FSH and LH results - advice please

[Tasker]

Evening everyone.

A couple of weeks ago I posted with a query about whether or not to take HRT, as my GP wants me to - grateful for the responses to that and I'm been mulling over the best way forward.

While doing so I came across test results for FISH and LH, taken at the same time as the tests that led to my hypo diagnosis on 31 Aug 2017. Both FSH and LH are very very low, below the bottom of their respective ranges:

FSH

49.5 u/L (range 1.7 U/L upwards, with >35 U/L being perimenopausal)

LH

25.2 u/L (range 1.0 U/L upwards, with perimenopausal being 7.7-58.5 U/L)

Those are not typos by the way; my results are in u/L ie milli-units whereas the ranges are in U/L ie units. So my results are very low.

Not sure therefore why my GP thinks I'm menopausal, but she seems to want to attribute my symptoms to menpause rather than thryoid. I don't know what those FSH and LH results do indicate though. I googled them, and found that apparently low FSH and LH can be caused by hypothyroidism or alternatively by dysfunction in the hypothalamus or pituitary. So the right course of action might be continuing to sort my thyroid - but if it's a hypothalamus or pituitary problem, I don't know what if anything needs to be done. Either way, the GP would need to have a very good answer to convince me to take HRT!

Can anyone explain these results or give any advice please? (I have the mirena coil fitted so don't know is what my cycle is doing as not bleeding at all now.)

For completeness, thyroid results 31 Aug 2017:

TSH 6.89 (0.27-4.2)

FT4 11.1 (12.0-22.0)

After these started on 25mcg levo.

Results 30 Oct 2017:

TSH 3.58 (0.27-4.2)

FT4 14.3 (12.0-22.0)

Dose increased to 50mcg after these.

Now awaiting results of thyroid bloods taken a few days ago, then will talk to GP again.

[helvella Administrator Thyroid UK]

Tasker,

You can edit your own posts and responses!

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[Tasker in reply to helvella]

Thank you!

[trelemorele]

The likelihood of pituitary or hypothalamus failure over menopause is slim.

Your tests point out to menopause.

You seem to be against HRT - don't take it then. No one is forcing you. You won't die of menopause.

You want to discover more about the other two and possibility of them failing, you need more tests which are most likely outside of GP pay grade so you'll need endo referral.

[Tasker in reply to trelemorele]

Thanks for your reply.

I'm not against HRT; I'm undecided as I've heard arguments for or against. But I had thought that in menopause FSH levels increased. So I was confused about why my GP had suggested HRT given my FSH is below range rather than being high. But from what you say, my very low FSH and LH can also indicate menopause, which is helpful to know as I hadn't realised that.

I have learnt from this forum not to automatically believe that my GP knows best! Just trying to be as prepared as I can be for my next GP appointment ☺️.

[trelemorele in reply to Tasker]

Hey nothing is wrong being against HRT especially if it's to do with your own body.

I believe it's woman's personal choice and no one can/should force her against or for.

[Babette]

My FSH is in the 90s. Things seemed to go a bit squiffy after being overmedicated but I'll never know whether that caused it or it's just coincidence.

My GP offered HRT to protect my bones - it's recommended for women who are menopausal under 52 and I'm a lot younger! I'm currently having acupuncture for a variety of problems and said I would be made up if he could also reduce my FSH. I'll have another blood test at the end of the treatment. He said someone went with fertility problems and he managed to reduced her FSH from 35 to 17, but then everyone's different and I could really be in a very early menopause.

[Tasker in reply to Babette]

Thanks for sharing your experience, Babette. As my FSH was tested before I started on levo, I guess it might be worth asking the GP to retest it to see if if has changed after four months on levo, before further discussions about HRT.

It's so hard to know how all these hormones interact, and what is cause and what is effect, isn't it? I don't know if my symptoms are just from hypothyroidism or a mix of hypo and menopause; and if my FSH and LH are low because of hypo, or menopause, or some other reason.

Good luck with the acupuncture; hope that helps you.