<s>[INST] At night only, I can hear my pulse in my right ear only along with a roar. Breathing makes it pause, but then it starts again. I get up and go to different parts of my house, and the roar is in my right ear still. During the day, I don't hear the roar (and perhaps that's because I'm keyboarding, washing machine is going, dishwasher is going, and so on). I am age 54, 5'2", 210 pounds, and am on medication to control my high blood pressure. I have PTSD and take Effexer 75 mg every other night. Sometimes I take Xanax. I workout at least 3x week, cardio walking and lifting weights. I struggle with food choices because I was a compulsive overeater, and now I make poor food choices but don't eat food until I'm too full. Any insight you can provide is most appreciated. [/INST] Hello!Welcome and thank you for asking on HCM!I carefully passed through your question and would explain that your symptoms could be related to different disorders: - an inner ear disorder (as your symptoms occur only in the right ear)- high blood pressure- chronic anemia- thyroid dysfunction- an intracranial vessel malformation. That is why, I recommend consulting with your attending physician for a careful physical exam and some tests: - complete blood count- thyroid hormone levels. An ENT specialist consult would help exclude possible inner ear disorder. If an intracranial cause is suspected a brain MRI may be needed. Meanwhile, I recommend you to closely monitor your blood pressure and refer those values to your attending physician. Hope to have been helpful!Kind regards, Dr. Iliri </s>