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July 03, 2023 9 min read

When it comes to managing hypothyroidism- an underactive thyroid- Levothyroxine often takes center stage as the standard treatment. It compensates for the thyroid hormone that our body can't produce in sufficient amounts. But, surprise, surprise! This thyroid superstar is not without its intriguing side-show; an interesting, albeit unsettling, association with shortness of breath. Let's navigate this unexpected relationship together.

Hypothyroidism 101

To understand the link between levothyroxine and breathlessness, let's first revisit hypothyroidism, a condition characterized by low levels of thyroid hormone in the body.

The thyroid gland, although small, has an impressive CV: it produces thyroid hormones, which are the chief choreographer of the body's metabolism, regulates the speed of our heart rate, and is instrumental in energy production. In essence, the thyroid hormone recounts a classic tale, one where a seemingly small component greatly influences the systemic harmony of the entire body.

Now, call it the plot twist, but what happens when this primordial hormone starts dwindling? As levels of thyroid hormone fall, they leave in their wake a set of distinct signs and symptoms. Imagine stalling gears and powered-down machines - that's your body under hypothyroidism. Without enough thyroid hormone, the speed of metabolism slows down, the heart rate dials back, and energy production slackens. This downturn translates to symptoms like pervasive fatigue, unexplained weight gain, and, counterintuitively, a sensation of breathlessness.

But why would having too little thyroid hormone lead to breathlessness? To understand this, you must look into the pivotal role that the thyroid hormone plays in the functioning of the respiratory system. Normal levels of this hormone ensure the optimal operation of your respiratory system. They keep the respiratory muscles - the primary muscles allowing you to inhale and exhale - performant and ensure that lung function is maintained at its prime.

In hypothyroidism, this thyroid-respiratory synergy gets disrupted. Low thyroid hormone levels can sap strength from the respiratory muscles, leading to their weakened state. This weakening directly impacts how efficiently these muscles can help you inhale and exhale air.

Furthermore, thyroid hormones play a direct role in maintaining lung function. When the levels of these hormones plunge, it induces a parallel decrease in lung function. This means that not only is breathing physically harder due to weakened muscles, but the lungs themselves may not be able to take in and expel air as effectively as before.

So, all in all, by diminishing the power of respiratory muscles and decreasing lung function, hypothyroidism creates a scenario ridden with breathlessness and fatigue. Therein lies the foundation of our unexpected link - Hypothyroidism, the underproduction of thyroid hormones, and the disturbing sensation of shortness of breath.

Levothyroxine is the standard medication

Typically, when it comes to treating hypothyroidism, levothyroxine steps up as the standard thyroid hormone replacement medication. It's a synthetic form of thyroxine (T4), the exact hormone your body may be lacking due to low thyroid function, and its role is crucial in thyroid hormone replacement therapy.

Whether we're talking about an underactive thyroid (hypothyroidism), an almost-underactive thyroid (subclinical hypothyroidism), or even thyroid cancer, levothyroxine is often at the center of the treatment plan. Its goal? To closely mimic your body's natural thyroid hormone levels and help restore balance in your system. In other words, it works by replacing thyroid hormone that's normally produced by your body.

And while levothyroxine is most commonly used to treat hypothyroidism, it's also often used to treat thyroid cancer. Following procedures to remove the thyroid, you would require replacement thyroid hormone, and levothyroxine plays this crucial role. Other conditions that can be treated with levothyroxine include enlarged thyroid gland (goiter) and thyroid nodules.

Remember, taking levothyroxine as your thyroid hormone replacement medication is not just about addressing symptoms; it's about treating the very essence of hypothyroidism - by supplementing or replacing the hormones that your own thyroid can't produce in sufficient quantities. Sounds like the perfect antidote, right? Well, let's dig deeper.

How can levothyroxine cause shortness of breath?

Levothyroxine's role is crucial and undeniable - it steps in to ensure the body has enough thyroid hormone at its disposal when the natural production levels falter. However, some patients notice a seemingly paradoxical symptom while under Levothyroxine treatment: shortness of breath. It seems counterintuitive because levothyroxine's primary duty is to manage similar symptoms, not cause them. So, how might this occur?

Poor T4 to T3 conversion

One plausible explanation is the potential scenario involving the conversion of T4 to triiodothyronine (T3). In a perfectly working system, once T4 is introduced into the body, it is converted into T3, the active form of thyroid hormone. Unfortunately, not all bodies handle this conversion efficiently. Some individuals may struggle with this conversion, and despite supplementing with levothyroxine, their T3 levels remain low. Since T3 is necessary for various crucial functions, its deficiency can lead to hypothyroid symptoms persisting, contributing to possible breathlessness.

Incorrect dose of levothyroxine

A less common but important scenario to consider would be the overcorrection of thyroid hormone levels. Levothyroxine dosage often needs fine-tuning to adapt to each person's unique biological needs. An excessively high dosage can inadvertently tip the balance, causing surplus thyroid hormone levels, a state akin to hyperthyroidism. In this state, the body's metabolism accelerates, manifesting in symptoms such as palpitations, anxiety, and, indeed, shortness of breath.

Does it mean you have hyperthyroidism?

Before panic mode sets in, remember this - experiencing some breathlessness doesn't automatically mean hyperthyroidism or that levothyroxine is harmful. Our bodies each react uniquely to medications, and several factors, including dosage, absorption rate, and even individual body chemistry, can influence how one responds to levothyroxine.

Other potential reasons

Changes in cardiovascular function are also worth noting. Both hypo and hyperthyroidism conditions can subtly tweak how the heart works, influencing heart rate and rhythm. With Levothyroxine treatment, these changes can potentially cause the sensation of breathlessness in some patients.

Whilst an unsuspected condition or drug interaction cannot be ruled out, the Levothyroxine dose itself or the body's handling of the supplemented hormone (T4 to T3 conversion) are crucial factors to consider.

Is there any way you can manage shortness of breath?

If you notice shortness of breath upon starting or during the continuance of your Levothyroxine treatment, it's essential not to ignore it. Shortness of breath, while a potential side effect, is also a signal that your body may not be reacting to the medication as expected. Plus, it can be dangerous. So, what can you do?

1. Seek medical attention as soon as possible

Feeling short of breath from time to time, especially if living with a thyroid condition, can be a common occurrence. However, it's essential to remember that in certain situations, this symptom can potentially represent a more serious underlying issue, such as a heart attack—an alarming side effect sometimes associated with Levothyroxine use.

Levothyroxine treatment, although highly effective and safe for most individuals, can, in a handful of cases, potentially impact heart health negatively. An excessively high dose or certain pre-existing heart conditions may lead to an increased risk of heart problems, specifically a heart attack.

Symptoms of a heart attack can sometimes present in unexpected ways, including an unexplained sensation of shortness of breath. This can be accompanied by other signs like chest pain that may radiate to the arms, neck, or back, excessive fatigue, dizzy spells, sweating, and a feeling of impending doom.

Therefore, it is exceedingly important that if you begin to experience shortness of breath, especially if it develops suddenly, seems to be getting worse, or is accompanied by other unexplained symptoms, you must seek immediate medical attention.

Don't underestimate this symptom or wait for it to pass. Time is of the essence in such situations, and prompt medical intervention can significantly affect the potential outcomes of a heart attack. Your health and safety are paramount, and healthcare professionals are equipped to evaluate your situation properly, establish the reason for your breathlessness, and administer the necessary treatment.

2. Consider dosage adjustment

Experiencing shortness of breath while on levothyroxine may be indicative of an issue with your thyroid levels - it could be a sign of either overactive (hyperthyroidism) or underactive (hypothyroidism) thyroid. Both situations might necessitate a dosage adjustment to get your thyroid hormones to the right levels.

When the issue is hyperthyroidism - that is, there is an excess of thyroid hormone caused by taking a higher dose of levothyroxine than your body requires, a reduction in the dosage can be the key. This typically involves lowering the amount of levothyroxine you're taking until your levels of thyroid-stimulating hormone (TSH), produced by the pituitary gland, are in the desired range. This is generally determined by your doctor based on regular blood tests and how you're feeling in terms of symptoms.

In contrast, if breathlessness is due to an underactive thyroid, an increase in dose may be the solution. Keep in mind an adjustment in Levothyroxine dosage would mean changing the amount of synthetic T4 hormone in your system, which amplifies the available pool for conversion into T3.

It's important to note that the thyroid hormone isn't simply about how much you use but also about how well your body utilizes it. This means keeping a careful eye on this T4 to T3 conversion, which is integral to maintaining appropriate hormone amounts in the body.

Once again, reaching the correct dosage isn't about guesswork - it involves close collaboration between you and your healthcare provider and typically includes regular blood tests to monitor your levels of TSH and the thyroid hormones T4 and T3.

So, if breathlessness becomes a concern or you experience other symptoms that you can't explain, talk to your healthcare provider. They can examine whether a dosage adjustment might be necessary and can guide you through the process. At all times, the goal should be hormonal balance, not an excess or deficiency, and your well-being should always take center stage.

3. Evaluate T4 to T3 Conversion

In treating Hypothyroidism with Levothyroxine, a crucial process takes place. The body takes the input of T4 from the medication and converts it to T3, which is the more active form of thyroid hormone your body needs to run effectively. However, sometimes, this operation doesn't go according to plan. A subset of individuals may struggle with converting T4 to T3 efficiently, leaving them high and dry in terms of T3 - the hormone they truly need.

If you find yourself among these individuals wrestling with inefficient conversion, you might want to explore an alternative thyroid hormone replacement therapy. One such approach is the combination therapy of T4 and T3. By providing your body with both T4 and T3 via medication, you essentially sidestep the issue of conversion entirely.

However, it's worth putting a spotlight on an often overlooked yet proven medication - natural desiccated thyroid (NDT). Derived from the dried thyroid gland of pigs, NDT is a natural blend of T4, T3, and other thyroid hormones. This full-spectrum thyroid medication is a saving grace for many who have problems converting levothyroxine into usable T3.

NDT has been used for decades to treat hypothyroidism and has seen a resurgence in popularity, with many patients and holistic healthcare providers seeing beneficial results. This therapy offers a couple of key advantages. Firstly, it directly provides T3, bypassing any potential conversion roadblocks. Secondly, since NDT reflects the diversity and balance of hormones naturally produced by the thyroid gland, it could potentially create a more harmonious bodily environment that mimics natural thyroid function.

If switching to NDT is something you're considering, a great brand to kickstart your transition is VitaliThy, which is available to buy online without prescription. This NDT supplement draws upon naturally sourced compounds to provide comprehensive thyroid support. Plus, it's free from lactose, gluten, shellfish, fish, and eggs, as well as artificial colors and flavors.

4. Monitor your symptoms

Keep track of your symptoms and share this information with your doctor during check-ups. This will provide them with insights into how your body is responding to the treatment.

5. Physical activity and breathing techniques

Regular low-impact exercise can help strengthen your lungs and improve your overall physical health. Certain breathing techniques can also help manage shortness of breath. Remember to consult with your healthcare provider before embarking on a new exercise regimen.

Remember, shortness of breath isn't something you should have to live with. If levothyroxine is causing this shortness of breath, there are plenty of options and therapeutic approaches to ensure you're comfortable and more in control of your health. In all aspects of your hypothyroidism treatment, your comfort, wellbeing, and symptom relief should be the top priority.

Bottom line: Ensure your treatment plan is as unique as you are

Dealing with hypothyroidism requires a delicate balancing act, and while levothyroxine fronts many successful treatment plans, it isn't the lone ranger in this journey. If its side relationship with shortness of breath raises a red flag for you, there's another experienced player waiting in the wings: Natural Desiccated Thyroid (NDT).

Reassuringly, NDT has been used for decades in treating hypothyroidism and is making quite a comeback for its comprehensive approach. It mirrors the natural hormones produced by your thyroid, potentially creating a more harmonious internal environment. Plus, for those finding T4 to T3 conversion challenging, NDT directly provides both, bypassing any conversion hurdles.

A transition towards the natural pathway can jumpstart with a top-class supplement like VitaliThy, a natural desiccated thyroid you can buy online. Made with naturally sourced compounds, this NDT supplement provides inclusive thyroid support and mindfully excludes common allergens and artificial additives.

However, amidst the myriad treatments and supplements, remember the focus remains unchanging - your comfort and wellbeing. If levothyroxine induces breathlessness or other discomfort, consult your healthcare provider for guidance. They can help you adjust your dosage, explore the NDT route, or address any ancillary issues that may arise.

Every person's journey with hypothyroidism is unique. You shouldn't have to live with shortness of breath or any other unsettling symptoms. Persistent exploration and your healthcare provider's insights will guide your treatment till you hit the right formula. It's not just about managing symptoms but feeling excellent every step of your hypothyroidism journey.

Wojciech Majda
Wojciech Majda

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