HRT Patches & Levothyroxine

[K80t]

I know oral HRT interferes with Levothyroxine. Do HRT patches interfere with absorption also?

GP wanting me to change to patches. I’ve been very stable for past 2 years so wanted to check this out here before proceeding!

[Hidden]

From what I´ve been told, only oral estradiol interferes with thyroid hormone absorption. Not sure if this happens directly or as a result of increased TBG (thyroid binding globulin) levels, but women on oral estrogen often need higher doses of levo as a result. As far as I know, oral progesterone does not interfere with thyroid hormone, at least not the bio-identical version (Utrogestan). Utrogestan should be taken at bedtime as it causes sleepiness.

I personally found patches annoying as they kept falling off, so I now use estradiol as a spray and previously as a cream. It´s easy to use and dries quickly. If the patches stay on your skin, they are a good option as well.

Plus, the increased risk of blood clots apparently only concerns oral estrogen, not transdermal.

[K80t in reply to Hidden]

Thanks. I’ll try them and see. It’s Estradiol I will be using in patch form.

[Hafa in reply to Hidden]

Have you been able to identify if your menopause symptoms are 100% related to menopause or if your thyroid is chiming in with symptoms of its own?

Your posting interests me because at 64 I thought I was over menopause, symptoms had ended a few years ago soI stopped taking Estradiol as a gel on the skin. I've been taking thyroid medicine for the past 3 years. The last few months I'm waking up at 4-5am and feel very hot and have restless sleep. I take my medicine and I'm so tired I go back to bed and sleep for 2-3 more hours. My doctor says it's return of menopause. 😟

[Hidden in reply to Hafa]

Of course there is a potential overlap between thyroid hormone and sex hormones as all hormones interact. But my current symptoms started in my mid-40s and slowly got worse (now 51). I have tried to go off HRT several times (as many doctors believe it should not be used for more than five years), but the most bothersome symptom - night sweats - always returns with a vengeance. I just hate waking up several times every night drenched in sweat. Only estrogen makes that go away. I´ve tried sage, red clover etc to no avail.I recently read that women who sail through menopause without problems have strong adrenal glands, and that the women who go through hell are those with compromised adrenals. Since I lived with hypothyrodism for several years before being diagnosed it´s likely that my adrenal glands have been affected to some extent. The reason menopause is more difficult for women with weak adrenal function is that after menopause the adrenal glands take over from the ovaries and produce smaller amounts of sex hormones. If the adrenal glands are unable to respond to do that (the body prioritises cortisol production over sex hormones), menopause-related symptoms tend to get worse.

[Hafa in reply to Hidden]

Thank you for your reply, especially the comment on adrenal glands. I've been working a lot lately and under stress. I think my body is sending me a message! Yes, sage, red clover...been there and done that too. One thing that helps me is to reduce caffeine and I take one capsule a day of a supplement that contains diosmine and hesperidine - it's available in France as Daflon and for circulation issues (I have restless leg syndrome). Some over-heating in menopause is related to circulation and this helped me. Your body gets used to it after a while and so I switched to gingko supplements and then went back to Daflon after a month. It is in the category of flavonoids.

healthline.com/nutrition/vi...

[Hidden in reply to Hafa]

Thanks, interesting tip! I´m always looking for natural solutions!

[K80t in reply to Hafa]

I had a full hysterectomy at age 42. I am now 60. I have attempted to come off HRT a number of times but it causes my Fibromyalgia to flare up terribly. GP is happy for me to continue on HRT but would prefer if I go onto patches. I know the risks but my choice is to have a better quality of life.

[Hafa in reply to K80t]

K80t, I'm sorry to read about your Fibromyalgia, that must be terribly challenging to cope with. Wish you the best

[milkwoman]

I have not found estrogen patches to interfere with Levo absorption. HOWEVER, as your estrogen levels increase in your body, you may find that you require more Levo to maintain balance.

Tip to keep patches from falling off: use a small piece of 3M Tegaderm waterproof transparent film dressing over the patch. Works great!

[Mouldyoledoll in reply to milkwoman]

Oestrogel is a good alternative to patches

[milkwoman in reply to Mouldyoledoll]

I’m actually now am on a custom compounded transdermal bi-est/progesterone cream. I was just giving insight to the OP re: patches.....

[130396 in reply to milkwoman]

you saying about as estrogen levels increase is really interesting as since my estrogen level has gone from almost zero to 1,642 I found my thyroid level changed.

Dr reduced my patch and it’s now 242 but my Ft4 and ft3 although they’ve increased a bit I wonder if they should be higher?? I’m on combo t4/t3 and Gp did increase t4

Also since being on patches my ankles and feet have swollen and I’ve now got awful constipation…. So…. Is it the estrogen causing this or my thyroid?

[milkwoman in reply to 130396]

It’s hard to say which is to blame for your latest onset of symptoms. Are you only on estrogen? Sex hormones all need to be balanced and that includes progesterone and testosterone.

If I were you, I would post this as a new post/question and include your latest thyroid test results including lab ranges as well as your latest sex hormone results. You should also include previous thyroid and sex hormone test results (and the date they were taken). They are many knowledgeable folks on here to help but it’s best to have all the information before trying to advise.

[130396 in reply to milkwoman]

I am on Oestradiol progesterone & testoserone .

These symptoms only seem to have occurred since being on estrogen.

Unfortunately I don’t seem to get replies when I post so I’ve pretty much given up posting these days

[milkwoman in reply to 130396]

From my experience, it takes time to balance all the hormones correctly. My GYN built up my hormones gradually based upon my feedback of symptoms. I also worked with my Endo to increase my Levo and also add in T3 slowly until symptoms alleviated. It was a long process to get things right. I hate saying that but hormone balance just takes time.

It’s true that estrogen can affect Levo uptake and I suspect that is what is happening to you. It will take time for things to level off. Keep track of your symptoms and talk with your doctors about changing dosages and testing levels until your symptoms are managed.

[130396 in reply to milkwoman]

since being on estrogen my ankles have swollen and I’m very constipated now plus weight gain.

I don’t have an Endo. My Gp just tries to work with me. I’ve been in Estradot oatches since April and only just discovered they’re made with soy , which as you know, we should keep away from soy.

So tonight he’s changed my patch to Everol which are made from yams.

We thought it best to change one thing at a time so decided to change the patch first, then look at thyroid results again in a few weeks.

At one point my Oestradiol was 1,642 so he halved my oatch and they are now 242

These are my latest thyroid results:

5/9/22 150 Levo plus 15mcgs T3 last dose 8.20 previous day TSH <0.03 (0.35-4.94)Ft4 14.1 (9-19) 51%Ft3 4.3(2.6-5.7) 54.94

[milkwoman in reply to 130396]

Since I’m in the USA, it’s difficult for me to know how to analyze your estradiol value as I have no idea what the reference ranges are or what the measurement units are. Here, we go by pg/mL for estradiol and my endo likes it to be in the range of 70-90 pg/mL. If you measure the sane, then 242 would still be very high.

In the beginning, I was on estrogen patches and oral progesterone and we just could not get things balanced nor me feeling well. Oral progesterone was the worst for me as only 30 days on it and my waist was getting “thick” (I normally have an hourglass figure). So I immediately stopped the oral meds and asked to be switched to a transdermal cream (which is what I now take for all my HRT). After stopping the oral progesterone, my waist returned (rather quickly) but it did take some time to build the dosages of estriol/estradiol and progesterone for my system to be balanced. I didn’t add testosterone until just recently when I was tested and found it to be low (it had been fine prior to that). I’m only mentioning all this so that you are aware certain forms of HRT can be the culprit and it’s good to catch things early. I’m very sensitive to medications which is why I take the purest forms I can and have also switched to custom compounded transdermal creams to save my digestive system. I too have issues with constipation but for me, it’s most likely due to my autoimmune disorders (lupus and Sjogrens).

As far as your thyroid numbers go, I think you need more T3 because your conversion isn’t great. Your FT3 isn’t even halfway through the mid range and it should be over mid range. Your FT4 seems okay.

I’ll admit, I’m not the best at analyzing thyroid numbers. Others here are much more knowledgeable than I. Sometimes it’s less about the dosage and more about the timing. Many folks here split their dosages of T3 over the course of the day.