Pulsatile Tinnitus Worsened After Starting Thyroid Medication

[Gstar2020]

Hi,

Please can someone give me some advice and guidance on where I need to go from here? Any suggestions are welcomed at this stage because I'm at my wits' end.

I will try to keep this post as short as possible but please bare with me.

I am a 37-year-old mum that lives in the UK. No significant health issues to date.

I have been suffering with pulsing tinnitus since February 2020 and regular tinnitus since April 2020, both came on suddenly out of the blue.

I have seen 3 ENT consultants, several GPs and one neuro interventional radiographer.

I have had several tests done including an E.C.G, MRI, CT scan with contrast, an angiogram, vEMP test, two hearing tests and a lumbar puncture but apart from showing slight thinning of the veins, there have been no significant findings.

I've had several blood tests checking my Iron levels, B12 levels and thyroid functions but all have been ok on the whole except for a recent result showing that my thyroid was borderline for being under active.

Last month my doctor started me on Thyroid medication at 25 mcg. I was fine for about a week but the past three weeks have been a nightmare. My pulsing is now constant and won't settle down whatsoever. I'm thinking it's linked to the med but it could just be a coincidence which makes me reluctant to stop the tablets.

I can still stop the pulsing for a few seconds by pressuring on the vein behind my ear but it slowly starts up again.

I've asked for second opinions from other hospitals but they all seem to just stand by my previous test results and tell me to just learn to live with this and to stop chasing answers. It's difficult when things are worsening though.

I also developed eye floaters a while back but was told there's no link to the tinnitus.

Where should I go from here? Has anyone had a similar problem?

I don't know what to do. I just get palmed off at the moment.

Thanks.

 

[Gstar2020]

My pulsing tinnitus began last year in February.

It was there every day but I did get moments of silence.

Over the months I felt it was getting slightly better as I was having days of silence rather than the odd moments. However, over the past month or so things have got bad again. The pulsing has now become 24/7 and won't ease whatsoever.

Is it common for pulsing tinnitus to get worse?

Does anyone know what this could be as whenever I speak to the doctors, they just tell me that I've had all of the relevant tests and leave me to it basically.

Has anyone else got pulsing that worsens?

Any advice would be appreciated.

Thanks.

 

[makeyourownluck]

Hello,

I'm sorry you are going through this. I have just developed what I believe to be intermittent pulsatile tinnitus with a horrible 'fullness' sensation. I don't have any advice, just saw you had not had any reply's.

If you look about you will see people who are well educated on pulsatile tinnitus. You can draw their attention to your post by typing @Username (their individual username, that is).

I hope your situation has improved.

 

[Sandra Menzie]

I also have pulsatile tinnitus 24/7. It's not bad at night. But first thing in the morning it starts again. Nothing stops this. So I know how you feel.

 

[Gstar2020]

Thanks for your kind replies.

Sorry to anyone that is going through this as well. I honestly wouldn't wish it upon anyone.

I personally think I'd handle the situation slightly better if I at least knew exactly what was causing my issues but the not knowing is half of the battle.

I've now stopped my thyroid medication and the pulsing has thankfully settled down to its baseline again.

Been monitoring my blood pressure to see if that changes the pulsing but my blood pressure is stable so I don't think it has any baring on the pulsing.

I have no idea what the issue is and no one else will see me now as I keep getting told that I've had all of the relevant investigations.

Thanks again for the replies.

 

[Shirlnga]

The comment about Thyroid meds was interesting.

I'm on Thyroid med and have been on it for many years. If you find anything online connecting this please let me know.

I've almost reached a point that I want to toss all medication. Too many side effects. Pulsatile tinnitus is bad enough on its own but combined with premature ventricular contractions, it gets very scary at times.

 

[Greg Sacramento]

@Shirlnga, your suppressive therapy should maintain the TSH level at the low end of normal.

Beta blockade can be used in patients who are hyper responsive to necessary L-thyroxine supplementation.

Lipid abnormalities do seem to be part of your problem.

Overzealous use of L-thyroxine to suppress TSH levels can be cause of premature ventricular contractions or increase them.

All the above can relate to pulsatile tinnitus.

BP is normally around 90/59 and pulse rate is 108-115 - not usually a problem, but may confirm the vascular nature of both thyroid and PVC.

Talk to your doctors about the above. These easy adjustments should make your life less concerning - more so when getting up in the morning. These adjustments should help lower pulsatile tinnitus.

 

[Shirlnga]

@Greg Sacramento, thank you! Your comments give hope where there was none as far as a way to deal with my issues. Hearing my heartbeat in my ears when it's very irregular (PVC's) is stressful, and that's putting it mildly.

I have also noticed that lying flat seems to make everything worse. Not as bad when I'm sitting up. My next door neighbor is a doctor and tells me he has pulsatile tinnitus along with PVC's every day! So that makes three... My GP, my cardiologist and my neighbor who don't seem as concerned as I am. Am I just worrying too much?

 

[Alan P]

Just out of curiosity. What does pulsatile tinnitus sound like?

 

[Greg Sacramento]

Am I just worrying too much?

Hi Shirlnga and yes.

Some other thoughts:

Small sips of water throughout the day may help with PVC.

Increased intake of water: Dehydration can cause an electrolyte imbalance resulting in signs of low blood pressure, and care towards adequate hydration would be important, especially in high temperature situations.

Each additional 60 minutes of napping time will reduce average 24-hour systolic blood pressure by 3 mm Hg. So a nap along with 7-8 hours night sleep may be better than 8-9-10 steady hours of night sleep.

All of this should also help with PVC and thyroid.

Postprandial hypotension

'Prandial' refers to the consumption of food, and sometimes eating a large meal can cause low blood pressure since the blood flow to the digestive system increases at this time, causing blood vessels to be dilated. Ordinarily, the heart would pump more blood to maintain the blood pressure, but in people with symptoms of low blood pressure, this does not happen, and instead, they experience fatigue.

Small, frequent meals with fewer carbohydrates: This stabilizes metabolism and would help with alleviation of symptoms of low blood pressure.

Postural hypotension can be alleviated with mindfulness towards standing up from a sitting or lying position. Avoiding sudden jerks would allow the body some time to recover from the blood pooling downward due to gravity, and keep the pressure steady. Getting up slowly, turning towards the side before getting out of bed and sleeping at an elevated angle are commonly recommended to correct low blood pressure.

All of this should also help with PVC and thyroid.

 

[Shirlnga]

@Greg Sacramento, again, thank you!

The very low blood pressure is ALWAYS when I first get out of bed in the morning and before I have breakfast. I've had BP readings of 70/50! This usually corrects to a more normal reading by noon. But in the meantime, mornings are a problem with dizziness, weakness, dull headache. I'm a totally different person in the afternoon.