Pulsating Tinnitus in right ear

[ETaylor1015]

I had a total thyroidectomy for thyroid cancer two months ago. About two weeks after surgery I started hearing my heartbeat in my right ear, I mainly only can hear it at night in bed or when it is very quiet. I strongly believe this is due to increased blood flow from being hyperthyroid (tsh .04). I have brought this up to my endo, surgeon and even went to an ent and none of them have every heard of this side effect from being hyperthyroid. The ent wanted me to do an mri, to rule out serious problems which at this point I really don't want any more tests or radiation exposure unless completely necessary. I just think due to the timing of this it has to be thyroid related. Have you ever heard of this before in a hyperthyroid patient? Any thoughts on what can explain it only being in one ear?

[Mark Lupo, M.D.]

It may be hyperdynamic b/c of hyperthyroidism - you may not need TSH of <0.1 - it depends on cancer status.  Make sure blood pressure is normal as well.  MRI is reasonable if it does not resolve.

[ETaylor1015]

Thanks for your response! My blood pressure is actually low (98/65)
You bring up a great point that I have asked my doctor. I also think that .04 is a bit low. My endo seems to think the lower the better. My cancer history is as follows... I am 32 and found my cancerous nodule incidentally. after removing my thyroid the pathology came back with a .8mm papillary tumor tall cell variant with two positive nodes, clear margins and and no extrathyroidial extension. BRAF positive. I had 109 mci of RAI and a scan a week later that only showed uptake of remnant tissue in the neck. I know this is not the ideal type of papillary thyroid cancer, but was found very early. Based on this would you allow a patient to maintain a tsh of .1?