I am at last on combined HRT to try to regulate my periods and also to help with ectopic heartbeats.
I am on the estrogen patches continuously, and the 12 days of progesterone (200mg). The patches I have no real problem with, but the pills are giving me some scary side effects. I ensure I take them 2 hours after dinner, and leave an hour before I have my usual snack and drink.
I have extreme tiredness to the point I am collapsing and losing my balance, my left pupil of my eye seems a little larger than the other (I had to come off antidepressants after a week last autumn because of the same reason and my pigment dispersion), and I cannot control my anxiety.
My anxiety has been out of control since lockdown and all the virus stuff, and I am constantly terrified I have the virus. I did chat with my Nurse (I cannot even SEE my doctor as they are just doing phone appointments) and she said it could just be settling into the routine of HRT. The extreme side effects of course happened after speaking to her.
Also have an extremely itchy and odd patch on my left side of foot which I think is palmoplantar pustulosis and I cannot get rid of it. Tried everything. The cream I have for the occasional flare up on my hands worsened the foot patch and spread it and burnt layers of skin away that will not grow back.
I have a thyroid blood test week after next (overdue from April) (and have to walk a 50 min round trip for that as my surgery is not open).
Sorry to go on and on, but what is normal? Will I be ok to have a can of lager this evening? I only drink twice a month but am worried if I will have even more side effects.
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DeeFish71
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Taking HRT frequently results in needing dose increase in levothyroxine
How much levothyroxine are you currently taking
When were levels last tested
What vitamin supplements are you currently taking
Recommend getting FULL Thyroid and vitamin testing after 6-8 weeks on HRT
Presumably you have been taking HRT at least four hours away from levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
If/when also on T3, make sure to take last third or half of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
100mcg a day. Not been tested since last July. Was due to be in April but this wretched virus stuff meant it was cancelled. Got a blood test week after next (the first available one they had). I take them at night, about 930 (2 hours after my dinner as recommended) and leave it an hour until I have my snack and drink as recommended. I take my thyroid pill when I get up in the morning as want to leave a good gap. I take a multivitamin every afternoon. I know I am having B12 bloods taken as well.
This is a reaction to the progestorone phase of the HRT. It's quite normal to suffer side effects when starting HRT and we need to give it 3 months at least to settle down. But this seems a bit extreme, you might need to switch to a different HRT with a different type of progestogen. However, are you saying that the progestogen part is a tablet? If so, what time of day are you taking it? What type of patch and progesterone tablet are you taking?
Yes the progesterone tablets are to be taken 12 days of the cycle for me (Days 15-26) then a break from them whilst continously wearing the estrogen patch. I take 2 of them 2 hours after my dinner (so roughly around 930pm) and then leave a good hour till I have a snack. They are "Utrogestan 100mg capsules". The patches are Elleste Solo MX 40.
I also think because I am really unwell with the amount of anxiety and fear in my life, all because of this rotten virus situation and the fear of people picking on me when I go out cos I cannot wear a mask (I tried and I had such a panic attack in town and felt disorientated), that the anxiety is worsening everything. I feel this hell is never going to be over. Maybe I would be adapting to the HRT better if all this other extra stress was not here.
Thanks for your reply, and hopefully things will settle down soon.
Yes, I wondered if it were Utrogestan. I couldn't take it by mouth at all, but I could take it vaginally (not that a UK GP would know anything about that, but it's what they do on the continent to reduce side effects). Take it at bedtime, as you go to bed so that you sleep off the worst of it.
If you are already struggling with anxiety this phase could be hard. It's a big hit of progesterone. Do you still have periods? If you haven't had a period for 12 months then you move to continuous HRT which means a smaller amount of progesterone every day, i.e. one of the capsules. That's easier on some women. Others can get by with 1 capsule for the 12 days or even reduce it to 7 days, but you need to be under a menopause clinic for that. I'm telling you that so that you know there are options. It might be worth asking your GP now if you can be referred to a menopause clinic. There will be a long wait, so get in now if you can.
As I said I couldn't take it orally myself. Vaginally was OK. But I switched to Provera, an older progestin, and got on much better with that one, no issues, until I had the Mirena coil fitted which gives me no problems at all.
It can take a while to get HRT right, but if you are struggling with the thought of the virus, then you do need the HRT because you should be able to cope with it, it's horrible, but we know what we have to do and provided we do it we should be OK. Lack of oestrogen will mean your brain goes rampaging through the "what if's" and disaster scenarios about anything and everything. When my oestrogen is too low I will make a catastrophe out of anything, so it really is worth pursuing and finding what works best for you.
I never knew you could take it vaginally! Problem is with my bedtimes is that I go to bed very late (we are talking 230 am) as things take me time to do and I never get to bed until I have finished my tasks. I am very slow, which frustrates me. I get up on average about 945 am.
I do still have periods, but they became rather erratic since last year, week early, then another 5 days late, then Dec/Jan didn;t have one at all. I have been ill with some virus since March 2019 and since then my body has just gone downhill. The last thing I needed was more stress with this virus stuff.
My GP - have not spoken to her since February, and been sorting HRT stuff out with a nurse over the phone. My surgery are shut and not likely to open for the foreseeable future. I have a worrying patch on my foot too which flares up into itchy spots, burst, dry and peel and the itching and pain is terrible. I just cannot get any of my health stuff sorted out cos of this bloody virus delaying/shutting places. I am in a very dark place mentally, and the attitudes of people to people who are ill and already suffering makes me so angry.
Sorry to vent, but thank you for your time - I really appreciate it x
I'm a late to bed person too. Just take it vaginally when you get there. In the morning there will be a little white residue in the loo, it's the capsules. If you think the progesterone is making you feel worse, try it that way next month. I'd finish this month as you are now.
Oestrogen helps, but it takes time. The patch on your foot could be helped by the oestrogen or it might be causing it! You just need to watch, make notes and keep track of things. Keep talking to the nurse when you need too, but try to work some things out for yourself as they can never do it all for us.
Also, stop worrying about the virus. If you keep telling yourself it's stopping you sorting out your health, you will stay sick because of the stress. It's not really stopping you, you do have the nurse and if you need a GP appointment there must be phone consultations. You can take a photo on your phone of your foot and send that in ahead of the call. I've had a phone consultation with a cardiologist the other week (routine), my surgery had me in and ran an ECG for me first for that appointment and I've had a video call with my HRT doctor, so it is possible, a bit harder, but possible. Just pick one thing and start working on that, don't try to deal with everything at once. One at a time.
You are still in need of the sequential HRT you are taking because you have not been period free for 12 months yet. So the method is right, but the progesterone needs work. Soon be over for this month though and back to patch only which should help you to feel better. Then start next month vaginally and see if you notice improvements.
No, you can. They are the same. On the continent they are prescribed that way. It's a gel capsule. The menopause forums here in the UK are full of women taking what you have Utrogestan 100 soft gel round capsules, vaginally. Just get into bed and pop them up as high as you can with a finger. Job done. It absorbs directly into the womb area to do its job. You should get less symptoms that way.
The only vaginal options actually prescribed as such in the UK are 200 and pessaries for infertility treatment. You don't need those. You just use what you have. It made the difference from suicidal to fine for me.
And the foot patch is not caused by the HRT as had this since March. I have pomphlyx on my palms of hands but this is more severe. The cream I have for my palms is useless and tried it on my foot and it's burnt layers of skin away and spread it.
Yuck, that sounds really painful! Can you get a phone appointment? Our surgery still sees any patients they need to examine. It's just a palaver to get in, you wait outside and have to wear a mask and they come and fetch you and are dressed in PPE. But they still do the job. But I know that friends have sent photos in of things like your foot for a phone consultation.
About the HRT, if you want more than just my opinion on it, especially the vaginal method, if you are on Facebook, join the closed group The Menopause Support Network. It's a brilliant resource and very supportive. No question is too much.
If you aren't on FB there is a web site with a really good patient forum called Menopause Matters. Again, a great resource for all things HRT.
I have filled in my surgery's EConsult form. I cannot be seen by my surgery (5 mins up the road), but their sister surgery is open. Only trouble is, it is 3 miles away, and I don't drive. I can't even get my poor Dad to give me a lift as he is shielding and high risk. Buses round here are awful, one bus an hour. I am reluctant to use a taxi, due to the risks of germs, and the fare would cost me £20+ which is just not doable. I would be happy to be seen at home but my surgery do not do this. I will see what they say in a call but it will be get to the other surgery or another cream that does not work
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