Does HRT affect Thyroid meds

[Daffers123]

I have noticed that since increasing my HRT, I need more T4 and T3.

Is there a link ?

Am hypo Hashi ,on levo and Lio, and on Estrogen gel and progesterone cream.

Thanks for any comments

[Jeppy]

Hi. Please can you tell me how to know this for sureI have patches and my TSH has gone up quite a bit

Thanks

[Jeppy]

Thankyou very helpful. I took evoril conti and had raised TSH.

[ettiebetty]

ive heard this quite a bit.

[Buttercupsareyellow]

This is a useful link

balance-menopause.com/menop...

They recommend ideally having bloods retested after starting HRT. My interpretation from reading it (this is only my take) is they talk about you needing less thyroid medication as you hit menopause. They do acknowledge oral HRT is likely to affect level and you shouldn’t take at the same time (as with other meds). They acknowledge it ‘might affect level so blood test recommended’. My question: if your dosing level requirements dropped as your bodies hormones decline in menopause, surely logically they would increase again as you replace those hormones with HRT 🤷‍♀️

I have just increased my dose myself as my T4 had dropped to 9.3 (range 12-22) after starting HRT. T3 was normal and TSH was 0.23 (normal range starting at 0.27). Have made a small 25 increase levothyroxine to supplement ERFA, based on it being the T4 was low. Last blood test T4 has scraped into range 12.3 but they now think I’m ‘hyperthyroid’ as TSH was 0.1. My T4 is 3% through range, my T4 35% through range 🙄

Whilst anecdotal the drop to 9.3 for T4 was about 6-8 weeks after starting HRT and would suggest it had an affect.

I’m on transdermal gel that you rub in…..

[klr31 in reply to Buttercupsareyellow]

I agree.

[Daffers123 in reply to Buttercupsareyellow]

Thanks for the link and also the information. Interesting that your T4 dropped after starting HRT. Its my T4 which I suspect (about to do bloods) has fallen rather than T3. I am increasing my Levo (only 12.5 so far as am scared !!) but will leave T3 dose unchanged. How did you work out your range percentages ?

Im on the gel that you spread over your shoulder, this one states that we mustn't rub it in. thats weird in itself...

[Buttercupsareyellow in reply to Daffers123]

thyroid.dopiaza.org

I hope this works. This was shared on another post to help work our percentages. Really useful, especially for the TSH

Good luck with your dose change 🤞🏻

[Jeppy in reply to Buttercupsareyellow]

Thankyou. So to wait about six weeks on hrt patch before retesting thyroid side?

Your question: Yes I agree

I had read here long time ago not to worry as your thyroid rights itself on hrt

So is it dependent on your dose? Is a thought

But either way if you think hrt is correct dose you need to up thyroid side

Is your progest separate bringing on a monthly

[SarahJane1471]

I can’t answer the question because I started HRT 5 yrs ago and Levo 10 months ago.However I am convinced menopause and/or HRT triggered my thyroid problem. I started having symptoms 2yrs after starting HRT. It just always seemed like there was a connection 🤷‍♀️

[PanCooJemLoo in reply to SarahJane1471]

As a thyroid problem can be considered hormone based, it's not surprising if there's a link, but it depends on the thyroid problem. Also 2 years is a bit long, maybe a 9 month time to react would be more relevant, as with autoimmune conditions often showing up approx. 9 months after any kind of trauma (my GP state this & other sources seem to agree).

[milkwoman]

This was true for me. I’m on custom compounded combo transdermal cream (bi-set/prog/test) and found I needed more Levo and Lio (Levo is oral; lio is transdermal cream) to be balanced.

[Lovecake in reply to milkwoman]

You get your T3 in a cream?

[milkwoman in reply to Lovecake]

Yes, custom compounded like my HRT meds. I’m in the USA.

[Lovecake in reply to milkwoman]

Oh wow. Never heard of that. Thank you for answering.

[Daffers123 in reply to milkwoman]

thanks so much for your reply. Of course, the other thing which might be affecting my absorption, is B12 jabs which I have currently had 4 out of 6. Hormones are such a minefield though. Wish we had transdermal T3 here (UK)!

[milkwoman in reply to Daffers123]

From what I understand, there are compounding pharmacies in the UK. You could inquire if they can custom compound a Liothyronine cream for you. If you found someone willing (and able) to do it and they wanted to know how (in case this is new to them) they could contact my compounding pharmacist. They are very helpful and king people!

For me, it gets dispensed in 10 ml(cc) plunger syringes (no needle) and I apply 1 ml(cc) daily split between an and pm. I love having a TD cream option for at least some of my medications as my system is super sensitive to fillers.

Besides the creams, I also have other compounded oral medications in bases that I can tolerate. Very grateful!

[helvella Administrator Thyroid UK in reply to milkwoman]

We do not have quite the same as the USA.

We have "Specials" laboratories but they seem mostly to respond to doctors, hospitals and retail pharmacists rather than patients.

Possibly some will respond to individual patients, but members would have to ask them.

[milkwoman in reply to helvella]

Ah, I see.

[Pearlteapot]

@sarahjane1471. My hypothyroidism became overt a couple of months after changing from a sequential to a continuous hrt in October last year. I wondered if it was a trigger but thought that doesn’t make sense because it’s the estrogen dominance that is supposedly the problem yet it was the hrt I had stopped that is the more estrogen dominant form. I’m going to talk to an endocrinologist about it because I don’t want to stay on this form of hrt if it is causing problems for my thyroid.

Around the same time I also had Covid (non-symptomatic) and my resting heart rate plummeted from mid 50s to mid 40s where it remains. So it could equally have been a trigger. Who knows.

[Poniesrfun]

HRT can affect the sex hormone binding proteins; there is cross over between SHB proteins and thyroid binding proteins. This has been documented as one of the reasons T4 needs to be increased during pregnancy. I would imagine how much effect your HRT has might depend on the makeup of your HRT.

Patti in AZ

[Daffers123 in reply to Poniesrfun]

thank you, thats very interesting and makes a lot of sense.

[milkwoman]

This was def not the case for me! I’m on Transdermal HRT and I’ve had to raise both Levo and Lio to be balanced. (Blood results showed this as well as my symptoms). Everyone is different!

[Jeppy in reply to milkwoman]

May i ask your non hrt symptoms vss thyroid ones.

[milkwoman in reply to Jeppy]

That’s a difficult question because many symptoms overlap. I also have two autoimmune disorders (SLE and Sjogrens), which makes things even more complicated.

I get tested (a lot) for thyroid levels and sex hormone levels and try to stay in good ranges and my docs will adjust as needed.

I will say that for HRT, in the past, if I start to get thick in my midsection that’s an immediate sign that my HRT dosage is off.

As for thyroid, it’s usually more about fatigue, tinnitus, tingling in hands, and joint pain.

[Jeppy in reply to milkwoman]

Thanks a lot for reply

My tinitus had quietened a lot with hrt I feel its because I’m feeling more robust already

May i ask how do you know it is getting thick. And does thickness get measured? Have you a womb?

Who investigated your autoimmunes pls. I’m sure I have but endo never went there……did endo give you your hrt

Sorry a few queries

[milkwoman in reply to Jeppy]

By “thick” I mean, when I start to see weight gain around my middle (waist). I’m fairly petite and fit so I can tell right away.

I do have a uterus and get yearly abdominal U/S to check the lining thickness - so far no issues. I want to stay on HRT for as long as I can and my GYN insists upon these checks as she is always concerned about the risk of uterine cancer. My GYN prescribes my HRT. My endo prescribes my thyroid meds.

I have a rheumatologist who diagnosed my autoimmune disorders. You can read my story in my profile about when I got sick and how I fought to get to the bottom of why. It was a tough process in the beginning because “I didn’t look sick”. Thank goodness for blood tests which proved I had lupus (and then Sjogrens) otherwise who knows where I’d be today!

[Jeppy in reply to milkwoman]

Very good for you! I’m very pleased youve won battle. Kudos. - Understand, like many of us

It’s seems you have a good team on hand if it’s all NHS ! 😊.

Yes I’m conscious to check lining.

- so you don’t take progesterone?

Do you get t3 checked too. If so you are very fortunate indeed

[milkwoman in reply to Jeppy]

I’m in the USA and from what I read, may have it easier than those having to deal with the NHS. But yes, I do have a good team. My endo does a full thyroid panel (TSH, FT3, FT4 and reverse T3) as often as I feel necessary but I usually only do this every 6 months. Not everyone here in the states has it so lucky. There is great medical care in my part of the country. Very blessed for that!

Yes, I do take progesterone along with two forms of estrogen (estriol / estradiol) and testosterone. It’s all combined in a custom compounded transdermal cream that I apply twice daily. Even tho my GYN prescribes my HRT, my endo also keeps track of the numbers do she can advise when necessary.

[Jeppy in reply to milkwoman]

😊👏👏👍🏼. Fab. Iv read story Thankyou and good wishes

[Hidden]

I have just found out in my research that all HRT is soya based which suppresses the thyroid, so it would make sense that it alters thyroid levels. I only found this out because I have been prescribed HRT for osteoporosis and V. Atrophy, but I don't want to take it if it's made with soya as I avoid it where possible.