Thank you Helly, that's really kind of you, but it's what we're here for
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It's good to know that your TSH has varied in the not too distant past as that indicates your pituitary is responsive to your thyroid hormone levels. Given your high FT3, as I said earlier, I suspect the 2 recent TSH results are just suppressed because there's been a bit too much thyroid hormone going into your system for a while.
I'm surprised to know you don't have Hashimoto's. Thank you for confirming the hypothyroidism is not a result of earlier Graves treatment either. If you know why you're hypothyroid it would be helpful to know e.g. congenital, resulting from radiotherapy etc, but please don't feel you have to say if you'd prefer not to.
Thank you too, for your honesty in answering the weight question. I'm sorry to have asked something so personal & should perhaps have said my reason for asking was that I was worried that if you'd been inadvertently on too much thyroid replacement for any length of time & that had resulted in your being underweight, that could have been the reason for an early menopause. Women with Hashimoto's have a higher risk of early ovarian insufficiency, but obviously that's not applicable if you don't have Hashimoto's. I was trying to make sense of your situation so that I don't suggest anything inappropriate.
What I meant by your FSH, LH & Oestradiol being in the postmenopausal range was simply that I'd checked the lab reference range for one of the Health Authorities near where I live as I wasn't sure about the range for LH and both FSH & LH at those values are classed as postmenopausal. Though LH at that level is also found in premenopausal women, I think your doctor will have been looking at the the 3 results together to suggest that you are in the menopausal transition. But we need to have had 12 months free of periods to be officially classed as postmenopause & even then, some women have further spontaneous periods, meaning they were not actually postmenopause at that 12 month point. So the lab ref range is simply giving an indication of hormone levels in that woman's body at the time the blood is drawn, to provide clinicians with a tool to help them confirm or rule out a diagnosis they are considering on the basis of symptoms & history. So, I can't tell you exactly where you are in the transition & if you have a Mirena preventing bleeds it will be difficult for you to be sure.
Yes, I understand you only went up to 3 sprays of Lenzetto in Feb, but what I meant was that as you were only getting an oestradiol level of 53 from 2 sprays, it seemed unlikely that going up another spray would give you enough to significantly improve your menopause symptoms. But you won't know until you test again.
I think that's a good plan to ask to have your blood tests repeated, see your GP & if need be go back to the Endocrinologist you made good progress with. As you don't feel you are having too much thyroid replacement despite your TFTs suggesting otherwise, can I suggest you ring/email your Endocrinologist's secretary & ask what conditions he advises for testing, i.e. does he prefer patients to defer that day's thyroid meds until after blood is drawn & follow his advice for your next test? As I said earlier, it's more difficult to be sure of what's going on if blood is taken within a few hours of your meds & as you yourself don't feel over-treated & your instincts are important, I think you really need to be as sure as you can, so that whatever changes are agreed they're right for you. It might just be possible that blood having been drawn only a few hours after you took your meds, the TSH is testing misleadingly low & the FT3 high because they're responding to the very recent, quite big dose of T3. That's why many endocrinologists like us to test first thing then take that day's meds afterwards.
I'm sorry if some of what I've written in the past few days has not been what you'd hoped to hear, but I really want & also feel a responsibility to try to make sure you don't come to any harm & if I can, to help you take the shortest route to feeling a lot better. Thyroid hormones are very much Goldilocks meds & as you know, T3 is very powerful, so it's crucial that we don't have too much or too little when every process in our body is affected by how close we can approximate the gland's production in perfect health. All the while our thyroid replacement is not the best it can be, nothing else, including our response to HRT, will be optimal & we will likely feel pretty rubbish as a result.
The other things I think it might be helpful to discuss with your doctors are changing to another method of oestradiol (patches, gel) if your next result is still below a likely therapeutic level & reducing your Tostran dosing frequency, or changing to a weaker testosterone product if your next T result is again too high. Please also make sure they know you have been feeling emotionally low. It can be difficult for others who've not been through the hypothyroid-menopause combination to grasp how terrible it can make us feel, so the clearer we can be about that the easier for them to help us.
I think it's absolutely admirable that you're thinking about how you can best exercise & tweak your diet at a time when you're so fragile. You deserve to feel a lot better & anything you can do to bring that about will be time & effort well spent.
You were in my thoughts when I woke in the small hours last night & will be again tonight.
Wx
