Graves and menopause, considering HRT-advice please?

[Jeanie1961]

I am currently in a second episode of Graves after 9 years in remission.( now taking 2.5mg carbimazole daily). I still have fatigue, arthritis and joint pains and wondering how many of my symptoms are menopause rather than Graves related. Both seemed to start around the same time, shortly after a very stressful car accident in September 2016. My consultant wanted to stabilise the Graves before treating for menopause, but has now said I can consider taking HRT. My question is what type should I consider? (I have low blood pressure, no significant family history of cancer, stroke, or diabetes, but a slightly raised cholesterol at 6.5. I am also keen to try any supplements or herbal remedies that may help.(currently taking vitamin D spray daily at 3,000 units. Thank you in advance for any replies. X

[Angel_of_the_North]

Are you sure you have Graves, not Hashis - were TSI or TRAb antibodies positive (that;s the only way you can tell you have Graves)? I ask because your symptoms (including high cholesterol) sound more like underactive thyroid and a Hsis flare is often mistaken for "true" overactive thyroid as it gives temporary high free T4 and low TSH. It's more usual with Graves to have low cholesterol.

I'd only consider bioidentical HRT tailored to your exact needs - not a one pill fits all solution. If you don't have real bad menopause side effects (vaginal atrophy, serious hot flushed and sweating etc), I'd try all the OTC remedies for menopause, one at a time, for at least 2 months each and see if anything suits you. It all depends on your ratios of oestrogen, progesterone and testosterone - different remedies suit different ratios. The only symptom you mention that I had around menopause was fatigue - because I couldn't sleep. It was quite different from being hypo, but I've never been overactive so can't comment on how like Graves it might be.

[Jeanie1961 in reply to Angel_of_the_North]

Thank you for your reply. I do have Graves, confirmed with antibodies, and quite significant menopause symptoms. I have been advised to avoid supplements containing iodine, such as menopace. Will do some research on bioidentical hormones and discuss with my GP next week.

[Angel_of_the_North in reply to Jeanie1961]

Most NHS GPs won't do bioidentical hormones as they don't believe that real progesterone is necessary, so you would need to go private. For supplements, I really meant the individual herbs like agnus castus, black cohosh, sage, red clover etc. Never heard of menopace, but Iodine used to be given as medication for overactive thyroid. There used to be a website Your Menopause Type or something like that which gave a clue as to what your hormone imbalance was likely to be. Worth a search to see if it is still there. You don't need to buy their supplements, just look at the ingredients list.