Hypothyroidism and Estrogen

Hello,

Can anyone tell me what is the most effective estrogen to take if you have hypothyroidism? Or is there a best combination of ERT and thyroid drugs?

I had a total hysterectomy in 1999 due to fibroids. I'm on Estrace, Levothroid and Prozac. Have been on Prozac for a few years, but have only been taking medicine for hypothyroidism for about a year. I believe that the reason I had to start taking thyroid replacement is because of taking estrogen but my PCP, GYN and Endcronologist say it didn't have anything to do with it. And that estrogen and thyroid replacement drugs do not interact. I'm just not convinced.

Anyway, I feel pretty good except for weight gain (especially water retention). I've gain 30 pounds since my surgery and gone up 2 dress sizes. Doctors say it's just because of my age (47). I do weight bearing excercises 3 times a week. I haven't been watching my diet though.

Any suggestions?

Cindia

Estrogen can cause hypothyroidism by increasing a protein called sex hormone binding globulin (SHBG). SHBG binds to thyroid hormone and testosterone, rendering both inactive. Many women who are taking estrogen unopposed with progesterone end up on thyroid medication. Because of the increase in the SHBG that ties up the testosterone, then many women complain of low libido. It is well known that estrogen increases SHBG.

The best way to decrease your SHBG is to start using progesterone and to probably decrease your estrogen dose. The doctors have a tendency to prescribe way too much estrogen.

Lauren,

This is interesting. About 2 years before my Hysterectomy, I had a thyroidectomy, and am now on Synthroid and taking Estratest H.S. am wondering if I should be taking Progesterone too. And about the only real set back seems to be the weight issue.
Just amazes me the the Dr's know about both surgeries and neither one ever mentioned about the Progesterone.
Then on the other hand, I am now just learning about bio identicals. And thinking of trying out one of the transdermal patches and Prometrium. Would really like to see if the weight would come down if I switched or just stay with the Estratest and then add the Progesterone.



Tina

Cindia is your hypothyroidism related to hashimots at all? Hypothyroidism can be caused by many things. I am also hypo and have hashimotos thyroiditis. I am on bi-est, progesterone, levoyxyl and cytomel. My doses of my thryoid drugs are fairly low though and in talking to my endocrinologist he also believes that the reason for this is due to the progesterone helping. If fatigue is really bothering you then maybe your doc would consider a small amount of cytomel (T3). It helped me some with the fatigue.

BrendaLee, Tina and Lauren, The doctor just said autoimmune thyroiditis. He did not say anything about taking the thyroid drug without food, but I've heard this. I'm planning to add progesterone and try taking my levothroid at night and estrace in the morning and see how this works. I would like to try armour. Have any of you tried it? Thanks for all your help.

Cindia

Cindia autoimmune thyroiditis would be Hashimoto's. In cases like ours its the immune system that caused this to happen. Your docs are right that the estrogen is not a factor in the cause of the hashi's BUT the estrogen could cause your hypothyroidism to become worse by binding the thryoid hormone as Lauren said. Hashimoto thyroiditis is a disease and hypothyroidism is a condition that in our case is usually brought on from the hashimotos.
I take my levoxyl and cytomel in the morning. You are not suppose to eat or drink anything besides water for 1 hour after and two hours before taking your thyroid drugs. It just works out best for me in the morning as I have had nothing to eat or drink for many hours. My hormones I take at night.
The armour works really well for some but I did not do well on it. If your body is good at converting the T4 to T3 the armour can cause you to go hyper fast and it is an AWFUL feeling. The problem with armour is that to get a high enough dose of T4 you get a large amount of T3. T3 is the active thyroid hormone and in large amounts can cause heart palpitations, panic, anxiety attacks and the list goes on. I literally thought I was going to die. For an example I take 50mcg oflevoxyl and 6.25 mcg of cytomel (T3) . In order for me to get that amount of T4 in armour i would be getting 25 mcg of T3. That is way to much for me as it sent me into a hyper state and my labs showed it. It took my T3 to 214 in a normal range of 60-181. My T3 is now running around 154 and not having any of the negative effects.
I'm not saying that this would happen to you but I would certainly see how well your body is converting the T4 to T3 before switching to armour. This is simply done by doing a Free T3 count during your next labs.
Hope this helps some and I havent confused you. Let me know if I can help any further.

A recent study showed that taking estrogen doesn't cause hypothyroidism in the sense that it attacks the thyroid directly (I don't want anyone more scared of taking HRT then they are already!). It causes hypothyroidism in the sense that when it binds up some of the thyroid hormone with SHBG, people with healthy thyroid glands respond and pump out enough new thyroid hormone. But people whose thyroid glands were just able to stay even can't respond and so estrogen causes the symptoms of hypothyroidism. So eventually the symptoms would have shown up, but this way they show up much sooner.

Thyroid testing (TSH and free T4 at the very least) is probably a crucial part of the Jungle in the first year or so. Janie wrote up her misadventures with it all www.hormonejungle.com/janie.php

I mostly wanted to chime in here and say that a terrific source of information on thyroid is at thyroid.about.com

One of the tidbits I got from there is to take 150 mg of selenium a day or eat two Brazil nuts, which are high in selenium. Selenium is very good for us as an antioxidant, but it's also needed for the conversion of T4 to T3, so it helps those of us on T4 replacement (synthroid in my case).

Cyndia,
I have recently started taking Cytomel (T3)along with my Levoxyl. I am on Estrace (generic)and Prometrium. I tried the patches but they did not work for me. Could have been because my free T3 levels were dropping. It took me a while to find out I needed to add the T3 because my levels were fluctuating from the surgery and the changes in HRT. Since starting the Cytomel, I have lost alot of the brain fog, and the bloating. My energy level is finally starting to come up too. I still have plenty of weight to lose. Needed to get my energy level up to where I could even think about diet or exercise. I too would like to see if I could go to a lower dose of estrogen, but only want to tinker with one thing at a time.
Terri