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Author Topic: Is this Peri Menopause? Can you help me look at this..  (Read 19051 times)

Rosanna

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Re: Is this Peri Menopause? Can you help me look at this..
« Reply #30 on: May 11, 2017, 01:29:29 PM »

There's SO MUCH helpful in it, thank you Wrensong! (What a great name, btw)

I'm at work at the moment so cannot reply fully, but that is all really helpful.

I have an underactive thyroid by the way, so interested in anything you know about the interaction between thyroid hormones and female sex hormones.

I found a very interesting article today that says that oestrogen is a natural 'calcium agonist' and can therefore help women with arrythmias and even microvascular angina....

I have a hunch it's oestrogen I need now, not progesterone....My cycle is still somewhat regular and somewhat predictable in terms of what is felt when, lol...So I'm thinking I might get clues as to what hormone is helping my symptoms if I keep a record....but it does seem its at, or just after my period and before ovulation.....so that would be the oestrogen.  Then sometime after ovulation the problems begin....and I read somewhere else that most palpitations occur in the 'luteal phase' which I believe is after ovulation and is associated with a decline in oestrogen...

I will do a bit more research and post up anything useful....I'm reluctant to take HRT because of the natural creativity that I get at certain times in my own cycle....Still not into artificially affecting it....BUT, I realise it might just make me feel so much better ALL the time and not just some of the time like now....so I am definitely considering it and your account of your experience has been really valuable.  THANK YOU.
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Wrensong

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Re: Is this Peri Menopause? Can you help me look at this..
« Reply #31 on: May 11, 2017, 04:59:46 PM »

Oh Rosanna, hypothyroid too?!  That changes everything!  First, just wondering when you last had a TFT, though I'm sure you will already be aware that if your meds dosage is not optimal, this might explain the palpitations.  Being over-treated seems to be the more documented reason for heart rhythm problems in patients on replacement, but I've also had problems when my thyroid levels have been too low.  If you've not had a TFT recently, I would try to arrange this & if you can, push for Free T3 & Free T4 as well as TSH.  If you have recently been feeling "high", red-faced and full of energy, as I think you described earlier, is it possible your Thyroxine dosage is too high?  I'm assuming you are not also on T3. 

I'm afraid as I understand it, the association between gynae hormones & the thyroid is far from straightforward, with complex biofeedback mechanisms to maintain homoeostasis - which the body tends to manage less well in hypothyroidism.  Thermoregulation seems to be a particular challenge!  I can only speak from my own experience, which may not be typical, but feel a thyroid condition can rather complicate menopause, to say the least!  To be honest, having the two ongoing caused me no end of worry, as no-one was sure which symptoms were down to thyroid & which perimenopause & I was for several years afraid I was on too much replacement.  I felt almost constantly hyper - hot, tense, burnt out, dreadful insomnia due to lengthy night sweats & also lost weight.  The palpitations were at their worst during peri & were especially worrying precisely because a thyroid imbalance can also cause these & it's important for heart & bones not to be over-treated.  However, TFTs were OK & tests for menopausal status inconclusive, as they often are in peri, so the advice, though kindly meant, was more or less to go away & get on with it.  This I found very hard & feeling alone with the combination of problems made it a frightening time, so I do feel for you.  I didn't know of MM at the time, but the ladies on this site are wonderful and will do their very best to offer support & advice, so you will definitely not be alone.

As I understand it, there is a relationship between suppressed thyroid activity & high levels of oestrogen (both natural & exogenous, ie oestrogen introduced via HRT), as oestrogen increases thyroid binding globulin, which I believe reduces the amount of available thyroid hormone.  However, how much this affects us at any given time during the hormonal chaos of peri is anyone's guess!  I mention this as you asked about gynae hormones' relationship with thyroid & because, if at some point you do decide to try HRT, you may find your Thyroxine needs increasing.

Though in uncomplicated hypothyroidism, patients are not usually under the care of an endocrinologist as I'm sure you know, it might be worthwhile seeing one at this stage to help guide you through peri & out the other side.  If your GP can't refer you on the NHS & you can afford it, going private tends to allow more time to get to the bottom of complex problems.  Please keep posting and ask whatever you need, there is always someone around to help.

« Last Edit: May 12, 2017, 07:24:58 PM by Wrensong »
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Rosanna

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Re: Is this Peri Menopause? Can you help me look at this..
« Reply #32 on: May 15, 2017, 10:11:06 PM »

The 'high' feeling isn't really high as such, it's just a feeling of well being and I can easily write poetry (which I like doing) and clean the house and tolerate rude people....lol

I'm not concerned about it at all, it's not like going on wild spending sprees or anything like that and no, I'm not flushed when that's happening.  :-)

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Rosanna

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Re: Is this Peri Menopause? Can you help me look at this..
« Reply #33 on: May 15, 2017, 10:12:49 PM »

Thanks for your experience, Wrensong, your posts are really valuable, I'll respond properly this week, once I get my long commute out of the way tomorrow.   :)
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Wrensong

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Re: Is this Peri Menopause? Can you help me look at this..
« Reply #34 on: May 16, 2017, 10:12:03 AM »

Hi Rosanna, glad to know you don't feel it likely that you could be over-treated/hyper.

Was a little afraid I might have said something off-putting!  Often feel torn when posting on MM, between telling it like it is & the knowledge that it can be so easy to unintentionally write something alarming, worrying or potentially harmful.  Before I knew of MM, I would have found other women's honest experiences of peri & menopause helpful & especially those of hypothyroid ladies.  When I was in peri, none of my friends had got there yet, I had lost my Mum & have no sisters.  If ever I mentioned menopause tentatively to older women who must have been through it, it seemed the subject was taboo & the conversation came to an abrupt end.  No-one seemed willing to admit to it being a difficult time & I quickly came to think I must be something of a freak.  I'm rather ashamed to say this lack of solidarity felt like a betrayal.  It got to the stage where if one more woman had said to me "Oh, I never had any of that" I think I'd have sloshed her!  I joined MM because I don't want other women to feel as I did and hoped I might be able to contribute something helpful, though am rather struggling with this.  MM is a wonderful resource & source of support, but there seems a fine balance to strike when posting.  Some members seem always to get this right, but I'm still very much finding my feet & trying to ensure what I post is more help than hindrance!

Though it's good to know how members are doing, there is never any obligation to reply - just post if/when you feel like it :)
 
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Wrensong

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Re: Is this Peri Menopause? Can you help me look at this..
« Reply #35 on: May 17, 2017, 09:35:17 AM »

Sparkle, what a kind thing to say.  Thank you.  You've made be blush, no wait a minute . . . my mistake . . . that would be FLUSH!   ;D
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Rosanna

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Re: Is this Peri Menopause? Can you help me look at this..
« Reply #36 on: May 17, 2017, 09:19:03 PM »

Wrensong....just quickly, your posts have been perfect.  Every single one of them.  I read them a few times and there's loads of really helpful and valuable info in them.  My limited response at the moment is my exhaustion, inability to concentrate, and just stuff, lol....I promise it's not you.  I mean that, keep being you because I for one really appreciate it. 

My response about the 'high' thing was just me in a mind fog, not able to say much but wanting to reassure you on that bit that it's a nice 'wellbeing' high....I probably used the wrong word.....if anything it's more a feeling of 'normal wellbeing' that I've called high because I don't get it very often these days, lol.  Reading back my response, it sounds abrupt but that wasn't how I intended it....it was just me exhausted and in a fog and not thinking through what I was typing.  :-)
« Last Edit: May 17, 2017, 09:26:43 PM by Rosanna »
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Wrensong

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Re: Is this Peri Menopause? Can you help me look at this..
« Reply #37 on: May 18, 2017, 10:03:19 AM »

Rosanna - please don't worry - there was nothing abrupt in any of your posts & my comment about no obligation to reply was simply to reassure you that as I understand it, nothing is expected of anyone posting here - we simply post to help & support each other.  I know so well the brain fog & exhaustion, so please do whatever you need to to look after yourself.  There will still be someone here to listen whenever time is right for you to post.   :)
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Rosanna

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Re: Is this Peri Menopause? Can you help me look at this..
« Reply #38 on: May 21, 2017, 09:00:21 PM »

Oh Rosanna, hypothyroid too?!  That changes everything!  First, just wondering when you last had a TFT, though I'm sure you will already be aware that if your meds dosage is not optimal, this might explain the palpitations.  Being over-treated seems to be the more documented reason for heart rhythm problems in patients on replacement, but I've also had problems when my thyroid levels have been too low.  If you've not had a TFT recently, I would try to arrange this & if you can, push for Free T3 & Free T4 as well as TSH.  If you have recently been feeling "high", red-faced and full of energy, as I think you described earlier, is it possible your Thyroxine dosage is too high?  I'm assuming you are not also on T3. 

I had a TFT about 4 months ago which showed my TSH to be around 1....which usually allows me to function well.  Some say that might be a little in the hyper range and others don't, I expect you know, but for me, over the last 20 years, it's always been the optimum for me. 

Yes I know what you mean about palpitations occurring when hypo thyroid as well as hyper.

I've never had anything quite like what happened in the last ten weeks though and my suspicions are with the peri menopause....

That said, I also had a few mild symptoms of labyrinthitis and wonder whether I've had a low level infection all that time.  I will ask if I can have T3 and T4 done next time, they seem to not do it, but I will ask.
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Rosanna

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Re: Is this Peri Menopause? Can you help me look at this..
« Reply #39 on: May 21, 2017, 09:07:54 PM »

However, TFTs were OK & tests for menopausal status inconclusive, as they often are in peri, so the advice, though kindly meant, was more or less to go away & get on with it. 

Yes, I baffled the doctor the other day.  I said I'd lowered my thyroxine just slightly, I'm on 175mcg, I lowered it by 12mcg just to see if the palps went away, well they kind of have at the moment but I still get the impression there are other reasons, not the thyroxine.  (because I've been on that dose a long time and because my periods have been chaotic since January, and thats when all the palps started too).

Anyway I told the doctor and she said 'no, take the thyroxine at the usual dose again.'  So, I've upped it again.  I'm glad because lowering it like that, and increasing the dosage of beta blockers at the same time had completely wiped me out and I'm struggling with work, and even just house work.  So, increasing it back to the usual dose and gradually going to lower the beta blocker down to where it was before all these palps started.

I have HRT (femoston) in my bag if I decide it's all getting too much, we will see.  :-)
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Rosanna

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Re: Is this Peri Menopause? Can you help me look at this..
« Reply #40 on: May 21, 2017, 09:14:09 PM »

As I understand it, there is a relationship between suppressed thyroid activity & high levels of oestrogen (both natural & exogenous, ie oestrogen introduced via HRT), as oestrogen increases thyroid binding globulin, which I believe reduces the amount of available thyroid hormone.  However, how much this affects us at any given time during the hormonal chaos of peri is anyone's guess!  I mention this as you asked about gynae hormones' relationship with thyroid & because, if at some point you do decide to try HRT, you may find your Thyroxine needs increasing.

Though in uncomplicated hypothyroidism, patients are not usually under the care of an endocrinologist as I'm sure you know, it might be worthwhile seeing one at this stage to help guide you through peri & out the other side.  If your GP can't refer you on the NHS & you can afford it, going private tends to allow more time to get to the bottom of complex problems.  Please keep posting and ask whatever you need, there is always someone around to help.

Thanks Wrensong, this is all really interesting.  There's definitely a link with the sex hormones and the thyroid hormone....the fluctuations in my energy during my normal menstrual cycle over the years has told me that.  Really high energy around the time of my period (but hit by a truck before) or just after....I suppose would coincide with oestrogen levels being low, allowing my thyroid hormone to run the show, lol.

I will ask about an endocrinologist, though at the moment I think one doctor in particular would rather put all this down to anxiety.  I have an open mind, but I know for certain this is not just anxiety, it's just beyond them...so yes, I may have to go privately. 
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Wrensong

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Re: Is this Peri Menopause? Can you help me look at this..
« Reply #41 on: May 22, 2017, 09:56:54 AM »

Rosanna, just seen your latest posts & will come back to them later as I'm running late (disorganised today!) & want to look at them when I have enough time to do them justice.  :)
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Rosanna

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Re: Is this Peri Menopause? Can you help me look at this..
« Reply #42 on: May 22, 2017, 06:01:15 PM »

No worries Wrensong   :)
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Wrensong

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Re: Is this Peri Menopause? Can you help me look at this..
« Reply #43 on: May 23, 2017, 11:04:24 AM »

Hi Rosanna, will go back through your last few posts & try to answer all today.  Sorry, may be very long!  Please don't be alarmed by anything I write - before peri began I had had a chronic pain condition for many years & was depleted by the lack of sleep this causes, so was not in a good state to start with.  I don't think for one moment you will necessarily experience all or at the severity I describe below, but I want to be honest in case this helps you feel more certain about what is happening, which should in turn mean you can take wise decisions to help you manage symptoms far earlier than I did.

Like you, prior to peri my optimal TSH was ~ 1, but difficult to keep steady - always different when tested, sometimes suppressed, sometimes above target range for replacement.  That said, I think the correct dosage for any individual is that at which (s)he feels their best & that there is no “gold standard” TSH.  Unsure whether you've had thyroid surgery, but mine was hemi-thyroidectomy.  If you have any remaining thyroid, or never had surgery but the gland is diseased, I think the following may also apply to you.  A private GP specialising in thyroid disorders told me that patients with only partial thyroidectomy are the trickiest to treat, as the disease process continues in the remaining thyroid, which continues to produce some hormones sporadically, possibly for many years.  This makes it difficult to arrive at a suitable dose of replacement & mine was continually adjusted up & down, with the body struggling to maintain stability.  A particular challenge in peri, which is what I think may be happening with you.  With gynae hormones fluctuating erratically, thyroid status seemed all over the place.  If declining oestrogen is sometimes too low and then during long stretches without ovulation unnaturally high, this must surely affect thyroid hormone levels & effectiveness in someone whose thyroid can no longer make the second-by-second adjustments it does in good health. 

Labyrinthitis - Yes, any possible infection could certainly have a systemic effect, so perhaps have this checked out again with your GP?  You've written of palpitations & possible flushing, both of which are suggestive of peri, together with your erratic cycle length.  As I've already written at length on palps I'll concentrate on thermoregulation today. 

From the start of peri it seemed each night impossible to reset my thermostat & I would lie awake from early hours, unable to get back to sleep, after what felt like one long night sweat I couldn't switch off.  The term night sweat can be confusing in hypothyroid ladies who may be unable to produce sweat to assist with cooling down.  I think this defective mechanism is probably what made my night sweats & flushes so long-lasting & added to my fear that something else must be wrong.  Reading that flushes & night sweats lasted only minutes, this was far from true for me.  Just before a night sweat I would wake suddenly, heart hammering, with a feeling of terror for no good reason, then the intense heat would spread throughout my body.  Even with slow, controlled breathing (counting in & out) & body scan meditations, I often found it impossible to get heart rate & temperature back down & subdue the alertness enough to get back to sleep. 

Symptoms, including palpitations, insomnia & overheating were certainly worse in the second part of any cycle, however long & eventually I went 9 months without a period then began again.  The 10 days before a period became increasingly awful & I came to dread this time.  I would lose huge amounts of fluid (& up to 7lbs in weight) - peeing like a gigantic & bad tempered horse!  This diuretic effect seemed to force up temperature even further.  Just before a period I was so hot & wired there were some nights when I would get no sleep at all.  Luckily I wasn't working at that time.

During weeks & months without a period when cycles lengthened, oestrogen would seem to build, tummy & aching calves swell with fluid & breasts become very painful.  Hands & feet were unnaturally cold & I was tense for no reason as if about to sit an exam.  Already slow gut transit worsened in spite of a habitually fibre-rich diet, as much fluid as I could manage & all manner of exercise.

I spent the peri years almost permanently in short shorts, even cooking Xmas dinner in them.  Always a keen cook, could no longer bear the heat of the oven & sunny holidays abroad stopped abruptly 11 years ago.  Hubby told me I felt permanently like a furnace & I could feel the heat of his body radiating from the far side of the bed!  Any fabric touching my body was enough to make me burn up at night, but without bed covers I couldn't fall asleep.  I sourced & bought a 1-tog duvet for winter, which was on-off-on-off, open windows meant hubby froze & an oscillating fan drove us nuts with its whirring.  A pile of 4 hot water bottles filled with cold water, sat by day on the bottom shelf of the fridge & came up to bed with me each night.  The heat of my body quickly warmed them up!  I became a mad woman on sunny days, rushing to shut all curtains to minimise solar gain.  We argued over air-con in the car.  I became so sleep deprived I began to dream vividly as soon as I shut my eyes & sat down, at any time of day.  As I dreaded going to bed, my lovely hubby began a routine of reading to me until I fell asleep which I quickly did & had no recollection of what he'd read the next day!

Like you I knew anxiety was not at the root of my symptoms, though it gradually became clear that any stress (emotional, mental & even physical as in exercise) increased palpitations, flushes, night sweats & insomnia.  Bizarrely, the more tired I got, the poorer quality my sleep.  I felt burnt out.   

It can be very helpful to practise some form of relaxation therapy - meditation, yoga etc & vital to do your best not to become over tired.  Prior to peri I was able to push myself habitually, but found a huge adjustment was needed over the coming years.  It's more a case of recognising that if you can make changes at the start of peri, slow down, learn to pace yourself & give your body what it seems to need, you will be far better able to get through smoothly.  Sounds like a recommendation from someone who lives on another planet, I know, but the pace of life today can be so hard on us & one of the most difficult lessons I learned was that without HRT there was no option but to adjust, put aside the guilt & expect less of myself.  I wish I could remember who said this to thank them, but advice I read on MM before joining was “lower your standards".  I had never before considered allowing myself to do this, but cried with relief when I read it & it turned out to be one of the wisest things I've ever heard.  I've found others do get used to any changes & if you explain, should understand & support you.  This can be difficult at work, but I hope it won't be for you.

Not GPs' fault as they seem often inadequately trained in thyroid & menopause, but you may need to be firm & stand your ground to get help with symptoms.  With the right support & understanding to help you make choices, there is every chance this will really ease your journey.  I'm sorry this is so very long & possibly boring, especially as you are long-term hypo & probably know so much already, but do hope there's something useful in it.   :)
« Last Edit: May 24, 2017, 05:29:08 AM by Wrensong »
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Wrensong

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Re: Is this Peri Menopause? Can you help me look at this..
« Reply #44 on: May 24, 2017, 05:00:55 AM »

Forgot to say: daytime flushes - as well as random ones provoked by activity/stress/ warm environment, some came at regular times each day, so predictable I could set my watch by them!  Whole body, not just face/neck.  Wearing layers you can remove quickly can help.  Also became more sensitive to cold & shivered excessively.

Palpitations came with flushes (markedly raised heart rate & often scarily irregular), but also in long episodes without flushing, for no apparent reason, as said before - especially at rest & after eating.  These unnerved me so much during the first months I was sometimes afraid to be alone & even regularly feared I wouldn't make it through the night - went on for several years, but still here to tell the tale!  Forced myself to go out alone despite fear of keeling over with palps (never did) & at night got up & wore tracks into carpet, walking round & round the living room to cool down & calm the heart!

Though body seemed terrified during night sweats, often aware of hunger & tummy would rumble manically (low blood sugar).  Hypothyroidism can bring tendency to hypogylcaemia which really became a problem for me in peri.  Reducing meal size, complex carbs & good portion protein at each meal & healthy snacks between (oatcakes, nuts, apple) helps stabilise blood sugar, which can otherwise lead to panic sensations, weakness & flushing if it falls too low.  Helps to avoid sugary drinks/snacks & if you have fruit juice, perhaps take it in small amounts/diluted with a main meal.  As breakfast is often high carb, I pour natural yoghurt (high protein Greek 2% fat + Onken full fat) diluted with milk over fibre-rich cereal, add nuts, seeds &/or a boiled egg with wholegrain/rye toast & always fresh fruit salad.  The right yoghurt/milk mix tastes like double cream!  Porridge is great but without nuts & egg is too high in carbs to sustain me until lunch.  Main meals are easier to include protein - lean meat, fish, beans, though had to stop purely veggie meals to get enough protein.  Also reduced pasta portions for sugar control.  No added sugar muesli or small bowl yoghurt with couple of prunes(!) before bed & sometimes an oatcake.  Found I had to eat a little about an hour before cycling, otherwise would crash (not literally!)

Learning to focus on slow, deep breathing helped calm body & mind & bring a sense of control in stressful situations eg GP waiting rooms.

If you're slim/small framed as I am, please try not to let body fat get too low. I think a healthier amount of body fat would have helped buffer me against extreme symptoms caused by too low oestrogen (which I understand is produced in small amounts by & stored in body fat after menopause, when ovaries have largely given up).  Post-meno when finally tested, my oestradiol was below bottom of MALE ref range at <44!  I now have osteopenia despite decades of trying to gain weight.  Symptoms of too much thyroid hormone can go unnoticed early on & it's possible to lose weight without realising why, so please do look out for signs you may need to reduce Thyroxine as you go through confusing peri (difficult to be sure, I know).   :)

Have written loads, I know, but sometimes a tiny detail can be life-changing & when I was starting peri, hypothyroid, it was so confusing/frightening it would have helped to know of other hypo ladies' experiences.

No need to reply Rosanna - there is so much, I hope it won't be overwhelming!
« Last Edit: May 24, 2017, 06:34:15 AM by Wrensong »
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