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[Baby]

Yes it's nearly five weeks. I am on everol conti HRT for two months and I am having spotting and am currently on my second full monthly bleed as well. Feel absolutely awful today. Don't think I should even be on conti. I am peri. Longest without a period was nine months.

[Baby]

Oh and when I had my bloods done before I had them done half five tea time and I have heard you should have them done in the morning for a better reading?

[Hurdity]

Hi there everyone - I know very little about thyroid and menopause except that I have always thought it is no coincidence that underactive thyroid/Hashimoto's seems often to become newly diagnosed more in women, and in the years leading up to and following menopause so there has to be a connection. Endocrine function is so extremely complex and balanced that I don't think it is fully understood and certainly I agree that thyroid function should be monitored at the same time as menopause - and that menopause specialists should also have an understanding of thyroid function and the interactions. Somewhere in a thread someone mentioned CFS, ME and fibromyalgia and I know thyroid UK say that the majority (?) with fibromyalgia may well actually be undiagnosed hypothyroid due to almost identcial symptoms. (And as an aside several on here were diagnosed with CFS/ME for sex hormones deficiencies at menopause or sometimes before - especially low oestrogen and/or testosterone and these conditions were cured once on a decent dose of HRT).
 
Re the confusion - as an outsider to this thread I think it is just semantics from coming to it new, which could be down to cultural differences in how we refer to different conditions and treatments....if I'm right Penelope you are referring to "thyroid hormone replacement therapy" which is thyroxine or T3 or both and you are differentiating this from "thyroid medication"?

In UK and US and maybe also Canada, we use the term "Hormone Replacement Therapy" exclusively in relation to female sex hormones that become deficient at menopause. Some menopause societies and academics use the term "Menopausal Hormone Therapy" or MHT although HRT tends to be used be lay people and especially in UK. The term "hormone replacement therapy" would not be used (to my knowledge - well maybe by academics/medics working in those fields?) for other hormone treatements eg insulin for diabetics or thyroxin ( etc!) for hypo-thyroidism. These latter treatments, even though they consist of hormones, are generally referred to as medication or thyroid hormones etc.

Is this what you mean? if so that is the confusion - just terminology! Apols if I've got thr wrong end of the stick!

Kathleen - I didn't know you were hypothyroid - that does explain why you had all those symptoms and none of the HRT regimes we suggested seemed to work which was puzzling! I couldn't even understand your symptoms but now I do - well - I have not experienced them, but at least you have an explanation. I hope you manage to get it sorted do that you feel a whole lot better very soon

Hurdity x

[Penelope]

Hi Wrensong when you reach the age of menopause the go to treatment for Hashimoto's is HRT.
When a women hits Peri and beyond her symptoms will ramp up way above someone that is going through menopause naturally without a thyroid condition.If I was say 30 I would be on Synthroid or something like that.
For example I was waking every two hours at night my flushes were every one-two hours my anxiety was off the charts.Brain fog.I had had all theses same symptoms all these years except the flushes I was just hot all the time.The symptoms were milder till peri hit!
Does that help?

[Kathleen]

Hello again ladies.

Wrensong - thank you so much for your encouraging and reassuring post. Sometimes I do worry that I'll never feel any better and that scares me.

Hurdity - I also know very little about the Thyroid and the menopause but I'm learning fast lol!  According to my neighbour's doctor Thyroid problems and depression were the most commonly diagnosed conditions for women in her age group. She was in her mid fifties at the time and was prescribed thyroxine and  an anti depressant but never needed HRT.  I'd like to think that once my Thyroid condition is sorted out my other hormones will fall into line and play ball! As you say the endocrine system seems to be devilish complicated. It even makes you wonder if all women who struggle to benefit from HRT should be automatically tested for Thyroid function.

Thanks again ladies for your interest and kind words.

Take care.

K.

[Chihuahuachick]

I haven't read all of this post but I use t gel coal shampoo on exfoliating gloves.

Also I put coconut oil on my skin.

Table salt baths too.

All the above keeps it under control.

[Penelope]

Hi Kathleen you just hit the nail on the head with that statement.

Every women should be tested.But the terrible thing is the dam tests keep coming back normal.GRR my sons T4 test just came back at 19.6 and 20.4 is the top of the range.
On my diagnosis and my aunts and my great aunts and his finger tremors,depression,and insomnia should as it was in the 1960s be enough to start treating him with thyroxine.
We won't go there about my tests.🥵

Every women that has miscarriages or can't get pregnant or has a baby with a deformity or has post natal depression should be tested immediately.But they don't.........

[Wrensong]

Hi Penelope, I'm still not sure I understand what you mean here:-

Hi Wrensong when you reach the age of menopause the go to treatment for Hashimoto's is HRT.

  &

I am not on thyroid medication the go to medication for Hashimoto's just happens to be HRT so fingers crossed

I thought I remembered you posting that you had recently started HRT & you've stated above you don't mean thyroid replacement so I thought by "fingers crossed" you were hoping that your menopause HRT medication would address the situation with your thyroid antibodies.

Not sure whether you've seen Hurdity's helpful post above explaining terminology relating the two conditions of hypothyroidsim & menopause as we talk about them in the UK, but I hope the attached link will also help.

 https://patient.info/doctor/hashimotos-thyroiditis

The article is entitled "Hashimoto's Thyroiditis" & the relevant para is under the headings Management, Pharmacological and states that the treatment is:-

"Thyroid hormone replacement - orally administered levothyroxine sodium, usually for life."

I am one such Hashimoto's patient, having been on Thyroxine for 25 years.

Menopausal hormone replacement therapy, usually abbreviated in the UK to HRT as Hurdity says, cannot correct a thyroid hormone deficiency.  However HRT may also be needed to address menopause symptoms in hypothyroid women on Thyroxine or other thyroid hormone replacement medications.  Several of us on this forum take both thyroid replacement & menopausal HRT.

It is possible to have thyroid antibodies & not need thyroid treatment if these have not damaged the thyroid gland sufficiently to cause it to malfunction significantly (either via under- or overactivity).  In this case it's sensible to monitor the situation with thyroid function tests & sometimes other investigations, so that any malfunction of the gland that may develop can be treated sooner rather than later.

my sons T4 test just came back at 19.6 and 20.4 is the top of the range.
On my diagnosis and my aunts and my great aunts and his finger tremors,depression,and insomnia should as it was in the 1960s be enough to start treating him with thyroxine.

A T4 level towards or above top of ref range is not usually an indication to prescribe Thyroxine.  High - above range - T4 levels are found in hyperthyroidism (overactive thyroid) not hypothyroidism (underactive).

However, there is an exception, in that a small percentage of patients on Thyroxine may consistently have a T4 close to the top of the ref range & still feel unwell with symptoms of hypothyroidism, which may indicate that Thyroxine is not being adequately converted into its active form.  In this case T3 (Liothyronine) may be needed in addition to or instead of Thyroxine.  If your son has not been diagnosed hypothyroid & is not on thyroid medication to treat that condition, the need for prescription T3 as explained here is not applicable.

TSH is produced by the pituitary gland to stimulate the thyroid to produce more thyroid hormone so it's when TSH is raised above top of ref range that hypothyroidism is diagnosed.  Raised TSH is usually accompanied by low levels of T4.

I hope this helps.  I'm just trying to be sure we all understand each other's situations. 
Wx

[Penelope]

Wrensong starting to see your confusion.
My blood tests are normal.
I have a double nodular goitre.
Symptoms through the roof for 26 years including a baby with cleft lip and palate.
Postpartum thyroiditis.
Biopsy of goitre two months ago showed Hashimoto's
Did antibodies test and very high.

Endo said only treatment for me is HRT.

[Wrensong]

Oh Penelope, I see.  Thanks for the clarification.  You are in a difficult situation, I'm sorry.   

Treating any menopause symptoms with HRT should help reduce stress on your body, so I'm wondering whether your Endocrinologist's thinking is that that may help reduce the progression of the autoimmune thyroid condition.  He may also perhaps feel he has few tools in his box while your thyroid hormone levels are within the normal range. 

There's also the issue of some thyroid & menopause symptoms overlapping (as you know) so please go back to your Endocrinologist with any symptoms you are not sure about that continue to be troublesome after a reasonable trial on HRT.  Or a different Endo if you are not happy with your current one.

Whatever you decide to do, please make sure if you can, that your thyroid continues to be monitored to try to catch any treatable changes early.

You may already know that the late Dr John Lowe had some interesting things to say about patients with thyroiditis & hormone levels within the ref range.  I won't post a link here because it doesn't help your immediate situation, but you may want to have a look at Thyroid UK's website if you haven't already.

There is a school of thought that autoimmune tendencies can be influenced for the better (I won't say controlled) by any measures we can take to reduce inflammation.  This includes anti-inflammatory diets & stress-reducing practices such as meditation.  I believe Kathleen has had great success treating her inflammatory digestive condition with diet, so she will know a lot about this natural approach if you want to pick someone's brains on the subject.

I feel at a loss to know what else to suggest, but I do hope the HRT helps with any menopause symptoms.
Wx

[Kathleen]

Hello again ladies

Wrensong -  thanks for the mention and yes I do believe my anti inflammatory diet has helped keep my UC in remission.  I am  however a bit miffed that I now have Hashimoto's, probably as a result of Glandular Fever.
I am trying to learn all I can so I am very interested in your replies to Penelope. Are you saying that she doesn't need to take  Levothyroxine even though she has Hashimoto's? Sorry to pick your brains  and the answer is probably in the links you kindly posted but I am a bit confused at the moment.

Wishing you well.

K.

[JCH187]

I've been in a battle with my thyroid for years now, was diagnosed under active at 37 (I'm 50 now), didn't ever feel the benefit of levothyroxine but kept going back to the docs, in the end pushed to see an endo, she put me on liothyronine (T3) too, things did improve, not massively but enough that I could live. I'm menopausal now and still struggling to get some relief, been on HRT for about 8 months now and have recently started on Fluoxetine as my moods are so low. I've had other autoimmune conditions throughout my life, had hives everyday for a year (heat/cold, pressure and urticaria vasculitis), things got so bad with them they wondered if I had Lupus.. Pretty sure everything is linked.

[Wrensong]

Hi Kathleen.  Please don't apologise for asking questions.  I understand your being put out about the hypothyroidism, given the lengths you went to to manage the UC & especially as you had such success with that approach.  I wonder whether if you hadn't managed the UC so well, your body might have been less well equipped to cope, so that the hypothyroidism might have presented earlier.  What I mean is can you maybe look at it that you may have helped delay onset or slowed its progress perhaps?  I know they think it stems from your recent Glandular Fever, just as I was told my hypothyroidism was probably caused by my adult-onset Chicken Pox, but my understanding is that no-one can be sure what led us both to develop Hashimoto's.  Anyway, please give yourself credit for what you achieved with the UC - that was no mean feat.

"I am very interested in your replies to Penelope. Are you saying that she doesn't need to take  Levothyroxine even though she has Hashimoto's?"

No, not saying that at all - Penelope may need thyroid replacement in the future if her thyroid gland becomes measurably underactive. 

Though I've been a bit unsure of Penelope's situation, what I now gather is (please correct me if I'm wrong Penelope), that Penelope has been found to have thyroid antibodies but that her thyroid hormone levels are still within the ref range.  Medics are usually reluctant to treat in those circumstances, though some will agree to a trial of Thyroxine if hormone levels are borderline & the patient has symptoms strongly suggestive of progressive thyroid failure. 

Not everyone with antibodies has clearly demonstrable thyroid dysfunction, especially in the early stages of the condition.  So I think Penelope finds herself in the regrettable position of having felt unwell for a long time with horrible symptoms/consequences she suspects are due to the effects of her thyroid antibodies, without confirmation from her doctors that this is what's been making her poorly.   Penelope's Endocrinologist may feel unable to help further with her thyroid condition unless & until her thyroid hormone levels go outside the ref range.  I sympathise as I was unwell for a long time before my Hashimoto's was diagnosed & as we all know, not having answers or effective treatment can be frustrating & upsetting to say the least.

As it can also be as difficult for medics as it is for patients to determine which symptoms are due to menopause & which may be thyroid-related, her doctor may be treating her with HRT in the hope some of the ambiguous ones will resolve.  Or he may just feel bad he can't treat her thyroid at this stage & want to see if he can help her feel better in general with the limited tools available to him.

Penelope, please put me right if I've misunderstood anything.   
Wx

Taken an age to get this posted with the server issues putting a spanner in the works!!

[Wrensong]

Hi Baby, sorry it's taken so long to answer your question about best time of day for TFTs - my (private) Endocrinologist likes me to have mine before I take that day's thyroid medication.  So fairly early morning.

I've had a trawl to see what I could find in the way of NHS advice on timing & drew a blank.  However I came across the following.

Thyroid UK website says:-
"TSH has a circadian rhythm (24 hour cycle) and levels peak between midnight and 6am.  T3 has a similar circadian rhythm. It is therefore a good idea to have your thyroid tests done at the same time of day each time as your levels may differ at different times of the day."

Interestingly, in the Indian Journal of Endocrinology & Metabolism they cite a study that found that food lowers TSH (in bloods taken 2 hours after eating):-

"TSH levels showed a statistically significant decline postprandially in comparison to fasting values. This may have clinical implications in the diagnosis and management of hypothyroidism, especially SCH." 

By SCH they mean subclinical hypothyroidism.

So unless your doctor advises otherwise, it seems sensible to have TFT's early morning, before taking thyroid meds & before eating.  Hope this helps.
Wx

[Kathleen]

Hello Wrensong

Thank you so much for your kind post.

It did occur to me that I may have been dealing with low Thyroid function for some time without realising it. As I've said before I asked for a Thyroid blood test 18 months ago but wasn't treated as I was just within the normal range. Given that hormones fluctuate throughout the day I assume  my thyroxine levels could've been much lower at times.

I like to think that my anti inflammatory diet has been of benefit and this may be why I have not developed a goitre (well, not yet anyway).

Thanks again for your helpful comments, especially as the server is making posting anything difficult at the moment.

Wishing you well.

K.

I will continue to learn