I have been hypo for twenty plus years and most of the time I feel well. However for the past 9 months I have experienced severe breathlessness, to the stage now that I cannot walk from one room to another without becoming out of breath. I am wondering if it has anything to do with my thyroid. I have had tests and scans through cardiology and respiratory but there seems to be no clear answer. I have tried various inhalers but they make things worse.
Last week I had a blood test and the results are:
T4 19.3
T3 6.7
TSH 0.01
Cortisol 802
The medication I am on is:
Levothyroxine 150
Liothyronine 40
Whilst my T4 has always been high, this is the highest it has ever been but when I have tried reducing it I feel very unwell, fatigued and just want to sleep. I wonder if anyone else has experienced breathlessness with an underactive thyroid. I am not keen to see another endo as they always want to reduce my T4 and like I say it makes me feel very unwell. Any help would be very much appreciated.
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sheila747
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Do you have any issues with iron levels or anaemia ? Oxygen is transported in the blood stream by adhering to iron in the red blood cells. Low iron could result in low oxygen ....
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
You haven't supplied ranges but both thyroid hormones & cortisol look high. This can be counterproductive in getting meds to work effectively. Also have you had iron tested recently?
Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Day before test did you split T3 into 3 smaller doses
Last 10mcg dose of T3 approx 8-12 hours before test
You need range on cortisol
It looks very high
Ft4 and Ft3 are right at top of range too
I would agree with tattybogle its worth trying a TINY dose reduction
Either reduce T3 by 5mcg per day
Or
Reduce levothyroxine by 12.5mcg per day
Retest in 6-8 weeks
Do you always get same brand levothyroxine at each prescription
Same brand T3 at each prescription
When were vitamin D, folate, ferritin and B12 last tested
Your cortisol result is very high, what time was the blood result done? What other symptoms do you have? If you are on the Oestrogen contraceptive pill, HRT or Biotin then they can give an elevated result & you need to be off them for 6 weeks before further testing if you can. If you are not on any of them then you need further investigations by an Endo who understand pituitary/adrenal issues, I can help you with that if you let me know where in the country you are. With results that high could mean that you may have Cushing's syndrome, have a look at the chart to see if you have any of these symptoms.
Thank you for your reply Pauline. I am 74 and not on any HRT. I had the blood test at 9 am as my doctor requested. I would be interested to know of a good endo in my area, I live in Berkshire.
I'll message you, in the meantime your GP can do a 24 hour urine test for cortisol to see if that is high. Was it your GP who did the cortisol test? The short synacthen test mentioned is for investigating Adrenal insufficiency not Cushing's. I'm just on my way out so will respond later. x
Thank you Pauline. I requested the cortisol test to be done with my thyroid blood test and my GP told me the result was normal. I have wondered previously if I have Adrenal fatigue. When I go to the dentist I have to make sure I have an adrenaline free injection because if I don't I get raging palpitations and feel faint. Does that mean anything?
Sadly GP's rarely understand cortisol results as they don't see them often in practice & a result of 802 is certainly not within the normal reference range which depending on the lab is usually 350-550nmol/Ls so you can see that yours is well & truly higher! Adrenal fatigue is not a recognised medical condition but is usually referred to with low cortisol & yours isn't low at all. Is there another GP in the practice you can speak to? It would also be worth emailing your current Endo with these results as you do need further investigations, high cortisol isn't good & can cause a lot of other serious issues in the body including blood clots, heart issues, strokes etc. Hopefully you found the private message I sent you?
just a thought , but looking at your previous post from 2 yrs ago. the reduction 's that made you feel worse then were pretty large, 150 to 125 then 100 and also you were'nt feeling unwell at the time. ... so it doesn't surprise me they left you feeling unwell. But have you considered trying a very slight dose reduction now, nothing as drastic as 25mcg .. just 12.5mcg Levo ? since your previous history doesn't have as high fT4 as you do now , i do wonder if you may find that a very small reduction in Levo is worth a try for a couple of months, to see if it does improve how you feel.
I've found improvement 's from reducing by just 12.5mcg Levo .. when a larger reduction would have left me feeling dreadful.
It might be worth a try as i have occasionally read of breathlessness being associated with overmedication.
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