Tinnitus due to levothyroxine

I am a 58 year old woman , prescribed Levi thyroxine 25m once a day I am feeling worse than ever, have constant ringing in my ears.Any hope I will feel better, or this noise in my ears will stop?

[pffft2017]

Hi, sorry to hear that. I'm afraid I've had permanent tinnitus since developing hypothyroidism but I did not think to connect it with the thyroxine but connected it with the thyroidism. Have you any evidence that the thyroxine has caused your tinnitus? The best thing to do is not focus on the constant background noise, I have the radio on all day and it's invaluable at night when getting off to sleep. Pretty soon you'll start to ignore it or ask for a referral to ENT for a noise cancelling hearing aid.

[Hidden in reply to pffft2017]

I believe Levo can cause tinnitus, but I need the med. Hope it goes away, only started 24 hrs after taking first dose.only in the first week. Thank you for your reply.

[csilva_31 in reply to Hidden]

So you started to experience tinnitus 2 days after starting levothyroxine?

[csilva_31 in reply to Hidden]

.....me too. I stopped taking my pills and realize it may take 4-7 weeks to wear off but I need to try something because this hissing ear ringing when quiet is annoying.

[Hidden]

I too have thyroid related tinnitus and wear hearing aids. Some people on here find that it disappears when they get to their optimal dose. Some like me seem stuck with it.

[Murphysmum in reply to Hidden]

I would tend to agree. I go through phases (now 🙄) when my tinnitus is really bad, then it will disappear totally. I think it is an optimal dose thing. Don’t despair, it may go, it doesn’t have to be a permanent thing 😉

[greygoose]

I think it's more likely to be due to a lack of levo, rather than the levo itself. Your doctor started you on too low a dose, which often makes people worse rather than better. The normal starting dose is 50 mcg. 25 mcg is just enough to stop your thyroid producing hormone, but not enough to replace it, so you become more hypo, rather than less, and new symptoms tend to appear.

How long have you been on 25 mcg? You should go back for a retest six weeks after starting it. Make sure your blood is taken early in the morning - before 9 am - and fast over-night. Leave a 24 hour gap between your last dose of levo and the blood draw, and you should get an increase in dose. Don't forget to ask for a print-out of the results!

[SlowDragon Administrator]

Tinnitus is often due to low vitamin B12.

Low B12, folate, ferritin and vitamin D are common when hypothyroid

Ask GP to test these with thyroid levels at retesting

25mcg is extremely small starter dose. Blood should be retested after 6-8 weeks and dose increased in 25mcg steps until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Standard starter dose is 50mcgs, but as you are over 50, it's recommended to start on 25mcg. But dose will be increased slowly over coming months

NHS guidelines saying standard starter dose is 50mcgs and that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine

beta.nhs.uk/medicines/levot...

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription. Many patients do not get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

[shaws Administrator]

Tinnitus is a clinical symptoms of hypothyroidism - one of the many.

thyroiduk.org.uk/tuk/about_...

The fact that you are on a miserly dose of levothyroxine at 25mcg is part of the problem, unless you are very frail with a heart disease. Usualy starting dose is 50mcg with 25mcg increases every six weeks until TSH is 1 or lower.

Low doses backfire as our body isn't getting the T3 it desperately needs. Levothyoxine is T4 only and it is also an inactive hormone. It has to convert to T3. T3 being the only ACTIVE thyroid hormone needed in our mllions of T3 receptor cells. We have to have an optimum of levo to convert to T3 so we need regular increases of 25mc after the 50mcg start.

[Sallybones in reply to shaws]

GP put me on 25mcg at the end of last year and I was worse in my head ie slightly out of control. Because I don't tolerate meds well she suggested starting really slowly and after 6 weeks suggested 1.5 tablets every other day with a whole one in between. I daren't do it at the time because I felt slightly out of control in my head even on 25mcg. Even on the small dose I noticed my TSH went up over 1 after always being 0. something.

Is that possible?

I live on my own so have no one to support me, see me through, when scary scary symptoms take hold especially at night.

I didn't realise that taking levo stopped it being produced by your body?

Learning all the time on here & I've read an awful lot.

[shaws Administrator in reply to Sallybones]

It is our own body that stops producing thyroid hormones for some reason or another. Levothyroxine is a replacement thyroid hormone. It is synthetic and inactive and should convert to T3. T3 being the Active Thyroid hormone and it is this that is needed in all of our millions of T3 receptor cells.

You could have a sensitivity to the levothyroxine you are taking ie. fillers/binders in it.

To try to figure this out - take one anti-histamine tablet before your next dose and see if it helps. If it does then ask pharmacist to give you a different make of Levothyroxine which is a synthetic T4 and it is an inactive hormone which has to convert to the Active thyroid hormone called T3 (liothyronine). It is our mllions of T3 receptor cells that need T3 within them, otherwise our body will not function well. T3 runs our whole metabolism. 25mcg will be insufficient to convert to an optimum of T3. T3 is needed particularly for our brain and heart.

If you can afford a private test - we have three labs that do home pin-prick tests and request TSH, T4, T3, Free T4, Free T3 and thyroid antibodies. Make sure you are well-hydrated a couple of days before blood draw and the lab may be able to arrange or GP might let you draw blood in the surgery.

You can ask your GP first if you wish for these tests but I doubt lab will do so and I believe they've been told only TSH and T4 is sufficient but it isn't and you can tell her/him so. 25mcg in no way can give you the amount of T3 your body needs. Our brain and heart need the most and I doubt your GP knows any of this.

You must understand that GPs and Endocrinologists seem to have had little training on the importance of thyroid hormones being at optimum and they seem to believe wholeheartedly that levothyroxine solves all problems. It doesn't if we are poor converters or dose is insufficient. If you are having a bad reaction to the levo you take, a switch to another might help but it has to be at a dose which helps you.

[Sallybones in reply to shaws]

thanks Shaws that's a really really helpful explanation and I shall get brave enough with this forums encouragement to have another go at sorting this for a better life again. Yes I'm soon learning re GPs and Endos!! My GP is supportive & have a good relationship with her but she admits she's limited in knowledge.

[shaws Administrator in reply to Sallybones]

You can tell her you've taken advice from the forum of the NHS's recommendation for help/advice i.e. Thyroiduk.org.uk. There are several thyroid help groups fighting at present with the help of The Lords - Lord Hunt in particular.

thyroiduk.org.uk/tuk/campai...

[Sallybones in reply to shaws]

will do Shaws

[Hidden in reply to shaws]

Thank you, hopefully my dose will be increased.

[FIT2018]

I came to this forum because of raging tinnitus, loss of hearing and vertigo/vestibular migraine. I have loudly changed to NDT, which helped at first, but I still am suffering from tinnitus and if anything, with inept self medication, I have also tripped off my vertigo again..grrrrr..... (but it is gradually rebalancing and improving)

BUT what I am learning is:

1: As I first assumed, tinnitus is clearly not necessarily related to levo itself as a medication (my initial assumption), although I am sticking with NDT, as overall I seem to be a bit better off hearing-wise on this (and like you, this whole issue kicked off the year I was put on levo...)

2: This is deffo a symptom of hypothyroidism

3: The correct dosage of (any) HRT is crucial to the experience of all these symptoms

4: HRT is slow acting and much more powerful than I gave it credit for (seduced by years of medication, I underestimated this and made myself ill!)

The doctors etc will tell you "no connection"... but this is not the case.

Sorry you are experiencing this, don't ignore it.

Good luck!

[FIT2018]

BTW, I also have had to have a course of B12 jabs - tinnitus is a major neurological symptom of B12 deficiency and like most Hypos, I was badly deficient.. these helped a lot