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I've listed some preliminary information first, that I consider to be important, (especially to anyone unfamiliar with my thyroid history), but if you get bored, you can always cut to the chase, below.
Soon after my first abdominal surgery, (5 years and 9 months ago), I began to notice that somewhat surprisingly, (since I considered myself to be in generally good physical condition), I was often short of breath, gained weight very easily, (weight was never a problem, prior to that, except for the times that I got down to hide and bones, during severe diarrhea episodes), and the outer third of my eyebrows were disappearing.
I still wonder if the anesthesia or something else connected with the surgery had something to do with that, but anyway, since those are symptoms of hypothyroidism, I asked my doctor to check my TSH, free T3, and free T4. He forgot to check the free T3, but the TSH, (and one or two other things that he checked), were within the normal range. My free T4, however, was slightly below range.Naturally, he insisted that as long as the TSH level was at mid-range, (which it was, since the lab he uses was using the out-of-date, extended normal range), I was fine, and no thyroid supplement was needed. I pointed out the below-range T4 result, so he agreed to write a script for a minimum dose of synthroid, to allow me to see if it might help. My next test results showed the TSH down slightly, (but still mid-range), and the free T4 was barely in the normal range, (at the very bottom). To him, that looked great, since my results were all "in the normal range". At my request, though, he agreed to try doubling the dose, so we did. My labs looked slightly better, but my symptoms did not change significantly, so he agreed to write a prescription for an equivalent dose of Armour.
That seemed to help a little, but my eyebrows continued to slowly atrophy, my weight stabilized at a higher level than previously, and I wasn't quite as prone to being out of breath, as I had been, prior to the treatment, so we settled there, and I didn't ask to try a higher dose, since I didn't want to risk tachycardia, or any of the bad stuff that goes with overdosing on thyroid hormone supplement.
Well, the years rolled by, and my last thyroid test, (14 months ago), showed my T3-Uptake to be in the lower third of the normal range, my free T4 was barely above the low side of the normal range, and my total T4 was below normal. My TSH, though, was below mid-range, (at 1.105, for a "normal" range of 0.34 to 5.6), so that number looked great, so like an idiot, I didn't even bring up the low T4 numbers at the followup, since really, the results weren't much different than what they had typically been.
Since my second TIA, (at least, that's what they decided to call it), 15 months ago, I've been declared a high stroke risk, so I've been taking stroke risk-reducing drugs such as Plavix, (an expensive blood thinner), lisinopril, (an ACE inhibitor, to lower BP), and metoprolol tartrate, (a beta blocker, to lower heart rate). Prior to taking those drugs, my labs were all pretty much normal for my age, (including my heart rate). As soon as I started taking the drugs, of course, they lowered my BP, and my heart rate, so that now, my BP and my heart rate are below normal, for my age. This morning, for example, my BP was 111/64, and my heart rate was 57. The problem with this, is that 57 is in the bradycardia range, (too low), especially for someone my age - I ain't no spring chicken, any more,
and I'm not a professional athlete, so my resting heart rate should be significantly higher. Anything below 60 is considered bradycardia, and anything below 50 is known to carry a risk of cardiac arrest. Of course, my heart rate isn't always this low - most of the time it's above 60. Prior to about 6 or 7 weeks ago, it was always above 60. Lately, though, it's occasionally showing up below 60. And, if my eyebrows were a species, they would probably be getting close to qualifying for listing on the endangered species list.
Soooooooo, I'm beginning to suspect undertreatment of hypothyroidism. (Bradycardia is also a symptom of hypothyroidism).I guess the point that I'm trying to make is that all this time, I've suspected that I was being undertreated for hypothyroidism, but it didn't seem to be a big deal, since, (like MC), that's not usually a fatal condition. Now that I'm taking drugs to artificially suppress my BP and heart rate, though, and I'm seeing a few numbers that don't look good, I'm beginning to wonder how these enter into the equation. Obviously, the drugs complicate the situation, making it more difficult to draw firm conclusions about symptoms.
I have also noticed that my shortness of breath, (dyspnea), is becoming more of a problem. A few months ago, I started to take a magnesium supplement, and that seemed to alleviate the problem, for a while, but now the symptoms are on the increase, again, even though I'm still taking the magnesium. Since shortness of breath can be a symptom of congestive heart failure, I don't consider it something to just ignore.
I've made what I consider to be a breakthrough observation, though, (at least I think it's a breakthrough observation): even when I'm having the most noticeable dyspnea symptoms, (late at night, when I'm trying to fall asleep, and the dyspnea is keeping me awake), my oxygenation level is still typically in the 98% range, and my heart rate is typically in the bradycardia range, (around 56 to 57, usually). I'm not a medical professional, but that suggests to me that my heart is working fine, but something is causing it to beat too slowly, and that something is probably inadequate thyroid hormone, since it would be logical that thyroid hormone would be becoming depleted by then, (since I take the Armour first thing in the morning).
I take the lisinopril, (10 mg), and metoprolol tartrate, (25 mg), at bedtime, and I take a second tablet of the metoprolol tartrate after breakfast. I think that the metoprolol gets used up pretty quickly, so that's certainly part of the reason for my low heart rate during the night, but that shouldn't cause shortness of breath, and I have a hunch that the heart rate wouldn't be so low if plenty T3 were available.
I guess what I'm trying to say is that I have a hunch that undertreated hypothyroidism is causing symptoms that mimic congestive heart failure. Thinking back, when I originally mentioned the shortness of breath problem to my doctor, the first thing he did was to check my oxygenation level, and pronounce me fine, because it was 98%, so I suppose that's why he's never been concerned about it. Anyone have any thoughts on this?
Love,
Tex
I checked my multivitamin, though, and it supplies the RDA, (150 mcg), so I should be OK, there.
