Thyroid issue

[Tre55]

Anyone prescribed Levothyroxine plus HRT (estrogen/progesterone patch) to help alleviate joint and muscle pain post menopause. If so, has it had a positive effect

[PurpleNails Administrator]

Hello

From reading your profile I see you have been on a 50mcg dose for 10 months.

This is often a starter dose and may be lower than what you need. Many report joint and muscle pain which resolve once adequately medicated.

Usually 25mcg increases are needed after retesting every 6-8 weeks until TSH around 1 and FT4 & FT3 in top third of range.

Do you have results to see what you readings are?

Does your practice offer online access? If not ask practice reception for copies, & don’t accept verbal or hand scribbled notes you need a printed copy with ranges (ranges vary between labs so essential). They shouldn’t ask why but if they do try to resist just say they are for your records. You are legally entitled to them.

Folate, ferritin, B12 & Vitamin D must be optimal for Levo to work well.

Doctor tend to supplement deficiencies until in range again but don’t often maintain levels & do not ensure they are optimal.

What was Vit D result? What was the supplement amount? There are 2 important cofactors for vitamin D, K2(MK7) which directs calcium to your bones and teeth where you want it and away from blood vessels where you don't want it. Magnesium another important co factor there’s a lot of posts about it on here & which type is best.

Do you take levo with water away from food, drinks, supplements & others medication? (Patches won’t interfere). Also do you always get the same brand?

When you test, do you test early in morning after fasting except water? This give highest TSH & lowest FT4. Doctor often think this is not relevant and don’t advise about this. Supplements containing high levels of Biotin (B7) can skew test results. Check labels & avoid 1 week before draw.

[Tre55 in reply to PurpleNails]

Thanks for that. Yes my test proved I was hypothyroid (5.2). Always ask for my blood test results and my surgery always willing to provide this. Have had 2x 6 weekly blood tests to monitor. Also asked for Vit D, B12, Magnesium and calcium tests done and most came back normal apart from Vit D which was on the low side of the scale . Have now been taking Vit D3 for approx 6 weeks. Pain has eased over this past few days so I am hoping that the Vit D helping. My HRT patches are oestrogen/progesteron based. Intend to apply the first one this eve but feeling a bit uncertain whether I should go down this track. Re Levothyroxine - I always take early morning and never have anything to eat or drink until at least 2 hours later. I will also ensure that I apply the HRT patch (if at all) this evening in order that one does not cause too much interference with the other.

[PurpleNails Administrator in reply to Tre55]

What was the 5.2 for? The TSH? If you post your results with ranges we can help further.

What was the Vit D result & how much have you been supplement, because GPs will only treat deficiencies until in range and often do not ensure levels are maintained and levels rechecked.

[greygoose]

It would be unusual to be prescribed levo to relieve joint and muscle pains if you're not hypo. And, if you are hypo, it will only help if you're prescribed enough of it. How much are you taking? Do you have any recent labs to share with us?

[Tre55 in reply to greygoose]

Thanks for your reply. Yes I am hypothyroid ,levels were 5.2 but now down to 1.2, after 12 weeks on 50mg Levothyroxine and 2 blood tests to monitor this. Also had bloods done for Vit and mineral levels. Vit D was on the low side so now taking a supplement (1000 mg). Rest of bloods always come back 'unremarkable'. Even had the CRP and RF done twice and they were all normal.

[greygoose in reply to Tre55]

There's no such thing as 'normal' where blood tests are concerned. When a doctor says 'normal', he just means 'in-range'. But, if we know anything about ranges, we know that that's not the same thing as 'optimal'. So, if you want helpful replies, it's always best to give your results and ranges, so everyone knows what they're talking about.

I imagine 5.2 was the TSH - always best to give the name of the test, too. But, just testing the TSH is totally inadequate. Once you're on thyroid hormone replacement, and the TSH is down to around 1, the TSH level isn't very helpful for determining thyroid status. Your doctor should be at least testing the FT4 - T4 is a thyroid hormone (levo), TSH is a pituitary hormone.

[HashiFedUp]

Oestrogen feeds hashimotos/uat so i have avoided it and take the progesterone only mini pill.

I also suffer a lot of muscle and joint pain caused by hashimotos auto immune attack - hashimotos causes an attack on the tendons where they attach to the joints in particular. So i have separate treatment for that with a cox2 inhibitor Celebrex. Its a wonder drug as far as i am concerned. Changed my life.

Do you only need HRT if the menopause bloods say you do? FSH etc?

[fiftyone]

I take levo and have recently started on HRT (age 76). I started on a low dose and am now on a medium dose 50mcg, Difficult to say. I think my knees are slightly stronger. I really struggled to climb stairs. Just a bit easier now. But my finger joints still painful. Legs feel slightly stronger walking. However, is this just placebo effect? Maybe. There hasn't been a sudden relief from all my physical woes. My hair still falling out, eg. Not sure how long the estrogen takes to make improverments. Anyone know?

[ShatteredofLee]

I really do learn so much on this site. Nobodies ever mentioned the effect of Hashimotos on tendons, and that now makes sense why I have tendon pain. I didn’t know about the effect of oestrogen either. I had been taking a small dose patch with my Levo and the GP never said anything (I’ve finished with it now, although it did help me in many ways for a couple of years.