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[Seasidegirl]

Seaside Girl - tnx.  It is known that the NHS won't do extra tests for T3/4 believing that results 'within normal limits' are that.  Despite patients retiring many times stating that symptoms continue.   

Let us know how you get on?

Will do,  I'll start a thread at some point in case it's useful to others.   

My GP managed to get T4 tested once but she couldn't get the lab to test T3 as my TSH was normal as it was hanging on the bottom of the range. 

NHS endo rejected the referral despite my symptoms.   

[CLKD]

Not good enough!

[Mariab]

Hi joannfran
Like yourself Anxiety is my main symptom of peri,  I started hrt first but for me it made little difference I ended up in a very dark place ..I had tried several antidepressants and anti anxiety meds with no luck as it made amxiety spike so much I couldn't cope...but I had to bite the bullet in the end and tried citalopram which took a long while to work but with a combination of hrt, antidepressants and much courage to push myself to get back out there things are now at least 80% better...which i will take and accept as we will all have blips and bad days...
You will get there..just don't give up and keep on going 

[CrispyChick]

Marian - may I pick your brain?

You say you had to bit the bullet with citalopram after lots of failed AD trials because they spiked your anxiety. Did the citalopram spike your anxiety and you rode through it???

And you say it took a long while to work - can you elaborate?

I'm week 6 into escitalopram and it's been hell.

I'm trying it because all hormonal trials simply make me worse. Joannfrann - AD may be worth a try. X

[CLKD]

Appropriate anti-anxiety medications should be the way to go: however, GPs are so afraid that patients will get hooked on i.e. valium that they trial Anti-Depessantss.  I believe that a couple will ease anxiety ......... of course, being meno brained  I can't remember which 

I have used Bachs rescue remedy mouth spray with success too.

CrispyChick - what isn't the Escitalopram helping with?  I take 10mg at night and 5mg in the morning; if I feel low for more than 3 mornings I add 5mg at breakfast.

[Mariab]

Hi crispychick
My anxiety did hit a high on citalopram and the first month was not fun but I had to push through it because if I didn't I probably qplouldnt be here now...
It has taken just over a year with 2 increases to settle there have been many blips along the way but they got easier and easier ..I still get anxiety but nowhere near as bad and now I know how to deal with it...it's just temporary and you will feel better

[CrispyChick]

Thank you Mariab.

I appreciate your reply. I'm just concerned I'm at the 6 weeks mark and worse than ever.

I've been on it before. And I know start up is always hell for me. But it's like giving birth - I forget how bad and how long it lasts.

What dose of citalopram have you finally settled on?

Clkd - so far it's helping with nothing!!! It is making me worse. 

[Mariab]

I finally settled on 30mg I know escitaloprám comes in different strengths....so not sure of the comparison.
I did alot of research on the subject of citalopram etc and found that taking antidepressants the second time can take longer to settle.. also
Recovery isn't linear it's slow and you may not notice it working but it starts with a few mins of relief then hours etc until you can manage a day but this takes a while i know some people recover after 6, 9. Months or more..I have experienced lots of set backs but it didn't mean it wasnt working, however if you feel there has been no improvement at all then maybe consult your gp for further advice
Sorry I cant remember if you mentioned if you work or not , what do you get upto during the day?

[CrispyChick]

Thank you Mariab

Oh. I didn't know there was a longer settling in period second time. This is actually my third time. In fact, i stayed on 5mg escit for the last 6 years, but it's been doing nadda. Hence the increase.

That said, I'm also really struggling with things that are looking likely to be more neurological than hormonal. Just waiting to see specialist. So it's maybe no wonder my nervous system is not coping with this big change.

I believe escit is half of citalopram. So your dose equates to 15mg escit.

I'm currently off work as I just tried a chem menopause - which has completely broken me. Hormones are not my answer.  I'm now in a bad place both physically and emotionally, hence the AD. 

Thanks for replying xx

[Minnie Mouse]

Hi JoannFran,
I'm sorry you're having such a rough time. I've been through phases of that adrenaline surge, and it's debilitating.
Just to throw in another option...CBD gummies.
Easy to take on a "when needed" basis.

[Mariab]

Anxiery wise I had to have cbt, the citalopram, pregabalin ( which I would prefer not to take). And alot of mindfulness which does work....
Going back to a routine of work really helped me recover along with friends and family, I'm really lucky I have a good support network...
I really hope you feel better soon..fingers crossed for you. 

[CLKD]

My anxiety bubbles away.  Worse when I have to go anywhere and I try. not to plan too far ahead.

[joziel]

JoannFrann.... Re your first post to me (sorry I am crap at this reply business)...

>What I can’t understand is that I feel like this wherever my hormone levels are. Had a few blood tests recently and I feel the same whether my estrogen is 100 or 200. Is it just that I haven’t got my levels high enough? I was on 100 evorel and my maximum estrogen was 349.
My last blood test without any HRT and estrogen was 175. 

So, if you are peri (I'm assuming you are), your results are likely to be all over the place. I would never rely just on one single result because you can't know whether your own body contributed a spurt of E or what... I tend to do 2-3 tests, all on day 3-4 of my cycle, before I really adjust a dosage.

Secondly, if you EVER get a low result, you know that is genuine. I mean, the goal is that HRT gives you a stable and decent dose. If you are getting a low result sometimes, that is telling you that your own body's E has dropped out and this is the level you are getting from the HRT. In other words, you want your LOWEST result to be decent. The high ones can be spikes.

Thirdly, 175 is crap. 250+ is the VERY PATHETIC(!) mimimum. 349 is okay. It's fine. It's not 'high'.

Keep in mind that even with E at 430, I was shaking all night, with tremors, hypnic jerks, heart beating and fast through the night.... It didn't stop until I got to 600-850 - and that took a lot of E.

Really, you need a doctor who is prepared to prescribe above the licensed dose because it's very likely that's what you will need. I wouldn't go for an endocrinologist - many don't know anything about menopause and these are neurological meno symptoms. I'd recommend the Newson Clinic, which is where I go. I see Dr Jane Robertson there and find her very good.

When you are on a stable dose, she will write to your NHS GP and tell them what to continue prescribing. So you won't have to pay for meds.

With the thyroid stuff, by all means run a complete test including T4, T3, thyroid antibodies. You can do that with a finger prick Medichecks test. But (from my experience with this) I recommend trialling much higher E doses before you start any thyroid meds. I went onto thyroid meds due to these exact symptoms and now I am stuck on them. I can't recover thyroid function if I stop them. So I'm now on thyroid meds for good - when I didn't really need them, before, and was just 'trying' them. I wish I had tried the higher E doses first....

[JoannFran]

Thanks for your reply joziel.  Yes I'm still peri.  My own hormones are obviously all over the place as my period this month was 3 weeks late, that's the first time that has happened.  I'll be honest I'm fed up with testing my levels now.  Nothing ever gives me any clarity and I think I just have to accept that I need to try the HRT again.  Which is scary because the utrogestan did not agree with me.  I've tried Mirena coil in the past and that really made me depressed.

Thanks for your advice re the thyroid.  Yeah I think I'll shelve that idea for a while.  I think I'm just grasping at straws to be honest as I just want to find a solution to this flippin awful feeling.  Like my insides are buzzing. 

Thanks for your advice.  It's really helpful x

[Jjumper]

Hi JoannFran - just saw your reply to me… if you are ever thinking of trying SSRIs again you could start on a very low dose to try to avoid those panic attacks in the first few weeks before the medication actually starts to work. Five years ago when I took sertraline I started on a half dose of 25mg but the first few weeks were brutal in terms of increased anxiety and panic attacks like nothing on earth. I was glad I pushed through it though as things got very much better. This time round I’ve halved the dose again, starting on 12.5mg and it is so so much better in terms of side effects - the increased anxiety is barely noticeable. It’s going to be a slower titration to get to a therapeutic dose, but worth it I think. Anyway, just an idea : )