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[marma2010]

I'm new to this forum although I've been reading posts for a while and it's so helpful.  I had a hysterectomy nearly a year ago and ovaries removed due to endometriosis and suspected adenomyosis. I am 42.  My treatment history as follows:
Elleste Conti due to endometriosis but couldn't cope with progesterone and told if no symptoms it would be OK to drop it.  Used for about 3 months
Estrogel - 2 pumps plus small amount of testim on recommendation of gynae.  Main symptoms were feeling extremely foggy / cognitive problems and insomnia although no hot flushes 
Tried dropping HRT for a month as felt so unwell.  Fogginess lifted but hot flushes and night sweats became unbearable
Now trying Estradot 100 plus testim over the last week. Hot flushes are dissipating but the fogginess is back and I feel sooo tired.
I'm also hypothyroid (take 125mg levothyroxine) and levels have been really up and down since surgery.

I am wondering whether I could have my levels checked to see what's going on.  I have asked GP on several occasions whether I could have a blood test to check current levels and been told that this would only show what we was being put in.  However, I wondered whether there could be an absorption problem and I've seen that other ladies on here seem to have regular blood tests (??).  Also, is it best to ask for a referral see an endocrinologist, given that I also have thyroid problems, or go back to the gynecologist? 

Whilst it's so great to be pain free following my surgery, I feel like I'm now living a dream-like state and this is really making me regret the decision to go ahead.  I really can't imagine going on like this for another 10-15 years!

[CLKD]

   blood tests are reliably un-reliable  .  Thyroid function and VitD levels can be measured.  I would ask to see an endocrinologist.  Did your Gynea give any inform or advice prior to surgical intervention, probably not? 

I'm sure Members with similar will be along.  You could put thyroid into the search box to see which threads pop up?

[Kathleen]

Hello marma2010 and welcome to the forum.

There are several ladies here who have thyroid issues and I'm sure someone will be along soon to advise you.

I've often wondered if we should be routinely referred to endocrinologists as well as gynecologists at this time in our lives but it's not likely anytime soon.We live in hope I suppose.

Take care and keep posting.

K.

[marma2010]

Many thanks for the replies. No I wasn't given advice prior to surgery as I was hoping to keep at least one ovary. Then on the day of surgery my gynae said he probably wouldn't be able to save either of them. So I hadn't really prepared myself for that!

[Hurdity]

Hi marma2010

  from me too.

It sounds like you really need to see and endocrinologist since your thyroid levels may well need adjustment. Fogginess as a result if added oestrogen is not a usual symptom - this is normally as a result of the progestogen part of the treatment but is it also a symptom of thyroid levels being low? The biochemistry of these hormones are intertwined and  governed by complex feedback mechanisms so you probably need ongoing monitoring given your surgical menopause.

There is also a surgical menopause thread in the main menopause section, you might like to have a look at.

Hurdity x

[marma2010]

Thank Hurdity. That's interesting and just read that mental fog can be a symptom of low thyroid too. Didn't realise the two hormones were interlinked though. I will definitely try and push for a referral. Just feeling really wierd all the time! When I spoke to my gp she said it might be because I'm stressed. I told her I'm not stressed at all and the symptoms came after surgery.

[babyjane]

You have the right to ask for a referral and your levels need to be checked at least every 6 months.  A consultant can order a complete thyroid function test to - Free T4, Free T3 ans TSH - whereas a GP can only request TSH and unless it comes back out of the reference range they do not do the other two. After a hysterectomy my thyroid levels became very unstable and took a long time to get right again, it can make you feel awful.  If you are taking HRT then this can also upset your levels (which is why I chose to manage without HRT as my levels are hard enought to stabilise as it is) and they really need checking every three months until your HRT and Thyroid levels stabilise at the best level for you.

Low thyroid levels can also make you feel cold and cause constipation and weight gain despite poor appetite.

[marma2010]

Thanks so much for your reply babyjane.  I was told by my GP that HRT shouldn't have any impact on thyroid levels - so much for that advice!  I have put on 5kg since my hysterectomy.  I really think I need my T3 levels testing - I have never had them tested although I have been taking levothyroxine for about 17 years now. 

Can I ask you if you have managed OK without HRT?  I did try without as I was feeling so lousy but the hot flushes and night sweats became unbearable.  I am also worried about long term effects of going without as I'm in my early forties. 

[babyjane]

Hello, GPs know a little bit about a lot whereas a specialist knows a lot about his speciality. My consultant told me years ago that when I hit menopause my levels would need closer monitoring as HRT affects thyroid absorption.  I think a referral to an endocrinologist would be a good idea for you.  I got referred when my levels just would not stabilise on thyroxine alone, they were all over the place.  that was nearly 30 years ago. I have been on T4/T3 combination treatment for over 20 years now.

I was fortunate that I could manage without HRT for several reasons. I was older, I had a hysterectomy (ovaries retained) when I was 38 so no bleeding and I didn't go out to work so I could deal with the symptoms easier.  I do use Vagifem topical oestrogen for vaginal atrophy - that was my worst symptom, and a low dose anti depressant for anxiety and depression.

As you are so  much younger you probably do need some replacement to protect your bones but you also need to get your thyroid stable and it needs regular monitoring if you are taking HRT.

ThyroidUK dot org is a very useful and informative website and it goes without saying that this forum is worth its weight in gold for support and advice.

[marma2010]

Great thank you, I will take a look at that website.  I thought I had my thyroid issues sorted but it may be back to the drawing board. 

Did you find improvements taking T3 as well and could you tell me what brand you are taking? I have been reading about Armour as an American friend is taking it but not sure if you can get it in the UK.

[babyjane]

You can get armour in UK but has to be a private prescription I think, I'm not sure as my endo was not a fan of it when I asked him about it.

I was found to be in the sub group of 15% of thyroid patients who do not convert T4 to T3 in the body which was why I was taking higher and higher dose of thyroxine but still having hypothyroid symptoms.  The addition of a small amount of T3 has made all the difference.  What worries me is there have been rumblings that T3 will no longer be prescribed for new patients, although those already on it will not be taken off it.  I asked my endo about this and he said it is a distinct possibility.  Sometimes the lab fail to do my T3 tests and then my endo gets cross because he doesn't have the full picture.

Anyway, pop over to ThyroidUK, and have a browse around.  I learned a lot from them in the beginning just as I learned a lot about menopause from this website.