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[Kai_63]

Could a better functioning thyroid mean you actual need to reduce estrogen levels (e.g. reduce oestrogel)?

I have had an underactive thyroid for over 20 years, been peri for at least 2 years.

Recently the doctors have been trying to get my thyroid level right. It's NHS only at the moment so I only get TSH and T4 results, which say I am underactive.

GP increased my Levothyroxine to 75mcg two weeks ago. Although i feel better I am now having some overactive symptoms including nausea, headache, thirst and not being able to sleep.

I've recently had full bloods that didn't show vit deficiencies or diabetes.

I'm on 12 day progesterone (but haven't had any for almost two weeks since last cycle), 3 pumps oestrogel.

Wondering if my thyroid is now performing as it should and has improved estrogen levels in the process?! If so could I try cutting to 2 pumps oestrogel?

[Wrensong]

Hi Kai_63, a few quick thoughts

1) could Thyroxine have been increased by too much if you are feeling over-treated already?  Would help to know what dose you were on before & what did the TFT look like that prompted the increase.

2) do you think you could be a bit dehydrated as that could cause some of these new symptoms?  The T4 increase means you are probably getting rid of stored fluid.  If possibly being too hot at night is what's preventing you sleeping, being better hydrated might help you stay cooler.  The increase in your metabolism from the extra thyroid hormone will probably be making you warmer too, so potentially interfering with sleep.

3) I'm not sure about your oestrogen query, though the headaches & nausea could be signs of a bit too much, but I'd have thought the increase in thyroid hormone would mean you are clearing any excess oestrogen from your system more efficiently if anything.  If you are in peri though, we don't know what contribution your own hormones may be making. 

Another possibility is that your oestrogen levels have as you suspect got higher than optimal for you during the time you've been on too little thyroid replacement (not being cleared efficiently) & it's perhaps too soon for the T4 increase to have made any difference to them? 

Sorry - always a range of possibilities with menopause & a thyroid condition ongoing, but you can discount any that seem unlikely.

I read your post at first as though you were currently on day 12 of your cyclical progesterone, so have rewritten my reply as I see it says 12 days progesterone not day 12 & that you are not currently taking prog!

I'm long term hypo btw & on HRT, so have encountered some of the pitfalls!
Wx

[Fizwhizz]

I’m on this same journey. Believe I’m hypo and lots of evidence to support this in the terms of symptoms which I don’t feel are menopause related like rosacea, Raynuards etc. I’m undiagnosed though as everything’s in range according to NHS tests. In spite of being on private HRT for several years I still have symptoms and my doses of HRT are being constantly tweaked. I’m thinking now if my thyroid/adrenals were working better maybe I wouldn’t need HRT or quite as much. I’m now experiencing spotting which is a concern even though I have a day off oestrogen each week to try and help it clear. It’s difficult to unpick all these symptoms and I feel down about at the moment.

[Wrensong]

Hi Fizwhizz, you are in a difficult situation if your thyroid is perhaps beginning to malfunction but not yet at the stage when tests confirm this.  Do you have any help with it?  I feel for you.
Wx

[Fizwhizz]

Hi Fizwhizz, you are in a difficult situation if your thyroid is perhaps beginning to malfunction but not yet at the stage when tests confirm this.  Do you have any help with it?  I feel for you.
Wx

Hi Wren,

Thanks. I’m just beginning to grapple with it all and learn as much as I can from others on various forums including here.

 It’s a complex thing to unpick. I seem to have suddenly got all sorts going wrong health wise in my mid 50’s.

I’ve had various autoimmune symptoms previously but nobody ever joined the dots.

The NHS seems obsessed with TSH being in range but mine’s slowly creeping up, 2.4 currently and so’s my cholesterol.

I’m spotting now too which I believe is because my body’s not clearing the HRT oestrogen and my vits aren’t great so working on d, folate etc with supplements. I’m feeling a bit stronger but really have to manage my energy carefully and my appetite’s gone weird.

It’s impossible getting anywhere with the NHS on my current TSH level even though I have so many symptoms as well as fam history.

My T3 is low and T4 not much better. I have a private appointment for March so hoping for some answers then but I’m a bit concerned about all this separate private treatment too as again I worry it won’t be joined up thinking.

Don’t feel I have much choice though as I’m gradually falling apart currently.

[Kai_63]

Thank you. I think it's unlikely I've gone overactive as my last test two werks ago suggested underactive (i was on a 75mcg and 50mcg alternate day dose).

Serum TSH level:
6.34 mU/L

Serum free T4 level:
15.5 pmol/L

My previous test before that when I was on 100mcg in Sept came back as overactive.

I am always cold, have been for years which I'm pretty sure has been down to thyroid. The full blood test (all vits and diabetes etc) which led to the overactive result above was down to me complaining I was always cold! But they can't find a cause.

I don't tend to have much issues with sleeping or getting too hot which is why it's strange that I get so thirsty.

I think I'll have to go to a specialist really?

Fizwhizz sorry you're having such a challenge. Wished there was more understanding within the NHS. I have cold toes a lot and did wonder if it's all related to thyroid/menopause too.

[RebJT]

A suppressed TSH on levothyhroxine does not mean you are over active.  It's totally normal with replacement hormones provided the T3 is unequivocally normal (I have no thyroid, and I'm TSH suppressed for thyroid cancer, NHS is utterly useless on thyroid knowledge, I literally have to do an education session with every GP I see).  Feeling jittery might mean low iron, this is usually the culprit in women.

Taking HRT usually means you need MORE thyroxine, my thyroid endo tells me by up to 25%.

A TSH of 6 is profoundly undermedicated indeed.  It should be between 0.5 and 1, with T4 in the upper quartile of the range and T3 near the top of the range.

Thyroid UK is a helpful site and they have a great forum.  Also this article was first published in Pulse Magazine (the GP Magazine) by Dr Anthony Toft, then head honcho of the British Thyroid Association, and I've used it more than once to get my elderly mum's GP to get off his backside and medicate her properly (she has a low TSH with middling T4 results and the idiots keep lowering her dose- she now has a note on file to leave her alone!!) https://www.tpauk.com/main/article/dr-anthony-toft-response-thyroiditis-thyroid-eye-disease-and-thyroxine-dosing/

Thyroid UK is here https://thyroiduk.org/

Girlscout
x

[Kai_63]

Thank you so much.

Iron levels are at mid range (they checked everything a few months back).

I think dropping from 100mcg (when I was overactive) to 75mcg/50mcg alternate days has led to the highly underactive TSH result.

I'll try sticking with the 75mcg daily now  for the next 6 weeks and they're testing again then but I might do a private one at the same time to see my T3 levels.

My private health through work seem reluctant to authorise an endocronologist so will have to stick with NHS for now.

I have just got my peri under control so it's annoying that this has now happened!

I'll take a look at Thyroid UK too.

[Fizwhizz]

Kai,

I’m permanently freezing too. No hot flushes here. I’m now spotting which is likely unopposed oestrogen or vaginal atrophy or could be worse things but am hoping not. I was told my body doesn’t clear oestrogen well by private meno GP so have stopped but on private testing my progesterone levels were good. I think thyroid has a function in clearing oestrogen so if I am hypo it would explain that but it isn’t good to have too much oestrogen in your system. Even with private HRT I’m not feeling like they look at the whole woman and I’m stuck between NHS for bits, and private for others. I had my blood done today for private thyroid appointment in March but I’m feeling so frustrated and fed up with it all. I’m 55 next week and falling apart. Soz to hijack the post and moan. The spotting has gotten me down. 😢

[RebJT]

Kai

No worries, although point to note, I doubt very much indeed you were 'overactive' - that's entirely my point, any doctor going off the TSH when your thyroid feedback loop is already BROKEN (how else would you have a thyroid disorder??) doesn't know what they are doing.  Overactive means T4 and T3 over the range, the TSH on its own is fairly useless for knowing anything (other than someone is UNDERactive).

Also swinging levels, they need to be testing your antibodies for Hashimotos, the way to treat that is with suppressive levels of thyroid hormones to shut down your own thyroid and stop the antibody attacks.

There's a good book by Anthony Toft, Understanding Thyroid Disorders.  Unfortunately we need to learn this stuff as doctors don't know it.  Thyroid UK is also good source of info for learning this stuff.

You won't have been 'overactive' on 100mcg, what you will have had is a doctor who doesn't know how to interpret the tests.

And what iron did they test, and what was mid range?  Ferritin  needs to be over 100 to feel well and not feel jittery on thyroid medication.

Girlscout
x

[Jillyboo]

My TSH results went completely haywire after the first two shots of Covid vax (AZ type). I'd been completely stable on the same dose of thyroxine for 25 years prior to that. Having increased my dosage I'm now borderline overactive! Not good.

[RebJT]

Sorry to hear you struggled with the vaccine, I also had a horrible time after one shot of AZ.

However, to correct a myth peddled by doctors, a suppressed TSH DOES NOT MEAN you are overactive, it's entirely normal to have a suppressed TSH when on thyroxine, one is only actually overactive when the T4 AND the T3 are above the top of the range.

This misconception keeps women on stingy doses of thyroxine and feeling unwell (90% of thyroid patients are women, and it typically shows up at the menopause) - this is a key health inequality issue and one area where medical sexism is alive and well.

Unless you are thyrotoxic which can ONLY be established by a full blood panel and signs and symptoms - include rapid heart rate, sweating, anxiety, tremors, fast bowels etc etc etc then the TSH is meaningless.

Also, the fear mongering about bones and suppressed TSH is not backed up by research (most thyroid research is of poor design and of low quality).

I know all this because I am deliberately TSH suppressed for thyroid cancer, my TSH is so low the machine cannot read it, however my T4 and T3 are unequivocally normal, and yet doctors endlessly want to debate this point, so much so I have a little card to carry in my purse to get them to leave me alone and if they want to argue they need to call my endo oncologist and argue it with her!

If you feel fine on your dose and are doing well, then they really need to shut up about the TSH.  It's really worth educating yourself on this as they will never let it drop, and I've had to intervene with my elderly mum to get them to stop lowering her dose because of this, she now has a note on her file.

[Jillyboo]

I was shocked at the effect the vaccines had. It only came to light because by sheer coincidence I was due an annual blood test shortly after the second jab.

To be honest I feel neither better nor worse now I'm on the higher dose of medication. T3 is at top end of scale and T3 at mid point. I don't seem to be particularly sensitive to changes in thyroid hormone levels - if only I could say the same for oestrogen and progesterone!

Happy to see my GP practice finally seem to have their act together again and are calling patients for blood tests at appropriate intervals.

[Kai_63]

Thanks for all the replies.

Still waiting for my blood tests but thankfully they are doing the full bloods so should give a fuller picture.

I now think the bowel issues were utrgoestan related. I've recently changed to continuous and the more even dose had sorted this out (checking my diary the bowel issues etc seemed to coincide with my sequential dose).

I think part of the issue with having thyroid issues plus peri/HRT are that is is hard to say what is causing what symptom and I've had various these past couple of years.

Hopefully the tests will shed more light.

[Floral]

Hi Kai63
Sorry you are struggling, have you ever had your FT3 done?