profile image
SlowDragonAdministrator in reply toJessycat

So did GP increase dose of Levothyroxine after such high TSH result?

Folate and vitamin D were deficient. Have you been supplementing to improve

Jessycat profile image
Jessycat in reply toSlowDragon

They wouldn’t budge past 200. Just said see an endocrinologist. I’ve been waiting months. They also said they don’t understand the thyroid enough to advise. I was already taking vitamin D tablets. Not taken anything for folate though

SlowDragon profile image
SlowDragonAdministrator in reply toJessycat

So how much vitamin D are you prescribed?

Should be 1600iu daily for 6 months

GP will only prescribe to bring vitamin D up to 50nmol. Aiming to improve by self supplementing to at least 80nmol and around 100nmol may be better .

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Retesting twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is good as avoids poor gut function.

It's trial and error what dose each person needs. Frequently with Hashimoto's we need higher dose than average

Local CCG guidelines

clinox.info/clinical-suppor...

folate was deficient and GP should have prescribed folic acid. However Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be more beneficial.

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).

Or Jarrow B-right is popular choice, but is large capsule

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

SlowDragon profile image
SlowDragonAdministrator in reply toJessycat

So the cough could be due to acid reflux or Gerd

healthline.com/health/gerd/...

Gerd and Hashimoto's are often linked

healthline.com/health/gerd/...

Getting vitamins optimal essential

Trying strictly gluten free and/or dairy free helps thousands on here

SlowDragon profile image
SlowDragonAdministrator

Link about dairy intolerance

thyroidpharmacist.com/artic...

Rosepetal60 profile image
Rosepetal60

Not the same but have you considered that this cough could be a result of allergies. And maybe post nasal drip. You might like to consider trying out 1 over the counter antihistamine tablet at night to see if it helps.

Jessycat profile image
Jessycat in reply toRosepetal60

Hi there! I take an antihistamine every day as I have a touch of hay fever

Caroline888 profile image
Caroline888

Hi Jessycat,

I have this too! A dry choking cough that, like yours, occurs only a few times a day. In my case it’s eased by a swallow of water and I think it’s down to being undermedicated!

As Rosepetal says, it could also be due to an allergy. I suffered badly with rhinitis last year and this has totally gone away now that I am on a higher dose of levo.

Hope you find the answer soon.

All the best

Caroline

humanbean profile image
humanbean

If you've weaned yourself off omeprazole but haven't managed to fix remaining gut issues then perhaps your cough is caused by silent reflux (or just the ordinary non-silent acid reflux). Do you know if you have a hiatus (or hiatal) hernia?

The stomach has two valves. At the top there is a valve between the oesophagus and the stomach. At the bottom there is a valve between the stomach and the duodenum.

In people with healthy digestion both those valves will stay tightly closed all the time unless the person is eating and food has to enter the stomach, or the food has gone through the process of being broken down in the stomach and its time for it to move on into the intestines. One determinant of whether the valves open or close is pH i.e. how acid the stomach is. When the stomach gets acid enough the bottom valve should open.

If the stomach never gets acid enough then eventually the response of those two valves becomes unreliable and they open under the wrong conditions. As a result people can end up with stomach contents or stomach acid going up the oesophagus and irritating the throat, causing the cough.

For much better info than I can give, you could read this series of articles by Chris Kresser. They are very good, I think. He gets a bit confused about how many articles he's written - he mentions there are five then adds another one at the end.

1) chriskresser.com/what-every...

2) chriskresser.com/the-hidden...

3) chriskresser.com/more-evide...

4) chriskresser.com/how-your-a...

5) chriskresser.com/how-your-a...

6) chriskresser.com/get-rid-of...

Chris Kresser also writes about the thyroid and this article may be of interest :

chriskresser.com/the-thyroi...

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