I have been prescribed oestrogen 2 pumps as well as Utrogestan 100 for a trial of 3 months.I had a small breast cancer 10 years ago so being cautious. is it better to start with just one pump for a week or so ? or do I go straight in with 2 pumps?Your experiences with this are invaluable . thank you.
I have hypothyroidism, this in effort to try to differentiate which symptom are hypothyroid and menopause.
thank you everyone
I personally prefer the ‘low and slow’ approach to new medication, I started with one pump of oestrogel alongside utrogestan, then added more after a few weeks. I think it’s very much trial and error to find what releases your symptoms best. There is an overlap for many between hypo symptoms & menopause symptoms, so it’s a good idea to check thyroid levels and key vitamins (ferritin, folate B12 and Vit D) to ensure these are optimal first.
For advice re HRT following breast cancer, it may be useful to have a look at Dr Louise Newson’s free Balance App, as I find it really useful for having up to date research articles. There is also an ability to post questions. healthunlocked.com/redirect...
You will need to retest thyroid levels (and vitamins ideally ) 6-8 weeks after starting (or stopping) HRT
Common to need to increase dose levothyroxine on HRT
ooh this is interesting, why the increase on HRT?
Don’t know the science….but we see this regularly
HRT started…..levothyroxine dose needs increasing
thank you
Francisneat,
Any increase in oestrogen risks increasing binding globulins made in the liver that transport the hormone around the body, and risk binding thyroxine (T4) as well. When thyroid hormone is bound it is inactive and must be cleaved to become free-fraction to activate cellular receptors.
Body identical HRT oestrogen transdermal gel doesn't go through the liver so theoretically shouldn't induce higher binding globulins but some members have reported they still require a Levo dose increase after starting the transdermal gel, so presumably due to the oestrogen amount that gets recycled.
There are other reasons too such as prolonged cortisol elevations that decrease the liver’s ability to clear excess oestrogens from the blood, and this excess will encourage further binding proteins that bind more thyroid hormone, and it becomes a vicious circle. This is why is is important to medicate the least amount of any hormone replacement that successfully alleviates symptoms.
I get it now but is raises lots more questions.
I have a gel, I'm supposed to used 2 pumps, but have only use one and every second day I use 1 and 1/2 pumps. But I also take one progesterone pill a day which is the full dose. Should I have halved too?
My cancer was oestrogen dominant so I am assuming that a higher progesterone level would be better.
I have discovered hat I have high blood cortisol and VERY low saliva cortisol. this is after 20 years of a stressful job.
How would I know if my liver was working properly ?
I must admit I have been feeling more tired since I started 2 weeks ago I didn't think it could be so quick so may be it's something else.
I don't know how I can fix my cortisol either?
PS thank you for your time and explanation
Yoll,
During our cycles we only produce progesterone once we have ovulated but not in late peri-menopause or menopause but we do/should still produce a bit of oestrogen in adipose tissues and inside certain cells. Therefore we are a little bit oestrogen dominant to start with (hence the meno symptoms).
Progestogen should be proportionate to the dose of oestrogen taken in order to to ensure adequate endometrial protection and 100mg Utrogestan is the lowest dose offered. For menopausal women taking 1 or 2 pumps of Oestrogel, the usual recommended dose is one 100mg capsule daily without a break. This should be increased with 3 or 4 pumps of Oestrogel but often mistakenly isn’t.
I would say it’s too early to make assessment of how you are feeling but if new symptoms were to continue you could try taking Utrogestan vaginally. It’s not licensed to use this way but Louise Newman (Balance) says it’s perfectly safe and some women prefer this method as only half the dose is required, it is close to the womb where needed and doesn’t go through the liver so reducing the risk of side effects. You would use one capsule every other day or you can use the bio-identical progesterone pessaries used in fertility clinic that come in more dose measures. There is great research supporting this. It’s just NHS HRT options and drug companies haven’t caught up with this yet.
The liver likes clean foods and not too much alcohol, coffee, chocolate, etc to be able to metabolise hormones well. I use a little bit of milk thistle now and then as known to cleanse the liver but usage can be controversial as too much can inhibit thyroid hormone transporters. Otherwise use lemon water, increase greens and reduce 'naughty' foods.
I’ve just seen your cortisol post. Your morning cortisol is low and wow, your night time levels goes high! Did you manage any sleep that night? I think it safe to assume that level was driven by your migraine and vomiting because normal night time levels that allow good sleep are low and start raising early morning in time to wake.
I think there's also risk it might have influenced the morning level when you slumped after a bad night. It’s a shame this test is so expensive because it would be good to rerun it. The 9am blood serum cortisol is elevated and I’m assuming taken at a different time to the saliva. Bloods are always more more than saliva as contain both bound and unbound cortisol.
Many of us have high/low/ imbalanced cortisol levels as it becomes compromised after years of supporting other low hormone levels and modern day stresses. Both my blood and saliva were extremely low but adding T3 and HRT helped everything work so much better and today my cortisol, DHEA and aldosterone levels are all fine.
so much info thank you, I did ask for body identical ! and was told she cannot prescribe it and it is not controlled so could be contaminated! dose not controllable etc... etc... I would much prefer to use body identical products. I will try the progesterone vaginally every two days, and see how I feel, I also use Ovestin 1mg so I hope that ok.
Thanks for all your help,
lots of great info Radd thank you!
Really interesting, didn't know anything about this. All the hormones are so linked to each other yet there is no one who can look at the whole picture! it is infuriating, all my symptoms could be liked to low adrenals but I can't find anyone out there that can help. My last ends appointment after she had completed endless tests (none on the thyroid!)Just said: "I can't help you!"
So thank you so much for your knowledge
What are your most recent TSH, Ft4 and Ft3 results
Always test thyroid early morning, ideally just before 9am, last dose levothyroxine 24 hours before test
Essential to test vitamin D, folate, B12 and ferritin at least once a year
What are your most recent vitamin results
What vitamin supplements are you currently taking
We need OPTIMAL vitamin levels for good conversion of Ft4 to Ft3
Thanks for your answer.
I have been doing all of this for the last 2/3 years, I am now on a small dose of T3 which has helped with sleep and digestion. Did AIP for 6 month too.
Nothing seems to touch the lethargy, low mood , lack of motivation; which irritates me even more. I plan my day all full of good intentions, but the thought of the effort needed and ensuing fatigue stops me! very frustrating.
I have great trouble regulating my temperature and these days I am always tooo hot. So I'm going to try HRT and see if that is the reason, I have had a small breast cancer 10 years ago so they are not too keen hence the 3 month trial.
I have hot flushes/sweats mainly on waking and going to sleep and at odd time during the day especially during any physical activity, so I'm thinking it could be weak adrenals! I had a lot of stress for 20 years so it could be that. Or could it be over active adrenals??
Another avenue to examine. One issue at a time I think, as no-one ever looks at the whole picture anymore.
I just want to feel something close to myself again
I'll keep plodding on hoping I don't make matters worse on the way.
Thanks for all your help
Poor conversion or inadequate dose thyroid hormones frequently results in high cortisol levels as adrenals try to compensate for inadequate thyroid levels
Eventually cortisol levels can drop as adrenals become exhausted
Cortisol and DHEA test
regeneruslabs.com/products/...
portal-app.inspira-regeneru...
I am rather confused by this, I had a migraine and was sick before the last sample. I did mention this on the notes. How to I supplement with DHEA? can you make sense of this, I don't take any steroidal inhalers or cream. Thank you for any help.
suggest you write a new post about this so that others can see
Your cortisol levels are far too low until evening
Please also add in new post what thyroid hormones your taking and most recent thyroid results
TSH, Ft4 and Ft3
Plus thyroid antibodies, vitamin D, folate, ferritin and B12 results
I started on one pump, only increasing to two after a couple of months. I can be very sensitive to some things so it seemed best to take it low and slow, though I probably didn’t need to take it quite so slow!
I hope you find HRT helpful. It’s certainly helped me.
I'll try that as I to tend to react , unfortunately I've only been give a 3 month trial, so I need to see changes within that time.
Obviously, we're different people, but I felt an improvement after about three days. In fact, I felt amazing for about four days, better than I have for years, and then that went away. 😥 But even though I haven't reached those heady heights again, I'm still better than I was and I could feel that pretty early on, on one pump. Good luck.
Me too! I felt amazing for the first 3 days or so and then back to feeling fatigued and joint pains and low mood... why is that? I'm not sure Oestrogel is working anymore. Maybe my body is not absorbing it well? but I'm also having more and more dizziness and IBS is bad again 
I'm still only on one pump I might add another half tomorrow,.
can't say I have felt any better, I got rid of my IBS and lack of sleep with taking 15mcg of T3. I'm waiting to see if anything changes. how long can it take? to feel some changes ?
What's T3 and where do you buy it?
T3 is Liothyronine, the body transforms T4 (thyroxine) into T3 so it can use it. Some people's bodies are not very good at doing this. I get it on private prescription. I use very little of it. Some people only take T3. I take both T4 and T3.
I can see on amazon you can buy thyroid complex as a supplement which has T3 in it, is that any good?
T3 is a common way of referring to triiodothyronine - one of the two thyroid hormones produced by a working thyroid and available as prescription-only medicines. As a medicine, it is often called liothyronine.
If there is a product on UK Amazon which actually says it contains T3, it is being sold illegally.
Everything I've ever seen which describes itself as "thyroid complex" is some sort of vitamin and mineral product possibly with some plant extracts. Many claim to be vegan or vegetarian which rules out any form of desiccated thyroid ingredient.
(Also, if it is sold as containing thyroid hormones, it would be against forum guidelines to identify the source.)
You are right. They seem to be vitamin complexes to support thyroid function. With Iodine and L tyrosine... How does one get T3 prescribed? I was once told by a functional doctor from the Dutch test that I am borderline hypothyroid I think... usually, routine blood tests don't really show this...
It is difficult to get T3 prescribed in the UK (and many other countries).
Basically, it isn't going to happen until you have at least tried levothyroxine (T4). And that won't happen without blood tests showing at least TSH and Free T4 being out of range.
Getting those tested (very much would want Free T3 as well) is probably a vital step.
I'm really sorry to hear it didn't last for you. I don't understand why it felt so amazing at first, and then went away again. If ever you find an answer, I'd love to know. I used to feel that way the day before my period, and while I know I'm not alone in that, I've never been able to find an answer to that either.
I've read that some people can feel dizzy in the early days of starting oestrogel, but not sure why your IBS has flared. I hope you have a decent doctor who can help.
Thank you everyone I too at times feel like A2C3, you all keep me going!
I started with one pump then gradually increased to two. I also changed from taking the utrogestan orally to vaginally which stopped all the symptoms I was getting ie wind/bloated/stomach pain
great I'll try that!
Can't believe I've been prescribed t3 in Wales!
Ultrasound - Some useful info at last
Multi vitamins - at last some recognition 
Anybody out there been through pregnancy whilst being prescribed some level of T3 or NDT?
I've just been prescribed T3...
