Oestradial HRT & the thyroid, Lenzetto blood tests

[CornishChick]

I just wondered if low oestradial affects the thyroid? I have been on HRT since March and my level is still only 197 pmol/L. I use 3 sprays of Lenzetto. I wondered if it could be affecting my thyroid function? I don’t have menopause symptoms, I had bottom of range testosterone, but this is now in range after HRT.

Does your thyroid levels affect your oestradial level?

I have just been switched to a gel as was told the blood tests on the spray Lenzetto aren’t always accurate. Is this correct? Has anyone else heard this? So my GP suggested switching to a gel.

Thanks in advance for your help.

[Hidden]

Why are you on HRT if you don´t have menopausal symptoms? Or did they go away with HRT?

The reason functional doctors prescribe topical estrogen is that it does not interfere with the thyroid like oral estrogen does. I know that estrogen dominance (too much estrogen relative to progesterone) can impact the thyroid. Are you also on progesterone?

I have read that, when on topical estrogen, levels should not be measured in blood but in saliva, for the most accurate results.

[TiggerMe Ambassador in reply to Hidden]

Intriguing, I've not heard or even thought of a hormone saliva test, that would be so much easier!

Edit...

Ouch £££ perhaps not then!

hormonelab.co.uk/collection...

[Dogbuzz in reply to TiggerMe]

It's called a Dutch test, yes expensive and saliva tests are unreliable

[TiggerMe Ambassador in reply to Dogbuzz]

Not done one of those but have done an OAT

[CornishChick in reply to Hidden]

Thanks, so the nhs do saliva tests then? Will the spray be less accurate than the gel as my gp said?

I had bottom of range testosterone which is why I was put on HRT. Yea I take progesterone.

[Hidden in reply to CornishChick]

OK, but I am a bit intrigued as to why they put you on all three hormones if your T levels were low. You can take just testosterone . My own experience is that both E and P can mess you up pretty badly, even body-identical, transdermal hormones.

[Pearlteapot in reply to Hidden]

Could you say a bit more please about your experience of taking E&P?

[Hidden in reply to Pearlteapot]

I retain a lot of fluid, and I also started having pimples in my 40s which I suspect are caused by HRT. My facial skin, which used to be dryish, is now oily. I was put on HRT by a functional doctor and was told that body-identical HRT and especially transdermal estrogen have no side effects if used properly.

I know that fluid retention is a symptom of hypothyroidism, but it got worse after I was put on HRT.

Also, I´ve had a worrying increase of facial hair, especially on my upper lip and chin, and have even been considering electrolysis to get rid of it permanently.

[TiggerMe Ambassador in reply to Hidden]

I think these changes point to excess testosterone? Have you had your levels tested? Did you need to tweak your thyroid dose once you added the HRT?

HRT is the same as thyroid hormones only good when balanced with the other sex hormones but also thyroid

[Hidden in reply to TiggerMe]

Yes, the interesting thing is I was told T was borderline low so I was put on it, but then it ended up out of range even with the lowest dose (Testogel from your fingertip to the first joint) and I went off it. But it has remained highish, so maybe I am making T from some other hormone. I don´t take DHEA, though.

[TiggerMe Ambassador in reply to Hidden]

That sounds like a big dose of Testogel? It should be small pea sized blob... after menopause your adrenals take up the production

[Hidden in reply to TiggerMe]

That is what I was told...there testosterone drugs designed for women have been discontinued (there used to be one called Testo-Fem or something like that) so we use the same products as men, only a lot less. I was told a man should use the size of his palm to measure it, a woman about her finger to get ca 1 cm (from fingertip to first joint).

[TiggerMe Ambassador in reply to Hidden]

Cripes, they must have concentrated it even more since then, the sachets are now 40.5mg and should last 7-8 days

[melodie in reply to Hidden]

where can you get Testogel

[TiggerMe Ambassador in reply to melodie]

If your GP already supplies you with HRT you should be able to request testosterone stating 'low libido' 🤗

[Hidden in reply to melodie]

I got it from the pharmacy (with a prescription). I am not sure though that it´s available in all countries. There are several brands of testosterone, another one being called Androgel (bottle).

[CornishChick in reply to Hidden]

I’ve been on levo for 30 years. I consulted a private hormone specialist GP who said it’s best to try HRT to increase testosterone, not to take testosterone straight off. To be fair my testosterone doubled within the first few months, so she was right.

Everyone I speak to said they feel better on HRT, I don’t. But then I didn’t have menopause symptoms and my insomnia I’ve had since age 30 and subsequently had two children nearer 40, so the perimenopause was not causing insomnia.

[Hidden in reply to CornishChick]

So, estradiol and/or progesterone increase testosterone? That´s interesting, because most functional doctors recommend either pregnenolone or DHEA or both to do that.

[CornishChick in reply to Hidden]

Yes they do, the private gp specialises in woman’s hormones. Worked for me. I’ve tried DHEA and pregnenalone but for below range DHEA. Could that be why my testosterone is also low then?

[TiggerMe Ambassador in reply to Hidden]

I think it's more a case of testosterone doesn't get used up being converted to estrogen when that is running low, so if you replace the estrogen your adrenals might be able to produce enough testosterone without supplementing that too

[TiggerMe Ambassador]

I'm thinking the finger tip blood tests are no good if using transdermal as it is hard not to contaminate the sample... same would be true for the gel

Some find the gel a little stronger? It depends how well you absorb so trial and error as ever.... I'm post meno and use 4 sprays to get what I need, which puts my level at 231pmol/L

I certainly found that when my thyroid hormones were low all my sex hormones went down the pan

What are your latest thyroid levels doing? Certainly changing one hormone has a knock on effect with binding hormones

[CornishChick in reply to TiggerMe]

My ft4 is only 48% through range, but I can’t convince the female gp to increase my levo as my TSh is dire since I used to take T3, so she wants to reduce my levo!

[TiggerMe Ambassador in reply to CornishChick]

Wow, so where does that put your fT3? This hormone specialist is an odd one if she won't take into account your fT3/4

Sounds more of a 'lets ignore the hormones specialist!'

[CornishChick in reply to TiggerMe]

FT3 has always been top of range or over when I trialled T3.

Yes this female GP knows a lot about HRT but thinks my levo should be reduced. My usual male GP is lovely and actually told me yesterday to ignore her, and even said he’d tell her to leave my levo well alone!

[TiggerMe Ambassador in reply to CornishChick]

Sounds like he has some sense at least 😅 will he give you an increase thought?

But I thought you'd stopped the T3 so on levo only where is your level?

[CornishChick in reply to TiggerMe]

Yes he’s good but unfortunately retiring soon.

Without T3 my FT3 is always top of range. Yes I did stop T3 as I didn’t feel any better on it.

[Hidden]

Also, estrogen dominance is known to mess with thyroid hormone levels. It does not mean having out of range estradiol levels, just that you have too much estradiol relative to progesterone. A certain balance between the two is necessary. Are you also on progesterone?

[CornishChick in reply to Hidden]

I am but my progesterone wasn’t tested, should it have been?

[Hidden in reply to CornishChick]

I think it would be a good idea as there should ideally be a specific ratio between E and P.

[CornishChick in reply to Hidden]

Thanks I’ll ask my GP to test.

[TiggerMe Ambassador in reply to CornishChick]

Do you notice any difference between the 2 weeks on 2 weeks off with progesterone?

[CornishChick in reply to TiggerMe]

I started with the 2 week break but then switched to every day to see if it helped me sleep, but it didn’t. I don’t feel any different on HRT no matter how I take it.

[thyr01d in reply to Hidden]

Hello TiredThyroid50, please could you tell me more about this. Everywhere I have looked I have seen that once you have no womb you don't need progesterone. I had a hysterectomy (for cancer) at 34, now 67 and get pregnancy symptoms when I use the prescribed oestradiol gel. Am sure my body needs progesterone as well. If you have information on this I'd be very grateful.

[SarahJane1471 in reply to thyr01d]

My GP prescribed Utrogestan for me to go alongside my Estrogen Gel. I have no womb but we agreed it might help my energy levels. She says there is no point having blood tests for sex hormones as when you are peri/menopausal the hormones are different everyday. Symptoms alone are enough to diagnose.

Ps. I did not like Utrogestan it made me jittery and no sleep. Although many women say it helps improve sleep

[thyr01d in reply to SarahJane1471]

Thanks SarahJane, my GP just rubbished the idea of progesterone as well and everyone says the same about testing, but I'm hoping TiredThyroid has more info.

[SarahJane1471 in reply to thyr01d]

You don’t NEED progesterone if you have no womb but you can take it as a trial to see if it helps.

[thyr01d in reply to SarahJane1471]

Well I know that, but how do you convince a GP?

[SarahJane1471 in reply to thyr01d]

I have a really good relationship with my GP and I just suggested it to help with my energy levels. This was last year. She agreed and I used it for about 3 months. It didn’t suit me. If you have tried all other things then asking for a trial should be no problem.

[radd in reply to thyr01d]

thyr01d,

HRT has traditionally only been oestrogen replacement for women who have had a hysterectomy but now there is thought that progesterone has many other health giving properties beyond protecting the endometrium from unopposed oestrogen.

Progesterones main contribution is towards neurological health after hysterectomy (and menopause) but it also helps with our bone health just as oestrogen does.

I'm sure this info is stated somewhere in Balance (Louise Newman) and there are plenty of research papers you could show your doctor.

scholar.google.co.uk/schola...

[thyr01d in reply to radd]

Thank you so much radd, this is very helpful, I have a new GP now so will discuss this with him and, since I have osteopoenia, you may have saved my bones.

[Dogbuzz]

Hi your estrogen is low, and 3 x sprays is only equivalent to 2 x pumps of gel. I might be worth asking to increase to 4 x sprays. Unless your GP is up to date on all things HRT they may not let you increase as it's only licensed for 3 x sprays, despite the manufacturers realising it's not as strong as originally thought, but the new equivalents are on the BMS website

[CornishChick in reply to Dogbuzz]

Thanks. My functional doctor said following my DUTCH results that my cancer risk oestrogen is too high and reduced me from 3 sprays of Lenzetto to 2. Do you think she has got it wrong?