I’m wondering if anyone has any insight on the impact of HRT on Levo - Estrogen & Progesterone specifically which are the medications given during a Frozen Embryo Transfer cycle. NICE says there is anecdotal evidence of a moderate interaction between the medications.
The progesterone is taken vaginally and intravenously so not impacted in the gut but the estrogen is orally and a high dose of 6mg per day.
Below are my results. 1st test was at the start of the medication, 2nd result on the day of embryo transfer, 3rd result when I stopped the medication.
The TSH increase is quite substantial.
You’ll see I upped my dose to a flat 75 from 75 - 6 days / 50 - 1 day half way though but such a small change shouldn’t have made a positive difference.
Hopefully this post helps others as the IVF docs want our TSH below 2.5
Caveat - pls ignore my FT4 as I do take it before I test (naughty naughty)
Thank you as always 😀
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Not my subject but oestrogen increases the binding of thyroxine to proteins and so reduces the amount of free thyroxine which will push up TSH. So, with increased oestrogen you have the same TT4 but lower fT4 and hence higher TSH.
thanks Jimh yes I had read that also. I will have to speak to my clinic and show them the results to understand how much I should increase the dose during the taking of these meds. Then return to normal dose afterwards
Are you testing correctly, 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)
All three results show Ft3 is too low
Last two results shows you need dose increase
When were vitamin D, folate, ferritin and B12 last tested
Thank you Slow Dragon. I try to test consistently at 7am because I have to leave the house for work. But I do take my Levi before so I generally don’t pay too much attention to the FT4. I know I should not take my Levo but I have always done this so I am comparing consistent results.
I have had to test every 2 weeks ish for a long time to ensure my TSH is stable for IVF because I has a thyrtoxic episode where I was over medicated despite being on my normal dose. I think you call it a hyper storm
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Underactive Thyroid and IVF- Blood results-advice needed please.
Surprising blood test results on small dose of levo.
TSH high level before transfer :(
TSH during IVF
