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277535 tn?1218139798

Estrogen too low?

Hi Dr. Lupo,
32 yo, female, 132 lbs, 5.5', good shape, very active
Currently on 112mcg synthroid, have Hashi's, labs on 1/26/09- TSH 0.98, FT4 1.5 (.8-1.9), FT3 2.5 (2.3-4.2)

My Repro endo wants me to start on Vivelle-dot and prometrium therapy because she thinks my current symptoms are low estrogen related.  I have irregular cycles, only two cycles since last April 2008 and one was induced by prometrium.  Last cycle was 42 days long.  I had estradiol drawn on day 12 of my cycle and it was 40 and was told it was too low.  My FSH is normal and does not indicate ovarian failure.  I have been checked for PCOS as well and it has been ruled out.  

I continue to have hair loss, sleep disturbances, moodiness, quick to anger, dizziness and headaches.  I felt very fatigued this weekend and took my BP and pulse- it was 104/71 and I had a pulse of 48.  I thought my BP was going to be high but instead was shocked by my pulse rate.  Do you think my symptoms could be related to a less than optimal T3 level or do you think I could benefit from starting estrogen therapy?  Will I likely have to increase my T4 meds if I start estrogen therapy?

Any advice would be appreciated as I am very hesitant to add estrogen.

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97953 tn?1440868992
Levels look ok on current dose -- likely no benefit from T3 treatment, but is is an option.  If starting on estrogen, may need higher dose so retest thyroid in 2 months.

I don't prescribe any non-thyroid hormones so would defer to GYN (RE) about the hormone treatments and expectations otherwise.
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