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Roughly 70% of people with hypothyroidism report having vertigo. This might leave you wondering what vertigo is and its connection with hypothyroidism. To understand the connection, let’s review the importance of our vestibular system.
Your inner ear and brain make up your vestibular system. This system controls your balance and eye movement. With aging, an injury, or certain diseases your vestibular system can become damaged. Thus causing a vestibular disorder. Symptoms of a vestibular disorder include:
- Dizziness
- Vertigo
- Brain fog
- Imbalance
- Ringing in your ears
- Hearing loss
- Changes in thinking, attention, or memory
- Nausea
- Mental health changes (anxiety and depression)
Symptoms of a vestibular disorder are very similar to those of people with hypothyroidism, a condition where your thyroid hormone levels are too low. While hypothyroidism isn’t well known to cause nausea, the rest could also be attributed to hypothyroidism. Common symptoms of hypothyroidism or autoimmune diseases such as Hashimoto's include:
- Cold intolerance
- Weight gain
- Muscle aches and pains
- Dry skin
- Constipation
The Workings Of The Inner Ear
The inner ear, called the labyrinth, consists of the cochlea, semicircular canals, and otolithic organs. Inside the walls of these structures are tubes and sacs filled with a fluid called endolymph. All these work together to help your balance and hearing. But how?
When you move, endolymph fluid in your balance organs (semicircular canals and otolithic organs) turns on specific receptors. Because of this, a signal is sent to your brain about the movement and the body’s position. Endolymph fluid responds to sound vibrations in the cochlea (the hearing organ). This causes sensory cells to send a signal to your brain. Disrupting the amount or flow of endolymph fluid can throw off your balance and hearing, as seen in different types of vertigo.
Vertigo is when you feel like the room is spinning and is often due to a problem with your vestibular system. You may experience nausea and vomiting during episodes of spinning. Moving into different positions may make your vertigo worse.
Types Of Vertigo
Vertigo is classified as either peripheral or central. A problem with your inner ear causes peripheral vertigo. This could be due to
- An injury such as a head injury
- Pressure on or inflammation (swelling) of the vestibular nerve
- Swelling or irritation to the inner ear
- Benign positional vertigo
- Ménière's disease
Causes of central vertigo are related to a problem in the cerebellum (back part of the brain) and include:
- Vestibular migraines
- Tumors
- Stroke
- Multiple sclerosis
- Blood vessel disease
Difference Between Dizziness And Vertigo
While these two terms are similar, they are not the same.
Dizziness is when you feel lightheaded or unsteady. It is usually a symptom of other conditions, such as low or high blood pressure or dehydration. Most times, dizziness will go away on its own with no treatment.
As previously mentioned, vertigo is when you feel like the room is spinning. Vertigo may require treatment from a healthcare provider that specializes in ear, nose, and throat (ENT).
Researchers believe that hypothyroidism causes inflammatory or metabolic changes. Because of this, your inner ear can become inflamed, or the flow of endolymph fluid changes, causing balance disturbances and/or hearing changes. These changes can lead to vertigo.
Peripheral vertigo, or a problem with the inner ear, is associated with mild cases of hypothyroidism. Whereas cerebellar impairment seen in central vertigo tends to be associated with severe and prolonged deficiency of thyroid hormone. Thus, symptoms of vertigo are linked to the severity of hypothyroidism. People that are born with hypothyroidism (congenital) have a higher incidence of vestibular dysfunction.
The Autoimmune Link
Another theory is that thyroid autoantibodies change the makeup of the endolymph fluid. Your body makes thyroid antibodies when your immune system mistakenly attacks your thyroid gland in an autoimmune condition called Hashimoto’s thyroiditis. Changes in the endolymph fluid can alter the flow. Thus causing vertigo.
A 2019 study showed that people with hypothyroidism had a greater chance of developing Ménière's disease than those without it. Ménière's disease is a disorder of the inner ear due to endolymph fluid buildup.
While the link between Ménière's disease and hypothyroidism is not fully understood, researchers from the 2019 and 2004 studies believe there may be an autoimmune connection. The thought is that the abnormal autoimmune response in people with an autoimmune thyroid disorder influences the inner ear autoimmune dysfunction seen in Ménière's disease.
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No, it doesn’t. Other causes depend on whether the vertigo is peripheral or central.
Vertigo may or may not get better with thyroid treatment. The results are mixed based on available studies.
A small 2016 study found 12 out of the 35 participants diagnosed with Ménière's disease had hypothyroidism. After starting thyroxine treatment, all 12 participants had improvement in their Ménière's disease symptoms.
But, another study showed that only 3 out of 17 participants with Ménière's disease and hypothyroidism had symptom improvement after starting thyroxine treatment.
Depending on the type of thyroid replacement medication, it could take up to 6 weeks for your thyroid hormone levels to reach and stay within the normal range. If you are still experiencing vertigo after starting thyroid medication speak with your healthcare provider or schedule a virtual visit with one of Paloma’s knowledgeable thyroid practitioners. They may want to review your symptoms, check your thyroid levels, or adjust your medication dose.
Your Guide To Thyroid Medication
Optimizing your thyroid levels with thyroid hormone replacement medication is usually the first step in minimizing symptoms.
Wondering if hypothyroidism is causing your symptoms of vertigo? Checking your thyroid levels is the easiest way to find out. Paloma’s home thyroid test kit is convenient and easy to use. A blood sample collected from a simple finger prick and mailed to the lab can tell you your TSH, free T3 and T4, and thyroid peroxidase antibody level. Schedule a virtual visit with one of Paloma’s thyroid practitioners to help you interrupt your results.
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