Many women with hypothyroidism report needing a slight increase in Levothyroxine when starting HRT. However, I actually found I needed a slight decrease in thyroid medication.
It does take time to adjust to any new medication. If adverse symptoms continue, you may need to try a different type of HRT (eg some find patches are better than gel).
Regarding HRT, it may be useful to have a look at Dr Louise Newson’s free Balance App, as I find it really useful for comparing HRT medications & having up to date research articles.
What do you think - we need a few ideas for ‘moving things along’. Have you guys ever experienced this?
Chouchou1234
Is there anything dietary wise you might have eaten that could have contributed? I fancy the mince GF pies we’re having a bit of a slowing effect on my motility this year. Never happened before!
Chouchou if you are still up - phone 111 in the morning. Very early. You will have more chance of getting through. They need to help you navigate this, liver is essential in converting levothyroxine so if it is flagging and your gut is struggling this could reduce conversion of FT4 to FT3.
Do what’s needed to navigate this and keep things moving - not ideal but needs must.
Chouchou1234 I'm thinking that adding quite a large dose of Oestrogen (with you being slight) is going to wobble the thyroid uptake, also people with very low BMI tend to have high SHBG which rather blocks the effect of HRT... I'd been looking into this for a friend who is slight and sporty (no thyroid issue according to TSH but certainly acts Hyper) but no matter how much HRT she adds her levels don't improve as I think it is purely down to her lack of body fat which creates high SHBG.
I'd suggest dropping the gel as it probably isn't going to help, have you had any hormone tests, results to share?
No problem... dealing with thyroid hormones is enough to get your head round and then you realize sex hormones are all part of the mix... it's a minefield ( as Chouchou is the original poster she gets every reply, the good the bad and the completely random off on a tangent ones 🙃 🤗)
HRT is a great thing but I'm wondering if adding oestrogen is the right route as you won't benefit from it, it is likely to just push your SHBG higher making less available, it might be that adding testosterone is the better way for you to try and bring down your high SHBG?
Have you had any tests done before starting as balancing your progesterone is really important, many people are oestrogen dominant which could be the case with you hence the high SHBG?
It could also be due to poor absorption of the HRT preparation. Some people don’t do well on skin absorption at all. I’m one. Your friend needs to try different HRT preparations until she finds one that works for her.
This could be true but the issue is with whatever form the high SHBG stops it from being available as it locks it away adding more oestrogen is just going make the liver increase SHBG levels
Only if it is absorbed so regular testing is required. However unlike finger prick thyroid tests, finger prick oestrogen tests are not reliable or recommended. Blood draw is more accurate. Although even then levels change so rapidly that tests are not reliable. The experts use them to double check clinical symptoms but allow for the variance.
Oh yes, finger prick tests are of no use once using transdermal as the tests are so sensitive and it's impossible not to contaminate your sample... I picture my house has a veneer of HRT... along with the dust 🙃
Testing when Peri is tricky when everything is a moving target
Friend has been on a high dose of oestrogen and testosterone for 6 months and all it has done is further increase SHBG, she is Peri and levels still lower than average Meno
How are you feeling this morning? Has the pain subsided?
2 pumps of gel are a standard dose (however like thyroid there is no one dose size fits all) but it’s a high start.
Drop back to 1 pump a day for at least 2 weeks to let your body get used to it. In your position that’s what I would do. You can’t alter the progesterone part but you can reduce the oestrogen. Maybe even only half a pump a day for 2 weeks. Then 1 pump a day for 2 weeks. Then increase by half a pump again etc. any sign of the blocking up of gut, drop back by half a pump and hold for longer.
Dosing HRT is much like thyroid as in most doctors get it wrong, go in too fast. Miss the sweet spot.
I started an Evra patch yesterday, my understanding is that only a pill increases SHBG as it has to go through liver and therefore decreases thyroid hormones. I know patch and transdermal systems don't increase SHBG, but the leaflet says you can get nausea, stomach upsets etc. as side effects of HRT.
If it's that bad why wouldn't you stop it and try a patch? I also don't know what dose you're on, but Evra has 33 uq ethinylestradiol and 200 uq synthetic progesterone
So sorry to hear you’re experiencing this. It sounds awful. Don’t know if you’ve ever been prescribed Prucalopride, but it was a lifesaver for me. I have had surgery for bowel prolapse twice and the surgeon recommended it for me. It stimulates bowel motility. Hope things improve soon for you.
Hi! Thank you for this I even have been taking that for a few years 1mcg am and 1 evening . Just very bloated . How much do you take? When I first started years ago it was a miracle then stopped working then also my t3 was so low 2.1 nothing was working x . Neuro gastro said to stop for a few weeks restart . X surgery prolapse my rectocele is 4.8 cm but can’t have surgery x x thank you . Not sure I should take 2mg tablet one go ? Xx
Oh poor you, I know how horrible a prolapse is 😔 - I was taking 2mg (1 tablet) every morning. Sadly I think I did hear that it can become less effective over time and I think increasing the dose mightn't make much difference. Amazingly since going dairy-free I haven’t needed to take it, as dairy must have been causing the constipation I have experienced my whole life. Going gluten free as well massively reduced bloating and trapped wind for me. I’m sure you’ve tried GF and DF already..
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