Thyroid ok but oestrogen low?

[Fizzwhizz]

Hi, on recent bloods to check thyroid etc my t4 levels are Free Thyroxine (FT4)

12 - 22

pmol/L

17.9

I re-stated HRT 3 months ago 25mcg patch and my oestrogen levels are still pretty low I think.

17-Beta Oestradiol

pmol/L

<18.4

Male - Oestradiol (pmol/L)

41.4 - 159

Female - Oestradiol (pmol/L)

Follicular: 114 - 332

Ovulation: 222 - 1959

Luteal: 222 - 854

Post-meno: < 505

Please note change of reference range 23 Oct 2022

So I’m assuming my symptoms now apathy, low mood etc are menopause related not thyroid symptoms? There’s an overlap but I think my thyroid results show I’m responding to the Armour treatment and need more HRT?

Thanks

[TiggerMe Ambassador]

Possibly a combination of both as your fT4 is only 59% do you have any idea how well you convert to fT3?

I find I need to keep my Oestradiol above 200pmol/L to alleviate symptoms

EDIT

Just read your last post and the bottom of this post and see you are on NDT 🤭

Free T4 (fT4) 17.3 pmol/L (12 - 22) 53.0%

Free T3 (fT3) 6 pmol/L (3.1 - 6.8) 78.4%

T4:T3 Ratio 2.883 

So these are pretty good results, whether they are your optimal level 🤷‍♀️

So yes I'd tackle your sex hormones 🤗

[Fizzwhizz in reply to TiggerMe]

Thanks, no I don’t know how well I convert T3. I’m on armour which has both so I might not be converting much. I’m on 1 1/2 grains and at my last review the thyroid GP was happy with my thyroid results which had picked up from being very low but in range. No idea how I convert the HRT either but unfortunately I have had spotting on and off too. I just feel so ‘meh’ and can’t be bothered with anything which is the worst symptom for me. I have a review soon so I can ask about maybe upping the armour. It’s difficult to unpick it all.

[TiggerMe Ambassador in reply to Fizzwhizz]

Sorry, I hadn't realized you were on NDT when I wrote that bit, just assumed you were on Levo and with no fT3 result... your thyroid results are good so I'd think tackling your very low oestradiol would be a good next step 25mcg patch is a very low dose why not try sticking 2 on for a couple of days and see if that starts to help?

[Fizzwhizz in reply to TiggerMe]

Thanks. Yes, GP left me with that option so I upped to 50 mcg last week. Still not feeling any different but I suppose it takes time. 🤞

[TiggerMe Ambassador in reply to Fizzwhizz]

Still a low dose but it may just be that you don't absorb well from patches, have you tried the body identical gel or spray?

[TiggerMe Ambassador in reply to TiggerMe]

I'd stuck 3 x 50mcg patches on before I noticed any difference then swapped to the spray

[Fizzwhizz in reply to TiggerMe]

Thanks, that’s helpful. I’ll see if that’s an option at the next review or maybe it’s time to try another form of HRT.

[Fizzwhizz in reply to TiggerMe]

I was on private treatment and bio identical cream before. That was so much faff and expense for a poor outcome. She (private GP) didn’t understand thyroid hormones at all so my HRT was never going to be optimsed with her.

[Tina_Maria in reply to Fizzwhizz]

I wasn't getting on with tablets or patches for the HRT, so I have been on oestrogel, which is quite easy to dose. I am sure they did, but did they prescribe you progesterone as well? If on HRT you should take progesterone whilst on oestrogen to avoid build up thickening of the womb lining - just a thought as you mentioned spotting.

[Fizzwhizz in reply to Tina_Maria]

Thanks maybe the patches don’t suit me the best. I’ll ask at my review. Yes I’m on progesterone and have been tried on a higher dose of that.

[Fizzwhizz in reply to TiggerMe]

Thanks this is my recent Free T3

3.1 - 6.8

pmol/L

5.4

So it looks like the HRT. My testosterone is so none existent it’s off the range too but I suppose one thing at a time. I’m just a bit worried about spotting again but I suppose we can try the increase HRT and see.

[TiggerMe Ambassador in reply to Fizzwhizz]

They generally like you to have been on oestrogen for a year before adding testosterone

[Fizzwhizz in reply to TiggerMe]

Yes, I know they like to optimise treatment. Unfortunately I’ve been on and off HRT and titration of doses for yeas, as it wasn’t really working for me. I only got Hashimotos diagnosed recently via a private GP so HRT was never going to be optimised unfortunately until that was treated and my body wasn’t not coping with the additional sex hormones either hence the spotting…. 🙈

[TiggerMe Ambassador in reply to Fizzwhizz]

It's a juggle as all hormones interact, I thought spotting is generally caused by low oestrogen? You might well have to tweak your thyroid dose when you get your sex hormones back up

[Fizzwhizz in reply to TiggerMe]

Thanks, I’m not sure. I assumed spotting was a symptom of things not being balanced. It is complicated with hormones but at least my thyroid is being taken into consideration now which wasn’t the case before.

[WestElf]

Hi Fizzwhizz

I’m new to all of this thyroid stuff but been experimenting with HRT for over two years. All background in my bio for your interest.

My specialist got my thyroid hormones optimal but I was still feeling horrible. Increased estrogen last week and already feeling marked improvement (although this usually deteriorates for me) but still fairly rubbish. I feel there’s a long long way to go with balancing it all. But I think tackling estrogen (and soon testosterone) feels like the right next step for me.

Hope that helps.

[Fizzwhizz in reply to WestElf]

Thank you. I had a quick read of your bio and I can see similarities. Not wanting to be with people (but yet for me feeling disconnected) is something that speaks to me as well as no appetite. I just have zero interest or enthusiasm in food and don’t get enjoyment from it. That’s how I feel about life currently. I’ve been on the merry-go-round of HRT tweak-ments for the last 5 years. I think the HRT possibly caused my by then failing thyroid to really struggle but my NHS blood tests remained within range apart from due to a referral to NHS endo they now show my antibodies are sky high but all she said was I may develop a thyroid condition in the future. 🙈 At least my thyroid now seems to be on target so hopefully I can improve my HRT regimen now. It’s helpful to know you and others understand how it feels.

[WestElf in reply to Fizzwhizz]

Yes, same, absolutely zero interest in food and no enjoyment from it. I also have slow swallow reflex and a fear of eating to make matters worse. Dread all meals and eating.

Levothyroxine has improved the swallow reflex but has worsened the lack of interest and fear. I’m hoping estrogen and testosterone will help with those.

And yes, I used to be a highly motivated and enthusiastic person but I live a very small life now.

Sorry I’ve just made your post all about me. It is reassuring to hear you have some similar feelings and experiences though so thank you. Please keep sharing on here 🙏

[Fizzwhizz in reply to WestElf]

I can understand how the loss of interest in food and the anxiety about swallowing combine to make it unappealing. I’m just so uninspired and underwhelmed by the whole eating thing. It’s a very strange feeling.

Ditto to the small life. In my head I know what I need to do to improve matters but I just can’t seem to find my mojo and push on through. I wasn’t like this before either.

It’s helpful to share and I read other posts that say either finding the right regimen or adding in testosterone works wonders. At least we now know we have thyroid symptoms too to consider previously I had no hope of improving things with HRT as I wasn’t dealing with the full picture.

[WestElf in reply to Fizzwhizz]

Yes absolutely. Thyroid hormones first and then sex hormones is what my dr says. And I too have high hopes for the testosterone!

I also wonder if I need a much much higher dose of oestrogen too - I hear so much anecdotal evidence that would suggest current recommended doses are extremely conservative… I wonder if oestrogen dosing is like thyroxine dosing - your body will keep recalibrating to increased doses and you won’t feel fully better until you’re on the correct dose for you… also likely to feel worse before better… I just wish we knew more about women’s health!!!!

[Fizzwhizz in reply to WestElf]

Yes, I felt a boost initially on my oestrogen patch but it soon wore off. We deliberately went in with a low and slow approach but it’s horrid not feeling your best self and trying to be patient. Here’s hoping we get there in the end.