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[flaxhigh]

I wonder if anyone can relate? I'm rather worried as for the last 3-months or so I can hardly keep awake after about 4 hours of being awake. So drowsy as if I've been drugged. Plus return of hot flashes.

I've successfully been on Evoral 50 x 2 a week plus Utrogestan vaginally every night for years. I should be on a higher dose of Evoral but can never increase due to palpitations. All meno symptoms had disappeared.

Now I'm getting pounding heart even on this dose. But it's the return of the other symptoms that is worrying me. Is this normal? The only time I had these - and it wasn't consistently, more for a few days a month - was in perimenopause.

I've read these symptoms could be something more serious....it's definitely not a post-viral thing as I have long term ME quite badly and this is quite different (not 'low battery' as in ME, but just extreme drowsiness/exhaustion)

I'd be super grateful if anyone can advise. Thank you!!

[jillydoll]

Hi

Yes, it’s probably down to the utrogestan, makes me tired after a good nights sleep too.
I take mine orally.

[bombsh3ll]

Perhaps your own hormones have declined to a new low in the background, or maybe something has changed to reduce your absorption or increase metabolism of the estrogen

Has anything else in your health or environment changed? A new medication or weight gain/loss? Being in a warmer or cooler environment?

Perhaps it is the patches themselves - manufacturers do sometimes change the formulation of a product to save money, and it doesn't always work as well. There are other complaints on here about patches no longer sticking, gel that seems weaker etc.

Assuming you have been checked out for the palpitations and they are benign, I would be inclined to trial an increased dose.

Also have you considered testosterone as well? This can be particularly effective for fatigue and exhaustion.

[CLKD]

MayB increase occasionally so that the body isn't overwhelmed?

[AKatieD]

I am about a year from experiencing the same thing. I found I had suddenly very high cortisol and sex hormones dropped drastically. Worth testing

[flaxhigh]

Thank you everyone who has replied.

I'm checking out the pounding heart with ECG on Thursday. Have had my heart checked out a few years back and no risk for C. heart disease but still...

AKatie - what was the high cortisol from? I'm going to ask GP to test my hormones this week and will ask about cortisol.

bombsh3ll - I'm going to go back to the Menopause clinic in London and talk to someone hopefully soon - see if they can shed any light on what's happening. I suspect it is my oestrogen level diminishing. Surely that happens as you get older otherwise why do older people develop osteoporosis (I already have osteoporosis and was put on HRT for it). But I've never been able to get higher than Evoral 50 as it gave me palpitations. Since I have a pounding heart now anyway though I might as well increase the dose and see what happens. I don't think it is the actual patch as I've started a new box and I'm just as bad on them as the last box. No new medication/weight gain. I am on testosterone - but only half dose. I'm going to up it to full dose and see if that helps.

CLKD - I already have put a sliver on as well as my usual patch this last 2 weeks - no difference as yet. Have to increase incredibly slowly as I"m soooo sensitive to hormones. It took me 18 months to build up to just one 50 patch!

Thanks ladies!!

[AKatieD]

@flaxhigh not really sure.

A year since partner died so would have expected the effect from that sooner. Nothing obvious causing high cortisol ( DHEA was very low too) so maybe just  a cumulative stress effect.

I had started testosterone about 6 months before but stopping that made no difference, so not that.

[pepperminty]

Hi,

do get a blood test for Ferritin, vitamin D , B12 etc just incase you are low in something. If you don't want to go through the GP medichecks do private testing.

PMx

[joziel]

flaxhigh, your cortisol can often go up because your sex hormones have declined.  The body needs something and responds to a lack of sex hormones by providing more of what it can make - cortisol and adrenaline.

I think really you should trial a higher dose of E. You might need to cut patches up into slithers and increase very gradually so your body gets used to it. But there's no reason you can't increase - your own body would have had hgiher levels before menopause....

[flaxhigh]

Sorry to hear about your partner - sending hugs. AKatieD

Thanks Pepperminty - I am getting the ferritin checked on Thursday, Am taking loads of Vit D and am qite high plus high in B12 so I don't think it's that - though could be low ferritin.

Joziel - thanks for that. Yes, I will start cutting up the patches again and increasing very gradually. It's just killing me that literally 4 hours after waking I'm in a severely drugged drowsy state. Just awful! Makes sense about the cortisol and adrenaline as my heart started pounding last September and has never stopped and then the drowsiness followed....it's all starting to make sense I think...

[joziel]

I would recommend doing a 4-point saliva cortisol test. Once you know when your cortisol is high and when it is low (symptoms can be very similar) you can do things to help that.

You can get 4 point saliva tests from Medichecks for eg.

I found that I had high cortisol late afternoon and before bed. This corresponded with pounding heart, inner tremors and insomnia. I take Seriphos (supplement) and ashwaganda plus zinc early evening, which all lower cortisol. But really also I've got my estrogen way up now, which has meant my body doesn't need to make all this cortisol. I am sleeping so much better.

I'd also recommend getting a full thyroid panel done, since symptoms can be very similar. Don't just rely on the TSH which the NHS do. My TSH was normal but my T3 was way below range and T4 only in range by 0.1. I'm now on T4 and T3 and doing so much better. You can get an Advanced Thyroid Panel also from Medichecks... 

[flaxhigh]

Thanks Joziel,

So glad. you've sorted yourself out. What level of HRT are you on now?

My thyroid is normal T3: 4.4, T4: 15.3, TSH:3.39. I did see a thyroid expert who said I could trial a very low dose of levothyroxine since I had thyroid antibodies but I declined. Maybe I should go back to him. Who did you see to get on to T4 and T3 if the NHS don't recognise a problem? I saw Dr Jenkins in London.

I will look at those supplements you mention - thank you!

[joziel]

I'm now on 275mcg of Estradot patches plus 6 pumps of Oestrogel each night. This gets me to between 650-850pmol. I am also on 500mcg of utrogestan vaginally, day 15-26. (300mg before bed and 200mg in the morning.) I need to test again this month to see if this is getting my progesterone levels up a bit higher, as on 300mg only (vaginally) it was in range but on the low side. Since I am taking a high estrogen dose, I take care to be sure I am getting enough progesterone as well. And I'm also on testosterone.

If you have thyroid antibodies, you probably should trial thyroid medication. Things will only get worse as your thyroid is further destroyed by the antibodies. I see Dr Momi from Functional Thyroid Care - he sees people online via Zoom so you can work with him anywhere in the UK. He prescribes levo but also T3 and he doesn't go by TSH but by your other levels. He's been my saviour. I am finally about right with the thyroid, on 75mcg T4 plus 30mcg T3 (split 10/10/10 - 3 doses each day). I have bloods in 2 weeks to check but, going by how I feel, I think I'm just about there.

The final thing to say is that I did my DNA via Ancestry. I mainly did it because thyroid people advised me to check and see if I had any relevant thyroid gene polymorphisms. You need to download the raw data after you've done the test, which is just a string of numbers and letters. It turns out I do indeed have the DIO2 conversion problematic gene, which means I can't convert T4 into T3 very well. This explains my low T3 and my previously high rT3. I feel like I have some evidence to show doctors in future, should it be questioned whether I need T3. BUT ALSO....

It turned out that I have SNPs that mean I don't convert beta carotene to vitamin A very well. I have a 69% reduction in ability to convert. PLUS, I have another SNP which causes low serum levels of vitamin A. All this means that I was very likely vitamin A deficient, especially given a rubbish diet most of my life. So I got some vitamin A and started taking it and I noticed an immediate improvement in sleep. I'd previously been too scared to take vitamin A  as it's one you can overdose on, and end up with toxicity - so I needed the DNA test to encourage me to give it a go. ChatGPT gave me a list of neurological vitamin A deficiency symptoms which sounded very much like what I was experiencing. Which is all to say, if you are trying to plough through symptoms and casting a wide net, I do think the DNA stuff can throw up things that are useful to try. It's also not very expensive compared with 65000 blood tests....

[SundayGirl]

My thyroid is normal T3: 4.4, T4: 15.3, TSH:3.39. I did see a thyroid expert who said I could trial a very low dose of levothyroxine since I had thyroid antibodies but I declined.

Your thyroid function is far from normal! (No such thing as normal with thyroid conditions)
Even without ranges it's pretty obvious. Your TSH is too high - the majority of euthyroid people, ie those without a thyroid condition, have a TSH round about 1 to 1.5

Go back to the doctor who offered you a Levo trial and take them up on the offer.

I wouldn't normally do this but assuming usual NHS ranges, your T3 is further through it's range than the T4 which indicates your thyroid is struggling.

The tiredness and heart pounding are symptoms of hypothyroidism and some hypos are misdiagnosed as having ME. Your thyroid could have been struggling for a long time.