HRT and Levo

[catlover339]

I've been reading the suggestion that these 2 drugs should not be taken at the same time. Can anyone tell me why/ give me their opinion or experience please? If they should not be taken together, it's going to be difficult for me, as my HRT is in the form of patches and therefore delivered as a continuous dose. Thanks in advance. Anne xxx

[nostoneunturned]

Maybe I am wrong, but I thought that even taking levo at different time from HRT or any other oestrogen bearing therapy was not the point, as just having extra oestrogen in the body might cause a need for additional levo.

These links might be helpful:

nejm.org/doi/full/10.1056/N...

ncbi.nlm.nih.gov/pubmed/151...

[helvella Administrator in reply to nostoneunturned]

NSU,

I think you are right (though at this moment I have not followed your links).

So the issue might well translate into one of making sure you get your dose and blood tests checked whenever anything changes on the oestrogen front. E.g. start HRT, finish HRT or adjust dosage of HRT.

Clearly everyone with oestrogen in them also has thyroid hormone. I don't think it right to overstate the case for keeping them separate. Though any oral form should be taken well apart in time from levothyroxine.

[nostoneunturned in reply to helvella]

Rod and catlover339:

Yes, this is the case: oestrogen therapy can increase the thyroxine need.

This is the link to the complete paper which can of course be accessed from my top link above. The last paragraph of the Discussion makes clear that any oestrogen acquired by pregnancy or therapeutic means can cause a need for an increase in thyroxine in hypothyroid women, because they have a fixed amount of thyroxine, but healthy women's thyroids are able to meet the demand. Interesting.

nejm.org/doi/full/10.1056/N...

[marmaris in reply to helvella]

Hello helvella I am seeing my gyno tomorrow and thinking of going on the combi patches for hrt. I am 57. Came off oral hrt before Christmas but all aches and pains are back and urination frequency. I have read on here that I would need to up my dosage of thyroxin. Currently taking 50mcgs Levo (recently reduced down from 100mcgs by Endo) and 30mcgs of T3. Your advise would be welcomed

[Heather77]

Hi

I take 125 mcgs of Levothyroxine and use HRTcombi patches ()l and have had no problems.

Best wishes

Heather

[Hidden]

Hi nostoneunturned,

I have no ovaries, so I must take oestrogen replacement therapy. This is done by implant about once a year. I have a constant supply of oestrogen running through my body. I also take thyroid hormones for Hashi/ hypo. I have never had any problems at all. Anything that is swallowed must be processed by the liver. Your patches will be going straight into your blood stream and should not interfere with your thyroxine. Obviously I'm NOT medically trained but this is how my endo explained it to me! You may find that you will need to take slightly more thyroxine than you would do without HRT.

XXXXX

[Hidden]

(excess) Estrogen increases production of thyroxine binding globulin (TBG). TBG attaches to thyroid hormones-higher affinity to T3, making less of free thyroid hormones available to your body tissues. That's why often while on estrogen replacement, the doses of thyroid meds often need to be increased.

[Hidden in reply to Hidden]

...so you have to closely monitor your free T3 and T4 levels, while on HRT.

[deniD]

The opposite for me I had to decrease!

[smelly]

It can be extremely dangerous as certain HRT when taken with thyroid meds can bring on a heart attack. And some Dr's who quite frankly haven't got a clue have been known to prescribe it to there patients.

Air on the side of caution.

[catlover339]

Many thanks everyone. All very helpful xxx

[joannec123 in reply to catlover339]

Im having the same problem now... im finding my hypo symptoms are coming back!

What happened in the end?

[PoppyRose]

I'm just at this point of considering HRT... BUT ONLY if the GP's agree to treat me with the correct dose of Levo in the first instance. (ongoing boring battle).

Interesting reading all the comments and links.

Good luck.

[hopem]

Please don't worry about HRT and Levo taken together. My private specialist who has looked after my thyroid condition for the last 15 years, put me on HRT three months ago. He would never advise it if there was any kind of risk (Apart from the usual risks of HRT). I hope you get to the bottom of this and feel much better soon. X