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Can Shortness Of Breath Be Related To My Thyroid Problem ?
Question: Hi. I have Hashimoto's disease and have been experiencing severe shortness of breath for 4 months now. The right side of my throat/thyroid is constantly swollen and it feels like I'm wearing a tight collar. I use an Albuterol inhaler constantly with little relief only for the symptoms of not being able to catch a breath come back full force. I've been to a Pulmonologist who found nothing wrong with my lungs. I've had a Pulmonary Function Test that was normal. He even believes it's thyroid-related. I have a history of thyroid cancer in my family (mom had it). I've had an ultrasound of the thyroid as well as a soft tissue x-ray that reveal slight enlargement of the thyroid but no tracheal compression. Once in a blue moon the swelling will seem to go down a bit but I still feel tightness. Just when I think the symptoms are improving they get worse. I am taking 112 mcg of Synthroid daily. This is not in my head and I'm very scared about the possibility of it being cancer. Thanks so much in advance.
Hello and thanks for your query.
Let me reassure you that I do not believe this is any sign of cancer.
I think more-so, there is some kind of inflammation going on which might explain some of your ailments.
A mild enlargement of the thyroid is not a pure sign of cancer.
The ultrasound would have shown suspicious areas rather than a diffuse enlargement as you have reported so this is even more reassuring.
Regarding the idea of inflammation I think you might benefit from a visit with an immunologist or allergist and perhaps a nutritionist for a comprehensive evaluation.
Allergy testing might shed some light on what may be going on - both environmental and food allergies can cause low level inflammation which can exacerbate symptoms of breathing or swallowing difficulties.
A nutritionist might be able to work on strategies of diet analysis and food selection to help promote better homeostasis and downregulate any inflammation.
If you're using albuterol every two hours this is worrisome and I am not sure it is helping the overall picture.
Could there be a component of panic or anxiety going on? I say this because on occasion anxiety symptoms can mimic respiratory or gastrointestinal illness.
Lastly I hope you are able to get 45 minutes or more of daily aerobic exercise. If you are not able to do this I don't think you can make much progress.
Baseline cardiovascular conditioning will serve as a foundation for your recovery.
I thank you again for your query and hope my response has served to be adequate and informative. I remain available if you have any followups as well.
Sincerely,
Dr. Galamaga
Let me reassure you that I do not believe this is any sign of cancer.
I think more-so, there is some kind of inflammation going on which might explain some of your ailments.
A mild enlargement of the thyroid is not a pure sign of cancer.
The ultrasound would have shown suspicious areas rather than a diffuse enlargement as you have reported so this is even more reassuring.
Regarding the idea of inflammation I think you might benefit from a visit with an immunologist or allergist and perhaps a nutritionist for a comprehensive evaluation.
Allergy testing might shed some light on what may be going on - both environmental and food allergies can cause low level inflammation which can exacerbate symptoms of breathing or swallowing difficulties.
A nutritionist might be able to work on strategies of diet analysis and food selection to help promote better homeostasis and downregulate any inflammation.
If you're using albuterol every two hours this is worrisome and I am not sure it is helping the overall picture.
Could there be a component of panic or anxiety going on? I say this because on occasion anxiety symptoms can mimic respiratory or gastrointestinal illness.
Lastly I hope you are able to get 45 minutes or more of daily aerobic exercise. If you are not able to do this I don't think you can make much progress.
Baseline cardiovascular conditioning will serve as a foundation for your recovery.
I thank you again for your query and hope my response has served to be adequate and informative. I remain available if you have any followups as well.
Sincerely,
Dr. Galamaga
Above answer was peer-reviewed by :
Dr. Shanthi.E
I appreciate your response doctor. It certainly is wise to uncover the underlying cause of this inflammation yet it is something that the doctors treating me have failed to do. I am currently under the care of an Endocrinologist who solely prescribes Synthroid as a standard treatment. I've had countless dosage changes throughout the years and yet my disease progressively gets worse.
There is absolutely no component of anxiety or panic in my case. I have come to believe that my thyroid in its swollen state is either pressing on a nerve causing the symptoms of shortness of breath coupled with the fact that my TSH levels are once again off thus causing these terrible symptoms.
Also, since I am unable to breathe well at all while in a resting state, I am unable to get the required daily aerobic exercise although I force myself to walk places with the inhaler on hand as needed.
Sadly I don't believe even most Endocrinologists fully understand how the thyroid truly works and my doctor even voiced that he believed my case was a "tough one." I guess I'm back to square one.
I do have one more question however: Do you believe that a thyroidectomy is the answer for relief of my symptoms? I keep reading articles suggesting this for the symptoms I'm experiencing. Some even suggest that removal of the thyroid will remove the antibodies that are destroying it. Is this true? What are the pros and cons of this surgery?
Thank you.
There is absolutely no component of anxiety or panic in my case. I have come to believe that my thyroid in its swollen state is either pressing on a nerve causing the symptoms of shortness of breath coupled with the fact that my TSH levels are once again off thus causing these terrible symptoms.
Also, since I am unable to breathe well at all while in a resting state, I am unable to get the required daily aerobic exercise although I force myself to walk places with the inhaler on hand as needed.
Sadly I don't believe even most Endocrinologists fully understand how the thyroid truly works and my doctor even voiced that he believed my case was a "tough one." I guess I'm back to square one.
I do have one more question however: Do you believe that a thyroidectomy is the answer for relief of my symptoms? I keep reading articles suggesting this for the symptoms I'm experiencing. Some even suggest that removal of the thyroid will remove the antibodies that are destroying it. Is this true? What are the pros and cons of this surgery?
Thank you.
Hi,
Thank you for your follow-up question.
Regarding thyroid surgery I really do not see any potential benefit. I have reviewed the literature regarding this and there have been no large studies that have demonstrated a true benefit in simply removing the thyroid in a case such as yours. This does not guarantee that the circulating antibodies or the inflammatory process will go away completely. I think maybe it would be a wise idea to seek a second opinion of another endocrinologist to see if there are other considerations which have not been entertained.
I appreciate a lot of your frustrations and I'm sure that this is a process which has been quite taxing on your physical and mental health.
Now it is remotely possible that a thyroid surgery could provide some kind of benefits but again this is a risky procedure with no true predictable benefits. Also get maybe even more difficult to determine what the appropriate dose of your thyroid medication might be in a postoperative setting. Surgery is not without its risks as well including bleeding or infection. I really would not support pushing you forward to have any kind of surgical intervention. The only way I would support something like that would be if a well-educated endocrinologist provided good evidence that you could have a predictable benefit.
I thank you again for submitting your question. I hope you found my response to be both helpful and informative. If you have any additional concerns whatsoever I would be happy to address them.
Sincerely,
Dr. Robert.
Thank you for your follow-up question.
Regarding thyroid surgery I really do not see any potential benefit. I have reviewed the literature regarding this and there have been no large studies that have demonstrated a true benefit in simply removing the thyroid in a case such as yours. This does not guarantee that the circulating antibodies or the inflammatory process will go away completely. I think maybe it would be a wise idea to seek a second opinion of another endocrinologist to see if there are other considerations which have not been entertained.
I appreciate a lot of your frustrations and I'm sure that this is a process which has been quite taxing on your physical and mental health.
Now it is remotely possible that a thyroid surgery could provide some kind of benefits but again this is a risky procedure with no true predictable benefits. Also get maybe even more difficult to determine what the appropriate dose of your thyroid medication might be in a postoperative setting. Surgery is not without its risks as well including bleeding or infection. I really would not support pushing you forward to have any kind of surgical intervention. The only way I would support something like that would be if a well-educated endocrinologist provided good evidence that you could have a predictable benefit.
I thank you again for submitting your question. I hope you found my response to be both helpful and informative. If you have any additional concerns whatsoever I would be happy to address them.
Sincerely,
Dr. Robert.
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Above answer was peer-reviewed by :
Dr. Raju A.T
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