Thyroid meds and HRT

[KT304]

Hi All,

Its been a wee while since posting here but have recently been struggling with decreasing thyroid results since starting HRT in Dec 2021.

Current thyroid dose - T4 100mcg and 10mcg T3 take together on waking.

Current HRT dose - 2 pumps of gel (am) and 100mg Progesterone before bed every day

I feel better with the HRT in regards to awful rages and mood swings, but my thyroid symptoms such as burning feet, itchy legs, weight gain, worzel gummidge hair which is falling out, eyebrows disappearing, joints hurting etc have returned with a vengeance.

Blood test Jan 2022:

TSH: 0.01 (0.27 - 4.5)

T4: 10.7 (11 - 23)

T3: 3.63 (3.1 - 6.8)

Blood Test July 2022:

TSH: 0.01 (0.27 - 4.5)

T4: 9.4 (11 - 23)

T3: 3.21 (3.1 - 6.8)

I've gone from T4 being -2.5% through range to -13.33% and T3 from 14.32% through range to 2.97% - blood tests always AM, T4 24 hours before, T3 taken at 10pm.

Telephone consult with endocrinologist in March 2022 saw him HOLD OFF on a dose decrease due to TSH as I explained I had a lot going on (and didn't have the energy to argue) - he agreed he would review in the Summer.

Mentioned I was now on HRT, said he was unhappy I was prescribed HRT as, and I quote "women don't need it". I replied I'd be on it until its not required - he said well you should end HRT by 55 years old.

Then suggested I needed a bone scan as "you are bound to have bad bones with your TSH" - sent me for a DEXA scan and results were in the positive range - I'll find the letter.

I don't have a stockpile of T4 to increase the dose - what I am reaching out for and know that I can't make a direct request, but the usual online source of thyroid meds is not available: the one named like the shop that Pheobe Buffet hates is gone and all I can find is bodybuilding sites with Bitcoin payment options - in fact if dosing via weight then dear lord at least another 75mcg more per day so looking for a box of 25mcg x1000! (More than happy for private messages).

But does taking gel type oestrogen reduce the levels of T4/T3 in the body (I thought maybe with tablet form yes, but I rub the gel on inside tops of legs?) If the 100mcg results in a 9.4 score, how much T4 would be required to get to the top say 80% of the range? Or do I need to come off HRT?

Many thanks, K.

[radd]

KT304,

Oestrogen transdermal gel isn’t supposed to bind thyroid hormones and I’ve never had an issue but other members have complained of it neccessitating a Levo dose raise. I can only think this must be due to the recycled amount that ends up going through the liver 🤷‍♀️.

I presume those TFT results refer to the ‘frees’ with FT4 under range & FT3 low in both sets of results. You are under medicated and in need of firstly a Levothyroxine dose raise, and if that fails to raise FT3 enough after 6 weeks, then a T3 med raise also.

Oestrogen gel and progesterone are best taken together before bed. I was also advised to rub gel on tops of thighs and rotate with other areas, or receptors on one small area risk becoming desensitised.

You don’t have to stop HRT by 55 years old but it should be reviewed after 5 years and possibly stopped after 10 years although not in all cases. It just depends on other health risks and how valuable HRT is to your well being. Pleased your DEXA scan showed positive results as many on here have osteopenia/osteoporosis.

Don't forget thyroid hormones require optimal nutrient & iron levels. If you write another post asking members to advise of the med supplier, members will message you by PM as this info is not allowed to be advertised on the forum.

[FancyPants54 in reply to radd]

I disagree with your application advice. Oestrogen is best applied in the morning after your wash/shower. It's stimulating and helps get the day going. Progesterone is calming and should be taken at bedtime to aid sleep.

[radd in reply to FancyPants54]

FancyPants54,

Haha, yes you are right in that the protocol advice certainly varies.

If you are sensitive to oestrogen in the morning, then that could be a better time to use it but remember we can suffer sleep issues and loss of temperature regulation with low oestrogen throughout the night. Progesterone is known to be calming but both contribute towards neurotransmitters that induce peaceful sleep. It is more the immune stuff where oestrogen has the aggressive tendencies or when oestrogen becomes too high.

I think the most important thing with the gel is applying it after a shower/bath no matter what time of day because of improved absorption. I used to apply mine in the morning just because is was warmer than at night waiting around for it to dry but have actually switched back to nights because I take both together and progesterone helps me sleep. Like thyroid hormones its a personal choice I guess 😊.

[SarahJane1471 in reply to radd]

Oh I wish I could have progesterone for sleep but I have no uterus 🤦‍♀️

[radd in reply to SarahJane1471]

SarahJane1471,

I've just bought Sleep Complex by Gutology to help me sleep during this warm period. It's a combo of sleep inducers .. . glycine, L-theanine, Inulin, magnesium & zinc all in a montmorency cherry powder which apparently have been researched to contain melatonin. Absolutely delicious and works well too 😴

[SarahJane1471 in reply to radd]

Thanks radd ……… is it on Amazon?

[KT304 in reply to radd]

Thanks Radd, Apologies they were Free T's. I've popped a post on the forum re supplies.

GP prescribed HRT and advised gel in the morning and tablet at night (to aid sleep) but I didn't know about the rotating the site of the gel, I've been rubbing on tops of thighs and any excess on outside top of my arms before I wash my hands)

Yes to nutrients, I had a medichecks blood test in Oct 21 that I will check now. Spent yesterday searching for the DEXA scan results letter and I just can't find it. BUT (with brain fog) just remembered I can see things on my NHS App - woohoo.

I don't think the results are as good as first assumed, it says "the recently performed DEXA scan showed a completely normal bone density (T-Score spine -0.8 and total hip 0.6) and no specific treatment is needed from this point of view" . Hmmm ok maybe back onto Vit D tablets, currently use there spray whenever I remember.

I'll be honest this has given me a right kick up the bottom with regards to my health...

[SarahJane1471]

Your dr sounds like an idiot!!! He clearly has no knowledge of HRT and the menopause. Think if it like this; if you have a wonky thyroid you will need to take thyroxine for life to replace what your body can’t produce. It is exactly the same principle with HRT!!!!I use the gel and will take it for as long as I want….for the rest of my life if needed. Please look up Dr Louise Newson. The advice on her website is incredible. Perhaps you could tell your GP to read up about the current guidelines. 😊

[KT304 in reply to SarahJane1471]

Honestly SarahJane1471 its so hard to have a reasonable debate with these people. If you challenge (not in a rude way but a "can you provide evidence" type way) you are regarded as difficult.

Private blood results: they won't read them, DIO2 result: hockum and means nothing, taking T3 reduces TSH: they don't believe it.

GP is great, although COVID has meant its pretty much a virtual service, but she agrees that HRT will remain til I say I don't want it. Local hospital endo - sadist - the DEXA scan results would have floored him - he insisted I had bad bones due to suppressed TSH.

[SarahJane1471 in reply to KT304]

🤦‍♀️….. what is wrong with these doctors!!!!!

[serenfach]

I bet your GP advices his male clients to buy viagra because of course men need an erection until they are very elderly!

[Josephineinamachine]

I’m 2 weeks into a return to my old HRT which is Tridestra. Tablets I’m afraid, but gel makes me feel very unwell - hot, bloated, constipated, ugh. I’ve tried it 3 times - 2 pre-thyroid kaput and once post thyroid kaput. No go. So I’m back on the old stuff which is just under 3 months oestrogen and 2 weeks progesterone. In 2 weeks my energy is returning and the fog lifting and I’m laughing more. Sleeping well. I take my tablet 4 hours after Levo. Waiting for thyroid to potentially play up but am ready for a small increase if that happens but so far so good. My eyebrows are checked daily 😊😊

[Tweetypie28]

Hi KTHow are you getting along? I’m in exactly the same predicament as you, I started HRT 3 months ago (evoril patch & testosterone gel) and my thyroid levels have plummeted and I’m now hypothyroid again with all the usual symptoms. It’s taking me years to get my thyroid medication/symptoms under control so I’m really upset. I’m now thinking of ditching the hrt as I can’t function properly like this. Just wondered what action you’ve taken?