Levothyroxine and HRT

[Batchelor23]

I have been taking Levothyroxine since Jan 2015 and still don't feel well. I went back to the doctor several times last year and in July she suggested that I tried HRT as she said my TSH were within the normal range and that it was most likely the Menopause that was causing my symptoms. I started on the HRT and felt much better for a few weeks however in January 2016 after a routine blood test, I was told I needed to increase my dosage to 100 which then seemed to make me feel worse again. I persevered assuming it would take a few weeks for my body to get used to the increased dosage. My blood test result after 6 weeks came back as normal but I was still suffering so went back to the doctors who suggested that I changed to the HRT patches as the tablet form may have been interfering with the absorption of my thyroid medication. I felt better for a few days and thought this may be the answer. Since then I have felt progressively worse - poor mental alertness, strange feeling in my head, feel very low and extremely tearful! I asked to be referred to a specialist but can't get an appointment until the middle of June. Has anyone else experienced anything similar? Any advice would be greatly appreciated as I am really struggling!!

[shaws Administrator]

With regards to thyroid hormones - never accept 'normal' 'fine' o.k.

We don't want or need 'normal' what we need is a low TSH when on thyroid hormones. Normal is o.k. for people who haven't hypothyroidism.

On an earlier post I responded too I'll give you the link and you can see what Dr Toft recommended for patients who are hypo.

Ask for a new blood test and get the earliest one, don't eat before it although you can drink water. Leave about 24 hours between your last dose of levo and the test. This allows the TSH to be at its highest as it changes throughout the day.

Also ask for a Vitamin B12, Vit D, iron, ferritin and folate as deficiencies cause problems too. Iron in particular helps in the conversion of T4.

healthunlocked.com/thyroidu...

We have to read and learn ourselves if we want to improve. Sometimes we come across some sympathetic doctors who do listen and take account of clinical symptoms (of which many are ignorant).

(I am not medically qualified and just have my own personal experience to go by. Sometimes we have to try a few thyroid hormone replacements to find one that suits us best but, unfortunately, we don't, in the UK appear, to be able to access).

[Batchelor23 in reply to shaws]

Thank you for your advice. I am going to have some more blood tests done next week and my appointment is 9.30 so I will make sure I don't eat or take levo beforehand. I have never been given a printout of my test results so will ask for one this time.

[Hidden in reply to Batchelor23]

If they will ask the GP to test for FT3 and FT4 as well, some will some won't.

[shaws Administrator in reply to Batchelor23]

Put your levo somewhere else when you take you previous day's dose so you will not be in autopilot. A few have taken theirs before they've realised.

[Batchelor23 in reply to shaws]

My blood tests results are TSH 1.67 (0.3-5.0), Free T3 4.6 (3.1-6.8), T4 21 (12-22), Vit B12 341 (200-960), Folate 7.5 (3.0-18) and Ferritin 62 (I forgot to ask the range for this one). Do these levels seem alright? I still have a strange tight feeling in my head and don't seem to be able to think clearly. I am on HRT patches and meant to ask the doctor if menopause hormones could be checked also. When I went for the blood test test, I mentioned it to the nurse and she said she would add them but it appears they weren't done. If my blood test results seem ok, I don't understand why I am still not feeling right unless having changed to the HRT patches, it takes a while for things to settle down. Any suggestions?

[shaws Administrator in reply to Batchelor23]

Unfortunately, blood tests don't tell the doctor how we are feeling and that's the crux of the problem.  Your TSH is still a bit on the high side, our aim is a TSH around 1 or lower. Some even need it suppressed.

A small increase might do the trick and the best way to know if your dose is optimum for you is 'how do you feel?". If well that's the answer we want.

Sometimes we don't feel better even though bloods look as if they are optimum and that might mean we might look to another hormone but, in general, most do fine on an optimum dose of levo or with the addition of some T3.

I'm not sure about menopouse patches and someone will respond as well as ferritin and folate as they seem a bit low to me.

B12 you should supplement with methylcobalamin sublingual tablets. The aim is 1,000. Your GP hasn't done Vit D. another important vitamin.

[trixiebucket]

Hi have you had your t3 tested? Your t3 can often be  overlooked and can be critical!  I take  hrt  and levothroyine as well as t3 medication. Your oestradial levels are also important.I had to go go patches 7 day patches as improved effectiveness. Also  special regime on changing patches suggested  by my endo that also  helped.do let me know if you  want any more info.

[Batchelor23 in reply to trixiebucket]

Many thanks. Any further information you can give would be great. I had blood tests done today and have requested free T3 as well as TSH, Vit B12, Iron, Ferritin and menopause hormones which I assume includes oestradial levels. Although I have been on HRT since July 2015, it was only 3 weeks ago that I changed to HRT patches. I still feel low, tearful and can't think clearly - tight feeling in my head and am wondering if it will just take a bit longer for the HRT patches to make a difference. Any idea? Do you feel well now? What is the special regime for changing patches? Thanks for caring