T3, T4, Osteoporosis and estrogen!

[Tuxi1]

Hi - I am just trying to get my facts straight before seeing my endo on Tuesday.

My T4 has been a bit low and i have been suffering extreme anxiety and joint pains etc. Am i right in thinking that taking T3 will make it lower? I am on 12.5mg a day in two doses. I know my endo said try taking T4 but I feel really terrible on it.

I have now got osteoporosis badly (early menopause at 28 and now 54 and but fit and active - except I keep breaking ribs and my hips have begun hurting a lot). I am unsure of the role of the thyroid in this. I am very very low in all hormones and have started taking estrogel again as treatment for the osteoporosis - will this change my thyroid status? Will I need more or less T3? or is it individual? What normally happens? (not that I ever fit the normal!)

Thank you for any advise - i just need to be a bit better informed I think!

[SlowDragon Administrator]

which brands of levothyroxine have you tried

Looking at your profile you’re on dairy free diet so likely to need dairy free levothyroxine (and T3)

Lactose Free levothyroxine

Vencamil 100mcg only- use to be called Aristo

Cut into 1/4’s to get 25mcg . Also mannitol free

Teva brand is lactose free, but not mannitol free

Available in 25mcg, 50mcg, 75mcg and 100mcg

There’s also liquid levothyroxine if these don’t suit

[Tuxi1 in reply to SlowDragon]

Hi - Tried almost all of them! Don't remember Vencamil though. I have the gene that doesn't process T4 well - can't remember what that is now but maybe that's why rather than the fillers? Liquids I looked at but have a feeling they are full of sugars and I cannot tolerate sugars - worse than lactose and maize etc I think. I will look at the Vencamil if doc really wants me to try again. Pretty sure I tired Teva and it was one of the slightly better ones!

[SlowDragon Administrator]

osteoporosis can be linked to LOW thyroid hormones

Also it’s ESSENTIAL to test vitamin D, folate, ferritin and B12

What vitamin supplements are you taking

[Tuxi1 in reply to SlowDragon]

Had all vits tested and nothing showing low. I am taking masses of supplements including B's but currently not D as test showed i didn't need. I have the MTHFR gene so need to be careful with folate. Maybe the combination of low sex hormones and the thyroid has made things worse then? I thought it was ok for my T4 to be low as I was taking T3 - maybe this isn't good for my body though? bit confused about it I need to raise the T4 when on T3 only. Thanks

[SlowDragon Administrator in reply to Tuxi1]

thought it was ok for my T4 to be low as I was taking T3

bit confused about it I need to raise the T4 when on T3 only.

Some people are fine with low Ft4 if on high enough dose T3

on just T3 many (most?) people would need somewhere between 40mcg and 60mcg daily

Many people need BOTH Ft4 and Ft3 at least 50% through range, so that’s less T3 (typically 10mcg-20mcg per day often as small 5mcg doses though the day) alongside mainly levothyroxine.

Guidelines on dose levothyroxine when NOT taking T3 is 1.6mcg levothyroxine per kilo of your weight per day

When adding T3 typically dose levothyroxine is reduced by 25mcg or possibly 50mcg

[Tuxi1 in reply to SlowDragon]

Thank you - I did try increasing the T3 but it lowered my T4 more and I didn't feel better on it - just worse really. Maybe I need to do some more experimenting but with adding the estrogen it now complicates experimenting as there is another element. Opted atm to raise estrogen rather than any thyroid as bone is desperate and need to stop the loss and thought that would be the most obvious route to increase it atm - sigh - will see what endo says but it does seem that i always have to make my own decisions and diagnosis's!

[SlowDragon Administrator in reply to Tuxi1]

Bone loss frequently due to being UNDER medicated for thyroid

Osteoporosis

thyroidpatients.ca/2018/07/...

T3 only analogy

thyroidpatients.ca/2019/08/...

[TiggerMe Ambassador]

I'd suggest testosterone to go with the oestrogen for bone health, (progesterone too if you haven't had a hysterectomy) you might find you need to tweak your thyroid hormones as they all bounce off each other and alter the level of binding hormones

Low sex hormones can cause anxiety and joint pain

How are you Vit D levels?

[Tuxi1 in reply to TiggerMe]

Yes - Thanks for the reminder - i was going to ask about that but last time I took it I grew long hairs on my thighs and didn't like it! Will try again I think. I have taken progesterone for years so that's not a problem but I may need to up it - not sure. D levels fine. Yes - I suppose I have ignored the warning signs of anxiety and joint pain as being connected - Just like to bury my head in the sand until something definite shows up - hmm

[TiggerMe Ambassador in reply to Tuxi1]

The overlap in symptoms with thyroid and sex hormones makes it really hard to pinpoint which one to adjust... in your case you know your sex hormones are low so you can give them a boost and then possibly tweak your thyroid ones to balance... usually if things start to improve and then drop back it's time for a tweak

[Tuxi1 in reply to TiggerMe]

thank you - that's what I thought so good to hear you think the same!

[MiniMum97]

I found oestrogel affected my absorption of both T4 and T3 (I am on a combination of both) and both had to be increased.

[Tuxi1 in reply to MiniMum97]

I am confused - why would the Thyroid need to be increased and not decreased? wouldn't the estrogen help the thyroid out? Would have thought the other way around?

[TiggerMe Ambassador in reply to Tuxi1]

Better sex hormone levels increase SHBG which can bind the thyroid hormone meaning a little extra might be needed to re-balance the system

[Tuxi1 in reply to TiggerMe]

hmmm! I will bear that in mind thank you