Hi Floral, thank you for the summary. OK so you've been on 75mcg patches 3 mo, with a recent oestradiol level of 200-ish, which is less than half what it was on oral oestrogen, but increasing your patch dose to 100mcg made you feel worse. You had night sweats & racing heart when your oestradiol was 470 & still have them following your most recent much lower oestradiol result. If the evening hot flushes are new, coinciding with the lower oestradiol level, it could be that your body needs a little longer to adapt to the lower level or that perhaps your sweet spot lies somewhere between 470-200. If you think you may need more oestrogen, you could try increasing to 87.5 if 100 was too much.
could it be that if I increase estrogen it affects the thyroid more?
It's really difficult to know, Floral. In theory, transdermal oestrogen shouldn't affect thyroid status (according to research into the effect of oestrogen on Thyroid Binding Globulin). But a few of our hypothyroid members - the impression I get is that it's those of us on T3 as well as T4 - have found that we do have to tweak our thyroid replacement when our HRT dose changes. It could be that there are other mechanisms involved that are not yet recognised in the medical literature. As I mentioned on here recently, I'm seeing more & more articles stating that transdermal HRT is just
less likely to affect thyroid status, rather than categorically that it doesn't.
A healthy thyroid should be able to compensate for the effects of HRT on the body, but if there is a possibility that your thyroid is not working as well as it should, then it does seem possible your thyroid hormone status could be affected by your HRT. Hopefully the thyroid clinic can help you get to the bottom of what's going on. You mention Covid & with that now in the mix for many people, I think researchers may be learning about the long term effects for some years to come.
I'm sorry I can't say anything with much more confidence, Floral. Joziel's situation with the rT3 testing is unlike any I have come across before, endocrine conditions can be very complex, especially with more than one ongoing & all of us - patients, doctors & researchers, are still learning about how it all interrelates.
I’m not on any T meds yet.
Do you mean testosterone or thyroid meds? If testosterone, as you've had BSO you will have lost all ovarian androgen output. The ovarian contribution makes up a hefty proportion of the total women produce & is thought to continue to benefit our health in various ways long postmenopause, so you may well feel better for adding a little Testosterone to your HRT regimen if you haven't yet tried it. There is mention in various articles that some women find T helps with night sweats & therefore sleep & my first menopause specialist back in 2015 cited it as beneficial for sleep, but it's not one of the effects it's usually prescribed for. If you feel unbalanced on oestrogen replacement alone, testosterone may help with this.
I'm in a similar position to you, with no ovaries, persistent night sweats with all the horrible trimmings & consequent insomnia, so I know how much this horrible problem can dominate our lives & the frustration & distress it causes when whatever we try doesn't fix it.
Wx
