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[Clarella]

I went slowly from 75 to 100 via half 25 patches.

I’ve started to use 100 and while some symptoms are improving, I feel really tired all the time! I’m on thyroxine but that’s not supposed to be affected by transdermal oestrogen?

I wondered if it was my body recovering? Usually there’s more energy when I raise a dose. (And I need energy!)

So close to asking for testosterone!!!!

[CLKD]

How long since you began increasing the doses?

[Wrensong]

Hi Clarella,

I’m on thyroxine but that’s not supposed to be affected by transdermal oestrogen?

Along with quite a few other members, I'm also on thyroid replacement & HRT.  As you say, the medical literature tells us that only oral oestrogen increases Thyroid Binding Globulin, in turn increasing our thyroid replacement requirement, but I think you could be right to question what's happening with your thyroid function.  Several of us on here using transdermal oestradiol have found that we do in fact need to tweak our thyroid dose during the process of finding our best HRT fit & personally I've had to do this repeatedly in response to changes of HRT dose.  My impression is that it's those of us in the subset who already have problems converting T4-T3 & who therefore take T3 as part of our thyroid replacement regimen, who seem to find it trickier balancing thyroid & HRT.

Is it possible to check your thyroid function, including Free T3, to see whether this confirms what you're feeling in terms of increased fatigue on the higher oestrogen dose?  Assuming you've not done that yet.  I know it's unusual for hypo patients to be able to get T3 tested on the NHS, so sorry to suggest this if private testing is not within your means.  So many things can cause tiredness, but I find it's essential to know thyroid status to help interpret what's going on during this confusing time of our lives.
Wx

P.S. If you have other classic hypo symptoms such as fluid retention, disproportionate coldness, constipation, these would also point towards your thyroid status being affected?

[Clarella]

Hello,

Thanks for replies.

37.5 in nov, 50 in feb and then I went to 75 in May (oestrogen was 135 on 50.) then in august I started moving up to 100 via 87.5 as oestrogen was 260 on 75 patches and I still had symptoms. I started 100 about week ago. Two covid infections jan and July. Jan one did linger a v long time mini long covid. I thought I’d recovered from July one but have wondered…

Interesting re thyroid levels being an issue for some. Up till now thyroid hasn’t been affected; Gp has tested at same time as oestrogen without me asking or even knowing. Tsh is always 0.2, t4 roughly 19-21.

I did for first time ever get a private test a couple of weeks ago, but it was finger **** and I’m not sure how trustworthy it is. Tsh was 1.3 I think, t4 19 and t4 lowish. However it was a week after a tummy bug and I’m not sure it was good timing. I mainly wanted the vit d and active b 12 etc. (b12 good, vit d 74, folate top of range and ferritin 112 which I’ve never ever had - which made me doubt the test!!)

I do have a second test in nov and was considering getting a blood draw to be more accurate; it’s just hard to get an appt near here.

Gp would probably test thyroid if I asked but I feel it’s wise to wait a few more weeks as I’ve only just raised.

I’m not really noticing many other thyroid symptoms other than v v tired. And my experience when I first started was feeling much more energy!

As an aside, significant issue for me has been burning/ tingling hands and feet, hence active b12 test to make sure. I started using 75 estrodot this week with the extra 15 after a whole summer of everol 75 and they’ve been feeling so much better. I’d used everol 75 +25 the week before and it did nothing; it was really noticeable with estradot. I have no idea if different patches even may affect thyroid???

[Wrensong]

Thanks for the TFT info Clarella 

Tsh was 1.3 I think, t4 19 and t4 lowish. However it was a week after a tummy bug and I’m not sure it was good timing.

  TSH & T4 (if 19) look OK don't they, though do you mean T3 was low?  If you're not feeling hypo, excessive tiredness aside & your TFTs have not usually changed in response to altering HRT doses then thyroid seems less of a concern.  But yes, we're usually advised to avoid testing around the time of another illness in case that skews thyroid results.  As you say, best to wait to retest until your body has had time to stabilise on the increased oestrogen.  I only ever have venous samples for hormone tests so don't know how reliable the finger ****s are for TFTs. 

Tsh is always 0.2

I'm amazed that your TSH previously stayed the same from one test to the next - I've been on replacement for nearly 30 years & have never had the same result two tests running & while trying to get HRT right thyroid results have been up & down enough to need repeated dose adjustments.  But the need for T3 seems to complicate matters, so if you are able to convert Thyroxine well I think that may account for the stability of your thyroid results.

Seems possible that your two episodes of Covid may be muddying the picture re tiredness.

Like you, I have horrible burning sensations, limbs though, not just hands & feet & these have persisted despite good B12 levels.  Some women get formication at menopause & though this is usually described as crawling sensations, some articles mention burning as a variant.  If you're finding it's reduced on Estradot I suspect you may be getting better absorption from Estradot than Evorel.  I used to find my oestradiol levels were a lot higher on Estradot patches than on the equivalent Evorel dose.  I can't see mention of a progestogen - have you had hysterectomy?  Sorry if I've missed something.

I hope you continue to improve on the increased oestrogen.  Please let us know how you get on & I'd be interested to know whether there's any change in your next TFT if your oestradiol level goes up significantly.  I only follow the forum sporadically but if you feel it might help to compare notes, please message me any time.
Wx

[Clarella]

Tsh has been staying the same between 125 x 4 times a week and 150 x 3 - but I was getting ups and downs and I do think slightly hyper. So it was around 0.2 but t4 21/22. I dropped the 150s and just stayed on125 only and tsh stayed around 0.2 but t4 was 19/20. I felt *a lot* better!

In the past yes it’s always been all
Over the place but I don’t know if I’ve always been really strict about how I took it. It was hard when I was busy in my 20s and 30s and I didn’t have the info I have now thanks to the internet!

Tsh was much higher on the private test. In the past on that I’ve not been great. I do best just below 1.