Surgical Menopause - Thyroid Levels Normal?

[Tempestteapot]

Hi! I hope you can help please. I'm struggling to optimise my HRT and am worried that my thyroid levels may be too low and are contributing to my problems. My TSH is 0.72 (range is 0.35 - 5.00)and my Free TH is 10.8 (range is 9.0 - 21.0).

If anyone can advise if I need to pursue further investigation with these levels, I would greatly appreciate it. Many thanks!

[Clutter]

Tempestteapot,

I would expect to see a higher TSH with FT4 10.8 which is low. It may be that FT4 will improve if surgery was recent. If FT4 falls without TSH rising your GP should consider secondary hypothyroidism (pituitary dysfunction).

[Tempestteapot in reply to Clutter]

Thank you so much, Clutter! Those levels are 17 months post surgery, so that's rather worrying?

[Clutter in reply to Tempestteapot]

Tempestteapot,

Not worrying, but low FT4 probably means FT3 is low and that can make you feel rubbish. NHS is unlikely to do anything until either TSH is >5.0 or FT4 <9.0. You might try supplementing 200mcg Selenium daily as that may improve thyroid function. Check your ferritin, vitamin D, B12 and folate levels are optimal too.

[Tempestteapot]

Thank you again, Clutter! I'm actually going to book a full thyroid panel privately via Nuffield to be on the safe side. I'm just learning that the NHS woefully doesn't test for or treat thyroid disorders sufficiently - it's awful of how many are suffering just from what I've read since visiting this forum!

[Learner1]

I, too, had surgical menopause, which is a big stress to the body. Have the endo check reverse T3, you could be converting T4 into rT3 instead of T3. Knowing both free T3 and free T4 is also quite helpful.

Also, how are your adrenals? If they've been impacted by stress, it's almost impossible to fix thyroid unless adrenals are addressed.A saliva cortisol test can help.

Look into a DUTCH test, dried urine test of comprehensive hormones. Their website has some educational videos. The test shows all thechormine metabolites.

It's like spinning 10 plates in the air, but worth it if you can fine-tune everything to be a new normal.

Good luck!