Progesterone v thyroid medication

[Jojomcc]

It's me, looking for input ... I supplement with progesterone cream, I started this 6 months ago, I take my levothyroxine at 6am 150mg prior to starting progesterone my levels were optimal both T4 and T3 ... now they keep dropping since then, can continuously supplementing progesterone cause absorbtion issues???

[RockyPath]

The only clinical reporting I found just now discusses the effects of progesterone on thyroid hormone availability and it suggests the opposite of what you've noticed.. We on this discussion board are definitely in unexplored territory. There's very little medical curiosity about thyroid -- hence the tendency of doctors to jump to conclusions based on the single metric of TSH.

This article suggests the opposite. Oral progesterone increased serum thyroid hormone levels.pubmed.ncbi.nlm.nih.gov/232...

The other one acknowledges that thyroid dysfunction is more prevalent in women than men and they've drawn a link between progesterone and follicular gene expression in the thyroid gland (where the hormone is produced).pmc.ncbi.nlm.nih.gov/articl...

This entrepreneurial website suggests a direct link between low sex hormones and hypothyroidism: womenshealthnetwork.com/thy...

Sometimes we can't go by things that are measured in blood samples. The blood is only the transporter of the free hormone. It has to reach the cells before it goes to work. I guess the appropriate question is, irrespective of lab measurements, how do you feel since starting the progesterone treatment?

[TooManyTablets in reply to RockyPath]

That's really interesting reading about progesterone and thyroid hormone levels.

I'm currently on a three month trial of HRT (100mg Utrogestan and estradiol transdermal spray) and I take 75mcg Levothyroxine.

I'm curious to see if the micronized progesterone in my capsules has any affect on my thyroid hormones so hopefully I can get these levels tested again towards the end of the three months.

Since starting the HRT (it's only been about 3 weeks) I'm tentatively observing my symptoms and for any side effects. Dare I say it, but there may be a slight improvement in my cognitive function. It's only a very slight change but I'm feeling a little more hopeful now. It may only be temporary but I'll have to wait and see.

If I can tolerate the HRT my dose may need changing and these next few months of experimenting will hopefully provide considerably more improvements for me.

Thank you for sharing this information Rockypath, xxx

[Jojomcc in reply to TooManyTablets]

They wouldn't give me utrogestan because like you it can only be prescribed as part of combination her, so i'm having to use onas bioidentical progesterone cream, but I'm wondering if that is causing my medication absorbtion issues or it's something else.

[Jojomcc in reply to RockyPath]

I feel well on it, but my body would tend to disagree, as I'm losing more hair, I'm gaining more weight even tho I'm eating healthy and at the gym, and I think it's because of the depletion of my thyroid levels

[RockyPath]

When I began HRT, the pharmacist advised that the estradiol “sucks up thyroid hormone” and suggested I might need to increase the dose.

You’re describing this effect.

The estradiol is loved by the brain and it feeds construction of new muscle fibers.

But you need more thyroid hormone now.

I was taking 1 grain (60 mg NDT), but with HRT I’m buzzing along on 2-1/2 grains, in university full time and my brain is clicking better than it has since menopause and the traumatic brain injury,

[Jojomcc in reply to RockyPath]

I don't take estrogen tho, just bioidentical progesterone cream 800mg per day, but I'm wondering if it's having the same effect it's just weird how my thyroid medication was making my levels optimal at first and now are so low

[GreenTealSeal_ in reply to Jojomcc]

Progesterone can deplete/lower estrogen over time so this may be worth double checking…just a thought!

[GreenTealSeal_ in reply to RockyPath]

I had heard that transdermal estrogen has less/no effect on thyroid levels but that was only what my endo told me! I think oral estrogens can have a bigger effect on thyroid binding proteins and thyroid function in general. 🤷‍♀️

[Jojomcc in reply to GreenTealSeal_]

I wouldn't take estrogen, high estrogen causes endometrial thickening, I have extremely heavy periods is why I'm taking progesterone to try balancing my hormone levels out

[GreenTealSeal_ in reply to Jojomcc]

Ah ok. Just to say that heavy periods can also be a symptom of hypothyroidism too.

[Jojomcc in reply to GreenTealSeal_]

Yeah it was after I was diagnosed with hypothyroidism I started bleeding heavier, my gynae wanted me to have the mirena coil or mini pill, but they are both progestins and not bioidentical progesterone...

[Jojomcc in reply to GreenTealSeal_]

They refused to give me bioidentical progesterone, so bought it myself

[GreenTealSeal_ in reply to Jojomcc]

If I were you’d I’d probably pause progesterone and try and get thyroid optimal first and see it that helps resolve your other hormone issues.

If not you could always tell a ‘small white lie’ to your Dr that you suffer with bad PMS, they should then be able to prescribe 200mg Utrogestan (micronised progesterone) to take cyclically.

Just a thought, hope you can work it all out and feel better soon!

[Jojomcc in reply to GreenTealSeal_]

My plan was to stop when my next period is due, because I'm only just by with my period and if I pause just now, I will start bleeding in a couple of days, at least then it will be my regular time... Aye if I see a change to my thyroid levels after stopping, I will change what days I'm taking it, cause right now I'm taking it everyday, whereas I can change to days 14-28 ... Aw yeah I could try that but my doctors would probably hit me with something else because I asked for utrogestan at my gynae clinic 🙄

[GreenTealSeal_ in reply to Jojomcc]

Sounds like a good plan! It’s annoying how all this hormone stuff is very much ‘wait and see’ isn’t it!?

You can also buy utrogestan without a prescription from abroad. I bought some from Spain recently to trial it. It’s not ideal and NHS should really be paying for it but it’s an option if you’re feeling stuck!

[Jojomcc in reply to GreenTealSeal_]

How have you found it??

[GreenTealSeal_ in reply to Jojomcc]

Not great tbh. But I’m a weird case as my female hormones have never ever done what they should and always been abnormal

[Tina_Maria]

It might be a silly question, do you take the progesterone cream shortly after taking the levothyroxine? Even though transdermal application bypasses the liver and enters the bloodstream directly, if you have taken levothyroxine as well shortly before, this may interfere with the hormones in the bloodstream and could impact how much levo you can use. Perhaps try to apply the progesterone cream at least 4 or more hours away from the levo or take it at night before going to bed instead?

A drop in your T4 and T3 levels could also mean that your levothyroxine requirements have increased and that you may need more hormones. Although normal replacement doses of levothyroxine are 1.6-1.8 mcg per kg of body weight, some people might need more. Or you may have developed absorption issues with levothyroxine, so you would need more levothyroxine to get to your usual levels. If you need increasing doses to get to your levels where you feel well, you could perhaps try liquid levothyroxine, which has a much better absorption profile?

[Jojomcc in reply to Tina_Maria]

No, I take my levothyroxine at 6am, and I apply progesterone around 10/11 am on first application

[ERIC107]

Hi Jojomcc - further to RockyPath's journal paper that suggests that progesterone increase serum thyroxine, I have the following (excellent IMHO) paper that agrees with the finding that thyroxine is increased... BUT goes on to say that they found progesterone also elevates the T4:T3 ratio due to a down-regulation of the deiodinases (DIO1, DIO2) - so they show that progesterone reduces the conversion of T4 to T3!

pubmed.ncbi.nlm.nih.gov/352...

While your transdermal application of progesterone cream is unlikely to affect the absorption or metabolism of your levothyroxine... it may well affect your conversion of the levothyroxine to T3, which could, maybe, lead to a change in your symptoms.

NOTE: the paper comes from the perspective of female reproductive fertility, which is how they frame many of their comments, but the general concept of cross-talk with thyroid hormones is fascinating and you can jump directly to the progesterone section, which is section 2.2 😊

[Jojomcc in reply to ERIC107]

Ahhh so it's not actually the absorbtion of the T4, it's the conversion of T4 to T3 within the body? But surely that would still keep T4 higher .. but reduce T3 low

[ERIC107 in reply to Jojomcc]

In theory - that's what they find, specifically for progesterone. There could be other hormonal/vitamin/mineral aspects at play too, though. I came across the paper as I was looking for links between prolactin (I have hyperprolactinemia) and thyroid hormones.

Maybe you have other, as yet undiscovered, factors feeding in to the changes you've observed?

[Jojomcc in reply to ERIC107]

I'm trying my best to get to the bottom of it all, my gynae just wants to give me idu or mini pill, I will not take any of them, that's odd because I also think I'm high prolactin too, I read about the link between estrogen dominance and high prolactin and low thyroid 🙄 but I need my gynae to work with me to navigate all these things lol I really don't see that happening.

[ERIC107 in reply to Jojomcc]

Uugghh... best of luck! I feel for you - the whole endocrinological maze is an absolute nightmare.

I'm lucky enough to have an excellent Clinical Pharmacist at my GP practice who has been very helpful with HRT - and it was through her that my Hashimoto's was also found. It really is a matter of lucky as to whether or not you can find someone (not necessarily the person, on paper, you'd expect) to help with everything. That being said, I'm still not right - so the search goes on.

[Jojomcc in reply to ERIC107]

Yeah not many doctors seem to know a lot about the endocrine system 🙄 not even endocrinologists lol yeah got to navigate for ourselves! As you say the search goes on

[Espeegee]

I have just been reading a Dr. Mercola article on the progesterone-thyroid connection. Here's the link but I'm not sure these days if it will work or whether you have to sign up to his website (it's free) articles.mercola.com/sites/...

[Mednews4]

began the combipatch and also testosterone injections. Didn’t feel any better, gained weight, didn’t really increase energy and had constipation, scalp acne everywhere and felt like hair was falling out. Went off all and feel less bloated, resumed regularity. Dr recommended stop the combipatch and try testosterone propinate rather than testosterone cypoinate. I plan to get blood tests to see where thyroid is. Been looking into the 100 blood test program that are being promoted online and start from there. Various sites recommend that vitamin deficiencies, adrenal, liver detox, gluten free, dairy free, and checking cortisol may be beneficial. Had tried HRT after cleaning up thyroid levels, to see if it would help with feeling more energy. Thinking maybe focus is really on my bloods and tweaking there rather than adding more (for me). I understand everyone is different. Anyone have success with HRT and thyroid medications at same time? (In mid 50’s)

[Nicole329]

a body only has so many hormone receptors, it’s possible that you’re taking them too close together. Try more hours apart and see if that helps

[Jojomcc in reply to Nicole329]

I take my levothyroxine at 6am, and my first dose of progesterone around 10/11am ... But I have read that eating low calorie diet can cause conversion issues 😬 I had started with a PT trainer who has me on a low calorie high protein diet, so think it's actually that

[samaja]

If your metabolism has improved which is one of the aims of high progesterone therapy, you might need more fuel which is both thyroid hormones and supporting with the sufficient carbs, proteins and fats in your diet. When people increase their thyroid meds, sometimes they can lower progesterone dosing. Another related issue is cortisol levels and also oestrogen clearence.

[Jojomcc in reply to samaja]

I think I've found the reason, I started with a PT trainer who has me on a high protein low calorie diet, and I've read that a lower calories can cause conversion issues,

[samaja in reply to Jojomcc]

Depends what you define as high protein as most women apparently undereat in general and protein in particular. And you also need carbs and healthy fats to go with this as low carbs diet doesn't support hormones.