HRT and Levo

[Henson1980]

Hi All

I’m hoping to start HRT in the next few weeks and wondered if any of you lovely ladies know anything about taking micronised progesterone alongside levothyroxine at the same time in the evening?

It needs to be take in an empty stomach apparently so not sure if If taking the levo and progesterone at the same time will reduce both tablets effectiveness?

I don’t want to take either of these tablets in the morning as that’s when I take my vitamins and fluoxetine x

[radd]

Henson1980,

I took micronised progesterone (+ estrogel - estradiol gel) for six years & benefited hugely.

Some members have advocated taking HRT separate from thyroid meds but my endo said you can take (all) hormones together as they often enhance one anothers benefits and any unwanted side effects (ie elevated SHBG/TBG) will happen regardless of whether hormones are taken together or apart. I multi-dose NDT & took both HRT & NDT at the same time with absolutely no issues.

Also, it is recommended to take progesterone in the evening because it supposedly has a sedative effect but I tried both am & pm with no felt difference, although this may be different for you. Because both O & P are suppose to be taken at the same time I eventually opted for mornings because couldn’t stand the cold feelings in winter whilst waiting for the alcohol in transdermal oestrogel had to dry 🤣.

[Henson1980 in reply to radd]

Thanks for your reply Radd it’s helpful to know you can take the HRT alongside levo. I’m going for the oestrogel and micronised progesterone as well. I’m just trying to work the logistics out of taking all my meds at different times of the day, some on an empty stomach…my head is hurting! 🤣 I tend to take my vitamins and fluoxetine (take for pmt) in the morning. Hence why I’d prefer to take the HRT at night alongside the levo x glad it helped you, I hope it does the same for me x

[radd in reply to Henson1980]

Henson1980,

In your previous post you were considering a Levo dose reduction. Transdermal oestrogen bypasses the liver so is supposed to eliminate any extra binding of thyroid hormones. However, some members have found they still require a small Levothyroxine increase to offset any amounts that have become inactive.

And considering your TFT’s which were good, I don’t think your ‘hyper’ feelings were a result of Levo overmedication but either meds not working effectively due to nutrient deficiencies or a Hashi attack due to your very elevated TPOAb’s.

Hashi is a progressive disease & thyroid hormones levels will progressively drop. Tightening up on the gluten free diet may help more than you think. Also other diet adjustments I found helpful in eliminating hot flushes were cutting out white wine & limiting caffeine intake and spicy foods.

On a positive note, I have never taken fluoxetine but HRT helped lift my depression and encouraged thyroid hormones to work more effectively. It’s amazing how intricately connected all hormones are and you should feel better once nutrient deficiencies are optimised. I couldn’t see any iron status. Have you had ferritin tested?

[Henson1980 in reply to radd]

Ah ok that’s interesting! Yes my Ferratin levels were low, I’m now taking a supplement to try and get it back to a normal level. It’s a real minefield when it comes to thyroid and menopause as most symptoms mirror themselves so it’s hard to distinguish what’s causing what! I reduced back down to 100mcg levo and have started regularly taking selenium, Vit b complex, Vit d and magnesium (away from my thyroid meds) so hoping this will make a difference.

I do feel the hot flushes, irregular cycle, dryness etc is down to peri meno so I guess I will know for sure once I start taking the HRT.

I will make sure my thyroid levels are checked regularly whilst I’m on it and if an increase is needed due to the oestrogen then I can go back up to 125mcg, thank you for all the advice xx

[Tuxi1]

Henson - what it this micronised progesterone? what country are you in? Is it prescribed? Thanks

[Marymary7 in reply to Tuxi1]

I take it in tablet form, yes on prescription in the UK.

[Tuxi1 in reply to Marymary7]

Is this synthetic progesterone?

[Henson1980 in reply to Tuxi1]

Micronised Progesterone is a body identical hormone derived from a yam so less risks and side effects compared to the older version of the progesterone tablet. Check out the menopause dr online, she also has an app called ‘balance’ full of helpful info xxx

[Tuxi1 in reply to Henson1980]

And can i get this on the NHS?

[Meno56 in reply to Tuxi1]

This progesterone is normally prescribed as Utrogestan and you can take it orally or vaginally. Depends if you can tolerate progesterone generally. I found I couldn't so had a Mirena coil fitted which delivers a synthetic progestergen in very small dose locally which works for me. Checkout the Menopause Matters website which is excellent. I read that Oestrogen can act as a stimulant so is better tolerated in the morning/daytime.

[Henson1980 in reply to Tuxi1]

It depends, I know my Drs prescribe it but some don’t. It’s a bio-identical hormone with a molecular structure identical to that of the endogenous progesterone produced by the ovary (so not synthetic) ie less risks and side effects x

[Tuxi1 in reply to Henson1980]

It's a while since I looked at natural progesterones from the NHS so this is a new one for me. I currently take Cyclogest - which is a natural suppository. May try this other one. Which route is better absorbed with the Utrogestan? Thanks for the info