Thyroid Dysfunction: Impact on Weight and Ear Issues

Q: Thyroid Dysfunction: Impact on Weight and Ear Issues

Hello： Based on your description, here are a few points to clarify： <br>1. <br>Regarding thyroid issues： I'm not sure if you have symptoms of hyperthyroidism, such as sensitivity to cold, weight loss, increased anxiety, or frequent diarrhea. <br>If you do not have these symptoms,

Hyperthyroidism?

Hello doctor, I have been taking the third pack of oral contraceptives, alternating between YAZ and NINA.
I have had issues with ear congestion for several years, which initially did not affect my daily life.
Recently, however, I have been experiencing multiple episodes of congestion throughout the day.
The only relief I find is when I lie down or keep my head lower than my thighs; otherwise, my ears feel blocked, similar to the sensation of being underwater.
I first visited an otolaryngologist, who diagnosed me with eustachian tube congestion and prescribed medication.
After two follow-up visits with no significant improvement, I switched to another hospital's ENT department.
The doctor there suggested that my eustachian tube might be too patent and recommended blood tests.
This week, my blood test results indicated thyroid dysfunction, which has led to weight loss, and I was referred to the endocrinology department.
I would like to know if the oral contraceptives could be causing my thyroid dysfunction and if the weight loss is contributing to the worsening of my ear congestion.
Which specialty should I consult for this condition?

Mei Ying, 10~19 year old female. Ask Date: 2018/10/22

Dr. Hong Yuanbin reply Internal Medicine

Hello: Based on your description, here are a few points to clarify:
1.
Regarding thyroid issues: I'm not sure if you have symptoms of hyperthyroidism, such as sensitivity to cold, weight loss, increased anxiety, or frequent diarrhea.
If you do not have these symptoms, an isolated abnormal thyroid blood test may not necessarily indicate a thyroid problem.
Therefore, it is essential to consult an endocrinologist for a definitive diagnosis.
2.
Concerning the ear fullness issue, it is not a common symptom of thyroid abnormalities.
If the ear fullness persists and the endocrinologist believes there is no hyperthyroidism, it may be necessary to return to a larger hospital's otolaryngology department for a detailed examination.
3.
Regarding the effects of contraceptive medications: To determine whether there are side effects from the medication, a clinical pharmacist typically needs to assess the timing of your medication usage.
It is challenging to provide an answer regarding potential drug side effects based solely on your description.
Thank you for your inquiry.

Reply Date: 2018/10/22

More Info

Your situation involves a complex interplay between thyroid dysfunction, weight changes, and ear issues, which can be quite challenging to navigate. Let's break down the components of your question and provide a comprehensive understanding.

Thyroid Dysfunction and Its Impact
Thyroid dysfunction, particularly hyperthyroidism, can lead to a variety of symptoms, including weight loss, increased metabolism, and even changes in mood and energy levels. The thyroid gland produces hormones that regulate metabolism, and when these hormones are overproduced, it can lead to symptoms such as rapid weight loss, anxiety, and increased heart rate. In your case, the blood tests indicating abnormal thyroid function suggest that your thyroid may be overactive, which could explain the weight loss you are experiencing.

Ear Issues and Thyroid Dysfunction
The connection between thyroid dysfunction and ear issues is not as direct, but there are some potential links. The Eustachian tube, which connects the middle ear to the nasopharynx, can be affected by various factors, including hormonal changes. Thyroid hormones can influence fluid balance and mucous membrane function, which may contribute to Eustachian tube dysfunction. This dysfunction can lead to sensations of fullness or pressure in the ears, similar to what you are describing.

Your experience of ear fullness that improves when lying down or bending forward could indicate Eustachian tube dysfunction, which can be exacerbated by changes in body weight and hormonal levels. The conflicting opinions from different ENT specialists regarding your condition highlight the complexity of diagnosing ear issues, especially when they may be secondary to other systemic conditions like thyroid dysfunction.

The Role of Birth Control Pills
Regarding your question about whether the birth control pills (Yueji and Nina) could be causing thyroid dysfunction, it's important to note that hormonal contraceptives can have various effects on the body, but they are not typically known to directly cause thyroid dysfunction. However, they can influence body weight and fluid retention, which might indirectly affect how you feel overall. If you suspect that the contraceptives are contributing to your symptoms, it would be wise to discuss this with your healthcare provider.

Recommended Next Steps
1. Endocrinology Consultation: Since your thyroid function is abnormal, it is crucial to follow up with an endocrinologist. They can provide a thorough evaluation of your thyroid function and determine the appropriate treatment plan, which may include medication or further testing.

2. ENT Follow-Up: Continue to follow up with your ENT specialist regarding your ear issues. They may recommend additional tests, such as tympanometry or audiometry, to assess your middle ear function and determine the best course of action.

3. Monitoring Symptoms: Keep a detailed record of your symptoms, including any changes in weight, appetite, and ear sensations. This information can be valuable for your healthcare providers in determining the underlying causes and appropriate treatments.

4. Lifestyle Considerations: In the meantime, maintaining a balanced diet and staying hydrated can help support your overall health. If you experience significant changes in your symptoms or weight, seek medical attention promptly.

Conclusion
In summary, your symptoms of ear fullness, weight loss, and thyroid dysfunction are interconnected, and addressing them will require a multidisciplinary approach involving both endocrinology and otolaryngology. By working closely with your healthcare providers, you can develop a comprehensive treatment plan that addresses all aspects of your health. Remember, it’s essential to communicate openly with your doctors about all your symptoms and concerns to ensure you receive the best possible care.

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