Premarin and Synthroid

Hello,

My doctor put me on Premarin .625 right after my hysterectomy. At about 7 weeks, I talked to him about my night sweats and hot flashes and he doubled the Premarin to 1.25. Before the increase in estrogen, my blood pressure was normal, I was sleeping pretty well (except for waking once or twice a night with hot flashes, then going right back to sleep), and I was feeling pretty OK.

I saw the doctor last Monday to follow up on another issue, and my blood pressure was 156/108. I'm waking up at night and can't go back to sleep because I'm all keyed up and can't get settled back down, then I fall asleep during the days - in meetings, in Home Depot, and in Pier One. The doc went kind of reactive about this and wanted to do a sleep study, then when I told him about being keyed up, he wanted to add serantonin and anti-anxiety medication. I convinced him to just drop the Premarin back to .625 and see what happened since the increase seems to be when everything else started. Then, he ordered blood work to check my thyroid level.

Friday his nurse called to say my thyroid level was high and that my Synthroid needed to be lowered. She said the doctor wanted to know if I wanted the results sent to my regular doctor (internist). I said yes because this man obviously doesn't know what to do and at least this way I get a second opinion. But, I don't know if the internist really knows that much about managing estrogen therapy, especially when we're talking about an estrogen/synthroid interaction. Also, everything I've read about this interaction says estrogen generally makes the thyroxin levels lower in people who have hypothyroidism, not HIGHER.

Oh yes, in addition to the symptoms of hyperthyroidism, I do also have the symptoms of too much estrogen - bloating, weight gain, etc. A week later, those symptoms are still there and my blood pressure is just as high as it was a week ago.

Does anyone have any information or insights on this? Any help would be greatly appreciated.

Hi

Thyroid and estrogen symptoms can be confusing. If you aren't sure your Dr is knowledgeable enough in both issues to treat you, then you may want to find another one. Everytime my thryoid or estrogen has been changed, then the other needed to be changed also. There have been times when I was sure that one was the culprit for a symptom, only to find out that it was the other.

You might want to call your internist and ask his nurse if he is comfortable treating surgical menopause with HRT and hypothyroidism.

Another way to find the right Dr can be through a local compounding pharmacist. You still don't have to use compounded hormones, but the Dr's who use compounded pharmacies usually have an interest in HRT. The pharmacists will also know which Dr's are knowledgeable in the area of thyroid also. This is how I found my favorite Dr, who was actually a family Dr with an interest in endocrinology. :-)

Hang in there.


Kay

Kay, Thanks so much for the suggestion of contacting the compounding pharmicist to find a doc. I'm going to call the internist tomorrow and really push to get in to see him - this blood pressure thing has me worried. If I don't think he knows what to do next, I'll definitely talk to the compounding pharmicist as soon as possible.

I'm just getting so frustrated with this whole thing - everyone else in my same week group is back to their lives and I'm still struggling to feel normal again.

I take synthroid as well. When I started with my current GP last year he told me to tell him if I lost weight. He said my weight would affect my estrogen levels and that my estrogen levels would affect my thyroid function. He also said that if that happened my synthroid dose would have to be lowered.

I would say definitely have your results forwarded to your GP. It may be that you don't need as much synthroid.