### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
For bout 6 months I have felt like crap. It started with just feeling exhausted all the time. Im a usually active person and other than smoking ... Which is bad... Pretty healthy. Now the fatigue is so bad I just cnt get enough sleep n I get shortness of breath whrnever I exert.myself. I doubt asthma becuz I had it as a child n this is not asthma... I have no cough I dnt weeze I just feel like I ran A MILE. I have a pinching pain in my chest tht radiates out to my armpitz n my stomach is constantly queezy. Ive lost 60 pounds since june n im not even on a diet. I went to my doc n my blood work is flagged for mpv of 6.9 im 6ft 2 in n weigh 205 i also have itchy palms with no visible dry skin n red dotts tht look weird on my feet i just want an opinion cuz i trust my doc but dnt feel like she has a clue another prof. Opinion would help in easing my mind n my thyroid is 1.055 which is the lowest its ever been

### output:

Hello, Welcome to Chat Doctor. To clarify, MPV 6.9 is not significant but the other values such as He, MTV, MCH, TC DC, platelet count are more important, but I presume they were normal. I do not understand what the thyroid 1.055 is ; if this is TSH value then it is pretty low and am surprised that you are not on treatment for this. Please get a repeat TSH fT4 value and if the TSH is low or undetectable with raised fT4 then the diagnosis is thyrotoxicosis and that is why you are getting the chest pains, stomach cramps, skin problems. An ECG with a thyroid scan is also important. Carbimazole with propranolol (beta blockers) to reduce the pulse rate and close monitoring of bloods is the management. I hope this helps. Get these done as soon as possible. Best Wishes.