Eyelid Twitch - Concern or let it pass? - Thyroid UK

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Eyelid Twitch - Concern or let it pass?

Andyb1205 profile image

For the past week I’ve noticed that the top of my left eyelid twitches occasionally throughout the day, from morning to night. At least that’s the most noticeable twitching. Possibly attributed to the 40mcg T3 I began two weeks ago.

Should I contact my Endo about this possibly hyperthyroid symptom or give it another month until the next appointment?

I was prescribed 50T4/40T3 five weeks ago. Have been on 50 T4 for 5 weeks, titrated to and began the 40T3 compounded capsules 2 weeks ago.

Previous prescribed dose was 75T4/25T3 with these lab results. With the new 50T4/40T4 dose I expect the FT4 is lower and FT3 is higher.

TSH suppressed <0.01

FT4 10.6 (10.6-19.7)

FT3 4.63 (3.00-5.90) 56% in range

Should I wait out the next 4 weeks to see if things fall into balance (co-existing hypo/hyper symptoms). Have only been on the prescribed regimen for bit over two weeks. Or does this new symptom warrant a call to the Endo?

Also, in the past few days, I’ve had brief and rare occasions of sharp stabbing pain in the chest. But I can’t remember if they are distinct from chest pains I had before treatment. They could be either hypo or hyper. But the eyelid twitching definitely sounds like a hyper symptom.

Any advice would be greatly appreciated!


27 Replies

Eye lid twitching is not serious in itself it's just a spasm of the muscle

If you get eye pain double vision or other issues then definitely contact endo

Blepharospasm or eyetwitcjing can also be due to fatigue stress a weaker eye in prescription and usually temporary - lasts a few weeks up to couple months

Unless your chest pain is an issue no need to contact endo

Use cold compresses on the eyes, scrub the lid margins and use dry eye drops if required if she feels tired or sore to help ease the twitching spasm

Simple eyelid twitching is something called myokymia, and not a symptom of thyroid disease. It comes about through tiredness or over use of a computer screen etc, and is of no medical significance. There is a potentially more serious condition known as blepharospasm, which in some cases can cause the eyelid to close, but what you describe is a very common and insignificant occurance which can come and go from time to time. By the way, as you've been prescribed replacement thyroid hormones I'm presuming you are hypothyroid; in which case you can't become hyperthyroid. If you have Hashimoto's it's possible to experience a flare during which blood hormone levels can rise, but it isn't hyperthyroidism.

Andyb1205 profile image
Andyb1205 in reply to MaisieGray

Yes I am being treated for hypothyroidism. What I was exploring was if my FT3 had shot up too high with my dose change. But it’s another 4 weeks until I get the labs drawn again after being on the 50T4/40T3 for 6-7 weeks.

MaisieGray profile image
MaisieGray in reply to Andyb1205

I'd say it's highly unlikely that your eye-twitching is related to being over-medicated. It could be associated with low mineral levels, as mentioned, and there is some indication that low vit B may be implicated.

I would suggest the problem could be caused by one or more of the following :

low magnesium

low potassium

low iron

Testing magnesium levels is not really worth doing - results are very unreliable. You can have sufficient magnesium in the blood while also having severe deficiency in the cells of the body. Most people who want to supplement magnesium just go for it.

Potassium and iron shouldn't be supplemented without proper testing. You might find these links of interest :



Saya85 profile image
Saya85 in reply to humanbean

Oh yes I second the magnesium- will help with the twitching and any other nerve or muscle cramps etc

Andyb1205 profile image
Andyb1205 in reply to humanbean

My Ferritin has recently increased from 91 to 144 (24-444) but the doctor didn’t run the iron panel this time. I remember you noted that my serum and saturation levels were previously low. But the twitching didn’t happen before.

I will be starting Thorne’s Magnesium Citrate right away tomorrow, it’s been collecting dust for a couple months. Hoping it helps my digestion problems too.

humanbean profile image
humanbean in reply to Andyb1205

I checked the dose of the product you mention - 135mg of mag cit isn't very high. I would suggest taking the maximum dose given on the bottle.

I take magnesium citrate in powder form, dissolve it in water, and use it to swallow my supplements with. Having taken pills in the past, which were absolutely massive and difficult to swallow, I wouldn't take anything else except the powder now.

I hope you find the magnesium helpful.

It has happened to me in the past... my GP suggested Magnesium. Once I started doing that they stopped. It wouldn't hurt though to go to your GP first for an assessment.

Because your system is now speeded up ensure you are remineralising. ReMag, ReMyte and ReAlign are very effective ( Botanicahealth). Healthy New Year

I had twitching of one eyelid when I was hypothyroid, as well as swelling of both. Since being on Levo and beginning to improve, it has disappeared.

As others say, nothing to worry about.

That's the trouble with unexplained symptoms, it's difficult to tell if they are important or not!

TSH suppressed <0.01

FT4 10.6 (10.6-19.7)

FT3 4.63 (3.00-5.90) 56% in range

I don't know much about T3 treatment, but it looks as if you might be slightly under medicated, or your medication will need to be tweaked - maybe a slight increase in Levo because T4 is at the bottom of the range and T3 isn't all that high. But two weeks is too short a time to know - it takes about 6 weeks for any change in thyroid medication to begin to have its full effect.

I think TSH is normally suppressed on T3, because if you have enough T3 you don't need TSH.

You mentioned chest pains. Where exactly in the chest are they? Do you get any breathlessness at the same time, or any other sensations such as a sense of pressure or aching in jaw or left shoulder or arm? You might know these symptoms already but mentioned them just in case - they do need checking out.

I don't think a stabbing pain is likely to be due to a heart problem, (it could merely be indigestion!) but best go to the doctor if it persists or gets worse. [I am NOT a medic, just an interested layperson]

Post any other recent blood results here. As humanbean said, it could be a problem with vitamins or minerals not being optimal.

in reply to

Just had a look at your profile, and Seasidesusie gave you advice on your thyroid results already. So I seem to have got that part right!

Andyb1205 profile image
Andyb1205 in reply to

Hi Jnetti. I will answer the rest tomorrow but wanted to quickly make a note. Those lab results are from my previous dosages, on 75 T4, 25 T3.

It was changed to 50 T4, 40 T3. I’ve only been on the 40 T3 for 2 weeks now (had to self-titrate to tolerate it lol, but began 50 T4 5 weeks ago).

So compared to those labs, my T4 will be lower and T3 will be higher. How much higher, that is the question!

If T3 is three times as potent as T4 then my dose is higher than what it was before, ~170T4 compared to ~150T4. But I feel so damn hypo, cold, dry, constipated, with some symptoms that may be hyper. I’m still shocked I’m tolerating 40 T3 without the hot sweats and shaking lol. Seriously though, every day I do consider self increasing my T4 by 12.5mcg. ☹️

A couple of months ago I had really bad eye twitching in both eyes which went on for hours at a time. A blood test revealed I had slightly below range potassium. I took potassium supplements and a daily banana, after a couple weeks the twitching stopped. I have now stopped the supplements but still have my daily banana.

I had eye twitching and took magnesium (about 350 mg / day) which resolved it. I recommend magnesium glycinate or magnesium malate rather than magnesium citrate. Magnesium citrate is used more for constipation. So your stools may become too loose on citrate (depending on the amount you need to take).

I get eye tics when my B12 is less than optimal for me. Nowhere near hyper from blood results. Chest pains could be muscular spasms as well, Are you supplementing B12 and magnesium? 40mcg T3 as a starter dose is rather more than is normally recommended - most people start with 5-6.25mcg.

I had already titrated carefully to my previous dose of 25mcg T3, and over the past 3 weeks titrated to the current dose of 40mcg T3.

Is the T3 the same as what you were using before? Different makes (that probably includes T3 compounded by a different lab - we don't have it in the UK) can feel like different strengths. Or you might be one of those people who needs a higher free T4 to feel well

Unfortunately this time it’s compounded T3 as there was a Cytomel shortage. But I do feel it is working, and is stronger as it should be. I may just need to give my body some time to adjust.

I felt the hypo symptoms hit me in the face when I previously decreased to 75T4 too, now on 50T4. What I do know is I tolerate T3 better with less T4, but less T4 does bring back hypo symptoms.

It’s possible I need a baseline dose of T4, which lasts longer and converts in the cells. With any T4 above that dose simply leading to buildup, toxicity and hyper symptoms.

I find I'm OK with Free T4 at the bottom of the range, but feel bad when it drops below. I take a grain of NDT about once a week just to top up the T4 so to speak. Perhaps you need 75mcg T4 at least a couple of times a week

My last labs showed my T4 literally at the number where the bottom of the range starts at. It’s definitely gone below the range now.

The fact I will find out with this Endo is assuring. I posted this below but thought I’d mention. In the past couple weeks I noticed my blood pressure has dropped from the high 120s to mid 130s, to now in the 110s. I was initially happy until my pulse rate went up to the high 90s to 100s, up to 110 even!

I was also going to suggest magnesium, I had twitching also of the left eye, I took magnesium and the twitching has stopped. I also take for the thyroid, blood pressure ( it’s lowered mine) and for constipation. It’s helped with all.

Will start the magnesium today and double the dose if need be!

I should mention. I’ve noticed that in the past 2-3 weeks my blood pressure has dropped, from the high 120s to mid 130s, to the 110s. My pulse rate has also climbed to the high 90s to 105ish, going as high as 110. I was happy that my BP dropped at first until the pulse started hitting triple digits!

I have had this eye twitching for off and on years before thyroid was removed. I had now had it again for a couple of days over the Christmas Period, I notice it's when I am over tired.

I assume the eye twitching is somehow related to your thyroid or treatment. However, I had several years of eye twitching and then my eyes started drooping. I was diagnosed with ocular myasthenia gravis which, like my Hashimotos thyroid disease, is caused by an autoimmune disorder. Just keep that info on the radar if you don't get resolution of symptoms as it is a rare diagnosis but usually found in folks with other autoimmune disorders. A neurologist and an eye doctor both figured out that I had this muscle/nerve disorder. Fortunately, my myasthenia never went systemic. My two sons in their 20's are both already dealing with the twitching and drooping eye and my Dad had it as well.

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