I was diagnosed of Hyperthyrodism 7 years ago, i was on carbimazole medication. This year June 2024 I went for RAI Radio Active Iodine Therapy. From Hyperthyrodism I am Hypothyrodism. Since starting this July after my RAI treatment I started taking levothyroxine from 100mcg down to 75 mcg my TSH level is normal range. However I noticed that the ringing of my ears got worsen especially going to bed and in quite environment. I want to ask some advice what could be the cause of my tinnitus I ask my specialist He said its not related. Have anyone come across these. Please share your advice and experience in resolving these Tinnitus.
thank You and God bless
Written by
Kramyy
To view profiles and participate in discussions please or .
Tinnitus is well documented and may well be associated with primary hypothyroidism.
Do you have Graves Disease and the reason you had RAI thyroid ablation ?
RAI is a slow burn and eventually your thyroid ill be rendered totally disabled.
It is very important that you are dosed and monitored on your Free T3 and Free T4 readings and not a TSH reading seen in isolation -
though totally understand that in primary care this maybe all you are likely to get - or with a T4 reading thrown in once in a while.
Your HPT axis - the Hypothalamus - Pituitary - Thyroid feedback loop - is now broken -
since you have had an invasive treatment and your body physiology changed -
and this internal feedback loop system that the TSH relies on as ' working ' does not any longer - as your thyroid now damaged and has / is being slowly burnt out in situ -
so your HPT axis down regulated and this feedback loop open ended as there is little / no reliable thyroid gland response - which in essence has ' turned you off ' so it will be a physically impossible to ever go ' hyper ' again - but you risk being wrongly medicated by a TSH reading.
RAI is also known to trash vitamins and minerals and we need optimal levels of ferritin, folate, B12 and vitamin D to optimise the conversion of T4 - Levothyrocxine into T3 which is the active hormone that runs all your bodily functions -
T4 is a pro-hormoneand needs to be converted in the body into T3 which then kicks starts ones metabolism and it's all about where your T3/T4 need to sit within the ranges that gives you back your wellness.
The thyroid is a major gland responsible for full body synchronisation of your physical ability and stamina including your mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.
A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1.T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg - with T3 the active hormone said to be around 4 x the power of T4.
When hypothyroid and taking T4 monotherapy we generally feel best when our T4 is up in the top quadrant of its range at around 80% through with the T3 tracking just behind at around 70% through its range and so at around a 1/4 ratio T3/T4.
I found the most well rounded of all I researched post RAI for Graves - is that of Elaine Moore - books and website - elaine-moore.com
Well informative Pennyannie. Yes i have graves disease. Unfortunately my doctor only checks the TSH. And now im requesting T3 and T4. I am currently on 75mcg Synthroid Levothyroxine. I was planning to cut it down to 50mcg. It could be im still on stronger dose my latest TSH level was 0.56 (0.27-4.20).. which is still normal range..
Graves is an auto immune disease and as such - there is no cure - and generally only gets diagnosed when the immune system ends up attacking your thyroid and or eyes.
All invasive treatment does is simply remove the target of the attack - the victim - namely the thyroid gland.
With Graves - the antibodies in your blood stick down on TSH follicles - pushing down the TSH - and that is what initially causes the over production of thyroid hormones and you becoming hyper and going to the doctor for help.
There is no way of removing these antibodies from your blood and no one knows how long they can stay ' sitting on ' sometimes referred to as ' cleavered ' onto the TSH follicles distorting TSH readings.
Being in a NHS range - somewhere, anywhere, is not optimal - being optimal within the range is where you feel well - and the TSH is a very misleading reading anyway and means nothing.
Considering you think you need to cut down your dose of T4 to 50 mcg and a fully functioning thyroid would be supporting you with around 100 mcg T4 daily - it sounds as though you are going in the wrong way - if the RAI has worked/still working -but unless we see at least a T4 reading / range and hopefully a T3 - we don't know anything - so I wouldn't just drop your dose like that -
Maybe ask to get referred back to endocrinology where at least you should get the most appropriate blood test run - a TSH + Free T3 + Free T4 :
Can you get Private blood tests in New Zealand as that is what many of us in the UK have been forced into running so to be able see exactly what is going on.
Hi Penny, yes im due for my blood test end of this month. I better wait for my blood results and ask my GP if i should stay the same with my current dose of 75mcg rather than 50mcg that i was planning. Yes I will try to get hold of my endocrinologist once the result is out.. thank you very much 😊
OK then - the thyroid blood test should be a fasting blood test by around 9.00 am in the morning -
with you just taking in water o/night and if you take your T4 in the morning - do not - so leaving around a 24 hour window from last dose of T4 medication - and you take that days dose after the blood draw -
You'll be ok - as if you take the T4 as usual and likely before the blood draw it may give a false high reading of the T4 just ingested - and not the level of T4 that you ' run on ' most of the time -
also any supplements especially any containing biotin and those of course that you are measuring need to be stopped around a week before the blood test - so we measure what your body is holding and not that just ingested and it seems biotin can ' mess ' with some Lab assay measures :
T4 needs to be taken on an empty stomach and you need to leave a good hour before eating or drinking anything other than water.
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
What vitamin supplements are you taking
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
A study was carried out in Taiwan demonstrating tinnitus was significantly more likely in people with hypothyroidism compared to those who did not have hypothyroidism. "This retrospective cohort study observed that hypothyroidism patients were more predisposed to develop tinnitus than those without hypothyroidism, even after adjusting for age, gender, economic, and hearing-related clinical comorbidities." The study does highlight some limitations in design such as being a retrospective study (with data drawn from a health insurance database) but had 6062 people with hypothyroidism compared with 24,248 who did not, so a very large study. Hsu, A., Tsou, Ya., Wang, TC. et al. Hypothyroidism and related comorbidities on the risks of developing tinnitus. Sci Rep 12, 3401 (2022).
According to relatively new research, 2018, a thickening (and in my view less elasticity) of a major artery in the brain passing by the ears, may be the cause. I have pulsatile tinnitus which commenced at 75 mcgs of Levo. I have now had it for about three years. Sometimes it’s handleable. Other times not so much. Two things, which seem to be ‘distracting’ are helpful.
A white noise machine for the bedroom - to remedy it being too quiet. And perhaps unsurprisingly a CPAP machine. A CPAP machine changes the pressure in your head around breathing, perhaps getting a ‘false’ bit of stretch on tissues that hypothyroidism interferes with.
Recently I found opening my mouth, to almost unhinging it, also temporarily eases it. I am thinking of putting - no you will think I am joking.
If it’s not pulsatile tinnitus there are videos on YouTube which might help other types!
Kramyy, I am hypo with Hashi's. I used to have pulsatile tinnitus. However once I had some T3 added to my levo the tinnitus ceased. I am only bothered on rare occasions for a short time. Just on levo my T3 level was always low in the range and I had other symptoms. T3 cleared up most of my outstanding symptoms.
I might have to try with this Eltroxin(Aspen) God willing it will work for me. As i dont think I cant take this levothyroxine. As my tinnitus gets worst each day i have been on this Synthroid Levothyroxine for 5 months ..Yes we have aspen Eltroxin.
No one is going to see these new blood tests tacked on the bottom of what ' is seen as an answered question ' - due to volume of questions answered it is always best to start a new post with new information -
We try and answer all new posts within a 24 hour window - with the volume of questions received meaning we very rarely look back at a post already answered unless you reply by name to a forum member calling them back to the post -
Once answered as fully as possible the post in considered closed after a couple of days -
So yes, your T3 is now under the range - suggest you start a new post - and share the full TSH/T3/T4 blood test results from each blood test so we can see more easily and in context what has been going on.
We can look back to remind ourselves of where you were and what has already been written -
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Hypothyrodism
Tinnitus???
Vitamin d causing pins and needles 
Tinnitus Sufferers
Pulsatile tinnitus - important info
