Pulsatile tinnitus - important info

[ann_g_k]

After a recent blow to the head (accidental) which caused mild concussion, my (pulsatile) tinnitus went into overdrive and although better, is still worse than normal. When I discussed the situation with my GP she was alarmed that I had never had investigations. I hadn't realised that this was a different form of tinnitus and has specific origins (including benign tumour in some cases - see tinnitusformula.com/library....

I've never been diagnosed with hypothyroidism (however, ME since late 80s), despite all the symptoms, and the blood tests to rule out hypothyroidism in relation to the tinnitus showed TSH to be within range. However, it does show a clear increase since it was last tested (currently 3.48 [0.27-4.20]; 2 Feb 2015: 2.53 [0.35-6.00]).

I'm now waiting the results on an MRI head scan to see what may be causing the tinnitus.

I'm wondering if anyone else has had a similar experience, bearing in mind that pulsatile tinnitus is generally associated with hyperthyroidism, rather than hypothyroidism.

[Hidden]

consider a private thyroid panel to see what yr t4 is and whether u have antibodies. What is yr b12?

[puncturedbicycle]

Have they done antibody tests? You can have Hashimoto's and/or Graves and still have otherwise normal tft results. And I agree that your tsh, although within range, indicates that you need to keep an eye on your thyroid function.

If your MRI results are normal and your tinnitus is annoying but benign, you might find acupuncture helpful. My mother has tinnitus and was having acupuncture for something unrelated and when she mentioned the tinnitus the acupuncturist did some treatment and my mum said it vanished (temporarily, but still amazing considering nothing else has ever provided relief).

[humanbean]

I found that I got pulsatile tinnitus + headache when I was seriously low in iron. It was always worst when I first woke up.

[ann_g_k]

Many thanks for your responses. Test results for various things at various times as follows:

18/12/15

B12 914 (191-663) Through the roof (and getting steadily higher with each test)!

Folate 5.4 (4.6-18.7)

Ferritin 120 (15-360)

20/4/15

Active B12 154 (25.1-165)

2/3/15

Cholesterol 5

Chol:HDL ratio 3.3

18/7/14

FT4 13.6 (10-22)

FT3 3.14 (2.63-5.7)

27/1/14

TPO antibodies <33 (0-59) (negative)

So it's a mixed bag. I'm considering having all TFT tests done privately shortly so I have an up to date comprehensive picture, plus adrenal saliva tests (tinnitus much worse when under stress).

I also have polycystic liver disease, which, someone recently posted, may be associated with hypothyroidism; also borderline polycystic ovaries (symptoms, but no visible signs on ultrasound).

[humanbean in reply to ann_g_k]

Can I suggest you copy your post with results into a new post with a title asking for help with results. Sticking them on the end of a thread about tinnitus means they probably won't get noticed.

[ann_g_k in reply to humanbean]

Thanks for the tip - I was thinking that as people were asking about which tests I'd had (the latest one to rule out thyroid conditions as being the source of the tinnitus) then I was answering people's queries.

[humanbean in reply to ann_g_k]

I understand your logic, but I'm not sure the forum works that logically!

[Hidden]

Kind of amuses me that your GP took an interest. I have had tinnitus for several years. I have hashimoto's and PA. It came on at a time the nhs was fobbing me off and saying there was nothing wrong when I actually had PA. It is somewhat better with weekly injections (which I give myself) but by no means gone completely.

My NHS GP is not remotely interested in my tinnitus, or anything else..........

[ann_g_k in reply to Hidden]

I think it is because it is pulsatile tinnitus which is different from ordinary tinnitus and which can be caused by a tumour that alerted her to action. Admittedly, as I didn't realise there was a difference I've never even mentioned the problem before to the GP (but I did to an endo to whom I was referred in relation to ME/CFS, though didn't describe it as pulsatile).

Disgraceful that your GP doesn't acknowledge your problems. Any chance of finding another GP or surgery?

[SilverAvocado]

Ann-g-k, in your test results from 2014 your fT3 and fT4 are absolutely on the floor! With that set up, and a TSH over 3 you are sure to be experiencing thyroid symptoms.

The rule of thumb for ideal numbers is TSH: close to 1, Often better under 1, fT3: top third of range, fT4: top quarter of range. So as you can see, yours are far short of that.

Unfortunately you will struggle to get a diagnosis with these results, as you've already found. Doctors often wait until TSH rises to 5 or even 10 to diagnose. One possibility is to get the antibody test for Hashimoto's. This is the most common cause of thyroid problems, it's an autoimmune disease where your thyroid is being constantly nibbled away. This means it will constantly get worse, which is the pattern you're already looking at. There's a slim chance a doctor will treat you even with in-range TSH if you're positive for antibodies.

Although your results are a little strange, and may follow a different pattern. You don't have a TSH result for 2014, but if it follows the pattern of the others we could guess it was lower then (total guess, as Hashimotos is actually erratic over time), which would mean you had both sets of measures low, TSH AND the fT3 &4. That pattern indicates central/secondary hypothyroidism (both names are used). It means your body isn't actually producing TSH properly, which is how it calls your thyroid to produce more hormone. So the problem is located in the pituitary, which is responsible for making TSH. Now I'm not experienced enough to know if those numbers are low enough to be central hypo, and of course the results are incomplete.

But it gives you another avenue to investigate, your fT3 and fT4 today may be even lower than they were in 2014.

[ann_g_k]

Many thanks for your comprehensive response. In error I missed the TSH for 2014: 3.36 (0.35-6.00) so the 2015 TSH is relatively much higher, esp as there has been a change in the range: 3.48 (0.27-4.20). I agree that it is highly likely that FT3 and FT4 are now lower - and possibly below the range! I've asked Louise for a list of private doctors so will follow this up.

The antibody test came back as negative (see above) and I've long thought I might have secondary hypothyroidism (I've read recently that usually the TSH is low as well as FT3 and FT4 but there are cases where it can be high within normal range or even beyond the upper range). I had wondered if there were problems with the pituitary which may come to light in an MRI scan (see latest post a few mins ago!) but the scan showed no abnormalities.

Thanks again.