Shortness of Breath - Hyperthyroidism

[Someome]

I have been feeling short of breath on and off but what causes this?

What exactly happens? Is it because of the heart? Or is anything else faulty?

And also what can I do to relieve it? Do I have to make an appointment?

[jimh111]

Definitely worth checking out. Could be irregular heartbeat or low iron levels or something else, or just anxiety.

[Someome in reply to jimh111]

yes but I just started anti thyroid medication 4 weeks ago. And doctor said come at the end of july, beginning of august. My heart beats kinda slow at 70, even 69. I just have episodes at night where it doesn't beat fast, just very hard. Ferritin was fine 4 weeks ago. I just had a bit more red blood cells than usual and they had lower volume. Also hypochromatic red blood cells. But I have eaten more red meat since then. Back then I didn't eat meat at all.

[PurpleNails Administrator in reply to Someome]

What medication & dose have you been prescribed?

Your system will still have excess thyroid hormones. Anti thyroid medication (eg carbimazole) works by reducing new T4 & T3. The process can take up to 8 weeks (most feel better sooner). By then you must have a repeat blood test as adjustment often necessary.

60 - 90 is “normal” heart rate. So 70 is ok. Do you feel is it slow or pounding? this could be palpitations? Last year my heart rate was average 70 and my thyroid level were in range and I had no symptoms.

Do you have your blood results and ranges?

Do you know the cause of your hyperthyroidism, for example have you had the correct antibodies tested for Graves.

[Someome in reply to PurpleNails]

Thanks for the reply.

I took Thyrozol (methimazole) 30 mg per day the first two weeks, and now I'm on 20 mp per day. I take Metoprolol as needed...but ended up taking it everyday (mostly at night, sometimes a quarter of a 50 mg tablet, sometimes half). I was vitamin D deficient and taking D and Selenium as supplements. That's all for meds. Had no side effects so far.

I know it takes a while until the medication works so that's why I hesitate to go to an appointment so soon, but the shortness of breath worries me most. It's on and off at rest.

I get palpitations but they last a second. Can't be arrhythmia because I get no chest pain and no palpitations when the shortness of breath occurs.

Blood tests at 02.06.2020:

TSH < 0.005, reference 0.27 - 4.2

FT4 65.5, reference 12 - 22

Ferritin was 46.2, reference 13 - 150

On 19.06.2020:

I had TRab antibodies 12.25, reference less than 1.75UI/L

T4 was 179.1, reference 66 - 181 (I didn't get other thyroid tests for fear they might not be conclusive cause I didn't fast, i got scared and decided on the spot to have blood tests that day since I felt weird)

Red blood cell count 5.41, reference 3.8 - 5.1

Red cell volume 80.4, reference 81 - 100

Mean Hemoglobin 26.1, reference 27 - 34

Immature red blood cells fraction: 1.3%, reference 3 - 15.9

No goiter, no ophtamopathy (so far).

:)) looks like a lot to read.

[PurpleNails Administrator in reply to Someome]

If it’s a new or worsening symptom don’t wait it out, speak to your doctor sooner.

High trab antibodies confirms graves. When you retest include TSH, FT4 and FT3. and adjust anti thyroid dose by FT4&3 not TSH. This can stay suppressed. Also very important to test B12 and folate as well as reviewing your vitamin D & ferritin.

Fasting not strictly necessary for thyroid test. (It’s with Hypo patients that it is advisable to book a morning blood draw, fast 12 hours (water only) and delay dose of Levothyroxine for consistent results).

Assuming you are not in uk? Here the NHS refer hyperthyroid patient to specialists. Do you have an endocrinologist?

[Someome in reply to PurpleNails]

I have an endocrinologist and I'll include those tests for B12 and folate next time too.

Thanks.

[Batty1 in reply to Someome]

I’m thyroid-less and I’m taking both T4/T3 meds and have been experiencing breathlessness off and on for sometime and someone mentioned folate and B12 so I started taking B12 and adding spinach to my morning smoothie and within 3 days my breathlessness has subsided and my heart rate (watch) has dropped.

[Valarian]

Shortness of breath is a very common symptom with Graves’ and is normally helped at least a bit with beta blockers, which you are already taking, while waiting for thyroid levels to come down.

I wonder if it’s connected with anxiety, another common symptom of Graves’ ? The issue with this is, the more you worry about the symptoms the more anxious you will inevitably become. It may sound a bit corny, but some people find yoga helps, or listening to beautiful music or going for a walk in the countryside or a park.

If it’s a new symptom and making you anxious, I wouldn’t hesitate - call your doctor.. Chances are they will reassure you, and if the symptom is connected with your thyroid, it should subside as your thyroid levels come down over the next few weeks.

[Someome in reply to Valarian]

I haven't noticed any change on beta blockers. And I'm worrying inevitably but I like to think that not to the point of anxiety. Thing is before methimazole, I didn't have the shortness of breath.

But yeah, should see with my doctor...

Thanks for the suggestions

[Lora7again]

Have you seen Elaine Moore's site? She has a lot of information on there.

elaine-moore.com/

[Someome in reply to Lora7again]

Will check out! Thanks

[pennyannie]

Hello Someone

Graves is an auto immune disease where the thyroid is the victim in all this and not the cause, as the cause is your immune system mistakenly attacking your body and the obvious question then is - why is this happening ?

When the thyroid is attacked the symptoms experienced can be diverse as the thyroid is such a major gland, and your body's engine, so some symptoms can just be seen as a bit odd, whilst other symptoms can be frightening and other symptoms considered life threatening.

The anti thyroid medication is to block your own thyroid hormone production during this phase of the illness with the intention being the immune system will calm down and your thyroid eventually fall back into normal ranges.

Too little AT medication and you may still feel hyper, too much AT medication and you may feel hypothyroid. It's a fine balance and many adjustments may need to be made while your own levels start to reduce back down.

I would suggest you talk through your current symptoms with your doctor and he can access an endocrinologist if he feels this necessary and beta blockers are often prescribed during this phase of the disease if you are feeling uncomfortable.

Grave tends to be a stress and anxiety driven auto immune disease and if you can, it will be to your benefit to try and slow down, relax, and sleep, as your body has been in overdrive.

There generally is some genetic relevance with possibly another family member, maybe a generation away from you, having a thyroid health issue, and Graves can be triggered by a sudden shock to the system like a car accident or sudden death of a loved one.

It will also help if you if you maintain your core strength strong and solid and would suggest you get ferritin, folate, B12 and vitamin D tested as these need to be maintained at optimal levels within the range, and not just anywhere.

You might like to read further, around this poorly understood and badly treated auto immune disease and I found Elaine Moore Graves Disease Foundation website and her first book very enlightening.

I'm with Graves and had RAI treatment in 2005 - a treatment I deeply regret and I now manage lingering Graves, thyroid eye disease and hypothyroidism and self medicate as the NHS do not routinely prescribe full thyroid hormone replacement.