Hi all in the last 6 months I've started taking utrogestan (progesterone) I've just had my throid bloods done and they've come back hyper thyroid. I have diagnosed hasimotos. I've not felt well for a few months now but am surprised I've swung into hyper. I've read somewhere that progesterone can cause this. My gp said drop my dose of thyroxine and retest in 6 weeks.
My recent results were
Tsh 0.04 range (0.30 - 4.20)
T4 16.4 range (9 - 19)
I just want to know if this is normal with progesterone therapy or weather it's flared up my immune system.
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arjs1973
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You most certainly are not 'hyper'. Your FT4 is still in-range. Just having a low TSH does not make you hyper. It's an over-range FT3, and they don't even test that.
And I doubt you need to lower your dose. It could even be that you need an increase in dose. Decreasing your dose could make you feel worse.
But, to answer your questions, as you're not hyper, it cannot be the progesterone that has caused it, can it?
Why on earth would they say I am and to reduce my dose. My throid has remained stable for a couple of years now. Its odd I start progesterone and it throws my levels off. Doctors scare me with there lack of knowledge
Why? Because they learn in med school - and therefore firmly believe - that the TSH tells them all they need to know, and that if it is suppressed like yours, then you are hyper, and no argument! The cannot be told! So very many people on here have had the same problem.
What's more, they have absolutely no understanding of Hashi's - because they don't learn about it in med school. But, with Hashi's, your levels are very likely to jump around a bit. That's what Hashi's does. Whether or not the progesterone has played any part in this, I cannot tell you, but my point was, you are not hyper.
So is it OK to carry on with a tsh that low, the gp said I need to go down on my meds as I could have a heart attack. Don't really want to go down on them if I'm honest
People with hyperthyroidism. ( graves disease usually) can have osteoporosis and heart problems, as well as low tsh. The doctors have made a leap and added 2+2 to get 5. The reality is that low tsh caused by thyroid replacement medication, is not the same as being hyperthyroid.
Years ago, when my doc challenged my low tsh. (0.02), and threatened a dose reduction, i stood my ground and insisted on a test for bone density. I was absolutely fine.
All I can say is that when I switched from taking Utrogestan cyclically to continuously (at the suggestion of my doctor), I started feeling hyperthyroid. I am on T3+T4 so my TSH is always suppressed (so of no use), but both my free Ts came back well in range. I had typical hyper symptoms such as increased sweating, hot flushes, restless sleep (the opposite of how progesterone is supposed to affect you), increased sugar cravings, and also felt more irritable. Plus my breast were swollen and painful. I went back to taking it cyclically (200 mg twelve days per month instead of 100 mg daily), and the symptoms went away. I cannot explain them, but a menopause forum I´m a member of suggested taking Utrogestan continuously could have caused this. Even if you are only taking it cyclically, maybe there is a connection depending on your hormone levels. A member of the other forum (menopausematters.co.uk) even suggested Utrogestan messes with thyroid meds (she´s also hypo). I have found it to work fine when taken cyclically, but not every day. I have to take progesterone since I am also on estradiol and the two need to be combined.
I guess different doctors will tell you different things, but from what I´ve read you are not supposed to switch to a continuous regimen until after at least 12 months since your last period.
As greygoose says ...just testing TSH and Ft4 is completely inadequate
Ft4 is nowhere near top of range
For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially as you have autoimmune thyroid disease (Hashimoto's)
Ask GP to test vitamin levels or test privately
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)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Interestingly, patients with a serum TSH below the reference range, but not suppressed (0.04–0.4 mU/liter), had no increased risk of cardiovascular disease, dysrhythmias, or fractures. It is unfortunate that we did not have access to serum free T4 concentrations in these patients to ascertain whether they were above or within the laboratory reference range. However, our data indicate that it may be safe for patients to be on a dose of T4 that results in a low serum TSH concentration, as long as it is not suppressed at less than 0.03 mU/liter. Many patients report that they prefer such T4 doses (9, 10). Figure 2 indicates that the best outcomes appear to be associated with having a TSH within the lower end of the reference range.
Just to chip in you are not hyper, in fact doc's own guidelines say it's fine to have a suppressed TSH provided your other bloods are unequivocally normal, as yours are. Your TSH will only rise because the feedback loop is telling your body to make more thyroid hormones, when you are optimally treated, it doesn't.
Why are you taking prog continuously? And are you taking E as well. With HRT prog is usually cyclical as part of combination therapy, what's your estrogen doing?
Some people take progesterone continuously with estradiol from the beginning - I did, on my doctors' advice - and with her support, continued on prog only after I was through the worst of the menopause symptoms. Prog only can be used as a bridge off hrt as menopause transition ends, or in my case for longer, as it benefits me enormously.
I take both continuously. My TSH is always low as I'm on T3 only but it's not suppressed and I don't get sore breasts or hot flushes. I'm on 125 mg progesterone and 2mg oestrogen plus 12.5mg DHEA
I've got estrogen patches but not taken them as yet due to a close family member being diagnosed with an aggressive cancer. I need to have my genes checked so only taking utrogestan at the minute x
They always tell me that I am over active. My tsh is the same as yours. I feel better and well on the tsh at the lower level. Talk to your doctor if you feel ok on the lower level.
The endocrine system is so complex and I think it’s difficult to pin point exactly what is causing changes in the body. But sex hormones and linked to thyroid function. So, oestrogen dominance (occurring as women transitioning into menopause/perimenopause) can contribute to suppressing thyroid function. When you take progesterone it closes the gap or ratio between oestrogen and progesterone. This may have contributed to the change in your labs. What were your previous labs? Although, hashis is autoimmune so doctor should be looking at antibodies along with the full thyroid panel as well.
I thought maybe the progesterone may be suppressing the TSH but no affecting the thryoid fT4 levels as much(mainly as I have neem on prednisone for almost 4 years and my TSH is now suppressed and my fT4 is 16 to 18now. Please ignore my message if you read it b4.
EDIT: I can't find this theory anywhere , only one study that had a slightly lowered TSH with a higher fT4 with progesterone (and the higher fT4 was around 16!!)..and they suggested this was a tad too high!! so please ignore my reply.
I can’t imagine why progesterone would affect your thyroid. I was under the impression it was oestrogen that can ‘feed’ thyroid problems like Hashimoto’s, and not progesterone. Im on the mini pill so
progesterone only pill and Im fine.
Your TSH is a little on the low side but i wouldn’t reduce your dose by much if you’re feeling well. Its fine around the 0.3 mark to 0.6 say. Aim for that maybe. T4 and T3 need to be tested and should be 75% up through the range ideally.
Make sure your vitamin D is strong too especially at the moment with the virus.
You are porbably correct and I was wrong. I'll edit my reply above. My TSH and Ft4 are almost identical and I am on prednisone (2.5mg) and I did read somewhere that steroids(ie pred) suppressed TSH but maybe not as I can't find it now. So sorry, I should have googled first to see if it did work that way. I've no idea why the TSH is suppressed but fT4 is OK for when on other drugs and does not need to be higher. I did find with pred that as I redued it my fT4 came up a little too, but my TSH is still suppressed though not a much. an fT4 of 16 to 19.5 is fine by me and I do not think anyone with a TSH of 16 needs more thyroid hormone (which I know disagrees with many on forums).
"research shows that progesterone can increase thyroid hormone levels in the blood. Progesterone also decreases the amount of protein that carries thyroid in the blood so that more thyroid hormone can be free and get into the cells. " Yes, posthinking01, - this was my understanding, and that the introduction of progesterone would require some tinkering with thyroid hormone dosage - ie "you would need less of it" which was indeed the case with me when I introduced progesterone cream. I was also advised to take a "break" every 25 days as in 25 days on and then 5 days off otherwise the progesterone receptors wouldn't get "refreshed" and the cream would be less effective.
I have been on the combined HRT for 10 weeks now (the prog 12 days of cycle and estrogen patch continuously) to help with my tight chest, ectopic heartbeats, anxiety and tiredness, as well as the erratic periods I have. I am 49. I am on 100mg Levo every day too.
I have found no benefit to the HRT at all - I get a period start a week before I should (not at the end of the progesterone part like I should). I also have incredibly itchy skin and a rash that comes and goes (no help with my anxiety I worry that it's a covid sign). My moods have got no better, I ache and feel like a 90 year old most days. My back aches, my ribs ache, I have a tight throat and chest and get easily out of breath.
So much for how this changes your life for the better- I think my body must be broken then.
Indeed! My friends, Mum and husband all urged me to try it. "it will transform your life and you will be like your old self". Transformed my life alright - to that of a 90 year old's!
If you were having erratic periods then you are perimenopause. What size of dose is your patch?
The period coming early means nothing as you were already erratic. When using progesterone in a cycle like you are, the period can start anywhere in the progesterone phase. Have you had a review of how it's going with the prescribing doctor yet? If not, book one. If your patch is 25-50 in dose, you are going to need to move up to a higher dose. The progesterone is a bit suppressive so if the oestrogen isn't enough to over ride that you will feel worse. It's a balancing act and takes patience and understanding. You have to be prepared to learn, decide what you want and insist on it and then stick to it for 6 weeks to before making another change. That can be hard, but it's not impossible. I think you need a bigger patch, unless they started you on a high dose (which I doubt).
My patch is Elleste Solo MX40 mcg one. I change it on a Monday and Thursday to opposite sides of my hips. The progesterone is Utrogestan 100mg, and I take 2 on Days 12-26 of the cycle. I never knew the period could start anytime in the days I take the pills. I thought it was a couple of days after stopping them for the month, like it says on the leaflet. I have had no contact with a doctor over this - it is a nurse. My doctors have been invisible since March and lockdown. I will speak to the nurse in a week or so once I am on the pill phase again. This is Week 10 of being on them. I had a worrying experience when first starting the progesterone and could barely stand, kept falling over, was confused and my left pupil was larger than the right. I was slurring my speech a bit too and the exhaustion was overwhelming. i told the nurse this and she was panicked and concerned and got me into the rapid assessment unit at hospital to rule out a stroke, I had not had one according to tests and a CT scan. It was terrifying and I always feel scared once I start the pills again.
We get some weird symptoms sometimes when starting new medications. Sounds like you got some then! I found Utrogestan too tiring and had to take it vaginally to avoid some of the side effects. I now have the Mirena coil and it's much better for me.
You are on quite a small dose of oestrogen, you might find if your patch size is increased you will feel better. It's certainly worth trying. Your bleed should settle into a regular pattern around about now, except if you are still peri then the tablets are fighting your natural cycle for a while and will eventually sort itself out. We are all different.
Natural progesterone is an immuno suppressant and damps down inflammatory reactions. It definitely does not cause flare ups and has never been known to interact badly with other medicines.
When my TSH is suppressed to below 0.1, mentally i feel insane. Yes my joints no longer are as painful but i can not string a coherant sentence together. and can longer deal with social interactions as maintaining eye contact is impossible.
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