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Thyroid and Tinnitus

I am curious if anyone has any insights/experience with tinnitus and their thyroid levels.  Over the course of about 18 months my Synthroid dose was adjusted down from 112 to 88 mcg.  I was clinically hyper and dealing with lightheadness.  My TSH levels now lean more towards the upper range 2.8 (with upper lab ref range of 4.2).
Recently I noticed a hissing/air rushing sound in my ear.  Of course we all know that the thyroid can cause just about any symptoms known to mankind. Therefore I am curious about any members that may have experienced anything similar.  Thank you.
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Avatar universal
So it seems you have only been tested for TSH, which is totally inadequate.  I suspect that you have been under medicated for all those years.  

Don't just ask for both Free T4 and Free T3,  you should insist on getting both, and don't take no for an answer.  TSH is useless as a diagnostic by which to adjust your med dosage.   Your med needs to be increased as needed to relieve hypothyroid symptoms, not just to get TSH within some level the doctor prefers.   TSH has only a weak correlation with the actual thyroid hormones, and a negligible correlation with hypo symptoms so why should it be used to adjust med dosage?    It should not.

I also suggest that you ask to be tested for Vitamin D, B12 and ferritin, just to assure those are okay.  Those are important for a hypothyroid patient.  

If your doctor gives you any difficulty, give a copy of my paper and tell him that you want to be treated clinically, as detailed in the paper.  If he is totally resistant, then you are going to need to find a good thyroid doctor that will do so.  

When you have test results, please post them, along with reference ranges shown on the lab report and we will be able to give you further info.  
Helpful - 1
2 Comments
Will do!
Hi Gimel - Jusr got the results in:

TSH = 0.64 (0.4 - 4.50)
FT4 = 1.7 (0.8 - 1.8)
FT3 = 97 (76 - 181)

Would appreciate any thoughts you can share, thanks.
Avatar universal
Wow, that is a long list of supplements.  Since you started by saying you were hypothyroid, I immediately  wondered if you are being adequately treated for that.  For most hypothyroid patients the answer is no because their thyroid medication is adjusted only to get TSH within range.  That doesn't work for most.  

What are your test results for the thyroid hormones Free T4 and Free T3, along with their ranges shown on the lab report?
Helpful - 0
Avatar universal
I've hypothyroidism and thoracic dry skin issues so it takes 10,000 IU viramin D3 from a sunlamp or enriched fish, milk to stop bone pain and to stabilize viramin A and Beta Carotene (yellow fruit and veggies, green leafy veggies, sweet potatoes), for the mucus membranes fluid balance, Niacinmide from grits or corn products to prevent it's protein breakdown and add lots of Viramin C asorboc acid 5,000 to 10,009 IU daily to metabolize Iron, greens, etc to sleep and B12 like nutrional yeast to balance the viramin C, apply Olive Oil for Omega 3's to stop dryness both topically and internally and either ingest thiamin from rice, enriched, to keep from getting an enlarged heart or use supplement like a B complex for most of the above...I used to smoke tobacco and that affects the ear, so I buy a combo of Coral Calcium, Magnesium and Zinc to prevent Osteoporosis with MSM so that I can do light aerobics and I'm staying fairly free from pain.
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Avatar universal
Thanks for the feedback.  Please let us know how it goes for you.  
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Avatar universal
No, I have not sen a case where a body is requiring less thyroid medication, and in your case your dosage is already  lower than normally required.  You said, "From 1998 -  2020 I was taking 112 mcg Synthroid.  My dose was adjusted down to 88 because I was in a hyper state."    Do you mean you were having hyper symptoms, or was it just that your TSH was low?

I cannot relate your recent weight loss to thyroid, so  with your high ferritin I think it is important that you get the full iron test panel done and carefully assessed to identify the cause.    Usually that would include  serum iron, TIBC, % saturation, and  ferritin.  Can you get those done?
Helpful - 0
1 Comments
Hi Gimel - Saw the hematologist yesterday and high likelihood that I have hemochromatosis.  By chance, I was taking my elderly mom to see her hematologist this week and she had elevated Ferritin as well.  All the other tests you mentioned in the post were normal but iron is creeping up.  

I want to thank this board because I only heard about ferritin in the numerous comments you and barb provided to the members.  Dr's here  do not test for ferritin unless you have developed serious symptoms.  All my iron has been normal but the ferritin has been building throughout the years.  Thanks for raising the awareness!
Avatar universal
Gimel - Since I last reported my test results to you on Feb 3, my resting heart rate has crept up from 77 to 81 for the last 2 weeks.  I would stop taking synthroid for 3 days and it would gradually come down.  In order to avoid getting into a hypo state, I would then take a half dose (normal dose 88 mcg) but my heart rate shoots back up within 24 hours.  This back and forth has been very frustrating.  

From 1998 -  2020 I was taking 112 mcg synthroid.  My dose was adjusted down to 88 because I was in a hyper state Aug 2020.  Now it seems like the 88 mcg is too high.  I have lost 6 lbs in the past month (5'6").  It was 170lbs for quite a long time  and now I am down to 164.  My workouts have diminished so it could be losing muscle mass at my age (56).  Have you seen such a case where the body is drastically requiring less thyroid medication?  









Helpful - 0
Avatar universal
The T3 will affect TSH, but that doesn't matter.  TSH frequently becomes suppressed when taking adequate thyroid medication.   That does not mean hyperthyroidism.  All that is covered in the paper I linked above.  

There will no significant effect on the Free T4 level.   Again, be sure to not take thyroid med until after the blood draw for thyroid tests.   If you ever forget that, just delay the blood tests.  That strategy avoids  getting false high results, which might result in poor decisions about your dosages.  

Please keep in touch and let us know how it goes.

Helpful - 0
1 Comments
Will do, thanks!
Avatar universal
From  your tinnitus and low Total T3 it seems to me tht you need to add a source of thyroid med to your daily routine.  Enough to get your Free T3 to at least mid-range and adjust from there as needed.   Will your doctor consider adding T3?   Also, any time you  go for thyroid tests, delay your morning dose until after the blood draw to avoid false high results.  

Also, you ferritin is abnormally high.  I suggest that you need to get a full iron test panel done, including serum iron, TIBC, transferrin and % saturation.    Those tests will help identify possible cause for high ferritin.   Can you get those done?
Helpful - 0
1 Comments
Yes, my endocrinologist suggested it on my last visit...cytomel.  I will discuss with her again.  Will cytomel affect the tsh and T4 numbers? I know it is a T3 so not sure if it will alter those numbers so I know what to expect.  

I just sent a note to my primary dr about the iron panel test.  Thanks again for your counsel!
Avatar universal
First thing I should ask is if you took your thyroid med in the morning before the blood draw for those tests..
If so then that may account for your Free T4 level.  If not, your Free T4 is  higher than needed, likely due to inadequate conversion of T4 to T3.    Inadequate conversion is evident from the T3 result, which is only at 20% of its range.  Actually that is not a free T3 test.  It is total T3, which is not nearly as revealing as a Free T3.  The difference is that most T3 is bound to protein, which makes it biologically inactive.  Only the unbound portion, called "free" is biologically active.   Did you ask for Free T3, or just ask for Free T4 and T3, which might have been misinterpreted as Total T3.  

If we assume that your Free T3 is as low in range as your Total T3, then that is why you are having hypothyroid symptoms.  

Since adequate ferritin levels are important for good conversion of T4, that is why I suggested you test for that.  Also, Vitamin D is important for its effect on the response to Thyroid at the cellular level.  B12 is important as well.   Were you unable to get those done?

After you answer the above questions, we can talk about what should be done next.  
Helpful - 0
1 Comments
Hi Gimel - I took synthroid at 6am and the blood test was at 1 pm. You are spot on, it was Total T3  and not free.   Here are the other results taken in August 2021:

Ferritin - 750 (38 - 380)...always this high!
Vitamin D - 61 (30 - 100)....I take 10,000 IU's daily.  My range is about 50 - 60, not any higher.

Thanks again for your insights.  

The onset of tinnitus has impacted me mentally and physically so my metabolic activity is all messed up.  I was hoping that there could be a connection to thyroid but not so sure now.  



Avatar universal
In addition to your Synthroid dose being lower than needed by most people, the lack of thyroid gland function makes it even more likely that the T4 med is not being converted to T3 as needed.    Many people find that they need a source of T3 in their med, as well as T4, in order to feel normal.  

Please  respond to my question about Free T4 and Free T3 test results,  and also any other  symptom you have.  
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1 Comments
Hi Gimel - My last test result was over 9 months ago.  I had been on the 88 mcg for about 6 weeks when the test was taken.   It was listed as "tsh w/reflex to T4"...2.8 (lab upper range 4.2).
Symptoms: forgetfulness, sensitivity to cold, lower energy than usual and hoarse voice.  I suspect that I am hypo as well thus looking forward to the upcoming test in 30 days.  I will be sure to ask for the Free T4 and T3.  Thanks again.  
Avatar universal
If you are only taking 88 mcg of Synthroid, I would bet my last dollar you are hypothyroid.  The reason is that as you take thyroid med, the TSH goes down, and this results in les output of thyroid from the gland.  The net result is little change in serum thyroid levels for Free T3 and Free T4, resulting in hypothyroid symptoms, including the possibility of tinnitus.

If you are only being tested and treated based on TSH, that does not work for most people.   You need to be tested for Free T3 and free T4 every time you go for tests.  Also good to test for Vitamin D, B12 and ferritin, since they affect how you feel.  To better understand all this, I recommend reading my paper in this link.

https://thyroiduk.org/further-reading/managing-the-total-thyroid-process/

What other symptoms do you have?  If tested for Free T3 and Free T4 please post results along with reference ranges shown on the lab report.
Helpful - 0
2 Comments
Gimel - Thank you for the article it is very informative.  The    
Continued - Does the total thyroid process matter if your thyroid was ablated?  I have barely any thyroid left from the radiation.  So I have been on Synthroid for over 25 yrs.  
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