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[JoannFran]

Hi ladies

I really hope everyone is ok!

I’ve not been here for a long time and hope it’s ok to ‘come back’? 🙏🏻

For the past year I have slowly been getting my life back after suffering from debilitating anxiety which I’d never had before. I’m 47 (almost 48). Dr diagnosed perimenopause and gave me HRT. It’s been a long journey to get dosage right etc and I don’t seem to be great with the Utrogestan. 

I’m now on 100 estrogen patches and meant to take 100 Utrogestan vaginally for 12 days. The utro was making me feel more anxious and really low so dr said I could try it one month on and one month off (and have regular scans to check womb lining).

Anyway, I’ve just completed the first month without the Utrogestan and it was much better in terms of mood, however I didn’t get a period. For the past week I’ve been having really frequent runs of ectopic beats and what feels like and irregular heart rhythm. This can go on for a couple of hours. I’m used to the ectopic beats as this was one of my first symptoms but they have always been every now and again. This is different. I seem to get a run of them, sometimes a few in a row. The only thing I can think of is that I’m estrogen dominant or low progesterone.

I had all the heart tests 18 months ago ECGs, Echocardiograms, 2 week holter monitor. Told that I have benign ectopic beats. 

I know lots of us have suffered with palpitations/ectopic/missed beats but wondered if anyone had multiple in a row or if you can attribute it to the high estrogen/low progesterone?

Sorry this is so long! And thanks so much for reading.

Have a great day!

[Flossieteacake]

Of course it is okay to come back! Please never think you cant.

Is ultrogrstan the only progesterone you have tried? I ask as there are other options and if you feel it is not the right progesterone for you then it may be worth trying a different one. You feeling better without it would indicate to me that it does not suit you.

You ask an interesting question and I will await answers from knowledgeable members. All I know is, heart palpitations can be common in peri but I do not know if it is anything to do with high or low amounts of hormones.

[Tracey1012]

My ectopic beats right now are awful. I’ve not had any for a year then 5 weeks ago they started out of no where. I was on Evorol Conti but started having bleeding so went to the Doctor and told her about the Ectopic beats and she decided to change my HRT and since then they have got worse. I’m now on Everol 100mg and Ustrogen 200mg 14/28 days. I feel so anxious today and I’m getting around 40 ectopic beats an hour. I’ve got an ECG in 20 mins at the surgery. I just want to feel normal. I was feeling great on the conti apart from a few Ectopics a day and the bleeding which was light spotting which has stopped now.

[Flossieteacake]

My ectopic beats right now are awful. I’ve not had any for a year then 5 weeks ago they started out of no where. I was on Evorol Conti but started having bleeding so went to the Doctor and told her about the Ectopic beats and she decided to change my HRT and since then they have got worse. I’m now on Everol 100mg and Ustrogen 200mg 14/28 days. I feel so anxious today and I’m getting around 40 ectopic beats an hour. I’ve got an ECG in 20 mins at the surgery. I just want to feel normal. I was feeling great on the conti apart from a few Ectopics a day and the bleeding which was light spotting which has stopped now.

Hello Tracey and welcome to the forum. Sorry to hear you are getting these. I hope the ECG goes well. It can take time to find the right HRT and it is difficult working around side effects.

[Wrensong]

Hello JoannFran & Tracey1012.  Sorry to know you are both having horrible ectopics.  I had these for about a decade spanning perimenopause & a few years post until I started HRT, at that time Evorel Conti (& had a change of thyroid medication).  They were gone within a few weeks of making those 2 changes.  They are quite common in menopause, unfortunately.

Mine used to come in long episodes of up to an hour at a time (so yes JoannFran, multiple in a row), 24/7, worse in evenings & overnight.  All cardiac tests came back OK & benign ectopics were diagnosed from Holter monitor.  They settled on HRT until I tried Utrogestan, which to my dismay brought them back, together with other horrible side effects, for which I had to stop Utro after 3 or 4 trials at various doses of oestrogen.  The ectopics I could feel while on Utro were confirmed on ECG & stopped within 36 hours of discontinuing it. 

I should perhaps say I'm progesterone intolerant & an atypical hypothyroid case, which seems to complicate matters.  Many women report feeling well on Utrogestan, finding it calming & sedative, but it has the opposite effect on me, making me feel wired, anxious, v hot & worsening insomnia, possibly because of its effects on thyroid status, or maybe because at 100mg the dose is way too high.

I'm sorry to say this as it's considered the gold standard for HRT use, but as Flossieteacake has suggested, there are other progestogens you can try that may suit you better if you feel it's Utro that's to blame.  Not sure with you JoannFran, as I think your post suggests your recently worsened ectopics came when not actually taking Utro?   The synthetic forms didn't cause ectopics for me, though I still felt very unwell on them in other ways.

Even long postmeno I have found the ectopics return in response to changes of either HRT or thyroid medication, but only a few a day & they have always settled after a couple of weeks.

I hope you both manage to get them sorted quickly as they can be very disconcerting.

  Tracey1012

[joziel]

I've also had palpitations, especially at night.

For me, I've narrowed it down to 2 things... Either estrogen (too high/low or peri fluctuations) or thyroid.

I've just recently discovered that I have really high rT3 (32) and pretty low T3. (It is still in range but bottom of the range.) The combo of these are giving me hypothyroid symptoms even though all my other thyroid tests are normal. I am waiting for an appointment in a few weeks to get some T3 from a private thyroid clinic.

I'd previously tested my thyroid with Medichecks and thought everything was fine because the results there were normal - but Medichecks don't test rT3. I recommend thethyroidclinic.co.uk if you want to get some private tests done which include rT3 and also online appointments for meds if needed. (Bit like private HRT clinics.)

[Wrensong]

Joziel, for those of us who need T3 it makes a big difference, so I hope you find it helps.  I've been on T3 for some years, being in the subset of hypothyroid patients - said to be around 15% - who can't convert Thyroxine adequately, meaning my T3 is always below bottom of ref range when tested.  I'm lucky to get it on the NHS, but I have to go private for testing as the NHS will usually only monitor TSH & sometimes T4, even for those patients on T3 & T4 replacement.  I find that surprising to put it mildly, as it's a very powerful hormone & it's important to be on the right dose.  I do also see an Endocrinologist privately on a regular basis, as balancing HRT & thyroid meds has been tricky.
Wx

[joziel]

Wrensong, give me more details about balancing HRT and thyroid doses and how it's been tricky?

With my symptoms at the moment, I'm not sure what is due to estrogen (needing more) and what is due to thyroid/needing T3.

I'm currently on 2 pumps of Oestrogel, due to increase to 3 in a couple of weeks time. (I'm with Newson.) If symptoms remain, I'm to increase to 4 pumps 4-6 weeks later. After the consult where I was told all that....

I then got my results back for thyroid, finding my rT3 was 32ng/dl and my Free T3 was 3.9 (3.1-6.8 was the range). I'm awaiting an appointment online with the Thyroid Clinic who can prescribe T3, which is in 3 weeks.

But I don't know if my symptoms are due to thyroid or estrogen...

I know that the cold feet and slow metabolism are thyroid, but I've had those symptoms for years and years and they predate the awful nighttime symptoms I have at the moment.

The nighttime symptoms are:
- Heart beating harder than usual and faster than usual (95bpm resting pulse, half asleep - usually 50bpm).
- Inner tremors - can be just in feet or hands, or can be core and more whole body.
- Hands going numb in my sleep even when just resting on my chest, not in a weird position.
- Insomnia - especially hard to get into deep sleep. When I sleep it is usually light dozing/dreaming. I feel like something is keeping me out of deep sleep - if my body starts to go there, I startle or jerk awake.

This has all been going on for 16 months now and I've explored so much. I had an iron infusion because I thought it was low iron at first. (My ferritin is now 192, but it was 30.) I got B12 shots from Germany and self-injected every other day because my B12 was 495 but I'd been taking a b-complex which I thought could have affected the results. Tested D3 (optimal), folate (optimal), electrolytes (fine). ECGs are fine. I'm scheduled for an echo on Monday but I don't think it's my heart, that's just another symptom.

So - I don't know if I should wait to increase the estrogen until I've got some T3 started and can see what that does? Or if I should go up a pump on schedule with the estrogen and see what that does?! arrrgggg......  What do I change first? And if these things can take many weeks to see the full effect (that's true with estrogen anyway) I've no idea how to work this out... How long does T3 take before you can tell it's doing something?  I feel like 2 pumps is a pretty low dose for someone in early peri anyway, so I probably should go up a pump on the estrogen anyway.... Then there will be 3 weeks before I get the T3 to start it, so maybe I'll know more by then...

[Wrensong]

Hi Joziel.  I'm happy to look at your situation with you, but shall we do it either on the thyroid thread or via PM if you prefer, so as not to take this thread further off topic?  You have a lot going on there in addition to the heart stuff & it probably won't be quick to go through.  You could copy your last detailed post across if you like?

I'm not on the forum so much at the mo as I've had a challenging few weeks of other stuff going on, so I might also be slow to respond.
Wx

[joziel]

Sure, I will PM you (not sure where the thyroid thread is?!)

[Wrensong]

Hi Joziel, just a quick post on one point you raised as it's not relevant to this thread.  A long time since I'd read anything about rT3, so just spent a couple of hours looking into it in light of your situation.  My need for Liothyronine (T3 supplementation) was established without rT3 testing & I am prescribed it on the basis that my fT3 is consistently below range & my (very senior) endocrinologist thinks this is due to a genetic conversion defect.  I had a hemithyroidectomy nearly 30 years ago & have Hashimoto's.  I had assumed you were a hypothyroid patient already on Thyroxine but you state that your TFT is in range so I'm not sure whether you mean on replacement, or that you have in fact not been diagnosed hypothyroid. 

Most of the articles I found do not advocate taking T3 to try to address a raised rT3 result, so I would look into this very carefully before you go ahead with that course of action.  The suggestion is that raised rT3 can be caused by various non-thyroidal factors such as low calorie diets, especially low carb, inadequate ferritin levels & a number of disease conditions & that as the body's production of rT3 may be a protective mechanism to conserve energy, taking T3 to address this can do more harm than good. 

I'm sorry if you have already researched widely on this & feel it is nevertheless the right course of action for you, but I simply don't want you to inadvertently come to any harm.  I won't go into more detail now but it feels important to sound this note of caution here, where the topic was raised.  I may go back to the articles on the controversy around raised rT3 & post them on the Thyroid Support thread later if it seems appropriate & they don't contain commercial links.  They are detailed & I had to scan parts.

I will have a look at your PM later in case there are other areas we can usefully look at together.  I'm sorry if this is disappointing for you, but I would advise seeking opinion from a good endocrinologist if you feel that high rT3 might indeed be at the root of your symptoms.  I don't know anything about the thyroid clinic you mentioned.

JoannFran - apologies - thyroid queries often come up on threads on other topics & sometimes points come out of them that it feels important to deal with at the time.
Wx

[joziel]

Hi thanks!

Yes, I’ve read all the opinions. There is a difference between mainstream medicine which completely disregards rt3 and naturopathic medicine on this one but given the severity of my symptoms it’s judged to be appropriate to trial T3 because it is far preferable than powerful neuro toxic drugs like Pregabalin which is the other way to go. It would give mybodya chance to resume normal functioning and to eat normally rather than one apple a day which is all I can currently eat alongside 3 hours of sleep. With a view to then weaning off the T3 in a few months.

All possible nutritional deficiencies have been fully investigated for over a year now and there are none since my iron infusion in February.

[KaraShannon]

I haven't been able to read all the responses here but just want to say that when I was taking estradiol only I started having really weird heart stuff going on.  I too have had all the tests and told this is benign, but it was different with the estradiol only.  After a while I even got dizzy, postural hypotension that was bad and feeling like my heart couldn't keep up with my movements after being sat down. 

I've been lowering the estradiol, re-introduced progesterone and feeling loads better.  I think there was a definite link with my womb lining and heart skips on this occasion.  With the progesterone reintroduced I had pretty strong period pains (though I'd been estradiol only for a few months) which I never have, but after it all the heart symptoms disappeared.

the progesterone I have is from the evorel sequi patches, so it's norehisterone.  I did try utrogestan but felt asthmatic and bloated on it very quickly.  I will try it again at some point, I know it's more natural, but for now I feel at my best on norehisterone.  I'm thinking of switching to evorel conti as I feel so much better on a combined patch.