I have struggled with vaginal dryness, dry eyes and dry nasal area for a few years. I drink plenty so it's not dehydration. My doctor put it down to low estrogen and I am currently using vagifem which has helped most of the time.
My question is........ Is there a link between hashimotos and these symptoms.
When I started my 50 mg levothyroxine I noticed the symptoms completely disappeared until recently when they have all come back about the same time as my tiredness appeared. I was feeling great for several months. I got my thyroid tested again, despite being told not to come back for a year and my TSH has gone up to 3.77.
My GP won't change the dose because it's inside the range. 😠 Is it a coincidence or is vaginal dryness another symptom. It is severe dryness to the point where it affects my bladder too.
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Sunflower535
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Your doctor is not wrong. Low oestrogen does cause vaginal dryness.
What your doctor probably is not realising, is that without sufficient thyroid hormone, your body will struggle to produce oestrogen.
'my TSH has gone up to 3.77'
This may well be part, if not all, of the problem. Leaving you under-dosed on 50mcg levothyroxine means all your other hormones will suffer too. Thyroid hormones is needed for everything in the body and brain to function normally. Without sufficient thyroid hormone, your body cannot produce the other hormones it requires.
You definitely need an increase in your levothyroxine dose. No-one can function forever on 50mcg levothyroxine. TSH needs to be at or around 1 for most people to feel well and function properly when on replacement thyroid hormone.
Thank you RedApple, but how do I convince my doctor? Could I just use the medication I have and up my dose a little and see if it helps or just wait till I go outside the range which might not be long.
If you increase your dose just by using the medication you have, you will run into problems quite quickly. You'll need a repeat prescription before it's due, so that may get refused. But also, next time your GP tests your levels, your TSH may have reduced, leaving your doctor to assume you are still on the right dose at 50mcg.
There is information you can take to your GP read to support your request for a dose increase, but I don't have the links to hand right now (sorry!). So I'm calling out to SlowDragon here because she will likely have up to date links for information / papers you can present to your GP to explain why you must have your dose increased and not be left under medicated.
We have a pinned post with links to information about keeping TSH low when on replacement thyroid hormone. You may find the info you need to show your doctor here healthunlocked.com/thyroidu...
My GP won't change the dose because it's inside the range.
See different GP …..or if necessary an endocrinologist
50mcg is only standard STARTER dose levothyroxine
Guidelines of dose Levo by weight
approx how much do you weigh in kilo
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
TSH should be under 2 as an absolute maximum when on levothyroxine
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Just testing TSH is completely inadequate
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
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)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Testing options and includes money off codes for private testing
Thanks. I will try and ring my Health Centre next week. It's a nightmare getting an appointment but I will push on and try and get my dose changed. I know myself I felt better even when my TSH was above 2 but now I feel I'm on my way down again. Thanks for taking time out of your busy life for to respond.
I don’t know, but I can say for certain there is with Levothyroxine only treatment with a below range TSH, upper range FT4 and middlish range FT3. That and a lack of arousal and orgasm. Thank you for bringing up a sensitive subject.
Your symptoms are synonymous of Sjogrens Syndrome, another autoimmune condition common in Hashi sufferers which affects parts of the body that produce fluids, like tears and saliva.
Many suffer dry eyes and mouth but it can progress to affect other areas such as vaginal fluids and even the lungs mucus membranes.
Having uncontrolled elevated thyroid antibodies can induce other inflammatory cytokines (chemical messengers) that predispose us to other autoimmune conditions. You might find going gluten free and supplementing natural anti inflammatories known to help reduce chronic inflammation help your symptoms improve.
Thank you. I will read up on this and learn more. I have been gluten free for a while although I may have slipped a bit by not checking labels enough. I appreciate you getting back to me.
I was just about to say the same. I was tested for Sjogrens a few years ago as I had an abnormal ANA result, but apparently 15% of healthy individuals have a speckled ANA result, mine could have been due to other AI causes like Pernicious anaemia. Autoimmune diseases go together and its always worth getting tested for Sjogrens.
I'm sure all women have been given the brush off before, I know I have. Funny how men rarely get told its their hormones or they're depressed. But they spout this BS to women all the time.
I hear you, try and rise above this feeling. They are delivering a service we need. We must see it that way. My husband thinks nothing of calling for any minor ailment and gets treated well. I go in apologising for taking up their time and they make me feel dreadful. Try going in with a clear demand and it’s amazing the difference. I’m going to ask to be tested for Sjogrens because my eyes have been awful and even with ovestin I’m not comfortable between doses (and no, haven’t been using ovestin on my eyes 🤣) good luck 🌱
Although I don't have any female parts so no direct experience there. However, I do have Hashimoto's, Sjogren's, and autoimmune gastritis. So I know Sjogren's can cause vaginal dryness, dry eyes, dry mouth, chronic dry cough. A person can have one of those symptoms or all of them.
Hash is associated with Sjogren's and Pernicious anemia.
So maybe suggest you be tested for SSA and SSB antibodies (a simple blood test) to confirm Sjogren's.
Multiple autoimmune diseases including those associated with Hashimoto's AKA autoimmune hypothyroiditis such as Sjogren's, diabetes type 1, Pernicious Anemia are a condition called Polyglandular Autoimmune Syndrome (PAS) type III.
Hello…I’ve had parallel issues. Diagnosed with hypothyroid in 2012, but having never seen an endo, symptoms like extreme dryness in vagina, eyes, skin and nasal membranes have persisted on and off for many years. I have such sore nasal membranes that they sometimes bleed and seem to become infected, so use colloidal silver to treat. I seem to have bladder/uterine prolapse which causes bladder sensitivity. With all the other issues I have tended to relegate these problems but they accumulate and become very overwhelming…
Thanks. I appreciate you confirming that others have the same and there could be a link. Sorry to hear you too are overwhelmed. This site has brought so much reassurance but it takes time getting everything under control. It's not an easy road.
I have the same issue and am also on vagifem like you, I also have hashimotos and I’m on levothyroxine and just started liothyronine. Thank you for sharing about something so personal, I don’t have any answers either sorry, I just wanted to let you know you’re not alone in this, and hearing your story makes me feel less alone too, so thank you x I hope you get some improvement if your symptoms x
Sorry that you too have these issues. Thank you for taking the time to respond. It's good to know I'm not alone. I will contact you if I find any answers.
Hello, just to say that I’ve suffered for years with dry eyes & recently developed vaginal dryness too. I presumed it was menopausal but it may all be connected. I’ve found Gina, bought over the counter, works really well. You might like to ask your GP for it or even buy it & try it out. It’s over £30. The first box goes quite quickly as you have to build the dose but the second box lasts a long time.
My optometrist has told me that he sees a lot of patients with thyroid issues, who also have problems with dry eyes. With your current TSH I would think that you are undermedicated. One result of insufficient thyroid hormones is that tear production is reduced, which leads to dry eyes. Here is some (older) research paper about this: ncbi.nlm.nih.gov/pmc/articl...
From what I understand, high antibodies can also affect the eyes.
I was also told that hypothyroid can cause dry eyes by the opthalmology dept. Its more often associated with hyper but some hypo patients get it as well. I was told I had tear film insufficiency.
That's good to know. At least now I know there is a link and I need to work at getting everything sorted. Appreciate your message. It helps me a lot knowing it's not just me.
Ah interesting my antibodies shot up last August/Sept and my eyes were constantly blistered and sore. Saw multiple opticians had allergic reactions to drops, old school pharmacist explained how to use a microwave warm bag for at least 5 minutes every night then taper to once a week, that forces the oils to be released in the lids, can’t see a blooming thing afterwards but it worked a treat. Highly recommend .
Antibodies now lowest they’ve ever been and it’s a bit better, I hadn’t made the connection, thank you 🌱
Like you I have sjogrens alongside Hashis. It’s always been quite low functioning, but Lately I’ve had horrific dryness of the mouth which sips of any liquid doesn’t quell. I wondered if it was the higher dose of ERFA I’m now taking or if not why this has happened… I’ve recently had kidney and uti problems too so am going to go back on vagifem as it doesn’t only help vaginal dryness the oestrogen helps bladder issues too so I’m told! You’re not alone as others have said. I had to stop wearing contacts 17 years ago due to dry eyes too! 😭
Hope you find things that help and do share here if you do 💜
Oh thank you. I will certainly share anything I find out. I am using vagifem twice a week but it just didnt seem to be working anymore that's when I thought could it be linked to hashimotos. It's a minefield but hopefully I will get back to normal soon. Plenty to think about and research. Thanks again.
It is possible to buy artificial saliva products without prescription although I don't know where you would source them. I've never bought them despite the fact I do need them, because I have the same dryness problems that others have mentioned.
There is a list of the artificial saliva products the NHS has approved on this link :
You might like to try a different toothpaste for your dry mouth & try drinking bottled water. In the past I’ve had huge problems with tap water even if filtered. Swollen red indented tongue, very sore. Turns out local water company put extra chemicals in as the local pipes were cracked. They didn’t bother to repair the pipes. I moved to a house with piped spring water. Problem gone.
Tooth paste can make the problem worse too. I use a strange one now which absorbs toxins using fine clay. Sold by Toxaprevent. Nouvelle Health. I like it, it doesn’t sting
I too have these symptoms, the dry eyes have now affected my sight. Nothing works for eyes, mouth or vaginal dryness for me, but I'm being investigated for Sjorgrens syndrome now, another autoimmune condition. Would be worth getting a referral to Rheumatology for testing. I don't have the antibodies, which us a big tick for NHS, but you can still be Seronegative fir the condition.
Hi Ontherun81, just wondering whether you are aware or have tried sea buckthorn oil tablets, i have found they make a difference to my dry eyes, the ones from healthspan are the best i have tried
Ooh no not heard of those...where do you get yours from? I'm always looking for new options to relieve symptoms! Eyes are quite blurry without reading glasses so concerned about further damage.
Hi these are the ones I get healthspan.co.uk/omega-7-se... I have tried other makes from Amazon but in my opinion these work the best, there are usually vouchers or discounts available if you search on Google for Healthspan, I tend to buy in bulk when I get a good code
I’m in the same position at 32 years old and have been put on vaginal estrogen. My mum has Sjogrens but doc wasn’t interested when I mentioned it. Said that would be severe dryness
I have Sjogrens which often goes along with thyroid autoimmune disorders. It flares up from time to time, but I haven't found any obvious triggers for these worse times. As well as the dryness, one of the main and most common symptoms is fatigue. I'd suggest that dryness and fatigue together make Sjogrens a possible candidate for your issues. LDN (low dose naltrexone) has helped me a lot with the dryness and to some extent with the fatigue. You can find out about it on the LDN Research Trust website and get it prescribed via Dickson Chemist in Glasgow who operate a great online consultation and prescription service and then deliver it to you monthly.
I had issues with dryness for years with excruciating pain which has disappeared after managing to get bio identical hormones. For me I think it was related to menopause because I’m on NDT and had great improvement in pretty much all my other symptoms .
I’m in Canada so not sure how helpful this is, but after testing I was prescribed DHE and topical progesterone, estriol and testosterone. Wellsprings health sell progesterone and oestrogen creams if you want to give them a try. I still source my progesterone cream from Wellsprings as it’s the cheapest I’ve found - it’s a UK site but the creams seem to come from the US.
as has been said 50mcg is a low dose so be brave and show doc latest test results. Any other symptoms like feeling cold or hair loss ? Trouble is when your under treated and tired it’s so difficult to fight your corner so if you can take a friend to back you up do.
How I wish there was a booklet to give to doctors explaining why TSH is unreliable especially in older people, anomalies, non-conversion etc etc…..and wrongly made assumptions.
hi, lots of good advice here already. I’m in the states and thought I’d add the only thing that has helped me so far with vaginal dryness is hyaluronic acid. My obygn prescribed it (vaginal gel) for me since I cannot take any hormones. It is from a compound pharmacy. All of the research I’ve seen state that this is completely safe. It has helped me so much, that I wish I had learned of it sooner.
Difficult topic but needs to be talked about. I have had a very dry vagina since I went through menopause. (It was dry before but nothing like this.) I'm hypo. Not sure if it's related to that, as it might be atrophied vagina. I read once that one third of women have serious problems with sex after menopause (dryness causing discomfort and pain), one third have no change and one third find sex better. Falling in the first category, all I can say is PTL for gel, there wouldn't be anything without it. Apparently there are laser treatments for atrophied vagina (the "Mona Lisa touch" for example.) Haven't tried that yet, as is fairly expensive.
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