Hi everyone, and happy new year!
I was diagnosed with hypothyroidism in Sept 2017 and initially put on 25mcg levothyroxine. My blood tests also showed I was perimenopausal. The GP that I saw then said he'd treat the thyroid first and then we could consider HRT if symptoms not fully resolved, given that some symptoms could be due to either hypothyroidism or perimenopause. My next bloods saw TSH back in range but I hadn't seen much difference in symptoms; the GP ( a different one in the same practice) had to be pushed to increase my levo dose but she did agree to do so, so I've now been on 50mcg for several weeks. But she seemed to think all my symptoms were menopause-related rather than thyroid, and said that if that didn't resolve things fully, HRT would be the next step. In the next fortnight I will be getting my bloods redone and will have to go back into battle - and I am fearful that they will put my continuing symptoms down to the menopause and that it will be even more difficult to get an increase in levo and that they'll push me towards HRT instead. And I don't know what the best way forward is...
As a bit more background, I was diagnosed with PCOS in 2011 (I'd had symptoms for years) and put on the pill (Yasmin) to control heavy irregular periods and hirsutism. The pill worked well for me for two or three years, then I started getting breakthrough bleeding that was increasingly heavy. Brushed off initially by GP, but in May 2017 referred to a gynaecologist. Hysteroscopy and other tests ruled out fibroids and relevant cancers, and I was taken off the pill and a mirena coil fitted in June. That controlled the bleeding brilliantly, but I started getting bad hot flushes. Then diagnosed hypo in Sept. When my levo dose was put up to 50mcg in Nov, the hot flushes stopped completely within a couple of days - wonderful! But I got a little spotting for several weeks. Then spotting ceased, and hot flushes have gradually returned ☹️. I don't think I can be over medicated with my levo as other symptoms (tiredness, weakness) continue, although improving.
All in all, I am really confused about what's due to being hypo/on levo and what's due to being perimenopausal. Coming off the pill brought to light what I thought were menopausal symptoms, but then for a while levo seemed to reduce those significantly, though that didn't last. I know all these hormones must interact but how do I figure out what to ask the GP for (or what treatment to decline)?! Is it just trial and error to see what works? If HRT will also help me get back to my normal self, alongside levo, then great. But the risk is that the GPs focus on HRT and leave my thyroid under medicated.
And then I've read some articles about oestrogen dominance which I don't claim to fully understand but which sounds as though it can exacerbate thyroid problems. As I have the mirena coil which has progesterone, I think I would just be given oestrogen as HRT, but apparently the coil's hormones just work locally in the uterus so could I end up with oestrogen dominance elsewhere in my system, if that makes sense?
I'm sorry for such a long post. But I hope someone else out there might have had to grapple with these issues and might be able to advise me on what the best way forward is. Thank you in advance!