Hello, I have had a thyroid problem for the last couple of years. I was very overactive with diagnosed Graves’ disease. I now have within range T3 & T4 but my TSH has always remained low. I have been having very short and light periods for some time and wondered if anyone has experienced this with low TSH or if I am peri menopausal. I am very worried and looking for anyone in this same situation.
Thanks
KM
The TSH itself has nothing to do with your menstrual cycle. It's not a thyroid hormone, it is a pituitary hormone.
When the pituitary senses that there is not enough thyroid hormone in the blood, it produces TSH to stimulate the thyroid to make more hormone. When there is enough, it reduces its production.
With Grave's, you will have had very high levels of thyroid hormone, and very low TSH, in part because no TSH was needed. However, if this goes on for any length of time, the feedback link between the thyroid and the pituitary becomes down-graded and the pituitary does not respond to lowering levels of thyroid hormone anymore. This might rectify itself with time, or it may not. But, the fact that your TSH is suppressed will not affect your menstrual cycel in any way.
On the other hand, could be that your thyroid hormones - T4 and T3 - are now too low, and that is what is having this effect. What are the blood test results and ranges, do you know?
I’m the wrong sex to comment but have some background information.
Graves’ disease is caused by TSH receptor (stimulating) antibodies (TRAb). These antibodies look like TSH and stimulate the TSH receptors in the thyroid causing excess secretion of thyroid hormone. There are also TSH receptors in other tissues. The high levels of thyroid hormone suppress secretion of TSH and it may take a long time for normal TSH secretion to resume, sometimes it doesn’t.
The antibodies can hang around for quite some time, often for about a year even if the thyroid has been removed by a thyroidectomy or radio iodine treatment.
Prolactin can be high in Graves’ and I believe this can cause light periods. As you can guess I’m out of my depth here but suggest you get your doctor to check your prolactin levels to see if they are abnormal.
Hello, I’m nowhere near as knowledgeable as most of the folks on here so just commenting on my own personal experience if it’s helpful. I developed Graves’ Disease this summer for the first time and strangely pre-diagnosis I had noticed that my periods were barely lasting 2 days - possibly only 36 hours - this didn’t used to be normal for me. I have been taking PTU for the past two months but my periods have remained in this way. I’m 32 incase that helps. All the best with finding answers.
Km684,
TSH absolutely affects your menstrual cycle. If somebody claims it doesn’t they have no understanding of physiology. If it is very low or almost undetectable this means the hypothalamus in the brain is not signalling the thyroid to produce it’s own supply. The body will stop using the sodium iodine symporter to transport iodine into the thyroid to make thyroid hormone. You might think that this doesn’t matter but it affects signalling in your brain which affects not just your thyroid HPT (Hypothalamic Pituitary Thyroid) axis but also the HPA (Hypothalamic Pituitary Adrenal) and HPO (Hypothalamic Pituitary Ovarian) axis. All these axes are interlinked. In fact the hypothalamus is involved in so many other processes.
The second image on this post explains this process.
instagram.com/p/CUHmh81oX2F...
In Graves'TSH receptor antibodies (TRAb) imitate TSH causing the thyroid to secrete too much hormone which suppresses TRH (from hypothalamus) and TSH (from pituitary). Once Graves' has been treated by drugs (carbimazole), thyroidectomy or radio iodine thyroid hormone levels are made 'normal' with levothyroxine and there is no longer excess feedback to the hypothalamus and pituitary. The thyrotrophs in the pituitary (that control TSH) have receptors for TSH and it's is likely that TRAb will continue to suppress the thyrotrops for some time. TRH from the hypothalmus stimulate both TSH and prolactin secretion, thus it is possible that a low TSH might cause excess secretion of prolactin as long as TRAb is high (this is conjecture, it hasn't been experimentally verified).
Whilst various axes might be disrupted by Graves' the instagram link seems to be stuff thrown together to find a role for vitamins. Where possible I would recommend we look at actual research rather than unreferenced blogs from the internet, there is a danger we get led up the garden path by people who have themselves gathered information from other websites.
Yes, Graves’ is a different kettle of fish but the role of vitamins cannot be underestimated or downplayed. The word vitamin is derived from vital. I don’t claim to be have much knowledge of experience in Graves’ but the role of nutrition, vitamins and minerals is cited in countless scientific papers through out our physiology. Not just in Instagram posts.
I wanted to highlight the point that TSH isn’t just a nuisance or a pointless marker that our doctors are obsessed with. Perhaps many of us feel we are wrongly treated or diagnosed by the medical community but TSH has a far greater reaching impact than most people realise.
Also the diagram in that post is a good illustration of that process.
TSH is important, more so when there is too little of it (for low or low normal fT3 and fT4). When TSH is subnormal it usually has a higher proportion of isoforms with reduced bioactivity, so there is less stimulation of the thyroid, deiodinase and other little understood actions such as the effect TSH has on bone formation. I think we get more severe hypothyroidism from too little TSH than too much, hence we should not focus on mildly elevated TSH it only reinforces the idea that thyroid failure is the be all and end all of hypothyroidism.
Thanks everyone for the information. A lot to think about and ask my DR. I am 33 and no longer have Graves’ disease. Have been off carbimazole for about 6 months but TSH just never coming into range and slowly going down lower each time I get my bloods taken. I sadly don’t have my most recent bloods. Thanks for replying. Having a thyroid issue can be so isolating and just not enough information out there.
Hello Km and welcome to the forum :
Graves is an autoimmune disease - something has triggered your immune system to attack your body - there is generally a genetic predisposition with someone, maybe a generation away from you, having a thyroid health issue.
Graves is said to be a stress and anxiety driven AI disease so please be aware there is no cure, but you can do much to understand why this may have happened to you, and once triggered, your immune system is likely to activate itself again.
I'm glad you seem to have come through this first phase of the disease relatively unscathed and the AT drug is used to block your thyroid hormones rising any further while you " ride out " the symptoms of the attack.
You might like to read further and would suggest you dip into Thyroid UK who are he charity who support this forum and I found the Elaine Moore Graves Disease Foundation website an excellent adjunct and read of more holistic, alternative treatment options and life style questions that I needed to face, once I saw myself in print.
P.S. Do you have your results at diagnosis and the medical evidence on which antibodies were positive and over range - they should look like either a TSI ( a thyroid stimulating ) and or a TR ab ( a thyroid receptor blocking ) antibody : one set stimulate your thyroid whilst the other set block - so it's a game in two halves with either one taking control of your metabolism and causing a multitude of symptoms some which seem totally unrelated.
Well I have hyper, and a suppressed TSH (has been for years). I don’t have autoimmune antibodies my hyper from a nodule.
So for me the only changing variable is the thyroid levels.
I find when my thyroid levels are higher I have a longer between each period (overall cycle) and they are light & short. When levels are low shorter overall cycle much heavier & last longer.
I don’t have research reference or a proven physiology explanation just sharing my experience.
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Low T3 Low T4 and very Low TSH
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