Timings of thyroid meds, calcium and HRT

[Spangle15]

Hi. I've had an appointment with my endocrinologist this morning, and he would like me to try taking my thyroxine at night (to see if it helps with sleep), which is actually what I did years ago before being told by a nutritionist I shouldn't. The trouble is, I now take HRT at night (progesterone tablets and oestrogel). I'm thinking f just swapping, so taking the gel in the morning and thyroxine at night. However I still need to take progesterone at night. Does anyone know if thyroxine and progesterone are OK to take together?

I also take T3, which he said to take am still. So I also need to know if I can take that at the same time as the oestrogel.

Finally, my calcium is currently low (very worrying as I already have osteopenia) so I need to supplement with that. Are there any timing issues with calcium?

Many thanks

[Shazy-B]

I personally wouldn’t t take HRT or any other meds with your thyroxine to be honest. I was doing the same a few years ago, not realising it was causing my problems my TSH was at 14 and my oestrogen was undetectable. It seemed one was cancelling the other out! I swapped to a patch and this helped greatly. You could always try a progesterone gel with an oestrogen patch if you need both...I don’t as I have no womb. Have a look at Dr Louise Newson (the menopause doctor) website menopausedoctor.co.uk/ she’s fantastic and gives brilliant advice. Best of luck 😊

[greygoose]

I'm assuming that oestrogel is something you rub on your skin? If so, it doesn't matter when you take it, because it won't come into cantact with anything else in the gut, which is where it would have a binding/blocking effect.

Calcium, on the other hand, is an entirely different matter.

First of all, my reaction is not to take it. Calcium supplements are difficult to absorb, and tend to build up in the soft tissues, causing all sorts of problems. And, it's not the most important nutrient for osteoporosis, anyway. Magnesium is far more important.

But, how is your vit D? If your vit D is low, then it's important to take that for strong bones, and that, in turn, will increase your absorption of calcium from from food. But, you would need to take vit K2-MK7 at the same time, to make sure that extra calcium went into the teeth and bones and didn't build up in the soft tissues. And, you would have to take magnesium, too, because vit D and magnesium work together.

Magnesium, calcium, vit D and estrogen pills all need to be taken four hours away from thyroid hormones.

[Spangle15 in reply to greygoose]

Thank you Greygoose.

My vitamin D is 116. And t take K2-MK7 so that’s good to know. I need to bring my calcium up because it’s pushed my parathyroid hormone up and I need to get that down. So unfortunately supplementing is necessary right now. My concern is why it’s dropped below range though.

[bantam12 in reply to Spangle15]

Have you been tested for secondary hyperparathyroidism ? Poor kidney function can cause low calcium and high parathyroid.

[Spangle15 in reply to bantam12]

I think I’ve had my kidneys checked. Blood tests were serum creatinine and eGFR. Both were fine.

I’ve actually had hyperparathyroidism in the past, and two parathyroid tumours removed 3 years ago.

[bantam12 in reply to Spangle15]

Then it looks like you still have a parathyroid problem, have you looked into Familial Hyperparathyroidism ? I ran a forum for hpth and we had several members with the genetic form who had persistent high parathyroid levels. Raising your calcium level won't help if your remaining parathyroids are running out of control.

A drug called Cinacalcet reduces parathyroid levels so might be worth asking your Endo, assuming he is experienced in parathyroid issues, many are not !!

[Spangle15 in reply to bantam12]

He thinks my pth is high because my calcium is low, and once that’s back ho normal then pth will go down. But I’ll look at what you mention, thank you.

[bantam12 in reply to Spangle15]

Well hopefully he's right but I'm not convinced, with previous pth issues and still your pth is high then that should be ringing bells with him !! Good luck

[Spangle15 in reply to bantam12]

Thank you. I missed the bottom bit of your previous message about raising calcium levels not helping. I don’t suppose you know if the people in the forum you mention had calcium issues, and if they had any symptoms?

[bantam12 in reply to Spangle15]

Yes they had the calcium issues and symptoms and awful trouble getting a definite diagnosis, several had repeated surgery which didn't sort the problem. I'm not saying you should ignore your Endos advice but if raising your calcium doesn't work then you might need to look for another solution. My husband had kidney problems and secondary hpth and was on Cinacalcet to lower his pth levels and it worked well.

I had primary hpth and after surgery I have only 1 parathyroid left but luckily levels are ok, so far !

[Spangle15 in reply to bantam12]

Thank you for all your help. I’ve done a bit of reading now, and it’s very unclear about calcium levels with familial hyperparathyroidism. It looks like calcium levels would be high and not low. However I’m not certain. But interestingly I never had calcium issues previously when they found the two tumours.

I’m so glad you commented just in case the calcium supplements don’t work.

[bantam12 in reply to Spangle15]

Calcium is low in secondary hyperparathyroidism which is why I first suggested that, usually high in familial but as with all medical problems things don't always go by the text books ! Hpth is complicated and typically takes years to get a diagnosis, frequently because Drs are not experienced in recognising or investigating it.

[Spangle15 in reply to bantam12]

Very true. Thank you so much for all your help.

[greygoose in reply to Spangle15]

You're welcome.