Free T levels dropped since being on HRT - Oestradiol patches

[130396]

I’m very confused !!! I had my thyroid levels tested along with Oestradiol as my feet are swollen. Skin feels tight on lower legs too. Weight gain. Constipation - having to use Fybogel every day now.

I’ve been on oestrogen only hrt since august of last year . Firstly the gel that you rub in. Then because of shortages I had to go onto patches.

I was put on 100 Estradot patch but my Oestradiol level fell dramatically so my Gp increased to 2x100 patch. I’ve been on this dose for almost 5 weeks.

But because of these new symptoms my Gp did the bloods after 5 weeks.

I’ll post here all the results I’ve had since starting the hrt.

31/08/21 test 8.10am

Tsh <0.03 (0.35-4.94)g

Ft4 15.3 (9-19) 63%

Ft3 4.4 (2.6-5.7) 58.06%

Add 20% = 5.28 86.45%

100mcgs Levo 15mcgs T3

1mg Sandrena

Last dose 24hrs prior

22/11/21

125mcgs Levo plus 15mcgs T3

Tsh <0.03 (0.35-4.94)

Ft4 12.8 ( 9.0-19) 38%

Ft3 4.8 ( 2.6-5.7) 70.97%

Add 20% 5.76 100%

1mg Sandrena

Folate 11 (3-20)

14/02/22

100mcgs Levo + 15 T3

Tsh <0.3(0.35-4.94)

Ft4 14.6(9-19) 56%

Ft3 4.2 (2.6-5.7) 51.61%

add 20% =5.04 78.71%

1.5mg Sandrena

Oestradiol here was 619

09/05/22

100mcgs Levo +15 T3

Tsh <0.03(0.35-4.94)

Ft4 11.4(9-19) 24%

Ft3 4.6(2.6-5.7)65.62%

Add 20% 5.3 84.38%

1x100 patch

Oestradiol here 169

24/06/22

100mcgs Levo plus 15mcgs T3 test 8.25am last dose 24hrs

Tsh <0.03(0.35-4.94)

Ft4 12.5(9-19)35%

Ft3 3.7(2.6-5.7)35.48%

Add 20% 4.44 58.6%

2x100 patch

Estradiol 736

Cholesterol 5.07

Sorry for such a long post

Just to also add , I take my thyroid meds once a day in the morning as this suits me well. I therefore add 20% to the Ft3 results.

Can anyone advise of what I should do now ? Increase T4 or increase T3

Many thanks

NB: I was told initially that transdermal didn’t affect thyroid but I think this says different

[130396]

Any advice please

[RedApple Administrator in reply to 130396]

Disclaimer: I know nothing whatsoever about 'balancing hormones', which is what seems to be required here. But, if I were in your situation, and didn't have a hormone expert on hand to advise me, I'd be trialling a 25mcg increase in T4. Keep everything else the same, and test again in four weeks and re-assess.

[130396 in reply to RedApple]

Thank you RedAppleI’m thinking along those lines too but wondering if I should wait another 3 weeks and test again ..

I’m thinking this as I’ve only been on the new patch dose 5 weeks and it may still be building up and possibly will affect thyroid results even more

Many thanks

[milkwoman]

I found I had to increase thyroid meds when I started HRT. Weight gain around my middle was the major symptom. Aside from estrogen, are you taking any progesterone? And is anyone testing your sex hormone levels?

[130396 in reply to milkwoman]

Were you on transdermal oestrogen ? I’m on patches. I’m not using progesterone as I’ve had a hysterectomy. Last Friday I had my bloods tested and Oestradiol was 736.

I know progesterone is almost zero.

[milkwoman in reply to 130396]

I have done patches in the past but couldn’t get the dosing right. I’ve been on a custom compounded transdermal cream for many years now. It contains two types of estrogen (estriol and estradiol) as well as progesterone. Just recently, a small amount of testosterone was added since blood results showed I was now low.

How do you function on zero progesterone levels?

[130396 in reply to milkwoman]

How do you mean “ how do I function on zero progesterone level”? Where do you get your compounded cream from?

[milkwoman in reply to 130396]

I’m in the US. We have specialty pharmacies called custom compounding pharmacies which formulate custom prescriptions written by doctors.

I didn’t mean to offend. I know I just couldn’t function without progesterone. It’s always helped to stabilize my mood (even before menopause I was estrogen dominant and needed progesterone to balance things out). With my sex hormones in balance I’ve not experienced the typical “weight gain around the midsection” that many post menopausal women do. Progesterone plays a large role in this for me.

Also for me, progesterone helps thin the uterine lining and prevents endometrial hyperplasia (a uterine lining that's too thick). Doing so helps reduce the risk of developing endometrial, or uterine, cancer (which is risk when taking HRT). This would not be a factor for you if you’ve had your uterus removed.

[130396 in reply to milkwoman]

Hi milkwoman I’ve had a hysterectomy so there’s no need for progesterone which is why I don’t get prescribed it.

When you say it helps your mood, what do you mean?

Do you get depressed? Anxious? Snappy,

[milkwoman in reply to 130396]

I get moody and angry like every little thing is a trigger. I’m much more even keeled when on it.

Progesterone is called the “happy hormone” and it def is for me!

[130396]

Good to hear you are doing well. My dr won’t prescribe progesterone. He has prescribed testosterone though I haven’t started it yet