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[warwick01]

Hi Ladies,

I seen Gyne Consultant week before easter. At that time was 4 month on Tiblone and suffering severe dizziness. He took my bloods and told me if things don't improve try Angeliq with Testo Gel, which I am 4 weeks into.

However received a letter this morning (6 weeks since apt) to say my blood results show:

Oestrodiol level undetecatable
Free Thyroxine 29.6 TOO HIGH
TSH level 0.06 significantly suppressed

Currently taking 125 Levthyroxine but he told me to reduce to 100mg immediately. I am really worried and peed off it has taken so long

Can anyone give me advice ie should I ask to see a Thyroid specialist?? I just want to feel well.

Wxx

[Wrensong]

Hi Warwick,

sorry to hear about the shock of the TFT result and the worry from hearing so long after the bloods were done.  I wouldn't worry too much about this if your previous TSH was OK and not too long before this latest was done.  If you may only have been on too high a dose of Thyroxine for this relatively short time, I don't think there's likely to be any long term damage.

Do you feel hyper/overtreated on the 125mcg with the Angeliq?  I realise you've only been on it a few weeks & the Tibolone before that may have muddied the waters.  I ask because I think the oestrogen in the Angeliq may raise thyroid binding globulin, effectively reducing the amount of thyroid hormone available for use in your body over time.  If this happens, you may not need to lower the Thyroxine so much, if at all in the longer term. 

As your oestradiol prior to Angeliq was undetectable, I'm wondering whether you were on HRT prior to Tibolone & your Thyroxine set at a dose to balance the oestrogen in that formula?  If so, perhaps that would explain why the Thyroxine seems to have been too high while on Tibolone, which your bloods indicate wasn't increasing your oestrogen levels.

For now, I think I would take the gynae's advice & reduce your Thyroxine, especially if you feel you are having too much & would certainly contact your GP asap for advice about this  & perhaps ask whether you can see an Endocrinologist if you don't feel confident that your GP can help you stabilise on both HRT & thyroid meds.  I am on HRT, Thyroxine & T3 & know how tricky a combination hypothyroidism & menopause can be.  Good luck with it & please try not to worry.  Easier said than done, I know!

[warwick01]

Hi Wrensong

Thank you, you do know a lot about thyroid issues.

To be honest apart from the dizziness on tibolone I felt good. No hyper symptoms, which I had prior to Tibolone on 3pumps of oestrogel, oestriodol was 285pml.

The last 2 weeks I have started to feel a build up of anxiety again. I will reduce to 100mc and stick with Angeliq/testogel for a few weeks and see if any improvement.

Wxx

T

[Tempest]

Oh my goodness, Warwick! No wonder youve been feeling dreadful! I always wondered if it was thyroid adding to the mix too!

Sending you so many hugs - you've really been through the wringer! And DO come and join us on the Road Less Travelled thread - we've missed you!

xxxxx

[Wrensong]

Haha Warwick - no don't be fooled - I'm absolutely no expert, have just been hypo for a very long time, so have a bit of experience, though not much of it good!  Just an afterthought, my Endo (brilliant & right at the top of his tree) likes TFTs done 4 weeks after any change in either thyroid meds or HRT, though I like to stretch it to 6 weeks if I don't feel too bad, as I think I take longer to stabilise (& GPs sometimes prefer 8 weeks).  Then consensus seems to be to repeat @ 3 months, but you probably know this already. 
Because the change to Angeliq since the last TFT might have altered the clinical picture and now you are, wisely I think, reducing Thyroxine, I would try to make sure you have a TFT done no later than 6 weeks from now & before this if your GP thinks it wise or you yourself feel the dose is wrong either way. 

All this juggling meds is hard on the nerves as well as the body & if you've noticed anxiety building, it does sound as though @ 125mcg the Thyroxine might have been too high, though with a new HRT regime I know, it can be so hard to tell what's causing what.  Hope you get it sorted & soon start to feel much better. 

[warwick01]

Tempest

You lovely lady it was you that suggested getting my Thyroxine tested. Unfortunatly I didn't has I didn't feel hyper, no constipation (first sign when thyroid too low) it was only when I had my gyne follow up re Tibolone consultant tested.

Since taking Angeliq/Testogel dizziness %80 better but the churning tum, feeling nervious is creeping back. Will wait 2 weeks on lower thyroxine to see how thing are then.

Wrensong - do you mind me asking which HRT you currently take?? I was advised Angeliq/Testogel works well. I read Nick Panney and other consultants like this combined HRT.

Also when will I start to see improvements and do you think too high Thyroxine has affected my heart?? as I have been having palps the last 2 weeks.

Many thanks Wxx

[Wrensong]

Wrensong - do you mind me asking which HRT you currently take?? I was advised Angeliq/Testogel works well. I read Nick Panney and other consultants like this combined HRT.

Also when will I start to see improvements and do you think too high Thyroxine has affected my heart?? as I have been having palps the last 2 weeks.

Warwick - I am on Evorel Conti patches which have helped to some extent, but haven't got rid of all symptoms & trials of other HRT combos have so far made things worse.  Had heard that transdermal methods are less likely to interfere with thyroid meds, but have still had to adjust my T4/T3 several times since starting HRT, especially when Sandrena gel was added for a while, then discontinued.  Endocrinologist agreed even transdermal HRT can alter thyroid status. 

Oh dear - wish I knew enough to give reliable answers to your other questions, but can only speak from my own experience I'm afraid.  If you mean how soon to see improvements in possible symptoms of too much Thyroxine, I really don't know, but when I was on Thyroxine alone (ie no T3, no HRT), I could usually feel a difference in major thyroid symptoms around 7-8 days after reducing/increasing Thyroxine. 

If you mean how soon to see changes in meno symptoms as a result of the Angeliq - I think I could feel a difference after about a month of first starting Evorel, but it wasn't dramatic - hard to remember now, as around 21 months ago.  Like yours, my oestradiol was below the bottom of the ref range when tested post-meno (but before HRT - not retested since) & they suspect I don't absorb well from patches which may explain why the response wasn't dramatic & why I still have residual symptoms.

Hopefully any anxiety, jittery tummy, hyper-type symptoms will reduce for you quickly, though I know from the forum that HRT can cause these symptoms in some ladies too.  Goodness, it's all so confusing isn't it & so hard to unravel everything when thyroid conditions & meno are combined?  With having had to reduce Thyroxine shortly after starting the Angeliq, I think this could make it more difficult for you to know which changes are due to which meds.  You will already be very used to being patient with HRT changes & it's a right pain, I know. 

I wouldn't think having had too much Thyroxine for just a short while will have had a lasting effect on your heart, but please do get in touch with your GP if you are worried as they are the best to ask.  As you know, palpitations can result from too much Thyroxine & in my experience too little, as well!  We also seem to be especially prone to them during the meno process & I have had a return of these very recently during a now abandoned trial of a different HRT regime, so for me they can be caused by gynae hormone fluctuations as well.  My GP wanted to listen to my heart & gave me a quick ECG to check the palps out again & this was all fine - for me they are due to harmless ectopics, though when they come in long, persistent bouts & feel irregular it can be scary, I know.

I find that each change of meds, whether thyroid or HRT can really upset the apple cart and take a toll on the body, but if you can get as much relaxation as possible, try to divert worries by doing whatever feels good for you & focus on the thought the latest meds changes could make you feel so much better, I hope this will help you get through the adjustment phase & quickly too.  Good luck with it - I will be thinking of you & willing it all to go well.

[Tempest]

All I can say is, bless both of your hearts!

When I saw my Endocrinologist recently to rule out thyroid issues, he said that balancing HRT with thyroid medication is indeed very tricky. Both need to be well monitored.

I think I mentioned before that a lady called Joesmum on the forum has problems getting her HRT right whilst balancing thyroid medication. She sees her Endo. pretty regularly I think. I would probably ask for a referral Warwick, as you have reason to do so after your recent test results from your Gynae. It could make all the difference! xxxxx

[babyjane]

This is the main reason why I chose not to go down the HRT route.  I have enough trouble keeping my thyroid levels stable as it is 

When I saw my Endocrinologist recently to rule out thyroid issues, he said that balancing HRT with thyroid medication is indeed very tricky.

[Tempest]

Gosh, it is so hard BJ! I discussed this with the Prof. Of Endo. that I'm  seeing (he doesn't dabble in HRT as he's focused on thyroid, adrenals etc). He said the thyroid should always be considered first and that steroid sex hormone changes whether it be from natural fluctuations during meno itself or HRT can greatly affect thyroid stability.

I know this is why wee Joesmum is having so many issues. I remember when another lady here went hyperthyroid from hypo. when she was on Estrogel too. It's a tough balancing act! xxxxx

[babyjane]

well T. I am 60 and post meno now.  My symptoms have abated considerably.  How I would have been on HRT I will never know but I opted for thyroid stability.  I can still remember the months and years post Hashimoto diagnosis, it took about 18 months to stabilise (30 years ago) but it didn't last long.  I have been up and down a lot over the years.  since I have been with my current endo I have been more stable than I have ever been because he is one of the top guys in the country, so I wasn't willing to rock the boat or upset the apple cart or whatever.

If I get problems from not using HRT later on I will cross that when I come to it, I may not, mother didn't 

[Annie0710]

Neither my mum or my nan took hrt

Nan died at 85 of a silly thing that shouldn't kill anyone but she wouldn't tell us she was suffering, I never knew my nan to be ill

Same with my mum, never ill, energetic although the nurse said she had the worst prolapse she'd ever witnessed, like my nan she never went to Drs.  When she had her brain haemorrhage we were told she had hours to live, she lasted 2 more days in a coma and Drs were amazed how strong her heart and lungs were, just goes to show x

[babyjane]

Yes, i think sometimes we can be so fretful of the future we miss out on some of the present.  My life is stable now and I try to get the best out of it with my limitations.  If things change I will deal with them as they happen 

I fought my limitations for a long time, feeling guilty about them, but I am ok now, in a better place of acceptance with a supportive husband and family.  I am fortunate 

[Wrensong]

Thank you Tempest.  As said often before on MM, with breast cancer in the family, I would never have started HRT had I not been absolutely desperate by the time I eventually agreed, 3-years post-meno.  Having tried to be patient and wait for symptoms to subside for more than a decade, my life still bore little relation to that before peri -  I was absolutely burnt out from so little sleep & felt I was wasting away.  Sound like a drama queen I know, but I actually felt that if this went on much longer, my body wouldn't be able to stand it & my future was not likely to be a long one!

Like Babyjane, I have a very good Endo, a Cons with decades of experience and on top of that he is simply the most lovely man.  As he was the one to say "I want you to have some oestrogen", I took this seriously and reconsidered, knowing that in this lovely doctor, I could have no better ally to help me get better.  That doesn't mean I think HRT is the answer for everyone & know it's sadly not a panacea.

Though there can be so much unexpected horror to come to terms with during the meno years, a lot of good has also come out of it for me.  It's taught me to be so much more appreciative of even simple things I used to take partly for granted.  Garden birds, a lovely sunrise or sunset, good company, a lovely walk & so much more.  After the constant worry of palps for several years, when they finally went a couple of months after going back on T3 & starting full HRT, I was so relieved & grateful for every day I got through with a normal heartbeat!  A menopausal madwoman overjoyed at a normal heartbeat- how sad is that?!! 

Though still a congenital worrier, I don't think I sweat the small stuff in quite the same way & may now be as chilled as I'm ever likely to get!  All sorts of things I hardly noticed before peri now give me so much pleasure & there seems so much to be thankful for.  It's as if prolonged difficulty, stress, struggle, whatever you want to call it, increases the capacity for happiness.  I imagine this happens to many of us after the worst of meno is over - it's a lovely silver lining, so I do hope so.

I really feel for all of us struggling to find our own path through - it can be long & strewn with steaming great cowpats, but I think we also learn a lot from it and dare I say, probably emerge stronger for the experience. 

When it was decided Utro might be the next best step for you Tempest, I thought it best not to pop up in your threads, a potentially worrying reminder of someone who didn't do well on it, so I'm afraid I'm out of touch with your situation, but I do hope you are OK and that the future will bring big improvements in your life.

[Wrensong]

Hi Warwick - just wondering whether you're starting to feel any better after reducing the Thyroxine?  Early days, I know.