Endocrinologist and HRT

[db16]

Good afternoon everyone

Though I have had a under active thyroid for many years, I have only been taking daily a 50 mg thyroxine (and for a very short time I was fortunate to obtain Nature Throid but lost my contact). I now have my very first appointment with an Endocrinologist and wondered if , as your thyroid is hormone related, can they also balance/subscribe Hormone Replacement Therapy for women? Do Endocrinologists do both jobs? I desperately need HRT and it just makes sense that an Endo can incorporate the two

but then , I'm no doctor. Any ideas? Much appreciated.

[Marz]

Do you really need HRT ? - do yo have any thyroid results with ranges you could share with us ? Maybe your dose needs a tweak as 50mcg is a very small dose.

How are your levels of B12 - Folate - VitD - Ferritin ? - all need to be optimal and not bumping along the bottom of the range

[db16 in reply to Marz]

Thanks, it all sounds like a minefield. Does any doctor actually know ?

See my Endo next week following bloods, which I will share with you.

Wish me luck

[Sewnsew]

I don’t want to be negative but I would advise you not to be too excited about your appointment. I find Endocrinologists tend to be diabetes specialists and know little about the thyroid, it must be their training, or lack of it. I wouldn’t expect an Endocrinologist to be involved in HRT, but I don’t know everything and you might even find one that is interested in you and not just your blood results!

Can you tell I’m getting old and cynical?

[shaws Administrator in reply to Sewnsew]

I don't think you are getting old and cynical. Many members have found out, to their cost, that few Specialists are knowledgeable as are GPs especially when the TSH reaches somewhere in the range and they state we're on sufficient and any symptoms must be due to other problems and will prescribe 'other' for the 'symptoms rather than increase thyroid hormones.

Hopes are built up before consultations and may be dashed.

[db16 in reply to shaws]

I will bear all this in mind with my appointment. Thank you

[G2G2 in reply to Sewnsew]

Endos are no more diabetes specialists than they are thyroid specialists. This is frequently mentioned here. I'm a T1 diabetic.

[db16 in reply to G2G2]

I never knew that. How much more don't I know??

Seeing my Endo next week, wish me luck.

[G2G2 in reply to db16]

Good that you don't know about the awful care diabetics receive. Wishing you luck with your endo.

[shaws Administrator]

Before you see the Endocrinologist I'd ask your GP to test the following. If he wont or wont do all of them you can get them done privately:-

TSH, T4, T3, Free T4, Free T3 and thyroid antibodies. B12, Vit D, iron, ferritin and folate - deficiencies in any of these can cause symptoms.

50mcg of levothyroxine is a starting dose and every six weeks after a blood test it should be increased by 25mcg until we are symptom-free. Many doctors are apt to stop if the TSH reaches somewhere in the 'range' when it should be 1 or lower.

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

Tick of your symptoms on the above link.

All blood tests have to be at the earliest, fasting - you can drink water - and allow a gap of 24 hours between the last dose of levo and the test and take afterwards.

Always get a print-out of your results for your own records and post if you have a query.

[db16 in reply to shaws]

Thank you all for your response. I am due to have blood tests before my Endo appointment and I will post them on line for your comments, which I would appreciate. As for my HRT, I guess that ws wishful thinking but I do think I need it. I will let you know.

[shaws Administrator in reply to db16]

I've added the others who commented just in case they don't see your response. Sewnsew Marz

[scoobydoo87 in reply to db16]

Hi , I was prescribed HRT several years ago , because of my symptoms, which have since been diagnosed as under-active thyroid, ME and Fibromyalgia.

I was referred to an Endocrinologist who was next to useless, the only thing he did was prescribe a different HRT , I was taking a combined oestrogen and progesterone tablet . Apparently because I’d had an hysterectomy I shouldn’t be taking progesterone, it should be Oestrogen only.

I was kept on HRT because of my bodies inability to control my temperature. I’m constantly hot .

HRT seemed to ease it slightly , but now it’s twice as bad . I don’t have hot flushes I’m always hot with a body temperature between 34.5 - 36 most days.

So I’m assuming Endo’s look at that side of things as well.

[Angel_of_the_North in reply to scoobydoo87]

That's because they think that the only function of progesterone is to prevent uterine cancer when taking oestrogen.

[RosamundG in reply to scoobydoo87]

I've been on HRT since my hysterectomy 14 years ago -- I had my ovaries removed as well and I have implants every six months for both oestrogen & testosterone (ovaries carry on producing diminishing amounts of testosterone post menopause). I also have an underachieve thyroid and as far as I know HRT is not a problem -- I'm treated at a major London hospital. Would recommend you have a look at the British Menopause Society to check it out. thebms.org.uk

[TSH110]

All my symptoms were put down to menopause. HRT did help but it was the wrong diagnosis and the wrong treatment as I had hypothyroidism all along. Had I got thyroid hormone replacement I may not have needed HRT. Comprehensive blood tests should reveal if you are undermedicated for your hypothyroidism. If you are, then get that sorted out. My endo was ok - I was lucky.

[milkwoman]

Thyroid hormones, sex hormones and nutritional health all work together and need to be in balance for optimal wellness.

I'm in the US and was a patient of Dr. Kenneth Blanchard. Besides being an endocrinologist, he was also a specialist in menopausal hormone replacement therapy.

As I was being treated by him for my hypothyroidism, I was in perimenopause, so when my periods halted, I asked him to test my sex hormones since he was testing my thyroid hormones for an upcoming visit. The results showed I was clearly in menopause so Dr. Blanchard prescribed HRT. It has helped me tremendously.

I now see Dr. Blanchard's successor who still prescribes my HRT but soon my GYN will be taking it over since anyone on HRT needs to be monitored closely - regular GYN visits, internal exams, PAPs, ultrasounds (if necessary) , etc. - for any endometrial/uterine issues that may occur. My HRT protocol is such that I do not have a monthly bleed (my preference) so any breakthrough bleeding is noted and checked out by my GYN.

[db16]

Thanks, I wish I lived in USA then because HRT hasn't even risen its head here in Portugal. Women just have to `'get on with it". That what why I was hoping that the Endo doctor I am seeing next week could have helped me out with HRT but she seemed very unconcerned! I had a complete hysterectomy 25 years ago and have been on HRT since but here now in Portugal, its hard work.

Thanks anyway.