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[Wrensong]

Baby, so sorry to hear how disappointing your consultation was.  It's such a let down when we get psyched up for those & it feels unsatisfactory in the end.     Can I ask was the 2.5 TSH you mentioned above the last time you had it tested?  Also how long have you been on Thyroxine?
Wx

[Baby]

It was 2.5 in June. I have been on levothyroxine about seven months. X

[Wrensong]

Oh dear, I had hoped you might have been on it for a fairly short while in which case I'd have said give it 6 months.  Do you know what your T4 level was with the TSH of 2.5?  And can I ask how old you are?  It's just that some people, especially when younger, find they need their TSH to be really close to bottom of ref range to be asymptomatic.  But if anxiety is a problem, then more Thyroxine might make you feel more jittery & 2.5 is close to what's considered optimal for TSH. 

What did the Consultant say about your symptoms not resolving with what he considered an acceptable TSH?

Also how far into your 3 month trial of your latest HRT are you?

Sorry Baby - a lot of questions.  No need to answer of course, especially if you need time off from thinking about it all.
Wx

[Baby]

I am in the third month of my HRT. My free t4 was only done once in Nov 2019. It was 17.9 with normal range between 12.00 22.00. He said my symptons just sounded like a terrible menopause

[Wrensong]

OK, well that T4 was pretty good then.

What's your gut feeling - do you think it could be "just" a terrible menopause?  I know it's so hard to be sure when so much is changing from what we've known for decades as adults.  I was so unsure what was going on with me in peri & far from convinced it was just that.  But I'm hypothyroid too & many years on that still complicates the situation.

Are you under a Menopause Clinic or is your GP overseeing your HRT?  Sorry if I've missed that.  Was it a one-off Endocrine consultation or will you be reviewed?
Wx

[Baby]

Just a one off consultation. I had a video consultation with newson health in April, they just advised the gel and to up the dose. I did up to eight pumps over four months. No difference, so they advised can't think what it's called but it's another kind of liquid spray but no difference.. I am wondering if the levothyroxine could be making me worse if my body doesn't really need it as I was only borderline 5.5 originally. Just fed up with feeling crap. Gp advised the latest hrt tablet. I have never had my oestrogen progesterone tested. Scared to in a way because if they were to come back as good levels I now I must really be going mad. 

[Baby]

I am 52 and a half.x

[Wrensong]

Oh, pity Endocrinology are not going to review you.

If you didn't need Thyroxine then yes it could make matters worse but your 2.5 June TSH (on Thyroxine ?4 months) didn't indicate you had had no need of it.  If the Thyroxine were more than you needed at that time your TSH would have been suppressed.

Do you have any symptoms of over-treatment other than anxiety - eg feeling permanently too hot for the conditions (I know flushing & night sweats can make it hard to tell), weight loss, diarrhoea, fast heart/pulse rate?  If so I would alert your GP as they may want to repeat the TFT sooner rather than, later.

On the other hand, if you are hypothyroid & on oral oestrogen that will probably affect your thyroid status, increasing your requirement for Thyroxine.

"Good levels" of sex hormones & those related to them, such as FSH & LH found on testing at around menopausal age would not necessarily indicate you are not menopausal.  It's a potentially very unreliable snapshot during a time of great hormonal fluctuation, which is why they prefer not to test.  But you are not going mad.  Or if you are, you are in good company here!
Wx

[Baby]

I lost a stone in weight earlier in the year in two weeks and when I started this latest HRT I put it back on after two weeks of starting it. No change in diet. Before meno I always had constipation, now within five minutes of getting up I go and its always loose. OnlY go once a day. One thing I have noticed is I feel uncomfortable in the sun even if it's not that warm. Was never a problem before meno only f it was realliy hot. I used to work with a girl who was hyperthyroidism and she couldn't keep still, she used to be like a little rocket around the workplace. She drank absolutely gallons of coffee and I remember her hands used to shake. She was treated with radio iodine I think its called. X

[Wrensong]

I lost a stone in weight earlier in the year in two weeks and when I started this latest HRT I put it back on after two weeks of starting it. No change in diet. Before meno I always had constipation, now within five minutes of getting up I go and its always loose.

That weight loss in 2 weeks was a lot if your diet hadn't changed.  Did your doctor have any explanation for it? 

Do you know your thyroid antibody levels?

If your tummy seems abnormally loose as opposed to an improvement on the former constipation, that's something else I would mention to your GP.  Do you need to change your diet to manage it do you think?  If you were used to eating a lot of fibre to try to manage the constipation is it possible you need to reduce it a little now the Thyroxine may have resolved the sluggishness? 

Or if you are now on a low fibre diet, depending on the nature of "loose" some bulk might help hold things together.  They sometimes prescribe bulking agents for looseness as well as for constipation.  Also, if you are hypothyroid there's increasing thought that a gluten-free diet can be beneficial systemically (not just for the digestive tract) to keep inflammation down.

That you are uncomfortable in the sun could be either menopause or thyroid related.  I have exactly the same problem with heat intolerance & it's so far not been fixed by HRT.

Yes radioiodine is used to treat hyperthyroidism.
Wx

[Baby]

The doctor just matter of fact said it's just stress dear with the weight loss. Never heard of thyroid antibodies levels and on checking my paperwork I've never had them checked.

[Wrensong]

The antibody tests give an idea of whether there is an autoimmune condition affecting the thyroid, that's why I asked.  Seems odd they haven't checked this as they have started you on Thyroxine.