Thyroid UK

Hashimotos, menopause advice needed

I’m 35 and I have been having night sweats and intermittent hot flushes for the past 8 months. I was diagnosed with hashimotos and hypothyroidism in April and leading up to this time I was constantly freezing. Now I am warm all the time which is unusual for me but I have been taking thyroxine (75mg) for the last 6 months. Initially my blood results were TSH 14 and antibodies 400+ . TSH is now 3.5.I also had my FSH and LSH measured 6 months ago and they were 6 and 7 respectively and so the doctor said I wasn’t in menopause or perimenopause so the night sweats and hot flashes were not due to that. I haven’t had children yet and just recently got into a relationship so I’m praying it’s not an early menopause (no family history of this and I have regular cycle) but I read that hashimotos is related to menopause and was thinking it was a massive conicidence that all this starting happening after I was diagnosed. Should I go back to my doctor and ask for a repeat test for female hormones? Should I have my thyroid levels checked again? Does hashimotos disrupt the menstrual cycle, any advice on this?

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If it is 6-8 weeks since you had a levo dose increase then you need a blood test - taken as early as possible in the morning and fasting leave 24 hours between your last dose of levo - and then a levo dose increase. The aim is to get your TSH under 1. Contact Dionne at tukadmin@thyroiduk.org for the Pulse article on dosing to give to your GP.

In addition to that you should get your nutrients tested - vitamin D, vitamin B12, ferritin and folate - you must specifically ask for these. Those with Hashimotos are frequently nutrient deficient and symptoms are frequently due to this.

Tell the GP you got the advice from Thyroid UK, a charity recommended by NHS Choices for those with thyroid disorders. DO NOT say you got the information of the internet as you will be seen as a crackpot and any other issue you have will be ignored.

Make sure you get the results and ranges for all tests and start a new thread to check whether they are optimal as the NHS only treats severe deficiencies.

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Oh frequently going completely gluten free - avoid processed supermarket stuff unless it is a rare special occasion - and taking up to 200mcg of selenium a day helps decrease antibodies as it help stops the immune system attacking the thyroid.

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Essential to test vitamin D, folate, ferritin and B12. Always get actual results and ranges. Post results when you have them, members can advise

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ask GP for coeliac blood test first

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NICE guidelines recommend TSH under 2 for pregnancy, but with Hashimoto's you likely need it lower than that anyway

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne:
tukadmin@thyroiduk.org

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Thanks for the replies and links very useful I didn’t have anything else tested except for TSH FT4 thyroid antibodies and FSH and LH. I’m just trying to get answers as to what is still going on since I’m having these night sweats Still and the doctor assured me I needed no more blood tests for the thyroid as it was now in normal range at 3.5. Does hashimotos bring on menopause? I assumed that I was feeling hot because I had started medication but it has been going on a few months. Just worried that these symptoms are no longer to do with the thyroid if I’m optimally medicated now. I will return to the doctor to see if they will test me for vitamin deficiencies also. Does the thyroxine reduce the antibodies or do I need to control that with my diet alone?

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