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Menopause (Expert Forum)
Hypothyroid and possible menopause-whatta mess ;)
Answered by
Machelle Seibel, MD - Women's Health, menopause, ReproductiveMedicine
University of Massachusetts Medical School
MA
Questions in the Menopause forum are answered by Dr. Machelle Seibel. Topics covered include menopause issues, depression, hormone replacement therapy , hot flashes, joint or muscle problems, memory problems, mood swings, osteoporosis , sexual problems, skin changes, sleeping problems, vaginal problems, and weight problems.
Hypothyroid and possible menopause-whatta mess ;)
by aireamdh, Apr 09, 2006 12:00AM
Background: I am 48 yrs old. Have had 4 c-sections/ 2 laser surgery for adhesions/endometriosis. May of 2005, I underwent a successful craniotomy for total resection of a benign convexity meningioma. MRI December 05 showed NO regrowth.In August I began to notice symptoms that seemed to me unconnected to the brain surgery. Asked my then GYN for thyroid testing, he at first refused.In the end he reluctantly ordered 1 test, a tsh which came back at 6. I continued to feel symptoms: bloating tummy, weight gain/25 lbs QUICKLY, fatigue,anxiety, muscle weakness, swelling in ankles and legs, and some neuro symptoms as well (parasthesias and some neuropathy in feet).Then night sweats and some insomnia. Told all this to neuro at F/U, he sent me to Endo. TSH was then (October 05) up to 57. Antibodies for hashimotos were near 9,000. Treatment was begun w/ synthroid by my internist. Am now just up to .112 synthroid with tsh just under 9. Internist has recommended a full GYN work up. I told him I would not be returning to my now former GYN. This gyn had initially refused not only the thyroid panel but any hormone testing at all, altho I reported pain and negative changes to my cycle. Internist has given me name of GYN to whom he sends his wife and sister. Sorry this is so long .I need to know what I should expect at this first appointment with new GYN . What tests should I be looking to have performed. I have the trusty 3 ring binder with all thyroid test results/ surgery notes/neuro visits results. Should I bring this as well? Thank you for any input.
Doctor's Answer
by Machelle Seibel, MD, Apr 09, 2006 12:00AM
, Apr 09, 2006 12:00AM
A. You’ve certainly had a difficult go of things. But it seems you’re on the road to getting things in order. It is always a good idea to bring your medical history with you to a new doctor. It allows all the small things that they may need to know to be easy to find and accurate.
Although you have had a very challenging gyn history, your first visit will likely be a good history by your doctor so he/she can be sure what your needs are and a pelvic exam which is going to be very similar to the exams you’ve had in the past. Your doctor may want to determine if you are in menopause and discuss with you the benefits/risks or taking estrogen or alternative options to treat your symptoms. Many of your symptoms might go away with just the thyroid treatment, but some might remain and they can be viewed as possibly due to menopause and see if treatment improves them. You and your doctor will have to discuss the benefit/risk of the choices you make for treatment.
One blood test the new doctor might order is an FSH (follicle stimulating hormone) to see if you are in menopause or getting close to it. Values differ from lab to lab but the higher the value (somewhere around 15 or more) the closer you are to menopause. If you do choose to try estrogen to help with some of your symptoms, keep an eye on your thyroid hormone blood levels. Estrogen increases the need for thyroid hormone so don’t be surprised if you need just a little more. Then it will balance out. The new gyn might want to do a bone density test too to make sure you don't have osteoporosis (thinning of the bones).
Machelle M. Seibel, MD
Although you have had a very challenging gyn history, your first visit will likely be a good history by your doctor so he/she can be sure what your needs are and a pelvic exam which is going to be very similar to the exams you’ve had in the past. Your doctor may want to determine if you are in menopause and discuss with you the benefits/risks or taking estrogen or alternative options to treat your symptoms. Many of your symptoms might go away with just the thyroid treatment, but some might remain and they can be viewed as possibly due to menopause and see if treatment improves them. You and your doctor will have to discuss the benefit/risk of the choices you make for treatment.
One blood test the new doctor might order is an FSH (follicle stimulating hormone) to see if you are in menopause or getting close to it. Values differ from lab to lab but the higher the value (somewhere around 15 or more) the closer you are to menopause. If you do choose to try estrogen to help with some of your symptoms, keep an eye on your thyroid hormone blood levels. Estrogen increases the need for thyroid hormone so don’t be surprised if you need just a little more. Then it will balance out. The new gyn might want to do a bone density test too to make sure you don't have osteoporosis (thinning of the bones).
Machelle M. Seibel, MD
You have made me feel better already :)