Levo affecting menstrual cycle, any advice before meeting endocrinologist tomorrow?

[Rubiales]

Hi there,

Trying to conceive following a miscarriage May 2021. Had been struggling with ringing in ears / muscle aches / fatigue and of course the infertility. Recently diagnosed as hypothyroid TSH awas 5.8 but consultant agreed to start Levo to bring down to 1 or 2. was n 25 mcg now 50 mcg.

Results of my latest blood test after 8 weeks on Levo 50 mcg, were

TSH 2.32 [ 0.3 - 3.94].

April was 2.94 (on 25mcg)

Feb was 5.8 (before Levo)

After a few periods of just 15 days, my GP agreed to increase my dose to 50 mcg, I then had a 28 day cycle, but now my period has vanished completely and I've had no menstrual bleeding at all. (Negative pregnancy test results too just in case you're wondering )

Starting to lose heart.. The thyroxine seems to have messed up my cycles completely.. Has anyone else experienced this??

TPO antibody test negative. Haven't had TG antibody test done yet, money is tight at the moment. Have stopped taking multi vits and trying to eat lots of iron rich foods as ferritin came back low.

I have an appointment tomorrow with an endocrinologist for the first time. If you have any suggestions of what to ask for / discuss please let me know... I'm wondering if I need to request another dose increase..

Thanks for everything, this forum has been massively helpful to me.

[SlowDragon Administrator]

Replied on previous post too

Ringing in ears (tinnitus) common hypothyroid symptom and also linked to low B vitamins, especially B12

It typically takes 6-12 months to get dose levothyroxine increased slowly upwards in 25mcg steps until on replacement dose

As metabolism increases, all the other hormones have to catch up

50mcg levothyroxine is only a starter dose

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine:

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

[Yeswithasmile]

Hi.

Experience only here.

With a dose raise in levo, yes my periods get further apart. However I’m 50 and so obviously delighted at this. I have always had a short heavy cycle but a levo raise means I am likely to skip one and then they go to 28 days. T3 seems to not affect this at all.

I know that this is a difficult time when you’re trying for a baby and the thought of delays can be overwhelming but… you need to get this right to have a happy healthy successful pregnancy so please don’t lose heart. Your cycle should come back and it be easier for being correctly medicated. x.

[Rubiales in reply to Yeswithasmile]

Thank you for replying.... Yes the idea of this taking months / years to get sorted is overwhelming.. But trying to take the view that my thryoid needed sorting anyway...whether we manage to have a other baby or not...

Thank you for sharing x

[Yeswithasmile in reply to Rubiales]

You do need to sort it and I’m sure it won’t take years. You just have to keep positive and understand that you need to be as well as you can for pregnancy. For you and for baby. I remember trying for my 2nd and when it didn’t happen instantly I found it very hard so I do get it. But I had to post and say this is so important for you to get right now or you could just be setting yourself up for a fall later and that doesn’t bear thinking about. Wishing you all the best for a speedy thyroid pick up 😊

[waveylines]

From your results it seems to me your GP made the correct decision to start you on levo. He started you on a very low dose though. Your results are showing that you likely need a further increase. The reason behind this is your thyroid is struggling more and this is probably why your periods have gone and the TSH hasn't reduced from your last blood test. Currently though you are on a starter dose so really need the increase. Once your thyroid levels are properly restored am sure your periods will return. Mine also disappeared but came back once I was on a much better level of treatment. It does take time because you have to wait 6-8 weeks after each increase to get the full effects on the body.

[Rubiales in reply to waveylines]

Thanks so much for your reply. Comforting to know others have been through the same. I will ask for a dose increase today a.

[limonene7]

My periods have been closer together ever since starting Levo. When I went on levo I ended up with less T3 (the important/active hormone) as I was a poor converter. Basically, my hormone T3 status was much worse on 125mcg of levo than before I started. The only way to know if one is converting levo into enough T3 is to test for T3 (I get this done via Medichecks). This test could be done 'after' levo is believed to be optimised and stabilized.

[Rubiales in reply to limonene7]

Wow that's really interesting... So when just TSH and at best T4 gets measured, I'm still totally in the dark about how efficient a convertor I am?

[limonene7 in reply to Rubiales]

Yes, that's right .🙂

[Rubiales]

Hi all,It's taken me until now to find the words to write this...

The endocrinologist appointment was, as many of you predicted, disappointing. According to her and looking at my results, I'm not a "typical" hypothyroid patient, ie I was prescribed it from a gynaecologist and not as a result of me asking to see GP due to symptoms. The fact that it gave me so much more energy and took away muscle aches etc, doesn't seem to matter. The fact that my period has been totally disrupted doesn't seem to be relevant to her either, can we really "blame" the thyroid for that, she said. Could be stress could be any number of things. I believe it is the thyroxine that has affected my cycles, as I've never this before.

She won't increase my dose from 50 mcg as my TSH is now below the 2.99 that the gynaecologist apparently specified, and my T3 and T4 are "in range". She's not worried about how far through the ranges they are, because I'm not a "typical" hypothyroid patient..

So I'm stuck on 50 mcg, she's agreed to test my cortisol and TSH / T3 / T4 again. But that's it. On 50 mcg, and this level of disruption to my cycle I'm wondering if I've opened Pandora's box and I'm stuck in a half way house of under medication... Would I have been better off not starting thyroxine ie is it more harmful to be undermedicated than not medicated at all, at its highest my TSH was 5.32 earlier this year. Sorry for the rant. Feel very lost and confused.