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Julia Kizhner
Julia Kizhner, Physician Assistant
Category: Health
Satisfied Customers: 1126
Experience:  7 years experience working in Primary Care as well as Gastroenterology, Sleep Medicine & Weight Loss
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My Metabolic Panel blood results showed CO2 at 32 mmol (High)

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My Metabolic Panel blood results showed CO2 at 32 mmol (High) and sodium 135 mmol (low), Anion gap 4 (low), TSH 5.9 (high), thyroxine free at .8 (borderline low). Can hypothryoidism explain the non thyroid results? I am having difficulty breathing lately

Hello and thank you for your question.

Your sodium is border line low. Sometimes low sodium can be due by the fact that someone drinks too much fluids, or if someone takes water pills. Your levels are border-line low and are not very significant.

Slightly higher levels of CO2 and low levels of anion gap I see on almost every since metabolic panel I get back. Unless you have problems with lung disease or having some kind of shortness of breath, CO2 is not a significant finding and does not indicate any specific disease.

Your thyroid is elevated and does indicate hypothyroidism. It is not a reason for your other levels to be somewhat abnormal. If not yet started, you should be on Synthroid. If you are already taking it, your dose needs to be adjusted. Make sure Synthroid is taken the first thing in the morning on the empty stomach.


I hope you find this information helpful. If you need any clarification or have any additional questions, please let me know and I will be glad to assist you further.

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Best wishes,


Julia Kizhner and 5 other Health Specialists are ready to help you

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Customer: replied 6 years ago.
I am having difficulty breathing...that is stated in original email. feels like my ribs won't move or muscles or sore but am a triathlete (Ironman) and marathon runner so I know this is unusual. Would it be related somehow to the TSH? off C02 or/and sodium a cause or effect? thanks for original info...don't believe I have lung disease!

Thank you for your reply.

I am sorry I did not get back to you sooner. I already logged off the computer when you replied.

I did not notice your last sentence about breathing difficulty, I apologize.


Your CO2 has really nothing to do with your symptoms. Your number is XXXXX slightly above where normal should be and is should not be of any concern.

Sodium is also just slightly low and will not contribute to your symptoms. Symptoms of low sodium levels is severe fatigue, nausea and vomiting.

Hypothyroidism (high TSH value) can cause many many different symptoms - anywhere from weight gain, to fatigue, to constipation. Thyroid is a very important organ in our bodies. It controls temperature, metabolism, energy levels and many other things. However, it should not cause you the symptoms of what you have described.


There are a couple of possibilities which can cause the soreness you are describing. The most likely cause is a condition called Costocondritis. It causes inflammation in the cartilage between your ribs. That in turn causes soreness when you take a deep breath.

I would suggest you have a chest x-ray done to rule out other possibilities.


So just to summarize, neither your abnormal levels on the metabolic panel or your abnormal thyroid panel are the cause of your symptoms. You need to have a full physical exam with a chest x-ray to make sure nothing serious going on. Most likely your symptoms are due to inflammation in your cartilage.


I hope this gives you more information. Please let me know if you have any other questions.

If you are satisfied with the answer, please click the green "Accept" button so that I can get credit for my work.

Best wishes,


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