These are my latest results.
Since being on Estradot my Ft4 and Ft3 reduced so 8 weeks ago Dr increased T4 plus ankles are swollen and awful constipation
150 Levo plus 15mcgs T3 last dose 8.20 previous day
TSH <0.03 (0.35-4.94)
Ft4 14.1 (9-19)
Ft3 4.3(2.6-5.7)
I’m thinking I need to increase T3 now
when on levothyroxine plus T3
Day before test recommended to split T3 into 3 smaller doses spread through the day, taking last 5mcg dose approx 8-12 hours before test
If you took T3 approx 24 hours before test, it’s false low Ft3 result
When were vitamin D, folate, ferritin and B12 last tested
What vitamin supplements are you currently taking
I always add 20% to the results to take into account that it was a 24hr gap.
B12 is 773 (150-800) folate 16.4(3-20)
Vit D 115?
can thyroid cause swollen ankles & constipation? This all started after I started using Estradot estrogen patches.
My T4 dose was increased because both ft4 and ft3 had dropped from the usual result levels
Many thanks
FT4: 14.1 pmol/l (Range 9 - 19)
Ft4 still only 51.00% through range
helpful calculator for working out percentage through range
Suggest you retest again in 6-8 weeks see if improving
What vitamin supplements are you currently taking
Magnesium good for improving constipation
SlowDragon
These are what I worked out
5/9/22 150 Levo plus 15mcgs T3 last dose 8.20 previous day TSH <0.03 (0.35-4.94)Ft4 14.1 (9-19) 51%Ft3 4.3(2.6-5.7) 54.94%Add 20% = 5.16 82.58%100 Estradot patch 242
I have always taken magnesium . I was taking 300mg chelated magnesium glycinate but since I’ve been so constipated along with the swollen ankles I’ve been taking 750mg ( of a different brand) with no noticeable difference.
I’ve also added flaxseed to my weetabix in order to try and help with the constipation.
I only use Vit D spray 3,000iu
I’ve been hypo for over 38 years and never had these 2 problems . It seems to have happened since being in Oestradiol patches.
The results above are from 8 weeks after I started the increased t4 dose leaving the t3 dose the same .
The following results are the ones I got in June which is when my Gp then increased my t4 to 150 from 125
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%
Hello 130396
Just thought I’d jump in about Estradot. I’d used these patches and had a similar response in a drop in levels. The pharmacist informed me that they are made from soy and not recommended for hypos. I liked them as they’re v small, stick well and didn’t irritate my skin, but my estrogen levels really dropped so assumed I wasn’t absorbing. I did then change to Evorel which are a derivative of yams. Levels then went up! I think if you’re increasing T4/T3 to compensate, that’ll work. I thought about this too, but struggle to tolerate higher doses.
Just thought I’d mention in case you weren’t aware 
🦋
Thank you so much for your reply. My level on 200 Estradot was 1,642 so was absorbing the Oestradiol well. They dropped to 242 after I reduced the dose from 200 patches to 100 patches.
I’m wondering now if it’s the Estrogen or the soy that’s giving me these problems.
Thank you
Hi again
That’s strange the big drop from the very high levels. Are you post meno? I’d felt ok for 5 weeks and thought I’d cracked it, then got my levels tested and the 100 Estradot was only giving me 50 pmol! I panicked at that point 😁! Maybe I would actually be ok with 50 (it’s crossed my mind) but I was in a race then to get them back up. When your thyroid is out of whack, you don’t need the menopause joining the party, do you?
I’m not a fan of the Evorel (did 150) as they’re too big, left awful marks and I felt like I was wearing cling film. My levels were better though around 350 pmol, but decided to go back to gel once the supply improved. I have no idea on what level I feel best. We’re you well on the very high level? Did you consider/ try 150, or jumped straight from the 200 to 100? How are you feeling on this level?
I believe that transdermal should not interfere with Levo absorption. I’d done quite a bit of reading, but with the HPA axis, I suspect all things are connected in some way. Someone very knowledgable on here did explain to me the relevance of the female hormone readings and what binds with what in terms of thyroid. But as far as I could understand, we should be in a better position than taking oral estradiol 🤞
Hi Butterfly 1942
I’m 18 years post menopause at least. I’m 69 now and only started on estrogen august 2021 as I had such a bad reaction to my 2nd covid jab. The symptoms I got were far far worse than actually going through menopause.
No I didn’t feel any better in the high dose with high levels . By chance I started using progesterone cream a few weeks ago to see if it would help ( I’d been using it for 6 years before starting the estrogen ).
It’s helped me feel better meno symptom wise!!! I’m wondering now if even should have stoped it but I did as the menopause nurse said I didn’t need it as I’d had a hysterectomy 35 years ago.
I was originally on Sandrena but haven’t been able to get it since March which is why I had to go onto patches.
I have read somewhere that estrogen binds thyroid hormones so obviously I’m thinking my ankles and constipation is thyroid .
Hi
Thanks for replying. Was your response to the vaccine like severe meno symptoms? I only ask as I had a sudden spike after years of control. I contacted a well known menopause doctor and she said that a number had noticed the same response. I’ve been on HRT for 8 years. I entirely agree with you on using the progesterone. I am one of those people who was always better on the prog phase of my previous cyclical HRT. I think some of us need the prog to counterbalance the estrogen. A shame your nurse could only see the benefit as regards to HRT and reducing womb lining. I’d say very shortsighted. It’s a hormone many of us need. I’ve recently had my mirena removed as I felt my estrogen wasn’t balanced and am going back to try utrogestan for the very same reasons. I know instinctively I need that particular hormone in good systemic supply.
I’m not too up to speed on the binding etc but I’ve read a lot that transdermal is far better. It’s so hard to get everything in balance and to identify what is causing what as there’s so much crossover in symptoms. I do believe that sticking to a HRT preparation/ treatment for 3 months will allow for the thyroid hormones to chime in and we get a true picture of levels for both thyroid and estrogen at that point. It’s so hard to grit teeth and sit it out, I’m finding. But it does give everything time to catch up. You could then adjust from there? I also need to practise this 🙄 when symptoms raged after so long on a stable footing, I’ve chopped about too much in a panic and have ended up even more confused, as is my body! And the added stress of preps not being available has made things worse for so many of us.
Is the sandrena still on shortage? What a nightmare this all is. So many women impacted and having resurgence of symptoms because of unavailability of their trusted preparation and having to switch out. I’m so pleased you’ve had some respite via the progesterone cream. If it ain’t broke! But we follow the advice of the ‘experts’ don’t we? I’m becoming more inclined to now listen to my own body instead.
Re the shortages: It’s not just HRT. I was due a trial of liquid Levo which is now becoming impossible to source via the pharmacy. Worrying times. I’ve decided to postpone my trial as not being able to rely on a repeat prescription fills me with dread.
My local independent pharmacist was bemoaning the struggles they are having in the face of the big pharmacies. Excessive price hikes etc
Hopefully one of the more knowledgable members on the binding etc will jump in to explain 🤞
hi Butterfly1942
Yes it was the covid vaccine that set off all my symptoms again after being very good for several years.
I’m feeling more inclined to lower the dose of estrogen even more as I can only think it is what is causing my swollen ankles and constipation.
The progesterone has definitely settled the anxious feeling I’ve had in my tummy for well over a year since having the jab.
I was on progesterone cream on its own for 6 years until starting estrogen last year . Wish I’d stayed on the progesterone also as I kept increasing the estrogen as was told “ it’s not about leveks but symptom relief” so up and up it went.
I’m also thinking the estrogen is causing the swollen ankles etc as my thyroid levels became lower than normal.
I’ve read that estrogen slows down gut mobility
If you think of anything else which might help please do let me know x
Hi
It’s such a difficult thing to know what’s behind symptoms. If you’ve got control of the meno symptoms with the current 100 patch and prog, I’d be tempted to stick with it a couple of months before lowering further. Maybe keep a symptom diary and then get estrogen retested? Estrogen levels and what we need is so individual but I believe about 300-350 plus pmol should give (mostly) symptom control and 400-600 for meno anxiety and depression. Again, no hard and fast rule- if only it was this easy!
I don’t seem to like my levels too high. I can feel jittery on too much estrogen so your first set of levels would have had me wired. As we are both post meno, there should be a much reduced level of our own to create peaks and dips so what we are getting mostly from HRT should be largely consistent. It’s finding what level (and prep) suits and I agree yes to symptom control over numbers. BUT high estrogen (your first levels) can cause slow gut transit/ constipation I’ve read and maybe the fluid retention in the ankles? Fluid retention being a known side effect until the body settles. I was like a puffy barrel with fat knees when I switched from gel to patches, but it settled eventually. I’d be tempted to stick with the current reduced dose of 100 patch and see if these two symptoms resolve in a month or so.
As you’ve (recently?) had an increase in T4, then adjusting the timings of the thyroid hormones as SD suggested first as it can help better absorption without a need for a further increase initially.
Even on higher thyroid levels, I have constipation but the magnesium does work. I’ll keep you posted if I find out anything else, but the most important thing I’ve learnt with both thyroid and menopause is to not chop and change too quickly. And ideally NOT at the same time 😁. I’ve made a mess of myself with this previously and am still unpicking the damage over a year later!
Let me know how you get on and what you’ve decided to do. Hoping all settles x
thank you Hidden .
I’m going to do what SD suggested and take 100 at night and 50 in the morning.
I’ve been on 100 Estradot for 5 weeks today so could the ankles & constipation still take time to settle?
I used the Balance app to note symptoms and also the calendar on my phone
Thank you so much for your help yesterday & today x
Hi
You’re very welcome. I can only speak from experience and hours of reading to find answers too I think this sounds a really good plan with the thyroid meds and yes! It can take longer than 5 weeks- I know it’s a pain but it could take anywhere up to 3 months. I think it’ll settle before that though as I’ve always found things are different around the 2 month mark 🤞. It all probably works like thyroid hormones and you can start feeling improvements in a few weeks, but they can continue way beyond the three month mark too! Best of luck and I’ll come back if there’s anything else I stumble across in reading 🦋x
Thank you so much.
You’ve got lots more years experience than me with hrt. I do wish I’d never stopped the progesterone cream though as it’s made quite a difference x
lots of experience but still playing catch up 😂 Yes I agree, that nurse probably didn’t do you any favours. There’s lots online about women who don’t function without progesterone post meno, or post hysterectomies. Apparently, we have pre menopause a significantly higher amount of progesterone than estrogen so it must do something for us! I read this online so please don’t take as fact, but we must need some in our bodies to feel balanced.
I don’t know if you’ve looked up Menopause Matters? You can post questions and get really good, first hand experience feedback on there too. Worth a look maybe for the meno specific?? Sorry if you’re already aware of it. Thought it was worth a mention
X
personally I need BOTH Ft4 and Ft3 at approx 70% through range
you might need less T3 and more levothyroxine
Have you tried splitting levothyroxine as half dose waking and half dose bedtime
Have you tried splitting T3 as 2 or 3 smaller doses spread through the day
Calm vitality magnesium powder is effective for constipation….start on 1/2 teaspoon in cup warm water ….increase until get desired effect
I don’t understand why I would split the T4 as it has such a long half life .
I have in the past split t3 but that was some years ago when I was on a larger dose.
Basically I’m trying to see if I should increase the T3 and also why it’s only now I’m getting swollen ankles and have constipation ???
yes,…..but many members find splitting levothyroxine dose is better…..may give slightly higher TSH and better conversion rate
I doubt it would give higher Tsh as I take T3 as well and as it’s well known , T3 does suppress tsh so I don’t think splitting will make any difference .
This was. Y ft3 result when I dit it and last dose was 5 pm
I take T3 as well as levothyroxine
I find splitting dose levothyroxine much better. Half dose waking and half dose at bedtime. Possibly gives better conversion.
I also split T3 as three doses, waking, mid afternoon and bedtime
TSH is still as low as before ….but symptoms are improved
so basically you don’t think I should increase T3?
I can’t take T3 later than 5 on as it keeps me awake. The reason I take it once a day is because I really don’t feel that I need it during the day as the morning dose doesn’t run out.
What amounts do you take if t4 and T3 and what are your results like,
As you can see I posted my Fr3 result after taking it at 5pm and it’s hardly any different from when I leave the 24hr gap
personally I wouldn’t increase anything yet
Ft3 was false low result as last dose 24 hours before test
Even if you don’t normally split dose…..you should the day before test
I take 125mcg levothyroxine 5 days and 112.5mcg 2 days a week….literally cutting tablets in half to take half waking (6.20am) and rest at bedtime
Since splitting levothyroxine ….Ft3 result increased
So I am currently week 12 into reducing T3 from 20mcg daily to 17.5mcg - 3 doses 7.5mcg waking, 5mcg mid afternoon and at bedtime
After next blood test…likely to reduce T3 again to 15mcg daily….
Also since splitting levothyroxine, no longer crave sugar….lost 11lb (approx 5 kilo)
I take 150mcgs T4 so I could not split that to two doses as I have no idea how to.
The reason I’ve stuck to leaving 24hrs after t3 dose is to keep it the sane as all my other results for the last few years so that I can compare them.
If I were to take my last dose at 5pm I wouldn’t be able to compare it to my previous results.
I know you take a last dose before bed but when I tried that I was awake the whole night and as I have to work I couldn’t go without sleep
I take 150mcgs T4 so I could not split that to two doses as I have no idea how to
If you wanted to try ….Just cut in half with craft scalpel or pill cutter. Make sure to mop up any crumbs with damp finger
Or just try 50mcg at bedtime and 100mcg waking
Before I started splitting dose I had taken whole dose at night for last 10-12 years on recommendation of endocrinologist…..like many members…..I found night dosing better than morning
what about taking 100 at night ? And 50 in the morning?
Thanks so much for your help.
Also, do my results at the moment explain why I’ve got swollen ankles and awful constipation?
no idea ….sorry
Constipation is common hypothyroid symptom
Very common to need to increase dose levothyroxine if start on HRT
I never added any HRT….my GP and I agreed there was enough going on without complicating things further
Swollen ankles…..could be lipodema?
But that usually builds slowly over years
These are both only happening since being on Oestradiol so I’m assuming it’s either that or thyroid not being right that’s caused it.
Even though I’ve been hypothyroid for over 38 years I’ve never experienced these problems before
Thank you
Is this HRT you swallow or patches?
if it’s one you swallow, try patches in stead
If already patches …..
try stopping HRT?
itsca patch do absorbed transdermally.
I don’t think at this moment it’s right to totally stop it as I only reduced it 5 weeks ago
My reply to your post is below SlowDragon
Hi 130396 , I've been reading through your post as I'm having the same problem with swollen ankles and legs and constipation since starting HRT and having to increase my T4 meds (T3 still 20mcg a day). I was just wondering if you managed to persevere with it and if things have settled after 2-3 months?
Hi jellybean
I reduced my Oestradiol and added Utrogestan and my ankles and constipation are all better now .
My Oestradiol level was too high and I was retaining fluid
Thanks for replying. Happy to hear you've resolved it. I think I may have similar issues. I started Evorel 50 patches in Aug 2020 due to menopausal symptoms. GP has never tested hormone levels so the results I've got are from Medichecks. I've not had progesterone tested but my oestradiol level was 1139pmol/L on 24th Aug and I was having swelling at that point. I removed the patches for a month to see if I really needed them. Swelling was resolved and I felt ok for about 4 weeks and then the menopause symptoms hit me again so I restarted them and felt much better. I started using the combi patches (50 mcg oestradiol and 170mcg norethisterone) constantly about 6 weeks ago which will should stop my periods within the next 6 months and on Nov 2nd my oestradiol was 1051pmol/L, which jumped to 1660 on Nov 9th (I had to redo the test because of a problem with one of the other tests). I've just read that progesterone itself can cause fluid retention so wondering if the change in patches has caused the issues and will settle in itself in a month or two or if my doses are just too high for me at the moment. Being perimenopausal I know that levels can fluctuate quite wildly which is why doctors don't tend to check blood levels. Not sure if I should keep going as is and see how things go or if I should cut the patch in half and see how that goes. I definitely feel better with them than without so don't want to stop them completely.
body identical progesterone is like a diuretic so there’s no fluid retention. The progesterone you gave in the patch is synthetic and can cause fluid retention.
Your oestrogen level is very high - was it a finger prick test or venous test?
If you’re under 45 then Drs won’t test leveks but if you’re over 45 then they can test for you.
How often do you take your T3?
What are your latest results?
I'm 51, first test was venous and the 2nd two finger prick. In June having been on the patches for almost 2 years years I discovered I was under medicated taking 100mcgT4 and 20mcg T3 free t3&4 both under the range and TSH of nearly 5. I've gradually increased the T4 to 150mcg 4 times a week and 125mcg 3 times a week. Last test no TSH as there was a problem with the sample but previous was suppressed at 0.02. FT4 14 (20% through range) and fT3 5.1 (54% through the range). I've increased to 150mcg 5 times a week and will test again in about 8 weeks. Since June I've been splitting my T3 and T4 doses. I was taking T4 4 times a day and T3 3 times a day. Just this week, to see if it will make any difference to the swelling, I've changed the T4 to twice daily (6am and 11pm) and still taking T3 at 6am, 11am and 4pm. I'm aiming to get my T3 to ~75% and T4 at least 50, but ideally around 75% too. Unless all my symptoms go before that. My prolactin is very high too, I'm assuming because of the high oestrogen (all my results are on my previous posts). Do you think body identical progesterone and/or oestradiol would make a difference. I'm not clued up on this at all, so not sure what my options are despite using the Balance app. I've halved my patches and will see how I get on with that over the next month or 2 before going back to the GP hopefully armed with more knowledge and a plan going forward.
T4 has a very long half life so there’s absolutely no point in splitting it.
Finget prick tests are not accurate as the blood comes from the capillaries. Always have venous blood tests.
Latest results after 9 weeks on T4 and T3
Advice on Latest results T3 only to T4
test results - on T3 and T4
T3 and T4 results interpretation
