Advice with hormone test results

[dizzy864]

Hi everyone,

Following a couple of endo telephone conversations, I'm struggling to understand test results and endo advice.

I had loads of blood test, no ranges were given for some of these :-

Serum oestradiol level < 18 (Post menopause 18 - 505 )

SFH 58.1

Serum LH 28.1

Serum potassium 5.6 ( 3.5 - 5.3 ) above range - repeated and back in range

Creatine eGFR 79 ( 90 - 200 ) below range - repeated the same result

CRP 2.8 ( < 5 ) repeated a month later 1.4

ESR 4 ( 9.0 - 20.0 ) repeated a month later 3.0

Red Blood cell 5.17 ( 3.85 - 5.15 ) above range

Haemocrit 0.452 ( 0.347 - 0.445 ) above range

Serum Cortisol 407 note added - this makes cortisol deficiency unlikely

On the basis of this, the endo told me that my estregen levels are too low. Causes Liothyronine to not be absorbed as it should and this accounts for my many hypo symptoms. He told me to take MenoSorene tablets. I bought these. I lasted five days on the recommended dose before side affects became intollerable. I then tried half the dose for another six days and have now stopped taking them. They caused insomnia. Not only could I not get to sleep but I could not stay asleep! I woke up after 15 or 20 minutes and laid awake for hours again. This was all night every night. All I could think about was how hungry I felt. I had to keep getting up to eat even though I was already eating loads more than usual during the day. I 've gained 12lbs already since late June so last thing I need is to have to eat all of the time! I also had a really upset tummy. MenoSorene tablets contain soy and I know this always causes problems with me so I suppose I was silly even trying them.

The consultant also asked that I have a heart xray and an echocardiogram and referral to a heart specialist. I have problems with breathing and was particularly bad during one of the consults. My gp refused as she was convinced I just had asthma. I kept a peak flow diary for seven days and after seeing it, my gp agrees that it is very unlikely to be asthma and that the results were too low. She is referring me for a chest xray. She told me to speak to a pharmacist and get estrogen only tablets rather than a multi vitamin and mineral tablet with estrogen. Unfortunately, they could not help.

I asked her what a low ESR means. She said she did not know. Added a high ESR indicates an infection, but she said she'd not come accross such a low ESR before. She's going to investigate and get back to me. My endo was quite clear - I am to repeat ESR and CRP monthly for three months. They should be constant and if they are not then it indicates I have an infection. Clearly neither is constant after two tests. My gp says this is not the case as far as she knows! Has anyone had a low ESR? Does anyone know what it means? I, surprisingly can't find out on line!

I've looked on line and all estrogen tablets I found contain soy. Has anyone been told they are estrogen deficient? Has supplementing with estrogen helped with absorption of thyroid meds? Can anyone suggest an alternative estrogen tablet that does not contain soy? I do have a long history of bad reactions to tablets, even extreme reactions!

I can't make sense of the results either. When I google estrogen deficiency, it comes down to problems with fertility or the menopause. I'm 68 and well past bothering about that! Incidentally I had absolutely no problems with the menopause or since.

I also can't find anything on line linking estrogen deficiency with absorption problems with thyroid meds. Has anyone come accross this ? I am concerned because the endo has already cost me £425. He wants another consult to discuss how I am in three months. I'm not convinced that this is the answer to my health issues as it just doesn't fit with the pattern of my problems.

I thought in the new year, I would have some further blood tests done privately.

Its at least two years since I had anti bodies tested - they were very low. My gp refuses to retest and the endo didn't ask for them to be tested again. I don't think I've ever had Reverse T3 and T4 tested.

My T3 was 6.56 (3.1 - 6.8 ) and T4 was 21.7 ( 11 - 23 ) last November. I'd been taking 30 instead of 60 of lio and my usual 125 of levo for five days on instructions from the endo. I was really hypo. This is not reflected in the results.

I'd appreciate any advice or suggestions on what else I should have tested.

Thanks for your help everyone. Have a great Christmas and a happy new year and stay safe.

[SlowDragon Administrator]

Low ESR healthline.com/health/esr#c...

labtestsonline.org.uk/tests...

[dizzy864 in reply to SlowDragon]

Thanks for that. It was very interesting. I assumed my endo requested echocardiogram and heart x-ray just because of my shortness of breath but maybe it was because of the ESR. I'm not at risk of heart problems. There's no genetic heart issues in my family and I ve never smoked. I ll have to wait and see what the X ray shows.

[Meanbeannyc]

ESR doesn’t indicate infection, it rather displays the amount of inflammation in your body. It’s a non specific test. Inflammation can be anywhere in the body if ESR is elevated. Low ESR means there is no inflammation present.

Source: I do this for a living

[dizzy864 in reply to Meanbeannyc]

Hi, thanks for your reply. I am very muzzled as to why the endo told me to repeat it and that if results varied it means I have an infection. This was in response to my asking him how we test for the type of infection that has not been ruled out by the blood work I'd already had done. Very puzzling!

[Meanbeannyc in reply to dizzy864]

ESR is indicative of non specific inflammation only. Not infection, while you could have inflammation with infection, I’d suppose a white count would be more specific to ruling in or out an infection without culturing the site of supposed infection.

Usually if infections are present, white count is elevated, or temperature. This is not always definitive. Minor bacterial infections like bacterial vaginosis for example usually wouldn’t present with elevated WBC or fever. But you’d have swelling, discharge and pain upon urinating. Therefore the location of infection would be obvious.

Major infections would not only present with inflammation, WBC, and fever, but their site would be obvious due to swelling and pain.

There are different types of infections; viral, bacterial, and fungal, these all have different presentations at the source and in the blood/serum, depending on severity and location.

[dizzy864 in reply to Meanbeannyc]

Hi, thanks so much for your reply. My white count was in the lower part of the range, so unlikely to be a problem with that. 5.9 ( 4.3 - 11.2 ) I don't have any swellings or inflammation other than many muscle aches, which I associate with hypo. I do get a lot of head aches - almost always over my right eye and throbbing. I have no problem with urination other than at times I need to go too often. My main symptoms at present are extreme tiredness, very low peak flow ( mostly 320 ish ) difficulty breathing all of the time and lethargy. I blame the tiredness on the difficulty breathing and the lethargy on always being so tired. I have a heart x ray later today.

[Meanbeannyc in reply to dizzy864]

Those all sound like hypo symptoms to me.

[dizzy864 in reply to Meanbeannyc]

Yup!! I have loads of hypo symptoms going back six years! Including splits in eyebrows and absolutely no hair under my arms. Unfortunately meds don’t show that. I ve tried increasing meds - I feel hyper. My endo tells me I have liothyronin toxicity due to poor absorption of meds caused by low eostrogen. I m not convinced but was willing to try his solution. But the tablets contain soy and I am allergic. I ve asked him for alternative but his only response was to tell me of my next appointment in late March. I am amazed how many tests they can come up with me to do and yet not find a solution.

[Partner20]

Low esr can be connected with congestive heart failure, however, the fact that your haemitocrit is also high points to other conditions. These should be re-tested, and, i results show the same level, a referral to a haematologist would be in order. Poor liver and kidney function is linked to low esr, too, so these functions should be tested too, especially as egfr is below range. My partner, also hypo has had similar esr and haemitocrit issues for a while, and is monitored by a haematologist, a hepatologist and a renal consultant.

[dizzy864]

Hi, thanks for your reply. I am worried about congestive heart failue - it is so serious! I am not at risk for it - no family history and I've never smoked.My liver function has been tested a few times and is always normal. My gp has agreed to investigate my low ESR and get back to me. I'll ask her about referrals. My breathing is really bad at times now. I read that severe hypo can cause reduced lung capacity. I wondered if it is that. I have lots of hypo symptoms and no explanation as to why. My bloods show I'm at the high end. I did read that in the USA 12% of hypo patients have blood results that are inconsistent. I just find it so hard to accept that I have so many different apparently unrelated things wrong with me. I've been referred to so many different specialists over the last five years. I was told years ago that if you have lots of different things wrong either you're a hypochondriac or your thyroid is playing up.