Banging noise in ears

[Brumhoy68]

Hi I have posted on here before. Just a brief summary, was overactive had iodine treatment been on levothyroxine treatment since. Have been bouncing from 100mg to 150mg to try and get a happy medium, have three weeks ago met middle ground at 125mg. I'm now suffering from ringing in my ears and I'm freezing cold all the time. My latest blood results were tsh 8 and t4 9 I dont have the ranges I'm sorry I was taking 100mg then, but I felt ok. Before that I was taking 150 mg with a ridiculously low tsh. I just want to be symptom free.

[greygoose]

We don't need a range for the TSH, it should be one or below when on thyroid hormone replacement. Yours, at 8, is rediculously high. You are very hypo. And, your FT4 is possibly very low, although impossible to say for sure without the range.

There's no such thing as a 'rediculously low' TSH. It is what it is, we can't control it without making ourselves ill. The most important number is the FT3, which doctors won't even test!

So, when were these labs done? And, how come you were taking 100 mcg at the time, when three weeks ago you were taking 125? The time scale isn't clear but is a most important element in understanding your problem.

In any case, with a TSH of 8 you are obviously under-medicated and need an increase in dose. Noises in the ears can be a hypo symptom, but can also be due to a lot of other things. Have you seen and ENT specialist?

As for being cold, it is cold at the moment! I'm freezing, too!

[SlowDragon Administrator]

The aim of levothyroxine is to increase dose upwards in 25mcg steps until TSH is ALWAYS under 2 When adequately treated, TSH will often be well below one. Most important results are ALWAYS Ft3 followed by Ft4. When adequately treated Ft4 is usually in top third of range and Ft3 at least 60% through range (regardless of how low TSH is)

Extremely important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Do you always get same brand of levothyroxine

What vitamin supplements are you currently taking

For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12 at least annually

Low vitamin levels are extremely common, especially after RAI and when very under medicated as you currently are

Ask GP to test vitamin levels

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Come back with new post once you get results

[tattybogle]

So if i understand the time line correctly , you had TSH of 8 on 100mcg and so, 3 weeks ago dose was increased to 125 ?

so you need to wait for a few more weeks at 125mcg to see:-

A) how you will feel on this dose ..... it takes time to know how you will settle on it , it takes me about 8 weeks minimum to know for sure what i'm going to end up feeling like at following a dose change.

B) what your blood test on this looks like .. when have they told you to come back next for blood test ?

[pennyannie]

Hello Brumhoy ;

Am I to understand that you were diagnosed with Graves Disease and the reason for you having had RAI thyroid ablation ?

Graves is an auto immune disease, and as such, it is for life it's in your DNA and blood.

Graves antibodies can go on to cause Graves ophthalmopathy and pretibial myxedema which may explain the skin issues you mentioned on your lower legs a few posts ago.

There is generally a genetic predisposition and maybe if you look to relatives a generation away from you, there are people there who suffered thyroid disease.

Your immune system response has been triggered - this is generally thought to be through stress and anxiety, and once " triggered " you immune system response will be more prone to further upsets, but now, since you haven' t, a thyroid to attack, your symptoms will not be life threatening but possibly life limiting.

The thyroid is the victim in all this and not the cause -

The cause is your immune system attacking your body, and when your thyroid comes under attack the symptoms experienced can be considered life threatening because the thyroid is such a major gland.

By removal of the thyroid, either by a thyroidectomy or RAI thyroid ablation all that has happened is that you now have hypothyroidism as well as what you started with and the NHS believe they can manage hypothyroidism better than they can hyperthyroidism.

RAI induced primary hypothyroidism is said to be more difficult to treat:

RAI is also known to " trash " vitamins and minerals :

Increased antibody titers after RAI skew lab test results adding to treatment difficulties, In particular the TSH test as this can be influenced by TSH receptor antibodies, causing false low levels :

So, in short forget the TSH as it means diddily squat : and you must be monitored and dosed on T3 and T4 levels with a view to these two vital hormones being balanced within the ranges and at a high enough level to restore your well being and metabolism.

RAI is also taken up, to a lesser extent by other glands and organs within the body.

OK I can go on but am stopping here :

I too have Graves Disease and had RAI treatment in 2005 at age 58 - I wasn't even given a choice, though well on the AT medication and just followed and believed the medical advice.

So, we are where we are, and in the first instance I think you need to get a full thyroid blood test so we can fix your thyroid hormone treatment to optimal as that will make a massive difference on your overall outlook as soon as you start to feel a little better.

We need the usual suspects, TSH, T3 and T4, inflammation, antibodies and ferritin, folate, B12 and vitamin D and if your doctor can't do this there are private companies who will, and listed on the Thyroid uk website who are the charity who support this amazing forum.

When with the results simply throw all the details and ranges back up on another post and forum members will advise accordingly.

This is where I started around 5 years ago and I now am so much better it simply amazes me how the NHS don't know this stuff.

You might like to read around Graves and I found the most all encompassing website to be that of Elaine Moore. Elaine has Graves and went through RAI and finding no help with her continued symptoms started researching this poorly understood and badly treated auto immune disease herself. 20 years on there are several books published and has a world wide reputation and a website on all things Graves for everybody affected by this disease.