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Unusual Situation
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida Sarasota - FL
Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

Unusual Situation

by yoga, Oct 21, 2005 12:00AM

I have an odd situation in that I go hypothyroid (by labs and charting symptoms) during my menstrual cycles as estrogen goes high. Just before my period, during, and shortly after, are when I return to normal. My cycles are around five-six weeks long so this means just over a month of feeling bad, to a week or week and a half of feeling OK.

I've read that estrogen promotes the formation of thyroid binding hormones in the body, and I'm suspecting that this is why this is happening but no one seems to have an answer for this.

I became further convinced when recently starting Demulen, a combo est/progestin birth control pill, to try to control this, which made things a LOT WORSE (when I didn't think they could) and after a week and a half I had to stop taking it.

I've bene using a compounded progesterone cream for about a month which seems to have minimally helped.

Therefore, I'm not sure if the proper direction to go is to take thyroid replacement, or micronor, which has no estrogen but supposedly lowers these binding hormones?? or ???

Thanks much,
Amie

by Mark Lupo, M.D., Oct 21, 2005 12:00AM
It does sound like your binding globulins are especially elevated during your cycle.  Did you mean that the menstrual period lasts 5-6 weeks or your cycle is 5-6 weeks (ie, menses every 5-6 weeks)?  The microor does not have estrogen, so that may help a little.  Taking thyroid hormone could help overcome the dip in bio-available thyroxine during your cycle - of course the med would also be bound, but if you get enough in your system it may help -- worth a try as long as you don't get symtomatic hyperthyroid and you've gone through the trouble of documenting the fluctuation in levels - did you measure TBG and SHBG (binding globulins)?
Member Comments (11)

by Ussie, Oct 21, 2005 12:00AM
To: Yoga
I am hypothyroid, and if taking estrogen whether patch, cream or pill. It causes me to go more hypothyroid.

by jkrl, Oct 21, 2005 12:00AM
To: Yoga
I don't understand when your problems are with your thyroid but I know that hormones most definately affect mine. Right before my period my fingers tingle and sometimes my face. The problem used to be much worse but I have managed to regulate it by my Armour medication and I also take amino acids, L-Tyrosine specifically. When I was diagnosed, my doctor took me off of birth control pills because of the fluctuation of hormones and said it was the worst thing for me. (Dr. Mercola, has a large web-site.) I am now having tightness in my throat which is why I came to this forum to see if this is something anyone else experiences. I do believe that seeing an endocrinologist is in order to rule out any problems.

by ArmourGal, Oct 22, 2005 12:00AM
To: jkrl
Folks with Hashimoto's often report a feeling of discomfort in their throat and difficulty swallowing...so if you're going to an endo, I would hope they test for thyroid antibodies.

by gassy, Oct 22, 2005 12:00AM
I have tested positive for anitbodies (476) and yes I still have that tightness in my throat and problem swallowing so this is a side effect of Hashi's and how do you get rid of it?

by ArmourGal, Oct 22, 2005 12:00AM
To: gassy
Yes, those are listed as symptoms.  
For me, the symptoms went away with optimal thyroid hormone treatment.  I take Armour Thyroid.  Some folks do mention some occasional discomfort which they attribute to antibody flareups for one reason or another, but mostly folks who have their Hashi's under control seem to not have much problem.  Sometimes ingestion of iodine (like in a vitamin pill) can cause the pain in the throat feeling too, so I make sure i take a vitamin with no iodine.
Cindi

by yoga, Oct 24, 2005 12:00AM
To: Forum M.D.
Thanks so much for the reply! Other places I post seem to go I would just get a "How strange, never heard of that before..."

SHBG was tested before and was in the normal range - don't have the #'s with me now as I'm out of town, but TBG has never been tested. I just started charting symptoms earlier this summer. Doctors seem to ignore the relationship to my menstrual cycles so many times I've also had to pay to order the tests myself.

I am somewhat worried about going on thyroid hormone since last year they thought I was hypothyroid and they put me on thyroid medications for eight months - and for whatever reason the more medication they would add, the lower my labs would go and the worse i would feel. I ended up 25 lbs heavier, in severe pain (muscles and joints), edema, exhausted. I did research and found I had what turned out to be a low-t3 syndrome caused by not eating enough (I am generally a high performance athlete).  After I found out about the low T3 syndrome, i improved my diet, and my menstrual cycles returned. I then got off the thyroid medications and got a LOT better but then have noticed this pattern worsening with each menstrual cycle ever since. I believe this is what caused the low calorie dieting with training because for 4.5 weeks out of each six, i can't lose weight or even gain.

An ultrasound also picked up my endometrial wall was very thick, too, 15, which just seemed to be caused by the excess estrogen - no polyps or cysts. This leads to a very heavy flow with each cycle.

My menstrual cycle is 5-6 weeks. I was on the birth control pill for eight years in my 20's to control irregular cycles and bad PMS, after I got off it, I noticed my health starting to go haywire - weight gain with slow loss, increasing allergies/asthma, which I didn't have before. Now I can't even go back on the pill I was on due to the increased fatigue it causes... which didn't happen before I was on the thyroid meds - so that's why i thought of micronor, i read it decreased the TBG in the body.

Thanks!
Amie

by yoga, Oct 24, 2005 12:00AM
To: Forum M.D.
Thanks so much for the reply! Other places I post seem to go I would just get a "How strange, never heard of that before..."

SHBG was tested before and was in the normal range - don't have the #'s with me now as I'm out of town, but TBG has never been tested. I just started charting symptoms earlier this summer. Doctors seem to ignore the relationship to my menstrual cycles so many times I've also had to pay to order the tests myself.

I am somewhat worried about going on thyroid hormone since last year they thought I was hypothyroid and they put me on thyroid medications for eight months - and for whatever reason the more medication they would add, the lower my labs would go and the worse i would feel. I ended up 25 lbs heavier, in severe pain (muscles and joints), edema, exhausted. I did research and found I had what turned out to be a low-t3 syndrome caused by not eating enough (I am generally a high performance athlete).  After I found out about the low T3 syndrome, i improved my diet, and my menstrual cycles returned. I then got off the thyroid medications and got a LOT better but then have noticed this pattern worsening with each menstrual cycle ever since. I believe this is what caused the low calorie dieting with training because for 4.5 weeks out of each six, i can't lose weight or even gain.

An ultrasound also picked up my endometrial wall was very thick, too, 15, which just seemed to be caused by the excess estrogen - no polyps or cysts. This leads to a very heavy flow with each cycle.

My menstrual cycle is 5-6 weeks. I was on the birth control pill for eight years in my 20's to control irregular cycles and bad PMS, after I got off it, I noticed my health starting to go haywire - weight gain with slow loss, increasing allergies/asthma, which I didn't have before. Now I can't even go back on the pill I was on due to the increased fatigue it causes... which didn't happen before I was on the thyroid meds - so that's why i thought of micronor, i read it decreased the TBG in the body.

Thanks!
Amie

by ArmourGal, Oct 24, 2005 12:00AM
To: yoga
a note on that endometrial wall..I too had a thickened uterine lining and biopsy was recommended...however I did not do that and my heavy menstrual periods were corrected in three months by Armour Thyroid...so i'm assuming my thickened lining was probably also a hypo thing.  I really haven't ever seen that listed anywhere (just heavy periods and clotting and infertility) as a hypo symptom, but I do know several other hypo women who have had the same problem at some point in their hypo.
cindi

by yoga, Oct 25, 2005 12:00AM
To: Armourgal
I started on a low dose of Armour today. I go to the doctor in about a week. I am also going to talk to them about micronor. These fluctuations with my cycle are really bad, when they occur. It's good to hear your heavy flows were cured by the Armour. What doseage do you take? I realize it varies from person to person.

by sannuska, Oct 27, 2005 12:00AM
HI, I am hyperthyroid and although am on medication now, an feel fine for the rest of the month, I go hyper during my period. In fact, I can remember having been like this always, not only since confirmed hyperthyroid. I'm sure there's a link. S
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