Can’t Breathe? Thyroid Dose may be Too High (Hyperthyroid) or Too Low (Hypothyroid)

Air hunger, shortness of breath, breathlessness, or a feeling that you just can’t breathe is medically known as dyspnea. If you don’t have asthma, pneumonia, or chronic obstructive pulmonary disease (emphysema or chronic bronchitis) and recently changed your thyroid dose, you could be over or undermedicated, which is affecting your breathing.

Thyroid hormone impacts metabolism, and this affects the lungs. Respiratory rate, or the number of breaths taken per minute, is one indicator of thyroid levels. Someone who is truly hypothyroid may breathe so infrequently that they complain of “air hunger.” Here’s a case study [A Case of Myxedema Coma with Severe Hypoventilation] where severe hypothyroidism (myxedema coma) was causing insufficient breathing (hypoventilation). Hypothyroidism causes neuromuscular dysfunction in breathing, which leads to respiratory insufficiency.

Hyperthyroidism will cause similar feelings of breathlessness during exertion, for a different reason. The high levels of T3 and/or T4 are causing stress on the heart, which is unable to keep up with the increased demands during exertion. Palpitations, exercise intolerance, and dyspnea (breathlessness) on exertion are signs of thyrotoxicosis (severe hyperthyroid state). [Thyrotoxicosis and the cardiovascular system: subtle but serious effects.] Tachycardia (rapid heart rate), systolic hypertension (top number in blood pressure is high), and atrial fibrillation (abnormal heart rhythm) are other signs that the dose is too high. Long term, this can lead to heart failure, which is why treatment of hyperthyroid Graves’ patients is so aggressive.

If you feel like you can’t breathe, look at other signs and symptoms, like your BP, heart rate, and respiration rate to determine whether your dose is too high or too low. If the breathlessness shows up only during exertion, chances are you’re overmedicated, not undermedicated. This may not be reflected in your body temperature, so don’t always assume you need more thyroid hormone based on that one variable. There may be other factors keeping your body temperature low, but in the meantime, your heart may suffer if you take too much thyroid hormone. Each organ takes up different amounts of thyroid hormone, depending on supply and/or need. The heart is one of the most sensitive organs to thyroid hormone excess or deficiency, and the heart rate usually reflects that. Ironically, heart rate can be high when severely hypothyroid too, so factor in other signs like bowel movements, etc.

11 thoughts on “Can’t Breathe? Thyroid Dose may be Too High (Hyperthyroid) or Too Low (Hypothyroid)

  1. I suffer from over active thyroid now for 2 years. I’m on Neomercazol medication and it doesn’t seem to help me. I’m suffering to breath and get tired very quickly. I started of with 12 tablets a day. Now I’m om 4. I just stopped it because my skin feels dead and my nervous system is affected. And now my eyes are also affected. Please help me. I’m desprate. I’m 59 years old

  2. I will get tested soon. My symptoms have been severe. I break out into sweats (night sweats are worse & are worse if I am active throughout the day). I have occasional difficulty breathing (my ph obviously does not register the proper terms when I try to enter them), exhaustion & feeling drained and shaken after weakening up. The shakes feel like low blood sugar. I have been very emotional; sad or irritable. My skin and hair has been severely dry and scaly. The skin around my eyes are always red. I have very little appetite, however, not gaining, nor losing weight. I believe the last symptoms are itchy skin and frequent cluster headaches. I sip on Powerades throughout the night as the sweats weaken me 2-6 times during the night. The drinks help some.

  3. I was suffering from air hunger for a while, and found a small article on the web about low iron. I started taking a mineral supplement with iron, and the trouble cleared up within a week. I take up to four pills a day on occasion (usually 2 pills at 9mg iron total) and that would be 18 mg total for the day. It’s really helped, and I haven’t had a reoccurrence in a few years.

  4. I was having this strange sensation not being able to get deep enough breath, but I could focus and get abdominal breath. However, I couldn’t feel satisfied. This would be on and off. I could work out alright, but would notice during workouts too. I was fine sleeping. It started when I started armor. Ten days after switching to NP Acella I have no problems.

  5. thank you for this article. Without information like this I would feel so unsupported and alone. I was taking 100mcg/125mcg levo for about 3 months when I started having overactive symptoms and the one that really bothered me was the air hunger. I went home sick from work one day when it got real bad, straight to the dr convinced it would show in my blood tests, but I was told it was anxiety and offered valium, prescribed propanalol, since my TSH was 0.38 (0.2-4.5) and ft4 15 (9-22). Thankfully I didn’t believe my once trusted GP and I lowered it myself. My symptoms disappeared. I really have lost trust in the medics who treat thyroid conditions. They don’t know what they’re doing!!

  6. I just don’t get why doctors never seem to hear when you explain that you don’t feel well. They just seem to have a go to answer of “but your levels are within normal the normal limits” So why won’t they look into things for you!! I don’t go to the doctors lightly. In fact a hate going. Surely that must mean something to them… but no, they don’t hear what your saying after they see the test results :(

  7. Hi—do you think you could help me figure this out?

    I have been having horrible, constant air hunger EVERY DAY, ALL DAY. I am taking NatureThroid. When my thyroid used to be low I had air hunger occasionally and it would come and go. For about a year i’ve been taking 65mg of thyroid and many of my symptoms have improved (cold intolerance, fatigue, depression, constipation, hair loss, etc.). About four months ago I experienced sudden, unexpected anxiety attacks for about a week straight and it was at that time I started getting air hunger. I thought it was just from the anxiety, but it hasn’t gone away. I read this article and thought maybe my thyroid is too high so I tried lowering it to 45mg. Within a week I felt SO fatigued. I raised it again to 65mg and the fatigue went away. I have a feeling my air hunger has to do with my thyroid but clearly lowering it is not a good idea. Therefore, does that maybe mean that I might need to raise it? I should also note that i’ve been loosing excessive amounts of hair recently as well. I am just really confused. My labwork shows my FT3 is on the high end, so i’m hesitant to try raising it.

    Maybe this doesn’t have to do with thyroid after all….is there any way of knowing?

    • what’s your t4 like? perhaps it’s too low and you need to add t4 in? I struggled on NDT only after a year or so. apparently good t4 levels are necessary for hair growth. Also low iron can cause all these symptoms, even if “in range”

      • Also maybe you’re on too much t3 hence the anxiety. I am feeling better on a combination- 100mcg levo and an 8th of a tablet of ndt actually! its a struggle. Also your levels might have fluctuated if you have hashis

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