Over the past few years I've had problems with skipping periods, and after testing was told the problem is hypothalamic amenorrhea. My LH is suppressed, i.e. what happens to underweight girls or athletes caused by a negative energy balance. I've been told by doctors that I'm probably slightly underweight which is causing these issues, however I have never been underweight and have actually gained 5kg this past year (BMI 22 now) and my body fat is >25%. Over this time I have felt my body get weaker to the point where I can only manage a 30 min gym session once a week as it causes so much pain and time to recover afterwards. I very easily maintained a lower weight with more exercise years ago (I'm now 28) so I feel this can't possibly be the root cause, however doctors are not taking me seriously.
I'm highly suspicious that my body's perceived lack of energy is due to a struggling thyroid, and my TSH is creeping higher and higher.
Test results from last week:
TSH: 4.4 (0.35 - 5.0)
LH: <0.5
FSH: 3.3
Serum Ferritin: 42 (15 - 250)
June 2017
TSH: 3.56 (0.27 - 4.20)
Free T4 : 16.2 (12.0 - 22.0)
Free T3: 3.7 (3.1 - 6.8)
March 2017
TSH: 2.9 (0.3 - 5.5)
Free T4: 12.7 (9 - 25)
Anti-thyroglobulin: <15 (0.00 - 60.00)
Anti-TPO antibodies: 36 (0.00 - 60.00)
I have all the typical hypo symptoms; extreme coldness (I get chilblains), muscle aches, extreme puffyness around eyes, neck and ankles, brain fog, I can forget what I'm thinking midway through speaking - I'm still in my 20s!!! Also it runs in my family. Just wondering if this could make sense to anyone or if anyone has any experience with how the thyroid and female reproductive hormones are linked, or am I barking up the wrong tree???
Thanks for any advice!
Written by
Pearl999
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Your thyroid has been struggling since March and TSH is now high in range. Weight gain is a typical symptom of low thyroid. Symptoms can precede abnormal bloods by months/years but NHS won't diagnose hypothyroidism until TSH is over range or FT4 below range. Exercise depletes the thyroid hormone T3 and that's why recovery from exercise is taking so long.
I'm not very knowledgeable about the female hormones but low thyroid hormone can dysregulate periods and can cause temporary infertility. Both resume normal operation once thyroid levels are restored.
I would ask for thyroid to be retested in March. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.
Thyroid antibodies are negative for autoimmune thyroiditis (Hashimoto's).
As hypothyroidism runs in your family there is a bigger possibility that you may also/have developed it. Female problems and miscarriages are also caused by hypothyroidism.
When you request a thyroid hormone blood test from the GP, you can tick off the symptoms you have on the above link. The blood test has to be at the very earliest possible, fasting (you can drink water) and if you were taking any medications take them after the test. Get a print-out from the surgery of the results and make sure ranges are stated and post them on a new question
If your blood test was taken later in the day I'd request another blood test.
Thanks so much for all your advice! So I guess all I can do now is wait for TSH to rise until it's out of range? I'm being referred to an endocrinologist by my last GP as they can't fully explain my symptoms, so I'll take the list and ask if they might consider giving me a trial of medication?.. they will probably say no, but I can try.
Good advice from Clutter above & you don’t have Hashimotos but your ferritin is quite low as is your FT3 level.
T4 is converted to T3 which is the ACTIVE thyroid hormone that gives us well being. Iron is key for this to happen and raising your iron levels may help your thyroid hormone levels become more active.
Low iron levels can decrease deiodinase activity resulting in conversion to reverse T3 ( rather than the ACTIVE T3 hormone) & this would have a very negative effect on how thyroid hormones are working. It also means you could be hypothyroid and yet appear “normal” according to blood test results when read by ignorant doctors.
Thyroid hormone levels can affect the metabolism of female hormones as the ovaries and uterus need proper amounts of thyroid hormone as much as any other organ or system. Common problems are to do with the fluctuations of oestrogens and progesterone, or cortisol related.
Long term low thyroid hormone eventually ends up compromising the adrenals glands that produce cortisol. The HPA-Axis and HPT-Axis work in parallel and cortisol and TSH should correlate for everything to run smoothly but prolonged cortisol elevations (that are supporting low thyroid hormone) will decrease the liver’s ability to clear excess oestrogens from the blood. This increases the levels of TBG, the proteins that thyroid hormone is attached to as it’s transported through the body.
When thyroid hormone is bound to TBG, it is INACTIVE as must be cleaved from TBG to become “free-fraction” before it can activate cellular receptors & become FREE (active). In blood tests these are known as free T4 (FT4) and free T3 (FT3).
LH stimulates the ovary to secrete oestradiol, progesterone, and androgens in a cycle that should serve as a signal for ovulation and all hormones interact with each other. A low LH level is usually accompanied by a low FSH level because they are both secreted by the same pituitary gonadotrope cells.
Was your FSH 3.3 result taken during follicular, ovulation or luteal phase ? ? …
Have you had prolactin tested ? ?
Have you had O & P tested ?
Have you had Vit B12 tested ?
Are you eating a healthy diet with enough calories ?
Have you managed to increase your low levels of Vit D and Zinc ?
oestradiol: 126 I believe this is all in the luteal stage - after a lack of mentrual cycle for a year I reduced my gym sessions from 3 or 4x a week to once a week, now periods seem to appear 6-8 weeks apart. I can't see any progesterone tests.
I had b12 tested in March: 706 (180-1100). However I take supplements which may have affected the result.
I do eat a very healthy diet with veg, fruit, lean protein, healthy fats, starch etc and aim for lots of variety. I've gained 5kg since last year and I'm only 5 ft tall, so I'm definitely eating plenty!
I've been taking vitamin D and zinc supplements, however I've not had them tested again. My ferritin levels were initially at 23 back in 2014, after taking 210mg iron supplements 2 or 3 times a day for about a year and a half, the highest my levels raised to were 68. I flagged this to my doctor and she said it's normal for stores to take a while to build up... after my periods stopped I stopped taking the supplements so frequently as I assumed I didn't need them, but now see that the level has dropped again and have begun 210mg twice daily again.
Thanks for the explanation, I did suspect the systems were linked. So I guess what I'm trying to work out is whether the low female hormones are causing my low thyroid function, or the other way around? I am not over-exercising or undereating, but my body seems to have no energy.
Have a look at the Thyroid Uk diteceho run this forum. There is a list of symptoms so I would print it off and ta k the ones you are getting and showcthat to your doctor as well. If he isn't impressed about you looking on the internet you can tell him Thyroid Uk is recommended on NHS Choices for thyroid dysfunction!
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