Early menopause / Hypothyroidism advise on blood test results.

[hb3427]

I have just been told I am in early menopause (at 37) FSH is75 and lh 36, could this be due to Thyroid levels. My TSH level came back at 3.14 and free T4 is 8.4 from what I have found on the internet this is high TSH and low FT4 but within the normal range in the UK, although would be out of normal range in the US. I have my next GP appointment this week and want to have informed questions to ask. For reference my TSH was 1.23 in 2006. Does anyone have any advice?

[eeng]

It sounds as though you might be right. What time of day did you have your blood test? TSH is highest first thing in the morning. A lot of people with low thyroid also have menstrual problems including very heavy periods and multiple miscarriages. It helps if you post the ranges (usually the numbers in brackets) with your results, but that T4 reading looks very low to me. It's worth getting your doctor to test your Vitamin D and B12, also folate, ferritin and iron because these affect how your body uses thyroxine and can give you symptoms if you are low.

[hb3427 in reply to eeng]

Thank you for replying eeng. My tests were done at 10.30am. I have a 16 month old son who I breast fed for 8-9 months. I got my first period back when he was 7 months, had 3 more periods, which were regular and since then they have just stopped completely, so 7 months now with no period.

The results with ranges are:

TSH 3.14 (0.34 - 5.6)

free T4 8.4 (7.5 - 21.1)

My appointment is tomorrow and i'm so confused as to what to ask for / discuss. My sister and niece have under active thyroid and also another niece and my sister have coeliac disease.

[puncturedbicycle in reply to hb3427]

Have a look here, particularly about the rising tsh. cks.nice.org.uk/hypothyroid...

I would never suggest that anyone lied to their gp, but if you were trying to get pregnant again might they be more helpful? I don't know, I'm just throwing it out there. (And just to clarify I'm not suggesting you actually try for another baby to get treatment! )

[hb3427 in reply to puncturedbicycle]

Thanks puncturedbicycle, I had thought about doing that but thought they wouldn't take it into consideration as my FSH is so high and reads that of someone who could be aged 70+ post menopause. Anything worth a try though!

Thanks for the link, it is interesting.

[hb3427 in reply to puncturedbicycle]

Puncturedbicycle, To be honest you are not far off the mark. The reason I went to the GP and had blood test in the first place was because we were considering having another baby so all this has come at a huge shock to me to say the least!

[puncturedbicycle in reply to hb3427]

Omg, apologies! Sometimes it's like my head is barely screwed on.

I did read your post(!!) but then I read the link and got distracted by the idea that your tsh was rising and by the time I came back with it it somehow escaped me that they'd already tested your hormones.

Rereading your post, my little joke sounds crass, so I'm sorry about that. Your discovery must have come as a shock. x

[hb3427 in reply to puncturedbicycle]

No need to apologise. I'm grateful for your advise, it's all so confusing!

[eeng]

Has the doctor suggested HRT? The minimum the doctor should do thyroid-wise is to offer you another test in 8-12 weeks time. As you say 5.6 is a high upper limit for TSH (even in the UK 4.5 to 5.5 is typical). If your doctor is sympathetic you might be able to persuade him to offer you a trial of a low dose of thyroxine, it will probably help if you assure him that you are familiar with the symptoms of hyperthyroidism and will stop taking it if you show the slightest signs of being over medicated. I don't know whether or how HRT interacts with thyroid function. Good Luck.

[hb3427]

My appointment is tomorrow but that is what I am expecting the doctor to suggest HRT. However, if the underlying cause of the early menopause results is hypothyroidism would it not serve best to treat that initially to see if it has any effect!? This is all so confusing!

[eeng in reply to hb3427]

It depends how you are feeling. The HRT should help you quickly (well it should bring your monthly cycle back). The Thyroid will take a while to sort out - even if your doctor lets you do a trial of T4 now it will take 6-8 weeks before your feel the full benefit of it. If he makes you wait another 6-8 weeks before having another test that will make it even longer. The HRT almost certainly won't affect your thyroid results. If you do start HRT now then when your thyroid results become sensible (say TSH<1 and T4 >14) you could try coming off the HRT and see what happens. Do you have the symptoms of hypothyroidism?

[hb3427]

Thanks eeng, symptoms of hypothyroidism and early menopause are very similar so hard to tell if they are associated with one or the other or both! Thank you for all your replies.

[puncturedbicycle]

Someone else posted this originally but you may find it relevant: theguardian.com/books/2014/...