Thyroid UK

Hypothyroid and menopause

I have been taking thyroxine for 24 years for hypothyroidism. I did post on here earlier this year because my GP reduced my dose and i began to get clinical symptoms of hypothyroidism. I have been so aching in my joints and tired I asked for a menopausal test as I had read recently that this could be symptoms. So I had the blood test 2 weeks ago and received a phone call from the nurse practitioner to say my thyroid levels need to be increased as TSH is 0.03 and lowest level should be 0.3 she said I now need 175mcg. But also the test shows I am menopausal and have a choice of starting HRT. So my overwhelming problem is very painful joints and secondary is lethargy. Shall I go for both at once or try the thyroxine increase first. My other thought is I have just read on here that low vitD can cause joint pain? Advice would be fab. Thanks.

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I wish they wouldn't adjust dose according to the blood test results but according to the patient's clinical symptoms. Unfortunately they appear to know not one symptom.

thyroiduk.org.uk/tuk/about_...

I never had menopausal symptoms so I think at present your priority is relief of hypo symptoms.

Deficiencies in vitamins/minerals can also cause symptoms, so I'd get these checked:-

B12, Vit D, iron, ferritin and folate. All should be optimal but are often deficient.

Many doctors who were trained before blood tests and levo were introduced as 'perfect companions' disagreed as patients were then not given a trial of thyroid hormones (NDT) but now the reliance is all upon the test and not the clinical symptoms, as used to be done.

thyroiduk.org.uk/tuk/thyroi...

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Thank you for your advice. The days of GPs who know us personally are definitely gone. I feel very frustrated by the lack of knowledge and always fobbed off so usually take to my own research. Luckily I am otherwise fit and healthy and can count on one hand the amount of gp visits for the past 24 years. But I am prepared to hassle them to sort this out - I don’t want unnecessary medication just the correct one - so thanks again for your input.

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Hi annegal

I have been successfully treated for menopause with HRT. But became very ill with hypothyroidism many years later. I feel they are different to each other but many doctors look at them together. I found Hypo symptoms way more difficult than menopause and found I was a new person when thyroid treated. I have read the TSH result is not as important after you are diagnosed and start taking thyroid tablets . it’s your FT4 and FT3 results which are important. Do you have those results? Take care x

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Thank you for your reply. I asked to have the other tests done and the nurse ticked them on the form but the lab did not do them we think it might be due to their guidelines from the local authority.

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Yes it is due to the guidelines which state that TSH and T4 are sufficient but it isn't as many who've had FT3 and FT4 privately these have been generally been found to be low.

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Yes.!! Go back and hassle them!! That’s their job. Perhaps a gp ordering bloods may get the tests done that you require. Good luck x

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Something not quite right, here. The nurse said your TSH was 0.03, and it should be 0.3, so she's telling you to increase your dose? Is that right? This nurse knows zero about thyroid. lol

Not that I'm saying you don't need an increase, you probably do, but the TSH is not a thyroid hormone, and will not tell you very much at all. They should at the very least be testing the FT4. Do not allow them to adjust your dose just based on the TSH alone, because that is how they keep patients sick.

But, you're right about the vit D. In your place, I would get vit D tested - and a proper thyroid test! - before embarking on HRT, because you might not need it at all, and best to avoid it if you can.

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Thank you for your reply. I did question the result as I Know that the medication suppresses the TSH. When I was first diagnosed 24 years ago my TSH was very high as to compensate and the thyroid hormones were normal but the consultant (fertility clinic I attended) started me on the thyroxine and I conceived after this. The TSH only was requested as I had gone about FSH and LH which were duly done. I am happy to try an increase in thyroxine to see if this alleviates my issues. This was all done over the phone as my GP is never able to offer appointments but I have said I need to be seen to discuss this properly and they are finding me a slot as soon as possible (took 4 months to get an appt last time I needed one) I want to be self informed before attending otherwise I will just be defeated and come home at status quo. Thank you for your help.

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TSH doesn't compensate for anything. It stimulates the thyroid to make more hormone. So, if you're on thyroid hormone replacement, and TSH is high, it means you need a higher dose. If it's low, it doesn't mean anything.

Could you not get private labs done? Then you would have results for everything relavent, including vit D :

thyroiduk.org/tuk/testing/p...

But, beware of nurses - or doctors, come to that - that make nonsensical statements like the one above!

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How confusing - lucky I asked you. I will do some research about private BT’s and make sure I am clear about what I need before making my decision on the hrt. Thank you.

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You're welcome. :)

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I would say try the increased thyroxine first because if your levels are too low all your joints will ache and you will feel tired. You don't want to take unnecessary medication either and have to be careful with what you take in supplements so as not to have adverse effects on your hypothyroidism. Best to check with your doctor or chemist before you take supplements. Too much thyroxine can cause palpitations and tiredness too and you don't want that either. .

Hope you feel better soon

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Hi..answering your email...I don't take levothyroxine as I am detoxing and it is toxic, I take Natural if needed...re HRT I would discuss with Dr and not complicate till after...175 is still mid range....I would take it to see if joint pain subsides (many reasons) INCREASE SLOWLY...so much of the healing is trial and error...in the mean time get lab tests done yourself, full panel including antibodies- Genova/ Blue Horizons...find a good pharmacist re vitamins and supplements...B vit's and D are essential pos iron...get sensitivity testing...

DIET IS CRUCIAL..."all disease begins in the gut" Hippocrates. (Unfortunately the NHS doesn't adhere to the Hippocratic oath.) Paleo diet/gluten free/organic as much as you can afford- no soy or dairy to start. Google for good and bad foods.

N.B. If you can afford it go to a Doctor who practices, 'Functional Medicine' hold back on all tests until you have spoken to them. At least get a consult.

cheers Muriell

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I wouldn't touch GET have you had a B12 vitamin check. Pauline

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It sounds odd that your TSH appears suppressed and yet they are offering you more Thyroxine. When your TSH is low it should mean your thyroid is producing more thyroid hormone or you are supplementing it. When your levels are high it means your thyroid isn't producing enough hormone.

But Hey I wouldn't titre your dose according to your TSH anyhow. How do you feel, have your symptoms been relieved and do you feel hypothyroid or hyperthyroid, these questions and their answers are much more valuable.

As others have said you need your T4 levels and your T3 and reverseT3 levels; work out the ratio of the T3 for a more accurate representation of where your are thyroid hormone wise. Plenty of information about thyroid blood tests on the internet.

I would be careful taking HRT if you are Hypothyroid as it further messes up the endocrine system. The best way to handle menopause is with vitamins and minerals which support your adrenal glands. Those of us with Hypothyroidism often find our adrenal glands need support anyhow, but more so if you are suffering stress of any sort and the menopause is a stressor on your body.

The menopause is a time of crisis for your thyroid gland; similar to puberty and childbirth; and often too for your adrenal glands. Most people forget that our body doesn't stop producing our sex hormones once we hit menopause.....our body carries on making oestrogen's x3, testosterone and progesterone and they do this as they always have, via our adrenal glands. Obviously once our ovaries or testes stop working the adrenal glands continue to do the job; once our ovaries stop working then we can't reproduce but our body still needs the hormones.

Taking HRT can upset a fine balance of hormones and supplements limited sex hormones often causing an imbalance. Taking HRT if you are already unbalanced with your sex hormones; which you may well be if you're Hypothyroid; then this causes more imbalance and this causes many more problems.

The vitamins a minerals vital to adrenal health are:

Bowel tolerance vitamin C divided dose through the day.

Vitamin E a fat soluble vitamin similar to the water soluble Vitamin C......be aware this vitamin has a slight blood thinning effect so talk to your doctor if you are taking blood thinning drugs.

Vitamin B complex

Separate Vitamin B5

Magnesium take at night but never with calcium - leave a gap of 2 hours between these vitamins....tho hypothyroid people often are too high in calcium and likely do not need calcium. Calcium doesn't prevent osteoporosis but magnesium will help. Magnesium should balance calcium and often calcium is dominant. If your thyroid isn't functioning well then its not producing Calcitonin, so calcium is already a problem. Excess calcium can cause hardening or calcification of the soft tissue including artery walls, kidney and other stones including gall bladder. If you have restless leg syndrome that is due to low magnesium levels. If you choke, etc., this is minimised with magnesium; look it up.

Potassium may be required too.

Ashwagandha is an adaptogenic herb which supports the adrenal glands.

Some people will find they are low in DHEA and find they feel better boosting this hormone; a precursor to sex hormones. Women should not exceed 25mgs and men 50mgs.

When taking these supplements regularly you should not just stop taking them but wean yourself off them slowly; i.e. over 2 weeks, especially vitamin C.

Always take the best supplements you can afford and check you're not buying synthetic chemicals which may not be absorbed or utilised by your body.

Take vitamins and minerals after food when gastric juices are flowing due to food intake. This aids absorption.

Best of luck.

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