Balancing NDT with HRT and Progesterone. - Thyroid UK

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Balancing NDT with HRT and Progesterone.

Jollypolly profile image
39 Replies

Does anyone have experience of the following...

Hashimotos.

On NDT

Esteogen only HRT following total hysterectomy

Progesterone cream

If so, have you had difficulty with dose of NDT since starting Progesteroe cream ..

Have you found your normal dose of NDT makes you hyper ?

This is me..and after many, many years am STILL trying to balance everything out.

Any ideas ? I’m doing everything else I can ..supps and diet etc.

I can’t reduce HRT lower than my already low dose,,.experimented thoroughly.,.need my 37.5 patch.

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Jollypolly profile image
Jollypolly
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39 Replies
BadHare profile image
BadHare

Have you tried cutting back on NDT, till you feel you're not overmedicated?

I took oral HRT prior to starting thyroid hormones, & found my only issue was taking them too close together, or with vitamin D. All work well when spaced out: THs early morning, D lunchtime, HRT evening. I didn't get on so well with separate bio-identical HRT.

I've only been taking THs for 3 years, though I'm aware I need a much lower dose of T3 when the weather is warm, & adding NDT from autumn to spring.

Jollypolly profile image
Jollypolly in reply to BadHare

Hi ..thanks....well, yes I’m absolutely having to cut down as not sleeping ..almost at all....I just didn’t expect to have this problem quite..and was just wondering about the experience of others,,..but I’m now wondering what I shall be cutting the NDT down to ...it’s always hard to tell as everything takes so long to kick in , doesn’t it !

BadHare profile image
BadHare in reply to Jollypolly

I take T3 only during the summer & a mix the rest of the year, so that makes adjustments easier & quicker. I feel the difference when I start taking NDT in about 48 hours. If I find I'm too hungry, I know to cut down on T3, though I've not taken enough to cause sleeplessness unless I'm poorly & running a temperature.

Tweeking takes time, so I hope you find a dose of everything that suits you soon!

Jollypolly profile image
Jollypolly in reply to BadHare

I should have said....

Am on HRT patch which suits me very well....

But also..

I’ve had no problem with my Thyroid dose for quite a while,..and the hot weather didn’t upset things...no..I’m convinced it’s to do with the progesterone. But anyway..I’ve cut that down now on suggestion of another HU writer.

Lovecake profile image
Lovecake in reply to Jollypolly

Hello, I’m also on HRT patches and use 75% of a patch as any less has undesirable effects in a certain place.

I was wondering, as you said you had a full hysterectomy, does that means you have no ovaries? I have no ovaries and last month asked my endocrinologist if I should be on progesterone. He said no, because I have to ovaries. So, is he wrong?

I have just managed to get my thyroid meds balanced T4 and T3 taken, so I don’t want to upset that apple cart. But am still wondering about progesterone.

Jollypolly profile image
Jollypolly in reply to Lovecake

Hi there,

Than you for replying.

As far as I understand....others will correct ,e if this is wrong but I’m 99 % sure it is right...that the doctors in general ..the NHS ...rightly feel you shouldn’t take estrogen AND progestin following total hysterectomy..

Progestin is all you are offers on NHS , I believe anyway...and that isn’t good...Natural progesterone is different. ..and nhs docs aren’t taught about estrogen dominance.

I’d really recommend you get a book on that subject,,,

Dr Lee’s WHAT YOUR DOCTOR WONT TELL YOU ABOUT MENOPAUSE....or there’s a good one by Dr Shirley Bond,..look them up. They tell you a lot about the need to balance out the estrogen. .and the wonders of natural progesterone cream.

But I’m finding it’s having an effect on me thryroid hormone..

You are on t4 and t3 separately which is probably useful...

Look things up and then see what you think...but I’m now totally sure that ALL of us should be taking progesterone if on estrogen therapy.

All the best to you,..

Lovecake profile image
Lovecake in reply to Jollypolly

Thank you. Will do some research. 🙂

Jollypolly profile image
Jollypolly in reply to Jollypolly

Just to add..yes..I had total hysterectomy many years ago..and like you , I MUsT have my hrt...am on Estradot...the best patch by far , I found...

Am on 37.5 patch..have tried cutting down to 22-25 but really it’s hopelesss...spend a penny every half hour,..dry and uncomfortable...so after lengthy experimenting have had to accept this is what I need.

Yes, you definitely can take progesterone alongside estrogen...in fact you MUST to balance things out.

So have been using Wellsprings Serenity cream...and following Dr Lams recommendations for it .,,but there’s a lot of help in Serenity website,

I’ve got the idea now that there IS NO one size fits all...no prescription for it all,..not for the estrogen , Progesterone, it the thyroid.

I discovered about progesterone whilst hunting for answers because , although I’m on an excellent estrogen patch, and I’m on the best natural thyroid pills...Naturethroid ...And id got the dose just right but...still wasn’t feeling quite well...

I knew there was something missing.

I soon realised it was estrogen dominance,,.yes..I need some estrogen..but also the prog to balance things up...because un opposed estrogen causes problems. ....I am certain this was the problem and the cream is the answer.

But then ..I found the cream affected my thyroid dose...at least, I suspected this...and needed assurance from others that I’d got this right .

It looks as though I’m on the right track..and just need time to find the right thyroid dose...have cut down from 2.25/grains..to 1.75;and still want sleeping...so now I shall try the one and a half grains ,,,it all takes ages doesn’t it...but there no shortcut. I do hope this helps you and guides you...it’s great to find people in the same situation isn’t it..as then we can all help each other 🌝

Jollypolly profile image
Jollypolly in reply to Lovecake

Hello..Again!

Have just re read your message and see that you are on a 75 patch...

Perhaps I can encourage you..

I used to be on this dose...many years ago..

I have very slowly got it down to the 37.5 patch..

Tried many and find ESTRADOT stands head and shoulders above the rest. This dose is JUST about ok...

But why don’t you slowly cut slivers off your patch...very slowly...and try and cut down to a 50 patch? I think you may find it worthwhile as the estrogen has such an effect on the thyroid ...

And also to balance it with the progesterone cream .

LadyCelia profile image
LadyCelia in reply to Jollypolly

Estradot instructions quote ‘do not open the pouch with scissors as you could damage the patch’. If you cut slivers off they will leach the medication from the cut edge, so will deliver drug erratically and slivers kept to use later will have lost their meds before use.

I can vouch for that as I used to do it, until I re-read the instructions, .... and suffered the consequences of being under medicated. I also have Hashimoto’s Thyroiditis.

Daily Mail article 2 years ago confirmed this :

A common mistake with HRT patches......, is to cut them up.

'This destroys the mechanism the patch uses to deliver drugs into the skin, meaning a person could get too much or too little of the medication,' says Mr Dajani. This is because some patches slowly release the medicine through a special layer - cutting the patch damages this layer, so it's all released at once.

Jollypolly profile image
Jollypolly in reply to LadyCelia

Hi..thanks for writing.

I’m aware that in certain patches should t be cut...funnythough...that pharmacists and doctors hav lo approved my cutting of Estradot...I will take another look at instructions.

However..I KNOW when I have enough estrogen,.its clear, because I then have no adverse urinary frequency and discomfort etc.

I am thinking of possibly reverting to Estogel anyway ....and maya discuss the issue with doctor..thanks for pointing it out...

Angel_of_the_North profile image
Angel_of_the_North in reply to Lovecake

No ovaries means you cannot make progesterone - fat cells can make oestrogen, but not progesterone. So I'd say he is wrong.

Lovecake profile image
Lovecake in reply to Angel_of_the_North

Oh wow! To both of your answers (inc jollypolly).

I have a lot of reading to do.

I’m on estradiol patches and have cut them down to 75% size. I found I was too dry etc on half a patch.

I had read that progesterone was helpful for when we get older with (and I’ve forgotten exactly which one) some Alzheimer’s.

Am sure there are other benefits too.

I get occasional sore breasts and wondered why. Have mammograms when requested and all ok there.

I will be making sure I have good quality of anything I take. Since being on this forum have learnt so much. Am really grateful to everyone who spends time giving out invaluable information.

Thank you 🤗xx

Angel_of_the_North profile image
Angel_of_the_North in reply to Jollypolly

I don't have Hashis but am on HRT. I don't sleep if I have too little progesterone and also get more anxiety. Too much oestrogen (relatively) causes low mood and sore breasts.

Jollypolly profile image
Jollypolly in reply to Angel_of_the_North

Yes...I understand...it’s all interesting. Thanks

Hashi-Monster profile image
Hashi-Monster

In my experience estrogen increases Thyroxine binding globulin (TBG) this keeps more of the thyroid hormones bound and unavailable to the cells. Progesterone cream opposes the estrogen reducing TBG and therefore making more thyroid hormones free. This will be what is making you feel over medicated.

You just need to adjust your dose of thyroid hormones if you are using progesterone.

Jollypolly profile image
Jollypolly in reply to Hashi-Monster

This is so helpful...don’t pretend to understand the science much but feel sure it’s right...however..one caveat...another lady sent me a link to a scientific paper sheing that the hrt PATCHES don’t oppose the thyroid in the same way ..I’d send you the link but don’t know how to do that on here ! Walk me through it if you like..but thanks anyway,,.it must be relevant to me as I felt sure it’s to do with the progesterone..as I’d got my thyroid at what seemed like the right dose .

Hashi-Monster profile image
Hashi-Monster in reply to Jollypolly

I’d like to see that paper if you can find out how to send the link. I can only imagine it says it doesn’t oppose the production of thyroid hormones (which may be true). What I explained is that estrogen increases TBG which keeps them more bound.

I’ve started using progesterone cream (only 10mg at night) to correct estrogen dominance and I can notice a difference in the effect of my NDT.

Jollypolly profile image
Jollypolly in reply to Hashi-Monster

That’s so interesting..thanks for letting me know...the Thenthing is,..

One,...I’ve found I fell considerably better on th Prog cream,..I do believe it IS the missing link for me to feeling more normal,.BUT...like you....it’s affected the thyroid ....and I think I’m right to adjust down to find the correct new dose..rather exciting really to think thyroid is improving and one may be getting better at last !

It s just that it takes SO LONG ..AND SLEEPLESS NIGHTS...to find the right dose ! But what’s new !!

Hashi-Monster profile image
Hashi-Monster in reply to Jollypolly

It’s not that your thyroid is improving it’s that the NDT is more effective with progesterone

Jollypolly profile image
Jollypolly in reply to Hashi-Monster

Thanks for correcting me AND educating me,,,,

I find this all very heartening ! Thanks.

Naomi8 profile image
Naomi8

I am post menopausal (68)& on NDT & I use natural progesterone,as I have oestrogen dominance.I have tried upping my oestrogen a little by using Agnus Castus drops & twice tried the Magnacare pelvic magnet.My fibroids swell up & it hurts if I sit down too suddenly.My urethra gets squished,I get stress incontinence & had a UTI the first time.

Dr Barry Peatfield states in his book that natural progesterone helps the underactive thyroid,so I would reduce thyroid medication if feeling over-medicated.

Jollypolly profile image
Jollypolly in reply to Naomi8

Thanks Naomi

Yes you’re confirming what others have said and I suspected

It sounds as you need help yourself

I do hope you get somewhere with your regime

If you don’t .. or anyway .. of you can afford it why not try specialist doctors

Someone poinnted mr to Marion Gluck clinic in London

Am a big this on my back burner if I can’t gwt sorted

Prices are not unduly high . I thought .. nonetheless it’s a lot if you ain’t got it which I suspect t most of us ain’t !!

All the best to you and Thankyou

Hormone-mess profile image
Hormone-mess

I’m also on NDT (naturethroid), estrogen, progesterone, testosterone and dhea. I have a Functional nurse practitioner that helps me. It is tricky to get all of the medications balanced. I’ve been diligently trying for a little over two years. She recently increased my estrogen and progesterone and suddenly my ndt was making me dizzy. Any how, to answer your question, yes progesterone can make your thyroid medication work better.

Jollypolly profile image
Jollypolly in reply to Hormone-mess

Hello H

Thanks for writing to me

Now I’ve insratoos that you shouldn’t take DHEA with HRT

Check it out .. and testosterone ?

And increasing estrogen and progesterone?

It SOUNDS a little alarming .. not saying your Nurse is no good but it does sound a little extreme

Do you mind telling me your doses of everything ? And which estrogen are you on ? I don’t know lot but his loads of experience and am gradually getting sorted

You learn a lot on web

From books and also on HU

All the best anyway

Hormone-mess profile image
Hormone-mess

Actually yes, I’m becoming frustrated that I am not leveled out after all of this time. I have an appointment with another Dr. that supposedly has a lot of experience with hormones on September 11th. After this last increase of all hormones I started becoming dizzy with low blood pressure and called, her response was to drink more water and add extra Himalayan pink salt to my diet. I’m 42 and have premature ovarian failure. I was told dhea and testosterone was low and would help me feel better and lower antibodies.

I cut my naturethroid back myself because I’m losing faith in this practitioner. I cut it from 1.75 grains to 1.25. I should have felt much better after all this time. All of the HRT I take is bio identical from a compounding pharmacy. I take 5 mg dhea, 2.5 mg estrogen, 262.5 mg progesterone and 5 mg testosterone.

I would love your insight!

Jollypolly profile image
Jollypolly in reply to Hormone-mess

Hi Again

Reading your letter makes me say I’d be out if my depth commenting ... however .. it does sound a bit alarming .. may I ask which doc you are booked to see ?

Jollypolly profile image
Jollypolly in reply to Hormone-mess

I’m worried about you practitioners advice ..

I’ve had three and a half ! Private docs .. not one had the whole picture and the answer ..

I’ve had to work it all out myself .. I feel I’m almos they now as I’ve managed to assemble the jigsaw . Years of Ill health with misdirection .. I’m 68 .. getting there ...

your ovaries .. who diagnosed this ? NHS ?

Hormone-mess profile image
Hormone-mess in reply to Jollypolly

I’m in the US. A gynecologist diagnosed this after several panic attacks and No menstruation for two years. I quit having periods when I was 38.

I have lost faith in many Dr.’s.

Hormone-mess profile image
Hormone-mess

Her name is Tracy Shulsinger and she’s out of Boulder Colorado.

Jollypolly profile image
Jollypolly in reply to Hormone-mess

Oh .. ok .. I’m definitely unable to comment ! You so need help in the States ...

tell you what I would do

Go to a really reputable doctor initially simply to get confirmation of state of ovaries and possibly treatments

Then .. it possibly first ... go on St Lams site .. read up .. take ad advantage of the first free phone call and see what they see .. I’d trust Dr Lam .. see if they can help .. meanwhile I’d go easy on all your meds ...

I’d definitely try Dr LAm

He has worldwide respect .. cancel your other doc maybe just for now as you may get good advice there

all the best .

So hope you get sorted .

Lozzer66 profile image
Lozzer66

I’ve been taking hrt for a few months (combined as I have a womb )and am post menopause 4yr or so and it has taken my thyroid bloods from in a good place to bottom of t3/t4 ranges ..it seems that even though I was taking hrt and thyroid medication 12 hr apart it had still increased tbg and had an effect on what was getting into my cells !Having a terrible amount of hairloss prompted me to get my thyroid bloods done which I do regularly...I had no clue that I was under medicated as my basal temperatures were bang on 37* and pretty much that all day and if anything felt like I was more over medicated than under !!I was shocked to see how hrt had destroyed my good thyroid levels !I read the hrt packet about hrt and thyroid and it said thyroid would need monitoring closely whilst on hrt and may need an increase in meds .Ironically going on a lower dose hrt has dropped my temperatures from the 37* to below par temperatures again !Go figure?!Have you done your bloods recently?could your feelings of “hyper”over medication actually be under?By far the best information I have ever found on menopause is the “Menopause Taylor “channel on YouTube...(she’s a doctor)she has much to say on progesterone and and estrogen dominance as mentioned in this thread giving out the facts .

Jollypolly profile image
Jollypolly in reply to Lozzer66

Hi..thanks for writing...

Your situation is radically different to mine ! Trust me on this ..

You have an intact womb and ovaries ..I don’t.

Therefore I’m not making estrogen and more besides .

Your hrt will be wuite different to mine...you will have an estrogen and a progestin..which is quite different to the progesterone I’m taking,

The list of differences goes on...and all the effects.

So what’s going on will be quite different..I, talking about quite a different scenario.

But thanks for writing..and wishing you lo the best.

Lozzer66 profile image
Lozzer66 in reply to Jollypolly

Yes I appreciate that and I am quite aware of it ...the point I was making is the effects that hrt has on thyroid levels

Jollypolly profile image
Jollypolly

Yes...I understand.

I’m fully aware of this..but there,are other factors for me too...

Mainly that I’m now on Progesterone,..which,has the effect of cancelling out / balancing some of the estrogen ..which means my throid med should work better..getting the balance right by lowering my dose of thyroid med and adjusting estrogen and progesterone to be right for me is the big question..and this is why I wrote my original post...looking for others with very similar experience who may have some guidance.

NtombiSA profile image
NtombiSA

Hi Jolly polly.....The only thing that rings a bell with me is that I was highly sensitive to progesterone. I became aggressive and restless. Once I took only Estrogen...I was fine.

Jollypolly profile image
Jollypolly in reply to NtombiSA

Well —,How to answer !

It took four attempts for me to get into the progesterone ... finally I got really clued up about it ... followed Dr Lam’s instructions and also was persistent . I’m still trying to balance the thyroid dose , estrogen and progesterone .. but that’s what I AM doing .. balancing ..

I Would say to you that all the He people who know ! - all day the same .. unapposed estrogen is not good . I bought books on estrogen dominance and it is very interesting .. but every body is different . Just beware ... read up about it and then make up your mind . I was on estrogen only for 25 years and felt all was well but

Couldn’t quite get my thyroid right

Have begun to feel better since using progesterone even though haven’t got the balance right yet .

Hope this is helpful .

Furbabymommy profile image
Furbabymommy

Hi Jollypolly,

I think I’m experiencing what you indicate- taking/absorbing oral progesterone is making my thyroid meds much more effective, to the point I had to decrease my thyroid meds 2 days ago.

This scenario may illustrate the point:

Taking 88mcg Tirosint (t4) and 5mcg t3 (Liothyronine).

I started taking sublingual dissolving estrogen/progesterone tablet from a compounding pharmacy, and DHEA 5mg oral tablet.

Doc did a lab test to check absorption which showed I absorbed the estrogen and DHEA but NONE of the progesterone.

Doc changes to sublingual dissolving tablet to estrogen only, changes progesterone to oral tablet (75mg from compounding pharmacy), and continues the 5mg DHEA tablet.

About 2 weeks after starting oral progesterone tablet I started to feel what I call overmedicated: hyper, heart palps, cry at anything.

Doc says stop the 5mcg T3 for 3 days to level out, decrease hyper.

I’m thinking my absorbing the progesterone correlates with me feeling overmedicated and needing to stop t3 as my initial step.

I’m still feeling pretty energized. If stopping the t3 doesn’t lessen the hype enough I’ll likley then decrease Tirosint dosage.

Btw I am 54, in menopause with last period 2/17, in USA.

Thoughts?

FBMommy

Jollypolly profile image
Jollypolly

Hi there...

Well...first to say I don’t quite understand about everything g you are doing,.however,.one thing screams out at me, simply because I’ve read all the very best advice regarding progesterone etc,

It is far, far better to use natural, biodentical hormones....and although I don’t know all the details..I don’t have enough detail..and anyway I’m not ultra knowledgeable.....

But,...I do know it’s better to use natural products...you may have to , like me, read up..and listen to others,..and treat yourself.

My advice is to stop taking hormones orally and start using biodentical creams...there are enough good ones out there...

Using Progesterone is rather a matter of trial and error I think..AFTER YOU HAVE READ ALL THE GENERAL ADVICE AND SUGGESTIONS FOR USE.

Buy the best books...Dr Lees What your doctor may not tell you about Menopause etc...and Hormone Balancing made easy...they are brilliant books and explain the whole thing.

Personally...it has taken me some months of trial to realise I do t need to take Progesterone cream twice a day ..as most people should or do...I only need it once in the evening ,.and around 15 gms ..1/8 teaspoon..

BECAUSE I use HRT following total hysterectomy and I do need some estrogen.This amount of progesterone cream balance up the estrogen enough then...to not negate the effects of the hrt...

I hope this helps....

You talk about getting hyper from the progesterone...if you get the dose right you won’t have issues..and then eventually it does help your thyroid .

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