From a very long list of symptoms that can be related to hypothyroidism, following are those specifically related to ears.
Noises in ears (hissing, ringing)
Internal itching of ears
Dizziness from fluid on the inner ear
Do you have any other symptoms? If so, please tell us about them. Also please post your thyroid related test results and their reference ranges shown on the lab report.
I have a constant ringing in my ears. I am reading more and more that this is indeed a symptom of low thyroid. I have had the tinnitus for 9 years now.
Below are my labs from 11/26/13
Ordered Items: CBC with Differential/Platelet; Comp. Metabolic Panel (14); Testosterone, Serum; TSH; FSH; Serum; Estradiol; Vitamin D, 25-Hydroxy; Thyroxine (T4); Vitamin B12; Thyroid Perioxidase (TPO) Ab; Triiodthyronine, Free, Serum.
CBC with Differential Platelet
WBC 6.1 x10E3/uL
RBC 4.41 x10E3/uL
Hemoglobin 13.2 g/dL
Hemocrit 39.2 %
MCV 89 fL
MCH 29.9 pg
MCHC 33.7 g/dL
RDW 12.5 %
Platelets 273 x10E3/uL
Neutrophils 50 %
Lymphs 38 %
Monocytes 9 %
Eos 2 %
Basos 1 %
Neutrophils (Absolute) 3.0 x10E3/uL
Lymphs (Absolute) 2.3 x10E3/uL
Monocytes (Absolute) 0.5 x10E3/uL
Eos (Absolute) 0.1 x10E3/uL
Basos (Absolute) 0.1 x10E3/uL
Immature Granulocytes 0 %
Immature Grans (Abs) 0.0 x10E3/uL
Comp. Metabolic Panel (14)
Glucose Serum 93 mg/dL
BUN 23 mg/dL
Creatine, Serum 1.01 mg/dL High
eGFR If non Africn Am 62 mL/min/1.73
eGFR If Africn Am 72 mL/min/1.73
BUN/Creatin Ratio 23
Sodium, Serum 145 mmo1/L High
Potassium, Serum 4.2 mmo1/L
Chloride, Serum 104 mmo1/L
Carbon Dioxide, Total 20 mmo1/L
Calcium, Serum 9.5 mg/dL
Protein, Total, Serum 7.0 g/dL
Albumin, Serum 4.5 g/dL
Globulin, Total 2.5 g/dL
A/G Ratio 1.8
Bilirubin, Total 0.5 mg/dL
Alkaline Phosphatase, S 68 IU/L
AST (SGOT) 24 IU/L
ALT (SGPT) 17 IU/L
Testosterone, Serum 21 ng/dL
TSH 2.100 uIU/mL
FSH 35.7 mIU/mL
Estradiol 136.5 pg/mL
Vitamin D, 25-Hydroxy 58.0 ng/mL
Thyroxine (T4) 7.6 ug/dL
Vitamin B12 808 pg/mL
Thyroid Perioxidase (TPO) Ab 223 IU/mL High
Triiodothyronine, Fee, Serum 2.2 pg/mL
We need to have the reference ranges for your labs. Ranges vary lab to lab and have to come from your own lab report. There isn't anything in the CBC or CMP that really jumps out at me as being abnormal, so instead of retyping the whole thing, why not just give us the ranges for your Testosterone, FSH, Estradiol, Thyroxine and Triiodothyronine Free.
Unfortunately, your doctor apparently did Total T4, rather than Free T4, so that will be of limited use. According to the ranges we normally see, your FT3 (Triiodothyronine, Free) is very low or even below range.
Are you currently on a thyroid replacement hormone? If so, which one, what dose and for how long have you been on it.
Your vitamin D is not bad, but many recommend that it be around 70. Low vitamin D can cause some hypo like symptoms.
Personally, I've had tinnitus for the majority of my life and can't attribute it to thyroid, but we've had some members who have had thyroid related tinnitus. When thyroid levels are optimized the tinnitus, typically, goes away.
Elevated TPOab would be a basis for a diagnosis of Hashimoto's. There's another antibody test you might want to ask for, as well, that would also confirm Hashimoto's. That's Thyroglobulin Antibodies (TGab). Some people have only one of the antibodies, while others have both.
It's not the antibodies, though, that cause the symptoms; it's the resulting hypothyroidism, after the antibodies have destroyed healthy thyroid tissue so it can no longer produce adequate thyroid hormones. Looking at your Free T3, which is the hormone actually used by the individual cells, you probably are hypo.
Do you have other symptoms of hypothyroidism, such as weight gain, constipation, hair loss, fatigue, muscle/joint aches/pains, puffiness in your fact, especially around the eyes, etc?
Thanks very much for your reply.
Ranges listed on the labs:
Testosterone, Serum 3 - 41
FSH, Serum (Postmenopausal) 25.8 - 134.8
Estradiol <6.0 - 54.7
Thyroxine (T4) 4.5 - 12.0
Triiodothyronine, Free, Serum 2.0 - 4.4
Yes, I am on BIH since 2006, but my doctor refused to change my compound when I told her that I was having nipple soreness so I could not take the daytime troche, because estrogen dominance is the reason for that - so as a result I am low on my testosterone and progesterone (by half) So I went looking for another doctor.
I have been on very low dose 15mg. Armour for about a year along with 200mcg of Selenium and 12.5mg Iodoral. My new doctor gave me Westhroid and is starting me on 1/2 grain (32.5) I think I may want to creep that up as time goes by. I have read you need to do it gradually. He is also going to put me on creams I think for BIH. We are waiting for the new labs to come in.
My Tinnitus started at the exact time I started to go into perimenopause with hot flashes and insomnia being my two main complaints. It took me a few months to find out about BIH and no one knew anything about how to treat tinnitus. Back then it was not so loud, I do think it's gotten worse.
I really feel like the low thyroid, which also was low when I had my very first blood test in 2006 (TSH 1.472) They did not do any other thyroid related tests at that time, only TSH unfortunately. I could have had the Hashimoto's even back then, I imagine.
I do have constipation, but have had that most of my life. I do have a little puffiness around my eyes in the morning mostly, fatigue a little, and joint pain a little as well. Weight gain not really. I have very few symptoms, but my nails have been a horror show for many years, chipping and peeling, and splitting. My skin is also very dry despite my 3 grams of fish oil per day.
My new doctor has ordered Free T3, Free T4, Anti-TPO Abs, Anti-Thyroglob Abs, as well as free and total Testosterone. So I am really hoping I can eventually get fully optimized. I feel like no one has really had enough knowledge, or taken the time or care to fully do that, so I do need to be the squeaky wheel and start screaming if I don't get what I want.
Thanks for your reply,
Once you've tested positive for a thyroid antibody, you don't need to test that one again; in your case, you only need to do the TGab.
Iodine is contraindicated in most cases of Hashimoto's; you shouldn't really be taking the Iodoral.
Yes, I agree that you need an increase in thyroid med. Your FT3 is only at 8% of the range and rule of thumb is for it to be in the upper half to upper third of the range. Will be interesting to see what your FT4 is; probably non-existent.
Most of the symptoms you list (constipation, fatigue, joint pain) are those of hypothyroidism. I had constipation problems most of my life, too, but being hypo really made it worse. And now that I'm no longer hypo, I'm no longer constipated. Makes me wonder exactly how long I have had a thyroid issue?
From what I have read and the writings of my MD, Iodine is only harmful if you are Selenium deficient. I have been taking both for almost a year. If my labs come back that I am selenium deficient, then I will stop it altogether.
I do need to be tested again for the TPO antibodies, at least I want to, in about a year to see if they have come down at all after treatment. My MD said they can take a long time to come down. There are three studies I have seen which show with selenium supplementation, numbers come down.
Once you've been diagnosed with Hashimoto's, you always have it, no matter what the antibody levels are. The use of selenium to reduce antibody count is controversial; I've been taking it for about 6 years and it did nothing for the antibodies. My antibody count only came down when my thyroid "died", meaning the antibodies have destroyed all the healthy tissue,
I am sorry to hear that Barb. Are you on Natural Thyroid meds now?
No, I'm not on Natural Thyroid med. I've been on synthetics ever since I was diagnosed in early 2008 -- first on Synthroid, then switched over to generic levo and when Tirosint (hypoallergenic gelcap) came out in May 2009, I switched to that and have been on it since then. I'm also on liothyronine, which is generic for cytomel (synthetic T3). I am, however, completely dependent on the meds.
That's what Hashimoto's does - it destroys healthy thyroid tissue, so the thyroid will eventually stop making hormones. It, typically, starts slowly (but not always) and we can have it for years before enough damage is done to cause us to become hypothyroid. There's nothing that will stop it and once damage is done, no amount of iodine, selenium, etc will reverse the damage, or restore thyroid function.
I do find, however, that selenium does seem to help with the conversion of FT4 to FT3; it seems that if I stop taking the selenium, my FT3 levels drop, even with added T3 med.
Would you mind telling us who your MD is? If he's had published writings, we might be familiar with him. You can send me a PM if you prefer not to put in it on the forum.
Here's a couple articles you might find interesting:
I had terrible ringing in my ears for months before being treated for Graves'-I noticed it more at night when trying to sleep. Went away once my levels were stabilized. Since going hypo from RAI, it'll crop up here and there when I'm off.
I am wondering what RAI is? (I am new to all this)
From what I have read, Graves disease is hyper and hyper seems to cause pulsatile tinnitus, while hypo seems to cause constant tinnitus. In the case of the pulsatile, in some cases a physician can hear it with a stethoscope, due to the blood flow increase. Very interesting how thyroid is somehow connected to the auditory nerves. The ENT I went to never even mentioned this to me. Amazing how this is so overlooked.
Very interesting. My doctor is Jeffrey Dach. He spent twenty years as a diagnostic radiologist specializing in thyroid disorders. He was referred to me from two separate sources, one is another physician friend in Michigan. That article with the references to the studies can be found here:
RAI stands for Radioactive Iodine. It's used to "kill" the thyroid. Graves Disease IS hyper. Every cell in the body requires thyroid hormone and when they get too much or too little, it's hard to say what might go wrong.
Unfortunately, Dr Dach isn't one I'm familiar with, but I'll certainly take a look at your link and do some research on him. Thank you.