Hypo and Menopausal

[Pixie50]

Good morning you lovely people does anyone have any information surrounding thyroid meds and HRT? Since taking HRT I feel more hypo and my main symptom is a lot of hair loss. GP is trying to help but doesn’t really understand and still only goes by TSH. Do the hormones interfere with each other? I make sure I take thyroid hormones in the morning and HRT in the evening. I take combination of T4/T3 (50mcg/25mcg which was fine until the HRT started) and now 1.5 sachets of Sandrena p/day. It’s so complicated being female! TIA

[TiggerMe Ambassador]

Yep, not unusual to have to tweak things as all hormones have a knock on effect, what are your latest full thyroid results looking like? You have an unusual thyroid dose ratio

[Pixie50 in reply to TiggerMe]

Thanks for replying Eeyore. Having bloods done again at the beginning of March. GP doesn’t really understand and this is the only dose of T3 that she will agree to even though I purchase myself as they won’t entertain an endo as TSH was in range! Can’t see how as being on T3 will suppress that. Can you give me any advice on the dose ratio. I’m finding it all really overwhelming tbh and can’t get the symptoms alleviated since being menopausal. I was fine for years beforehand when I was taking NDT but since covid I can’t source regularly enough and prices have rocketed so has to go back to T4/T3 combo with a clueless GP.

[TiggerMe Ambassador in reply to Pixie50]

There are no hard and fast rules, we all need what we need but like you say T3 usually suppresses TSH but for many it also suppresses fT4, I find even with T3 I need to keep my fT4 above 60% which for me requires a dose of 800mcg a week

What were your last results?

Do you have any results for folate, B12, Vit D and ferritin?

[Pixie50 in reply to TiggerMe]

Wow! Think my GP would have a heart attack with that doseage. Because I’m not firing on all cylinders at the moment don’t have the fight in me. Last results nearly a year ago and don’t have a copy unfortunately. I’m booked in for some in a couple of weeks. I already have B12 injections so that should be fine but will ask for the others to be tested. Thanks for the advice

[TiggerMe Ambassador in reply to Pixie50]

I weigh 72kg so x 1.6 = 115 which is standard guideline dose, sounds like your GP has other ideas?

5 days 100mcg and 2 days 150mcg

[Pixie50 in reply to TiggerMe]

I weigh 56kg so really should be on 90 then? Yes she doesn’t have a clue really

[TiggerMe Ambassador in reply to Pixie50]

Makes the 25mcg T3 sound even more extreme unless you have uptake issues... and not tested for over a year?? She really is clueless

[Pixie50 in reply to TiggerMe]

Yes seems that way. I am still learning so not sure what uptake issues mean? I’ll have to learn everything so I can fight for it. So I should really be on 90mcg T4 due to my weight and my T3 doseage should be higher as well? How is that worked out?

[TiggerMe Ambassador in reply to Pixie50]

I would have thought 90mcg would be a more sensible starting point and more likely half as much T3 as it is strong stuff and too much is as bad as too little

We are in the dark without full blood results, I'd suggest you grab a private test kit from MMH or Medichecks as I don't suppose your clueless GP does more than TSH?

[Pixie50 in reply to TiggerMe]

Great thanks for the advice Eeyore100 I’ll order some tests then post the results on here and at least I’ll have a starting point. No unfortunately she doesn’t. Sometimes she does my folate but I presume they are ‘in range’ as I’m never contacted

[Buddy195 Administrator]

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. There is also an ability to post questions.

healthunlocked.com/redirect...

Like thyroid medication, I’ve found that HRT also needs tweaking to find an optimal level. With both, I only increase/ decrease super slowly as I’m very sensitive to change and don’t want to miss my sweet spot where I feel most well.

[Pixie50 in reply to Buddy195]

Thanks Buddy195. I do go on the balance app regularly however I can’t find anything specific to HRT/Thyroid meds but will keep on it. Hope you’re feeling well

[SlowDragon Administrator]

Hairloss frequently low iron/ferritin

50mcg is very low dose levothyroxine

Were you on higher dose BEFORE adding T3

Approximately how much do you weigh in kilo

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

T3 ….day before test split T3 as 3 smaller doses spread through the day, as 1/2 and 2 x 1/4 tablet…..with last 1/4 tablet approximately 8-12 hours before test

use sharp craft scalpel to cut tablets into 1/4’s

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[Pixie50 in reply to SlowDragon]

Thanks SlowDragon. I have been on all doses of T4 but yes was on a higher dose of levo beforehand. Unfortunately I have a GP who just doesn’t get it so panics when my TSH is suppressed so reduces levo even though I have tried to explain to her. She’s always talking about keeping me ‘safe’ I’m at my wits end tbh as feel no one listens. Haven’t felt well for over 12mths now. Thanks for info will follow up

[SlowDragon Administrator in reply to Pixie50]

So you need to get FULL thyroid and vitamin testing

Come back with new post once you get results

Highly likely your Ft4 (levothyroxine) is below range

[Pixie50 in reply to SlowDragon]

Will do thanks again for all your help