Hi. Have people who are hypo and use HRT gained weight since starting it? Everything I read re HRT, claims it can cause weight gain, which to a Hypo/Hashi sufferer, this is the last thing you want to hear.
What have been people's experience?
Thanks, appreciate it.
It depends on the type of HRT. Body identical transdermal estradiol and micronised progesterone (Utrogestan) are said not to cause weight gain, whereas oral estrogen messes with thyroid hormone levels, lowers free cortisol and can lead to weight gain. Progestin (synthetic progesterone) can make this worse.
So, avoid oral estrogen and progestin drugs like Elleste and Kliovance and opt for Oestrogel, Sandrena, Lenzetto or patches, and combine with Utrogestan if you still have your womb.
Is Utrogestan Bio-identical?
Yes it is.
You need progesterone whether you have a womb or not - to do with cortisol among other things
Not according to most sources. It would seem estrogen only decreases the risk of breast cancer whereas combo therapy increases it slightly.
Sunflower64, can you cite where you read that info? As far as I am aware there has been no research on topical oestrogel or utrogestan, all the research was done on the old style drugs.
This is just one article of many:
breastcancer.org/research-n...
Unfortunately the article won't load fully. From what I can see it does appear to be based on very old data and is therefore almost certainly not conducted on women using topical oestrogel and Utrogestan. This is key information. As you say, there is a lot of info available and it is helpful to point people in the direction of the latest medical opinion so that they can make a well informed decision. It is not helpful to make generalised statements without backing it up. B
But " most sources" haven't done any recent research that was not funded by pharmaceutical companies, and what research there is about "combination therapy" mostly deals with horse pee (aka progestin), not actual human-identical progesterone. See, for example: virginiahopkinshealthwatch.... . For most women, progesterone declines much faster and further than oestrogen at menopause, esp if overweight.
’Horse pee’ is Premarin which is CEE (conjugated equine estrogen) so not progestin which is synthetic progesterone (like norethisterone).
I know that progesterone declines faster than estrogen, but that was not the question. The question was: do you need progesterone if you have had a hysterectomy, since progesterone as part of a HRT regimen is prescribed to protect the endometrium? You said yes, but only referred to cortisol levels. I would love a link to your sources!
Exactly. No company could synthesize mare's milk, so had the idea of telling people that they needed to take progesterone as well, to be safe. That was when people started getting cancer from HRT. Good and bad. Money and lies - what can we believe??
Are you referring to the claim that the body will use progesterone to make cortisol when it is under a lot of stress, leaving you deficient? That is what they say on US forums discussing estrogen dominance. Interestingly enough, some forums blame it on what they call ’Pregnenolone steal’ where the body uses Pregnenolone to make cortisol instead of progesterone. In both cases, taking progesterone is the solution.
As far as I know, progesterone is a fertility hormone, and the reason you need it when on estrogen is that it prevents the endometrium from thickening. It is low estrogen that causes symptoms like hot flushes, night sweats and later on osteoporosis.
Not just that. Progesterone is also used by the brain/body to support immunity, the cardiovascular and respiratory systems, kidney function, mood, and even appetite and weight management. You might also need DHEA and/or testosterone to feel well.
Thank you, that's helpful to know.
I have not gained additional weight with Oestrogel and Utrogestan.
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...
I haven’t gained weight either. I am on oestrogel and initially utrogestan (2 weeks a month cycle) Then I changed my progesterone to the merina coil which is a low constant dose. I haven’t put weight on with that combo either.
That's good to hear. I am only considering HRT as I have menopausal and T3 induced osteoporosis.
Be aware the mirena is progestin, not real progesterone - the type associated with all the nasty side effects
I started hrt a year before becoming hypothyroid and it didn't cause any weight gain. I have gained some weight since becoming hypothyroid though.
Adding: I take sandrena gel and utrogestan tablets.
Thank you, it's helpful to know people's own experiences.
Hypo and been on HRT for over a decade. No weight gain. BUT as someone else has said, it may depend on the type of HRT. Mine is bioidentical, compounded for me with the amounts of each hormone that I need. A friend got HRT from NHS and they gave her 5 x the amount of oestrogen that I use and no progesterone or anything else. She put on about 4 cup sizes (really) and definitely gained weight. She also didn't really feel any better.
Oh, that's not good. I don't really want to go on it, but it has been recommended as a management treatment for menopausal and T3 induced osteoporosis. The last thing I want is to feel more hypo and gain weight.
Just curious: how much T3 did you take to get osteoporosis?
I was told that it would have been due to a combination of things: Ageing and the menopause, gluten issues and taking additional T3. I have had T3 for numerous years through NDT. I did try T3 monotherapy for a very short while but it didn't suit me. There is no history of osteoporosis in my family.
Are you sure that it was T3 that caused osteoporosis, as T3 encourages bone building and T4 encourages bone breakdown (probably, sort of, but not that simple) - obviously you need both in order to keep making new healthy bone: see ncbi.nlm.nih.gov/pmc/articl... and frontiersin.org/articles/10...
That is what the Endocrinologist and Rheumatologist told me, that the menopause, a gluten free diet and taking T3 is a concoction for bone loss.
Well, how many endos have told that you are "fine" as long as TSH is in range, or that you die of heart failure if you take T3. It's not the gluten-free diet that contributes to osteoporosis, but the coeliac disease that made the diet necessary. See theros.org.uk/media/5delxgz... In fact, the phytates in grains can bind to minerals such as calcium and magnesium, which are needed for bones.
It is "normal" for bone density to decrease with age, but some reason, you need the same bone density at 70 as you had at 30 in order to be "well"
I think it very much depends on the HRT in question and on the person itself. We all react differently to medicines and even if it says it should not cause weight gain, everyone is different.
I had a mirena for a long time and had oral oestrogens (very low dose), but GP suggested to change to oestrogel and uterogestan. Did not get on with the progesterone (uterogestan) and put a bit of weight on despite exercising and watching what I eat. Took a while to get the oestrogel dose right but its okay now. I had a mirena inserted again (much lower dose of progesterons, as it is released locally) and my weight is getting better now (slow process though!). It is a bit of trial and error but in the end it is worth finding the replacement that works well for you and the benefits you get.
Thanks!
Hi Mindful Moments 
my experience was that I gained the weight once menopause set in, many years before starting HRT, which I did at age 59 when I couldn't stand the symptoms any longer. You can of course consider starting on the topical Oestrogel and Utrogestan and see whether you gain- there is nothing stopping you changing your mind. My experience of HRT is that it stopped flushes within a month, reduced anxiety, helped me control my bladder ( alongside vagifem) and reduced vulval itching. Goodness knows what else it is influencing that isn't so obvious. Everyone is different and you have to weigh up the pros and cons for you- what are you prepared to put up with? Good sources of info, Balance app as someone already said, Newson Health and the British Menopause Society.
Thank you, appreciate your thoughts.
I would never be without my HRT! My goodness life was over for my brain without it. I am fat, but that's because I can never get my thyroid meds right and I have no energy so am very sedentary and eat for comfort. I hate myself a whole lot less with HRT than I did without it.
I am so sorry to hear that FancyPants54. Maybe worth trying a different type of Thyroid meds, which may work better for you. Thank you for telling me your HRT experience, appreciate it.
Oh I have tried them all, and in all combinations I can think of. Currently on NDT, Armour. It's better than the rest, but it's not right yet. Might need to add some T3 to it.
HRT has made such a difference to me. I got to the stage that I could not read for pleasure anymore. I couldn't focus enough to read a page. I was a life-long reader. HRT gave me my books back. Gave me back the ability to work out new prices for stock in my shop. Stopped me crying about nothing at all sorts of inappropriate moments. Gave me back my confidence in my person, so I could go out alone again. I went through a stage when I could not leave the house alone and hated to leave it even with my husband. I spent my 50th birthday at a friend's house round the corner with 6 friends. And my husband had to drag me there. I just wanted to be alone. I had intended to have a much bigger event for my 50th.
I don't think it was HRT that gave me any of my weight issues. A bit of fluid imbalance at first but that soon passed. I will be on it until I die. I will fight any doctor who tries to take me off it. I went to the Newson Clinic to get sorted out. Now I get all I need from my GP and just have an annual assessment review with the clinic. Who then write to my GP to tell them how I'm doing and what they want me to continue with.
Sounds like you had severe menopausal symptoms. Apart from hot flushes, headaches and poor libido/atrophy, all of which I can tolerate, I have menopausal osteoporosis which is being treated medically. HRT was recommended for bone density management.
I’ve hardly ever had a hot flush. I’m hot and sweaty all the time and have been for decades, probably thyroid related.
Mum has severe osteoarthritis and osteoporosis. She’s never had HRT but has been on alendronic acid for 12 years (max is 5 but no one noticed) and now has a 6 monthly injection treatment. Her bones are in a right mess. Another reason why I intend to keep on with HRT for life.
There is no osteoporosis in my family. My grandmother could bend, crouch and kneel like a teenager at the age of 91. She once fell down a flight of stairs in the night at a hotel age 90 and didn't even fracture or sprain anything. She just got up and said oops I feel silly. A different story for me I think. I am taking a once yearly injection for 3 years ( not the same one as your mother) and it will be assessed from then. I have just started supplementing Lactoferrin which is proven to improve bone density and I need to take collagen supplements. I've tried bone broth, but I heaved so much due to the disgusting taste that it is still sitting in the fridge. I do know a lady that has been on HRT since the age of 40 and she is still on it at the age of 81. It's mind boggling how she was allowed to be on it for that long, but she was a nurse, and somehow has managed to coerce her doctor into staying on it. She has dreadful osteoporosis, bent nearly double and has just been diagnosed with breast cancer, so the HRT hasn't helped her much, and not a good advert for it. I am reluctant to take it probably because of her, but also because I prefer to take as least medications as possible.
Well your grandmother was a very lucky woman. That's not the norm.
HRT has changed a lot in the past 20 years. Even the last 10 years. Almost all HRT is now body identical and applied through the skin for oestrogen and through a capsule for progesterone. These types of HRT do not affect stroke risk and do not cause blood clots. Although some doctors haven't yet caught up with the new reality, most women starting HRT now will be able to use it for the rest of their lives.
Oestrogen, which everyone once panicked over thinking it causes cancer, has been proven now to no raise risk, and in fact in the past oestrogen was used to treat some forms of cancer, so no idea really why it got a bad wrap. Too much progesterone however does have links with cancer, but it's easy not to use too much progesterone. It's not even a medication if you use the body identical kinds, it's just hormone replacement. Diabetics who need insulin use it for life. People like me with hypothyroidism take thyroid hormones for life. It's no different. The bad studies of the past have been debunked and were mostly down to journalists getting the data wrong anyway.
If your friend has cancer and has been on HRT for a long time, she is perhaps using the old HRT made from pregnant mare's urine and an older progestin rather than micronised progesterone. And anyway, the cancer is just that. There is no evidence it will be from the HRT. The incidence of cancer in the population is very high as we age. I'm surprised she has bad osteoporosis though, I'm going to suppose she's just been on too low a does of oestrogen for too many years.
The best place for up to date factual info on modern HRT and ways of thinking over it's use can be found on the balance-menopause.com web site. It's full of info and pod casts, videos, data sheets, fact sheets, case studies and explanations. Really useful site. I intend to use it for life.
PS. Have you visited the forum menopausematters.co.uk? They discuss all the treatment options available in the UK and their pros and cons. They have hypothyroid members as well.
Yes, thank you. I have found some natural supplements, so I am going to post a query about them, thanks for the advice.
That's another good site, but mostly it's people chatting back and forth rather than a site full of official (as it where) information. However Diane Danzebrink who runs it is lovely and well worth paying to talk too on the phone if you have questions and doubts about anything to do with the menopause and HRT. She has lots of videos on YouTube too. Under her name.
Thank you, appreciate it.
This just popped into my feed on Instagram today. This is the doctor behind the balance.com web site I shared with you. She was also the doctor who helped me get sorted with the right HRT for me at the start.
This new paper is important for anyone considering HRT and worried about the historical bad press.
In the interest of full disclosure: are you getting paid to promote her? Because this forum is also about people ’chatting back and forth…’. As soon as you pay someone for advice, you cannot assume it is unbiased…which is why researchers always have to state in articles if they receive funding from pharmaceutical companies etc…
What!? Of course I'm not getting paid to promote anyone!! Jeeze. Life's hard enough as it is without trying to catch people out for sharing experiences.
If you don't mind me saying so, you seem to be very brittle and sharp with your comments on this thread. Perhaps you should pull back a bit and not jump on everyone!
Thank you for the advice. It saved me a therapy session.
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