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[Fizwhizz]

Hi Furry,

I think oestrogen does have an impact. I believe from my reading the more oestrogen you have the more thyroid hormones you need in your system to clear it. I think I’m having this problem I’m getting oestrogen heavy as not enough thyroid hormones to clear it from my system. I’ve been spotting so that’s a whole another worry. I’ve stopped oestrogen at the moment until I work out what to do. I’m on progesterone. I think Rachel Hill thyroid advocate is on your regimen of T3 and NDT. I was reading something about this today. I’m feeling rather fed up currently so can relate and am sure I have thyroid eye disease. I have so many issues from dryness, to puffiness, redness, sudden pain and they just look weird but currently according to NHS blood tests results I’m fine. 🤦‍♀️

[Fizwhizz]

This is interesting.

https://www.imaware.health/blog/hypothyroidism-and-menopause#:~:text=Estrogen%20regulates%20the%20protein%20that,menopause%20can%20magnify%20one%20another.

[joziel]

Furyan, that is going to be a false estrogen reading. Was it a venous draw? And you don't use gel so there's no way the site could have been contaminated?

I think it's very unlikely that 3000 is going to be your correct estrogen result. I suggest you to another test on day 3 of your cycle (during your period, assuming you're still peri) to get a sense of what your 'lowest' reading is and what the HRT is giving you. (Your own body might be contributing at other times of the month more.)

Too high estrogen is definitely not a factor for me. I've never had a reading over 400 and that was only once. Most of the time it was 150-198 until I went up to 6 pumps of gel, and now it's about 343pmol.

I am very confused about what is going on with me and whether I do indeed have anything wrong with my thyroid now.

I got results back from my last bloods on 50mcg T4 and 15mcg T3 (5mcg 3x/day) and my T4 was pretty low, only just in range - but my T3 had gone up quite a lot, to 5.1 (top of range 6.8 ) having been at 4.3 on my last bloods. And the only change I made between those bloods was to add the 50mcg of T4. Which suggests that my body is able to make use of T4 and convert it.

In which case, why was my original pre-thyroid meds blood test showing high/optimal T4 but low T3 and high rT3? That doesn't make any sense. If I can convert levo, I should be able to convert my own T4. I'm so tired of trying to figure out what's going on and why I have these awful night time symptoms. I'm waiting for my rt3 result this week to confirm that I'm not converting T4 to rt3 - but if that is low, then I should probably increase my T4 to 75mcg and see if that helps rather than adjust T3 at this time. (As I'm now on 10, 10, 5 of T3, I might need to come down on the T3 if I increase T4.)

But I am still not understanding why I can convert levo to T3 but not my own T4. And then I start to wonder if we weren't originally right in the first place, that I just needed to clear the high rT3 to reset things but don't need ongoing thyroid meds. Anyway, it's all v confusing.

[Furyan]

Furyan, that is going to be a false estrogen reading. Was it a venous draw? And you don't use gel so there's no way the site could have been contaminated?

I think it's very unlikely that 3000 is going to be your correct estrogen result. I suggest you to another test on day 3 of your cycle (during your period, assuming you're still peri) to get a sense of what your 'lowest' reading is and what the HRT is giving you. (Your own body might be contributing at other times of the month more.)

Too high estrogen is definitely not a factor for me. I've never had a reading over 400 and that was only once. Most of the time it was 150-198 until I went up to 6 pumps of gel, and now it's about 343pmol.

I am very confused about what is going on with me and whether I do indeed have anything wrong with my thyroid now.

I got results back from my last bloods on 50mcg T4 and 15mcg T3 (5mcg 3x/day) and my T4 was pretty low, only just in range - but my T3 had gone up quite a lot, to 5.1 (top of range 6.8 ) having been at 4.3 on my last bloods. And the only change I made between those bloods was to add the 50mcg of T4. Which suggests that my body is able to make use of T4 and convert it.

In which case, why was my original pre-thyroid meds blood test showing high/optimal T4 but low T3 and high rT3? That doesn't make any sense. If I can convert levo, I should be able to convert my own T4. I'm so tired of trying to figure out what's going on and why I have these awful night time symptoms. I'm waiting for my rt3 result this week to confirm that I'm not converting T4 to rt3 - but if that is low, then I should probably increase my T4 to 75mcg and see if that helps rather than adjust T3 at this time. (As I'm now on 10, 10, 5 of T3, I might need to come down on the T3 if I increase T4.)

But I am still not understanding why I can convert levo to T3 but not my own T4. And then I start to wonder if we weren't originally right in the first place, that I just needed to clear the high rT3 to reset things but don't need ongoing thyroid meds. Anyway, it's all v confusing.

Joziel - lovely to see you! Yes, I was shocked about the oestradiol reading being slightly short of. 75 patch. As said, I’ve now reduced by cutting it to a .56 equivalent and been off testosterone for a week. It was a finger **** test but I persuaded my GP to do test this week via venous to see what the levels are now. I’m 3 years post meno now so no periods.

Your T3 looks good! It’s ok for your T4 to be low to mid too so it seems as though you are converting. I’m very interested that your results appear to have done a complete turnaround? How does this translate to how you feel energy wise and all things hypo though?

Really sorry about your nighttime symptoms. What are they? x

I’m a little nervous about adding T3 to my NDT without a full consultation so I’m very keen to see the thyroid doctor (or the consultant) as soon as possible. Hoping that by then the rT3 result will be back. For now, the consultant suggested a way to get started on it but I’m taking it very slowly. What is clear is that I have to be prepared to raise my T3, which is only 3.7, hence why I started to add it.

[Furyan]

Hi Furry,

I think oestrogen does have an impact. I believe from my reading the more oestrogen you have the more thyroid hormones you need in your system to clear it. I think I’m having this problem I’m getting oestrogen heavy as not enough thyroid hormones to clear it from my system. I’ve been spotting so that’s a whole another worry. I’ve stopped oestrogen at the moment until I work out what to do. I’m on progesterone. I think Rachel Hill thyroid advocate is on your regimen of T3 and NDT. I was reading something about this today. I’m feeling rather fed up currently so can relate and am sure I have thyroid eye disease. I have so many issues from dryness, to puffiness, redness, sudden pain and they just look weird but currently according to NHS blood tests results I’m fine. 🤦‍♀️

Hi Fizwhizz, I thought there is a link between thyroid and oestrogen too. I feel rather in the dark about adding the T3 because, ideally, this should be done following consultation. It’s unfortunate and frustrating that the thyroid doc isn’t available at the moment and my consultation has been put back as a result. I started to spot too, but I think it’s because I reduced my patch when I saw those elevated results. I’ll be interested to see what the levels are now as it’s been over a week that I reduced it.

[Fizwhizz]

Hi Furry,

I think oestrogen does have an impact. I believe from my reading the more oestrogen you have the more thyroid hormones you need in your system to clear it. I think I’m having this problem I’m getting oestrogen heavy as not enough thyroid hormones to clear it from my system. I’ve been spotting so that’s a whole another worry. I’ve stopped oestrogen at the moment until I work out what to do. I’m on progesterone. I think Rachel Hill thyroid advocate is on your regimen of T3 and NDT. I was reading something about this today. I’m feeling rather fed up currently so can relate and am sure I have thyroid eye disease. I have so many issues from dryness, to puffiness, redness, sudden pain and they just look weird but currently according to NHS blood tests results I’m fine. 🤦‍♀️

Hi Fizwhizz, I thought there is a link between thyroid and oestrogen too. I feel rather in the dark about adding the T3 because, ideally, this should be done following consultation. It’s unfortunate and frustrating that the thyroid doc isn’t available at the moment and my consultation has been put back as a result. I started to spot too, but I think it’s because I reduced my patch when I saw those elevated results. I’ll be interested to see what the levels are now as it’s been over a week that I reduced it.

The link I posted second to an article helps explain some of it I thought. It gets very complicated though and as soon as you do something with one hormone it has a knock on effect it seems. I panicked about the spotting and have stopped the oestrogen immediately. Waiting to hear from the private menopause GP re that. She upped my dose before Xmas as symptoms and tests showed oestrogen was low but I think as my body’s not clearing it effectively it’s now ramping up. I’m sooo fed up of all the faffing around and not feeling great. My eyes are bothering me too. I have dry eyes, puffiness etc and think it’s thyroid related but not Graves. I dunno what’s going on! 🤷‍♀️
Solidarity ladies! x

[joziel]

It's all a bit confusing really, what's going on with me. I'm definitely not symptom-free but I am a LOT better (overall) than I was last summer, before starting thyroid meds. I did also notice a huge improvement in symptoms when I first began T3 and when I first began T4. I didn't retain that improvement totally, but the fact that what I did affected the symptoms I had, was enough of an indication for me to think that thyroid is somehow behind this.... (I've tried so much else - B12 shots, iron infusion etc - and nothing else has 'influenced' the symptoms at all. So I feel like I'm mucking around with the right things when it begins to do something, even if it's not very clear yet what is going on.)

My symptoms, by the way are:

Inner tremors, worse at night - can just be a buzzing or fizzing in my feet when minimal, when at max my whole body feels like it's shaking the bed
Heart beating hard (can see aortic pulse in my chest, hear it in my ear) and faster than usual (resting pulse can be 95bpm, taken just after being woken from sleep)
Hypnic jerks as I start to fall asleep (either my body jerks or my mind startles and I feel totally awake suddenly) - until I just stop being able to fall asleep
Insomnia from all the above, resulting in sometimes 3 hours light sleep...

So they are really neurological symptoms which happen mainly at night...

I am thinking it's not just about estrogen or just about thyroid, but about some kind of interaction between them and both need to be optimal. I'm currently on 6 pumps of gel but that only gives me 334pmol so I might be changing to Sandrena in the next couple of months. (I've got my Newson follow up at the start of March.) I'd like to try getting estrogen to 400-600pmol and seeing what that does to symptoms.

And with thyroid, I never really had energy problems or fatigue. Even when I couldn't sleep I was so wired-but-tired during the day, I was just pumped with adrenaline. My metabolism is definitely faster and I can eat more than the ridiculously small amount I could eat before.

My T3 is actually slightly low, because if you're on only T3 or mainly T3 then you need it right at the very top of the range if not slightly over - and mine isn't there yet. But if my rT3 shows that I can convert T4 when I finally get the result this week, then I will try to increase T4 instead of T3. I also will have zero understanding of why my body can do that but couldn't convert my own T4...

[klf68]

klf68, thank you for the further detail.  I very much doubt you're a hypochondriac.  The combination of menopause with a thyroid condition can make this time of our lives especially difficult & though there are some great clinicians out there willing to listen & work with us, there has historically been a tendency to medical gaslighting with hypothyroidism, in common with other conditions that predominantly affect women, meaning over time our confidence in our own instincts & judgement can get trashed, leaving us feeling dismissed, hopeless & ashamed to keep telling it like it is, as if the very real symptoms we have are somehow imaginary or due to our own failure.  You will be heard here though.

Looking at your latest post in order of the points you raise . . .

Given your v poor absorption, have you tried methods other than patches for your oestrogen, or even just changed to a different patch brand if you prefer to persevere with patches?  I used to get around 240 from a 37.5mcg Estradot patch (long postmenopause & no ovaries) to give you an idea of what's possible for women who absorb well in contrast to your <18 from that dose which I'm assuming was also Estradot, unless you were cutting down another brand?  Have you tried Estrogel or Sandrena?  Personally I don't get on well with once/twice a day methods but many women on here love the gels.  Lenzetto has a reputation for giving lower levels so I'd avoid that in your case, at least for now.  Agreed, private treatment can be very expensive & sadly, given long NHS lists & frustratingly patchy expertise in menopause care, beyond the means of many women.

Before I logged on & read your latest post I'd been wondering whether going as long as 36hrs between your thyroid meds & the latest test had skewed the picture a bit.  Given the difference in that TFT & the one when you'd had your meds only 12 hrs before & your TSH was considerably lower with correspondingly higher T4, it does now look as though time between last dose & testing could have had some bearing each time.  But other variables can affect our results too & if one test was fasting & the other not, as you know that may have made a difference.    You'll know too, that Thyroxine has a long half life, but I wouldn't be surprised if at the Dec test your body was registering you'd gone too long without that day's dose, giving a possibly misleading picture, making you look a bit under-treated.  I don't fast for my TFTs btw - it's impractical for me given the long drive involved & test timing, but I take my meds around 2hrs before breakfast, avoid any supplements that might interact & time tests to be ~24 hrs after last dose (28 in practice) & that's what my Endo prefers.

Can I ask do you feel you'd like to try some form of T3 & does your Endo support its use?  Be good to know how your T3 levels & symptoms have been over time before going down that potentially stressful & complicated route, as the low T3 on this latest possibly skewed test might be a blip.  If you have the T3 result for the Oct test (or any previous ones) that might give us a better idea of whether there's a conversion defect contributing to the way you feel.  Also, have you only had the symptoms you describe since menopause or never felt well on Thyroxine?

I'm not aware of this advice:-

I think the optimum is that your T4 is 3 x higher than your T3?  Mine isn't.

but your symptoms, below mid-range T4 & low T3 on the Dec test made it look as though there might be leeway for upping your Thyroxine a little, but we don't know how reliable that test was & I can see your Endo wouldn't want to muddy the picture with too many variables if he's focusing on getting your oestrogen up to see how you feel on that.  My feeling is that our response to HRT is unlikely to be optimal though, if thyroid status isn't right, but you'd need to discuss with your Endo any changes you feel might be sensible & you may well feel better by addressing the oestrogen issue.  So if you can stick with that one change for now you can maybe look at your thyroid with him next time, assuming your symptoms are bearable in the meantime?
 
They don't usually seem interested in antibody levels once we're established on thyroid replacement, I think NHS advice is not to retest levels after initial diagnosis & since I've been treated privately I can't remember my Endocrinologist ever requesting they be tested.  They were high on diagnosis 30 yrs ago but I think only tested once since then, a decade or so ago in tests ordered by a non-endocrine clinician & they were negligible at that stage.

I agree ref ranges are not the be all & end all & it can be disastrous for some patients if their doctor won't take into account their symptoms & instincts as well as blood results.  I'm not sure about the controversy over revision of the cut off for the TSH range.  6.5-ish  (from memory) used to be top of TSH ref range when I was first started on TH replacement & if we were below that we were deemed to be fine.  Many of us, me included, were nowhere near fine with a TSH that high, so thankfully top of range has come down a bit since then.  But as I  said earlier, I don't feel good in my 60s with my TSH as low as I needed it to be at 30 or 40 & I think it's not as simplistic as saying everyone should aim for a TSH for example around 1.  I think what's needed most is recognition that hypothyroidism is a complex condition with far reaching effects on our bodies, that for some of us Thyroxine alone doesn't compensate adequately for a healthy thyroid & that patients need to be listened to & treated as partners in their care, with ref ranges just a tool to aid in treatment.

You could well be right about Utrogestan lowering your mood, especially if you felt similarly on Mirena.  Many of us on here have problems with Utro in various ways.  I'm progesterone intolerant & Utro was the worst of the lot for me, making me very unwell indeed.  There was a study that found that progesterone also potentiates thyroid hormone, so that's something to be aware of for anyone on HRT with a thyroid condition.  Oestrogen can have the opposite effect as you'll know, but it's said the interaction is less likely on transdermal oestrogen than with oral.  That said, a few of us on here have had to tweak our thyroid dose in response to starting/changing even transdermal HRT, but I have the impression it's mostly those of us on T3 who seem to have more problems balancing the two types of replacement.

Sorry this is rambling - I copied your last post out & wrote the reply in a WP app without your previous posts visible at the time, but scanned them when I logged back on & hope what I've written reflects your situation well enough!
Wx

So sorry haven’t replied, am away and too much to reply on phone, will do it when home !

[Wrensong]

klf68

So sorry haven’t replied, am away and too much to reply on phone, will do it when home

Yes, sorry, it was an epic wasn't it? .  Please don't worry about replying, you can take anything from it that might be helpful & report back when the time's right for you.  Or not, if there's nothing useful in it!  I tend to write a lot on thyroid posts, as there can be so many factors involved & I've had to think outside the box over the years trying to get my own issues sorted.  I'm not on the forum much at the mo, so your not having responded relieved the guilt of my not having been around!  You can always send me a PM if I'm not about, but there's a lot of combined experience on here from a good number of members on thyroid meds so someone is usually around to compare notes.
Wx