advice on oestrogen and magnesium welcomed. ..lingering fatigue

[BiscuitBaby]

hi all

I would welcome some advice on lingering fatigue. I am on a trial of t3 with nhs endo. Currently on 75mcg t4 and 15 t3. I am fairly well on this. Given that endo is highly unlikely to change this as he wants my tsh higher, I am thinking this is me now. However t3 allows me to exercise and that's important to me. I take vitd with k2 (think that's right) 4000iu. Thorne basic b. I'm 46. Periods still regular but less painful now than they were and a bit lighter...t3 related?? I would like to add in magnesium but not sure of the best one? My bowels are good now with the t3 so I don't need it for that.

my other thought is that it's oestrogen related. Am I right in thinking it is best to be topical than oral?

as ever, thank you in advance to all who respond . I really value your opinions.

[SlowDragon Administrator]

Have you retested TSH, Ft4 and Ft3 since changing doseMany members find they need BOTH Ft4 and Ft3 at least half way through range

[BiscuitBaby in reply to SlowDragon]

HiI has bloods done due to my resting heart rate dropping a bit on 22/7

Tsh 0.01 (0.35-4.94)

Ft3 4.1 ((2.4-6)

Ft4 11.7 (8-19.1)

In June on 125/10 they were <0.01, 4.2 and 12.5 same ref ranges

Endo happier as tsh not fully suppressed. I do feel they could be higher and I have some pain in my thyroid back again but this was dismissed by Dr. I don't think the Dr is going to do any alterations to my dose so I think I need to explore everything. I feel ok generally. Just my dry skin hair and fatigue that are lingering and some exercise intolerance. Although this is nowhere near what it was.

[SlowDragon Administrator in reply to BiscuitBaby]

FT4: 11.7 pmol/l (Range 8 - 19.1)

Ft4 only 33.33% Through range

FT3: 4.1 pmol/l (Range 2.4 - 6)

Ft3 only 47.22% through range

Helpful calculator for working out percentage through range

thyroid.dopiaza.org

Was test done as recommended

Early morning, ideally just before 9am, last dose levothyroxine 24 hours before test

Last 5mcg dose T3 approx 8-12 hours before test

Suggests you are under medicated

Perhaps try increasing levothyroxine by 12.5mcg daily and retest in 6-8 weeks

[BiscuitBaby in reply to SlowDragon]

Hi Yes. I did the tests as per here not what Dr advise. He wanted them 2-4 hours after t3. I see him in September and am going to suggest upping t4 a bit. Not sure he will be agreeable which is why I feel I need to look for ther solutions. However its reassuring that my thinking is similar to others and not unreasonable. Thank you!

[Lalatoot]

Glad things are settling down on your new doses.

Scroll down to Seaside Susie's reply on this post to get links about which magnesium:

healthunlocked.com/thyroidu...

[BiscuitBaby in reply to Lalatoot]

Hi LalatootThanks. I'll have a look at that later. I feel I have to explore everything else now. I just long for the day that I don't think about how tired I feel!!! It upsets me when I listen to others and hear what they do on their holidays and I just want to have the freedom to nap at will!!

[Lalatoot in reply to BiscuitBaby]

You have to explore all possibilities. Try to focus on what you can do! Compare yourself to folks who can't do as much as you and you will see how much better you are. x

[BiscuitBaby in reply to Lalatoot]

Thank you. I just get frustrated. I feel so much better and much more like my old self I just want to feel 100%. Maybe my expectations are too high! I'll keep trying and check out the link you posted! Thank you.

[Lalatoot in reply to BiscuitBaby]

Your symptoms most likely crept up on you over many years until you noticed them. The body is very good at adapting.Now the body needs to adapt again so you need to let it have the time to heal once you are settled on doses.

[BiscuitBaby in reply to Lalatoot]

I'm impatient I know. I can't help it! You are right.

[EebieJeebies]

Topical oestrogen is apparently safer than oral, avoids liver etc. Rising oestrogen levels (hrt) can result in more thyroid meds being needed.

[BiscuitBaby in reply to EebieJeebies]

Thank you for your reply. I thought I'd read that somewhere. I thought if it was topical it didn't affect thyroid levels? I honestly don't know if I read that or not now! I can't see endo parting with more t4/t3 given that it already feels like he's paying for it himself from his meagre salary! My levels are already quite low, not sure I can afford them to go lower! 😕

I need to wait till my follow up with endo before I look at anything else!

Thanks fir taking the time to reply. I appreciate it.

[helvella in reply to BiscuitBaby]

I thought if it was topical it didn't affect thyroid levels?

You might have read it. I'm pretty sure someone was told exactly that by a doctor and posted that here. Quite possibly it has been said several times.

But many here suggest it is a mistake. A wrong-headed view. Topical delivery might avoid the first-pass effect (or at least one version of that effect), but it is more difficult to see why delivery route would make any difference once it is fully circulating in our bloodstreams.

[Josephineinamachine in reply to helvella]

Exactly this. I tried topical oestrogen and couldn’t tolerate after a week. I couldn’t tolerate it before Hashi diagnosis. Couldn’t tolerate it after either. Now back on tablets. 2 weeks in on oestrogen only and tolerating. Fatigue is diminishing and brain fog lifting. Who knows if it will last but for now much better than topical. It gets in the system one way or another but there are different compounds of oestrogen and everyone suits something unique to them. Bit like thyroid hormones I guess. Gold standard = oestrogen gel but doesn’t work for everyone.

[BiscuitBaby in reply to Josephineinamachine]

That's good to hear. Brain fog fatigue and a couple of other lingering things are still hanging around and I don't think I'm going to get any joy with regard to getting thyroid dose altered. How old are you if you don't mind me asking?? You don't have to say! What thyroid dose are you on?

[Josephineinamachine in reply to BiscuitBaby]

Hi is fine to ask! I’m just turning 57 (still not sure how that happened!) and atm I’m on Levo only 100/100/75 etc. Am prepared to increase slightly if I need to now I’ve introduced oestrogen but going to give it a few more weeks and see how I feel 😊 that’s important to remember - introduce any ‘new’ hormone and it can effect everything apparently. I can’t tolerate T3. Good luck! X

[BiscuitBaby in reply to Josephineinamachine]

Thank you. I'm 46 so not even sure that it's my female hormones that are the culprit right now. It's good to know that it seems to be working for you though. That's encouraging. I might just have to try it. Thanks for sharing.

[BiscuitBaby in reply to helvella]

That does make sense. I did wonder how it would work. I've read the links re magnesium posted above so I'll try that first. It's just such hard work trying to get Dr's to work with you. There is no negotiation with them. Thank you for replying. It was useful.