underactive thyroid/menopause or other?

[CleverCatty]

OK. Posting this here because no idea what this is... could be a combo.

I'm 49 - menopausal as far as I know and get the usual symptoms, but not too badly.

I also have an underactive thyroid which is medicated with 150g Levothyroxine. Had blood test recently which came back as slightly high (they never give exact levels) and told to retest in a few months.

What I've been finding recently is hard to get to sleep/fall asleep/stay asleep, dry mouth, a bit of depression etc - and also a bit of anxiety too. I can snap out of the depression/anxiety quite easily.

I have had anxiety/depression/insomnia in the past which has had brief medication then therapy (including natural remedies) and a period of Prozac in late 20s but apart from that nothing else in my life.

So is this thyroid/menopause? and if so what? Ordered some magnesium sleep butter.

Unsure if I want to go down the route of HRT because I've heard people say once you're on it it can be hard to get off it.

I take multivitamins (WellWoman, Vit D, Floradix, another one for dry eyes) and have a good diet including no caffeine after 2pm and also not much alcohol as that seems to be bad for me now and also exercise regularly.

Any clues?

What have you dropped to? Thyroxine requirements can change as hormones change; iirc less oestrogen can sometimes mean you need less thyroxine. It can be a fine balancing act though as oestrogen can fluctuate (I've been having a lot of issues!)

Dropping could help; it sounds a little like too much thyroxine but you may not want to drop too much.

Ideally levels would be helpful, do you know results from previous tests as well as this one?

If you need to drop, going to alternate days or 4 x150s and 3x125 could be enough to balance you out.

But (annoyingly) , it could be menopausally related too.

I'd also try taking a couple of magnesium glycinate or biscylate at night. I found Taurine also really helpful for sleep, with the magnesium. Or you could try magnesium sprays.

Sometimes low iron (ferritin) can cause sleep issues too. It's best over 100 if you have hypothyroidism anyway.

www.larabriden.com/benefits-of-taurine-for-womens-health/

Try to find out your levels, ‘slightly high’ can mean different things to different GP’s. Slightly high TSH or slightly high T4? These figures form part of your medical records and you should be allowed access to it if you request it. The more info you have the clearer your decisions will be.

right - so have checked my TSH levels - I am now 0.19mu/L and normal range is 0.27-.4.20.

marginal thyroxine over-replacment according to notes...

Do you know what it's been in any previous tests when things were ok?

What was T4? Did you take test before or after that day's dose?

It's very hard to judge as everyone is an individual.

Some people will only feel well at that level. I was recently 0.23 and felt far too over replaced and buzzy; I'm better around 1, but definitely not if creating towards and over 2.

Your tsh can be a little lower in the morning than afternoon so always take test in the morning.

How much have they dropped you by?

I'll have a look at previous results and try to make sense and post them here.

I always take the medication in the evening so it was before that day's dose and yes I always take the test in the morning.

They haven't dropped me at all - re medication - I'm just on the same and the doctor seemed to say another blood test in a few months time would resolve it. but I've been fine for ages on previous blood tests.

Have you always been on the wellwoman?

You shouldn't take anything with Biotin in (a B vit) a few days before a test, week to be on safe side. It can sometimes change the results depending on the test, but as you'll not know what assay they'll do it's best to avoid it. It can sometimes show a falsely low tsh (repressed.) But if you've always been on that and had different results it's unlikely to be an issue, hard to know.

Ideally knowing what previous results were would help you work out what's going on. Certainly peri menopause can cause those symptoms.

In a way it's good they're not reducing the dose as many patients find they are better at a v low tsh, however if it's causing issues it's best to reduce a little.

It's just really hard to work out what's going on sometimes, working with the Gp and trying different things helps but takes a long time.

I've been on the Well Woman for approx 9 years - since I hit 40 and before I took a multi vitamin (cheaper) every day. The Well Woman for me is good because it has evening primrose oil etc in it but I'll upgrade to the Menopause one.

I've noticed (may be just me) but restless leg syndrome for a couple of nights too! God it's fun being a woman!

I'll try to find the earlier results of my tests soon

Not being able to stay asleep could also be your progesterone levels dropping. My sleep improved when I took progesterone. I also take bio-identical hormones and they control the hot flushes and other delights of menopause. Thyroxine is a juggling act, I found it more useful to take a lower amount of T4, 50, and top up with T3, Novothyrol, that has worked better for me. When I say I, what I really mean is the expensive private dr who specialises in these things 🙂 but worth every penny.

@PerseverancePays

Not being able to stay asleep could also be your progesterone levels dropping. My sleep improved when I took progesterone. I also take bio-identical hormones and they control the hot flushes and other delights of menopause. Thyroxine is a juggling act, I found it more useful to take a lower amount of T4, 50, and top up with T3, Novothyrol, that has worked better for me. When I say I, what I really mean is the expensive private dr who specialises in these things 🙂 but worth every penny.

Hmm I might try progesterone - but I see it's mostly HRT which I'm not sure I want to get into the roller coaster of taking that. I don't necessarily mind the symptoms of menopause as it will happen anyway and as long as they're not too life altering I don't mind.

My last thyroid (FSH?) appears to be 74.5 io/L.

I actually feel slightly better today.

I'm not sure I can afford private medical care but can afford a private thyroid doctor just a question of finding the right one and seeing them so thanks for that.

It's worth looking into hrt; the tricky bit is getting the balance with thyroxine too. Oestrogen can mean you need more.

I'd second progesterone if you can; I'm just starting to look at options.

Everyone is individual with thyroxine; I know I'm ok with it I just need to find the right routine at the moment; I'm going to really slightly adjust my dose as 0.23 is a bit high for me.

The wellwoman is fine; it's just that biotin can falsely lower tsh. Your result might be different without it. (Again, hard to tell.)

My last thyroid (FSH?) appears to be 74.5 io/L.

It's tsh and usually much lower; unless that was your diagnosis level?

@WarriorN

It's worth looking into hrt; the tricky bit is getting the balance with thyroxine too. Oestrogen can mean you need more.

I'd second progesterone if you can; I'm just starting to look at options.

Everyone is individual with thyroxine; I know I'm ok with it I just need to find the right routine at the moment; I'm going to really slightly adjust my dose as 0.23 is a bit high for me.

The wellwoman is fine; it's just that biotin can falsely lower tsh. Your result might be different without it. (Again, hard to tell.)

My last thyroid (FSH?) appears to be 74.5 io/L.

It's tsh and usually much lower; unless that was your diagnosis level?

my medical records are very strange - they say when I was last tested which I think was in 2019, but no test result apart from that!

I'll try to ring them on Monday and ask.

there was 23.5 but that was back in 2017!

Thanks for being helpful though - my doctors although good on other levels have never been that helpful re my thyroid condition and barely explain anything to me!

Low ferritin can cause restless legs and anxiety / low mood