T3 affecting sex hormones

[Sunnyyellowlady]

Hi,

I was diagnosed with an underactive thyroid earlier this year. I am currently taking 25mg T4 (50mg caused significant bloating) and 30mg T3 as split doses.

I'm on a high dose of adrenal support as my Cortisol & DHEA were shown to be very low in a Dutch test earlier this year.

Since starting T3 medication, I have noted an increase in anxiety and what I'd describe as many hormonal symptoms.

I am supplementing with Vit B12, Vit B Complex, Vit D& K.

In terms of HRT, I am currently adding back Progesterone & Testosterone. My Oestrogen was very high from implants, therefore I have not used any Oestrogen HRT.

I understand that there is a link between T3 and the reduction of Oestradiol and that when Thyroid is optimised that there should be a balancing of sex hormones. However, I'm unsure how this works with a woman like myself who has no ovaries.

My SHBG has increased significantly since starting Thyroid medication. Again, this will impact the availability of sex hormones.

Can anyone offer any advice on any of this please?

Also, if anyone else is in surgical menopause and has found a specialist who understands both sex hormones & Thyroid in a woman with no ovaries, could you please DM me with their details?

Thank you.

[TiggerMe Ambassador]

My head is spinning a bit at the speed you have ended up on such a high dose of T3 so I can imagine your body might be too 😵

So 3 months ago your results before treatment...

TSH 1.19 Miu/L (0.27-4.20)

FT3 4.4 pmol/L (3.1-6.8)

FT4 13.8 pmol/L (12.0-22.0)

I am currently taking 25mg T4 (50mg caused significant bloating) and 30mg T3 as split doses.

Have you any current results? Highly likely you are over replaced hence the anxiety

High SHBG suggests high levels of thyroid hormone

Progesterone to balance the high oestrogen but why the testosterone were your levels low?

Once the ovaries shut down or are removed it falls to the adrenal glands to deal with sex hormone levels

It's concerning that in the last 3 months you have tried a small amount of T4 and then jumped to a large dose of T3.... it takes at least 6 -8 weeks for levo dose to settle before next increase and unless you are extremely petit 50mcg wouldn't be a full replacement dose and another increase would have been needed, so for most it takes 6 months to get up to the correct level on levo, it's a slow process adding T4 and then looking to see how well you convert to fT3 before thinking of adding a small amount of T3 (5mcg)

I get the feeling you are bombarding your body with excessive amounts of replacements in the hope of a quick fix and not giving it enough time to cope with these changes which puts a massive strain on your system

[Sunnyyellowlady in reply to TiggerMe]

Thanks for replying.

I'm following a protocol as suggested by the Thyroid specialist I'm under, I'm not self-medicating. My most recent results (whilst on 50mg T4 but before starting T3) are:

TSH 0.342 (0.27-4.2)

FT3 4 (3.1-6.8)

FT4 15.2 (12-22)

The specialist felt that the above results warranted the introduction of T3 and he asked me to keep my T4 dose at 50mg. I have only reduced it, because of the pain from the bloating. I also felt an increase in anxiety on T4 alone. I don't have any results since introducing and building up the T3. I am still experiencing hypo symptoms.

My SHBG has always been on the high side, but it actually increased when on T4 only - it was tested as part of the above test, and as you can see by my results I definitely wasn't over-medicated at that point.

Because I have no ovaries, I add back Testosterone, as without it my levels fall way below reference ranges. I'm aware that the adrenals produce some sex hormones, but it's my understanding that they don't take over the job of the ovaries, and therefore the amount of sex hormones available are significantly less than for a woman with ovaries.

I'm following doctor's instructions, and I'm in it for the long game. I have been living a very reduced life for many years due to hormonal issues, and of course want to get well, but I'm not looking for a quick fix as you have suggested I may be. I've had enough experience over the years, to know that there's no such thing.

My post was really looking for advice on the effects of Thyroid medication on sex hormones, specifically in women who are in surgical menopause.

I take your comments and advice on board regarding the speed in which I have added in medication, but as I have said this has been done by following the protocol of my doctor. I have contacted him to explain how I'm feeling and I'm waiting to hear back.

Thanks again.

[TiggerMe Ambassador in reply to Sunnyyellowlady]

I'd be very concerned that someone would suggest adding T3 to these results before increasing T4 so early in your treatment, is this Dr also selling you these things?

T3 really isn't to be messed with as it is incredibly strong, so my concern is for your health, I would suggest testing asap

Free T4 (fT4) 15.2 pmol/L (12 - 22) 32.0%

Free T3 (fT3) 4 pmol/L (3.1 - 6.8) 24.3%

T4:T3 Ratio 3.800 

Your conversion is good and an increase in T4 was required as you were only on a starter dose, the bloating could be due to an intolerance to the excipients or low stomach acid which is common when under replaced, it isn't uncommon to become dairy and or gluten intolerant intolerant when hypo and standard T4 contains lactose... 😕

All hormones have an effect on each other and finding the balance is key... high oestrogen is linked to high SHBG

[TiggerMe Ambassador in reply to TiggerMe]

I don't want to be a downer just want you to realize that you are on an extreme protocol which your body hasn't been given time to adjust too and could lead to bigger issues

[Sunnyyellowlady in reply to TiggerMe]

I understand your concerns. I actually stopped taking T3 yesterday, as I felt so awful. The thing is, I had symptoms on just a quarter of a tablet. Perhaps it's just not for me.

Back to the drawing board.

Thanks

[TiggerMe Ambassador in reply to Sunnyyellowlady]

I'm thinking with your fT4 so low even with added T3 you'd still feel awful as adding T3 often further lower fT4, most need there fT4 above 50% even when taking T3 🤷‍♀️

[Sunnyyellowlady in reply to TiggerMe]

Thanks for your reply and the information you shared. The Dr is not selling me the medication, he prescribes and it's supplied through an online pharmacy.

I've been pretty much gluten free for a long time, but have not eliminated dairy. I've had bloating for many years, but the T4 medication 100% exacerbates it.

I'm actually questioning whether I can tolerate synthetic forms of thyroid replacement, as I can't with sex hormones.

I understand all hormones are linked to each other, but it feels like it's impossible to find a medical professional who thoroughly understands surgical menopause and the implications of it on finding balance together with improving thyroid function.

Thanks again.

[TiggerMe Ambassador in reply to Sunnyyellowlady]

Worth trying dairy free as I noticed the difference within a few days if this helps you need to request lactose free levo (though beware Teva as this contains excipients that upset many) these little things can make a big difference...

I'd suggest increase to 75mcg levo and retest in 6-8 weeks, you are aiming to get your fT4 to around 80% and hopefully your fT3 won't be far behind, then you'll know if you are a good converter or if you have a need for a small amount of T3

I don't think they differentiate with menopause, surgical being sudden much like thyroid issues they treat the outcome the same way replace what is missing.... the reason most of us are here is that they aren't very good at it so self care, private testing and experimenting are often the key to finding our personal sweet spot

[Sunnyyellowlady in reply to TiggerMe]

Thank you.

[Star13]

I’m the same as you surgical menopause years ago due to endometriosis followed by autoimmune thyroid - Hashimoto now Atrophic Thyroid. Been stuck on the same HRt for years but now at last Endo actually testing and waiting for results.

Had same issues as you but I found dairy and soy was an issue but the biggest was getting my levo changed to an oral solution. Once I did that I was able to tolerate it completely and slowly, very slowly push my numbers up to the point that I’ve gone from 3 to just under 14 and my FT3 is slightly over range at 7.2 so may have to now cut back. Perhaps look into oral solution levo if GP will supply and try elimination diet for both diary and soy. Soy is easy cos you can cut it for a week or two then have a soy based coffee and see what happens - I won’t describe here what I had except to say it was enough to know to avoid soy🤪

[Sunnyyellowlady in reply to Star13]

Thank you. I'll look into this. I'm glad things are better for you now.