Wheezing is a high-pitched whistling sound that occurs during breathing, usually during exhalation. It’s caused by narrowed or constricted airways that limit the flow of air in and out of the lungs. Wheezing is a common symptom of asthma and other respiratory conditions, but thyroid issues can sometimes also contribute to wheezing and other breathing problems.
Overview of thyroid and its impact on breathing
The thyroid is a small gland located at the base of the front of the neck. It produces thyroid hormones that help regulate many essential body functions, including metabolism, heart rate, body temperature, and breathing. Thyroid hormones also play a role in lung and airway function.
When the thyroid is not functioning properly, it can produce too much thyroid hormone (hyperthyroidism) or too little (hypothyroidism). Both hyper and hypothyroidism can potentially lead to breathing difficulties.
Hyperthyroidism
With excessive thyroid hormone production in hyperthyroidism, the body’s metabolism speeds up. This can place extra demands on the respiratory system. Some ways hyperthyroidism may impact breathing include:
- Faster breathing rate
- Shortness of breath (dyspnea)
- Difficulty getting air into the lungs
- Wheezing or whistling sound when exhaling
The mechanisms by which hyperthyroidism contributes to wheezing may include:
- Increased metabolic demands lead to faster breathing and oxygen consumption.
- Thyroid hormones act directly on lung tissue, causing muscle contractions in the airways.
- The lungs become more sensitive to other triggers of wheezing like allergens or irritants.
Hypothyroidism
On the other hand, insufficient thyroid hormone production in hypothyroidism slows down metabolism. This can also negatively impact breathing. Potential effects include:
- Impaired drive to breathe
- Weakened breathing muscles
- Increased risk of respiratory infections
- Fluid accumulation in lungs (pulmonary edema)
- Wheezing or labored breathing
Mechanisms by which hypothyroidism may contribute to wheezing and labored breathing include:
- Respiratory muscles don’t receive adequate stimulation to contract fully.
- Soft tissues around airways become swollen.
- Impaired mucus clearance leads to narrowed airways.
- Weakened immune defenses increase risk of respiratory infections.
Common causes of thyroid conditions
Disorders of the thyroid gland are very common, especially in women and older adults. Some contributing factors include:
- Hashimoto’s thyroiditis – autoimmune disorder causing progressive thyroid failure
- Graves’ disease – autoimmune disorder leading to hyperthyroidism
- Thyroid nodules – lumps in the thyroid that may produce excess hormones
- Thyroid cancer – uncommon, but can cause hormone imbalances
- Pregnancy – increased thyroid hormone demand can unmask mild deficiencies
- Iodine deficiency – leads to hypothyroidism
- Medications – such as lithium, amiodarone, interferon-alpha can impact thyroid function
- Radiation therapy – for cancers of head, neck or chest
- Congenital hypothyroidism – infants born with thyroid deficiency
Many of these conditions cause chronic problems with low or high thyroid hormone levels, which in turn can contribute to long-term breathing difficulties.
Key symptoms of thyroid-related breathing problems
Some signs and symptoms that suggest wheezing and other respiratory complaints could be related to an underlying thyroid problem include:
- Unexplained shortness of breath or labored breathing at rest
- Wheezing that seems unrelated to asthma or allergies
- A dry cough that persists and is not due to infection
- Feeling like you can’t take a deep breath
- Shortness of breath with minor physical exertion
- Choking spells or gasping for air at night
These types of breathing difficulties are particularly suspicious for a thyroid connection if accompanied by other thyroid-related symptoms like:
- Unexplained weight changes
- Fatigue, muscle weakness
- Hair loss
- Sensitivity to temperature changes
- Palpitations, fast heart rate
- Changes in mood or cognition
Diagnosing the cause of wheezing and breathing problems
To determine if thyroid dysfunction could be contributing to wheezing and shortness of breath, the following diagnostic steps should be taken:
Medical history
The doctor will ask about symptoms, including how long wheezing and breathing problems have been present. Details about other ongoing conditions, family history of thyroid disease, and medication use can also provide clues.
Physical exam
Exam of the neck checks for enlargement or nodules of the thyroid gland. Listening to the chest with a stethoscope can detect abnormal breath sounds.
Thyroid blood tests
Blood tests measure levels of thyroid hormones T3 and T4, as well as TSH (thyroid-stimulating hormone). These reveal if thyroid levels are abnormal.
Pulmonary function tests
Breathing tests check airflow, lung volumes, and gas exchange. This helps pinpoint the location and severity of any obstructions in the lungs.
Imaging studies
A chest X-ray or CT scan of the chest provides visual assessment of lung structure. These can detect narrowing of airways or other lung abnormalities.
Laryngoscopy
Viewing the vocal cords and upper airway with a camera inserted through the nose can identify issues like vocal cord paralysis or tracheal obstructions contributing to wheezing.
Treatments for thyroid-related wheezing
Treatment focuses on normalizing thyroid hormone levels, which often helps relieve respiratory symptoms. Possible approaches include:
Thyroid hormone replacement
Daily levothyroxine tablets restore adequate thyroid hormone levels for people with hypothyroidism. Breathing difficulties usually improve once the hormone deficit is corrected.
Anti-thyroid medications
Medications like methimazole and propylthiouracil block excess thyroid hormone production in hyperthyroidism. This helps resolve hyperthyroidism-induced respiratory symptoms.
Radioactive iodine
Oral radioactive iodine is absorbed by overactive thyroid tissue to destroy some of its hormone-producing cells. Often leads to eventual hypothyroidism requiring thyroid hormone replacement.
Surgery
Removal of part or all of the thyroid gland is an option for hyperthyroidism that cannot be controlled with medications or radioiodine treatment.
Beta-blockers
These medications do not affect thyroid levels but can alleviate symptoms like rapid heart rate. By controlling cardiovascular effects of excess thyroid hormone, wheezing may also improve.
Glucocorticoids
Oral steroids like prednisone help reduce airway inflammation. This can provide relief for severe wheezing and shortness of breath, especially while waiting for hyperthyroid treatments to take effect.
Bronchodilators
Inhaled medications like albuterol act quickly to open constricted airways and may provide temporary wheezing relief during thyroid treatment.
Lifestyle changes to improve breathing with thyroid disease
In addition to medical treatment, making certain lifestyle adjustments can also help minimize respiratory symptoms associated with thyroid conditions:
- Avoid respiratory irritants like smoke, strong fumes, or air pollution.
- Use a humidifier to moisturize dry air, especially at night.
- Drink plenty of fluids to keep mucus thin.
- Utilize relaxation techniques like yoga or meditation to ease breathing.
- Use supplemental oxygen if prescribed.
- Get regular moderate physical activity to improve respiratory muscle strength.
- Employ pursed-lip breathing and diaphragmatic breathing exercises.
- Avoid large meals late at night to reduce reflux, which can aggravate breathing symptoms.
- Sleep with head elevated on pillows to minimize reflux.
When to see a doctor
Consult a physician promptly if you experience new onset or worsening respiratory symptoms, including:
- Wheezing that persists throughout the day
- Severe shortness of breath
- Tightness or constriction in the chest
- Trouble catching your breath or gasping for air
- Dizziness or confusion due to lack of oxygen
- Need to sleep sitting upright due to difficulty breathing lying down
Seek emergency care for breathing difficulties accompanied by:
- Chest pain
- Rapid, irregular heart rate
- Coughing up blood
- Fever and other signs of respiratory infection
- Loss of consciousness
Even mild but persistent wheezing or shortness of breath should prompt evaluation by a healthcare provider. Prompt diagnosis and treatment of thyroid dysfunction may help resolve these symptoms and improve respiratory health.
Conclusion
Problems with either excessive or insufficient thyroid hormone levels can sometimes contribute to wheezing and breathing difficulties. The effects of hyperthyroidism and hypothyroidism on respiratory function stem from their impact on metabolism, respiratory muscle function, airway constriction, and lung inflammation. Treatment to normalize thyroid levels is the primary approach, which often relieves associated respiratory complaints. However, medications to open airways, control symptoms, and reduce inflammation may also be needed to improve wheezing, especially when first addressing thyroid dysfunction. With proper management of the thyroid disorder, wheezing caused by the thyroid imbalance can typically be resolved.
