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Estradiol and T4?
I've read somewhere that estradiol (I'm on the patch) can increase your T4. Has anyone else heard this? Also, that time of day and fasting can affect TSH. I'm going for TSH, FT4, and FT3 tomorrow.
Thanks!
~Sue
Thanks!
~Sue
Please post the last set of thyroid related test results and reference ranges, so we can see what prompted the doctor to reduce your dosage. Also, if tested for Vitamin D, B12 and ferritin, please post those as well.
In Barb's absence, I wanted to give you this bit of info. It comes from the link following, which I recommend you read.
"Estrogen dominance causes the liver to produce high levels of a protein called “thyroid binding globulin”, which, as its name suggests, binds the thyroid hormone and decreases the amount of thyroid hormone that can be assimilated into and utilized by the cells.
What does this lead to? Low thyroid function and all of the negative side effects that come along with it."
http://hypothyroidmom.com/progesterone-thyroid-a-hormonal-connection-essential-for-optimal-womens-health/
What are your Free T4 and Free T3 levels? If not tested for Free T3, it is very important to do so. Free T3 correlates best with hypo symptoms, while Free T4 and TSH do not correlate.
"Estrogen dominance causes the liver to produce high levels of a protein called “thyroid binding globulin”, which, as its name suggests, binds the thyroid hormone and decreases the amount of thyroid hormone that can be assimilated into and utilized by the cells.
What does this lead to? Low thyroid function and all of the negative side effects that come along with it."
http://hypothyroidmom.com/progesterone-thyroid-a-hormonal-connection-essential-for-optimal-womens-health/
What are your Free T4 and Free T3 levels? If not tested for Free T3, it is very important to do so. Free T3 correlates best with hypo symptoms, while Free T4 and TSH do not correlate.
I had my thyroid removed several years ago due to thyroid cancer. Everything went well until the cancer reappeared in my neck and my throat because the amunt of synthroid I was on was not enought.
My synthroid was increased by half a pill a week and everything has been going great untilrecently. My TSH levels are low, and my Free T4 is high. I am on Estradiol as hormone replacement therapy...but I always had been, so this is not a new thing.
Any ideas as to what to think?
My synthroid was increased by half a pill a week and everything has been going great untilrecently. My TSH levels are low, and my Free T4 is high. I am on Estradiol as hormone replacement therapy...but I always had been, so this is not a new thing.
Any ideas as to what to think?
I am on 100 mcg climara and 25 mcg euthyroxin. Having anxiety and panic attacks.shud i stop the euthyroxin
Thanks Red_Star, that very well may be what I read. It is good to know that the Estrogen does not affect FT4.
Thank You, The Dr has absolutely no plans on giving me anything for thyroid (but he had no qualms about giving me very potent antibiotics, telling me I had strep, without any testing).
I have an appt with an Endo, but not until Jan. 15, and don't know if he's a TSH guy or not. I guess we'll see!
I have an appt with an Endo, but not until Jan. 15, and don't know if he's a TSH guy or not. I guess we'll see!
I recently came across the August 2012 study on the "Clinical Significance of TSH Circadian Variability in Patients with Hypothyroidism" (Sviridonova MA, et. al.)
The researchers of this study found an average morning TSH level in the subclinically hypothyroid group was 5.83 mU/L and in the afternoon was 3.79 mU/L; 73% TSH circadian variability.
The average morning TSH level in the hypothyroid group taking levothyroxine was 3.27 mU/L and in the afternoon was 2.18 mU/L; 64.7% TSH circadian variability.
Based on the current TSH reference range, hypothyroidism was not diagnosed in about 50% of the cases in the afternoon. Morning: 8 - 9 am. Afternoon: 2 - 4pm.
Estrogen induced TBG (thyroxine binding globulin) elevations raises total T4 but does not affect free T4.
The researchers of this study found an average morning TSH level in the subclinically hypothyroid group was 5.83 mU/L and in the afternoon was 3.79 mU/L; 73% TSH circadian variability.
The average morning TSH level in the hypothyroid group taking levothyroxine was 3.27 mU/L and in the afternoon was 2.18 mU/L; 64.7% TSH circadian variability.
Based on the current TSH reference range, hypothyroidism was not diagnosed in about 50% of the cases in the afternoon. Morning: 8 - 9 am. Afternoon: 2 - 4pm.
Estrogen induced TBG (thyroxine binding globulin) elevations raises total T4 but does not affect free T4.
You appear to be well Hypothyroid.
Your TSH isn't horrible but it is virtually a worthless test anyhow.
Your FT4 is BELOW range and your FT3 is only 38% of the range.
Many people on this site have found that in order to feel well they need BOTH of the following to be true.
1) FT4 to be in the MIDDLE (50%) of the range if not slightly higher. You are BELOW range which is a far cry from being mid range.
and - that means in addition to
2) FT3 to be in the UPPER 1/3 (66.7%) of the range.
Now every one is different but it seems that many people need to have their Free's well up into the range. Simply being "somewhere" in the range is NOT good enough.
Your Dr I would hope will recommend a starter dose of thyroid medication. If he/she doesn't, then you should demand it.
The next likely battle you will face, is that once you get the medication, your FT4 will edge ever so gently into the very bottom of the range, and with the Low TSH, your Dr will want to stop the medication at that point regardless of how you feel. This is the battle many, many people on this forum fight.
Your TSH isn't horrible but it is virtually a worthless test anyhow.
Your FT4 is BELOW range and your FT3 is only 38% of the range.
Many people on this site have found that in order to feel well they need BOTH of the following to be true.
1) FT4 to be in the MIDDLE (50%) of the range if not slightly higher. You are BELOW range which is a far cry from being mid range.
and - that means in addition to
2) FT3 to be in the UPPER 1/3 (66.7%) of the range.
Now every one is different but it seems that many people need to have their Free's well up into the range. Simply being "somewhere" in the range is NOT good enough.
Your Dr I would hope will recommend a starter dose of thyroid medication. If he/she doesn't, then you should demand it.
The next likely battle you will face, is that once you get the medication, your FT4 will edge ever so gently into the very bottom of the range, and with the Low TSH, your Dr will want to stop the medication at that point regardless of how you feel. This is the battle many, many people on this forum fight.
10/16
TSH: 2.78 Range: 0.34 - 4.82 uIU/nl
FT4: 0.73 Range: 0.77 - 1.61 ng/dl
I haven't received the FT3 back yet, but will update when I do.
TSH: 2.78 Range: 0.34 - 4.82 uIU/nl
FT4: 0.73 Range: 0.77 - 1.61 ng/dl
I haven't received the FT3 back yet, but will update when I do.
6/15
TSH: 1.51 Range: 0.34 - 4.82 ulU/nl
FT4: 0.67 Range: 0.77 - 1.61 ng/dl
FT3: 3.03 Range: 2.10 - 3.90 PG/ML
TPOab: <0.25 Range: 0.25 - 9.00
Anti Thyroid Ab Screen: <20 Range: <20 IU/ml
TSH: 1.51 Range: 0.34 - 4.82 ulU/nl
FT4: 0.67 Range: 0.77 - 1.61 ng/dl
FT3: 3.03 Range: 2.10 - 3.90 PG/ML
TPOab: <0.25 Range: 0.25 - 9.00
Anti Thyroid Ab Screen: <20 Range: <20 IU/ml
COMMUNITY LEADER
Since you are fasting for the lipids, you will also be fasting for the thyroid labs, so make sure you're consistent.
What I meant about jockeying the results is that since the patch is part of your everyday life, not having that variable could create different readings than if you didn't have it.
What I meant about jockeying the results is that since the patch is part of your everyday life, not having that variable could create different readings than if you didn't have it.
Thanks Barb,
I took the patch off yesterday afternoon, but it was overdue. I'm not so good at remembering things that aren't everyday. Turns out I won't be having my bloodwork today, hopefully tomorrow.
I'm not trying to "jockey" the results, just trying to get a clear picture of what is happening in my body without external variables.
I do understand that I am required to fast for the Lipid profile.
Thanks Again,
~Sue
I took the patch off yesterday afternoon, but it was overdue. I'm not so good at remembering things that aren't everyday. Turns out I won't be having my bloodwork today, hopefully tomorrow.
I'm not trying to "jockey" the results, just trying to get a clear picture of what is happening in my body without external variables.
I do understand that I am required to fast for the Lipid profile.
Thanks Again,
~Sue
COMMUNITY LEADER
When did you take the patch off? If it hasn't been very long, it probably won't matter all that much.
You want your blood work to reflect what's going on, and if you, routinely, wear the patch, you'd want the blood work to reflect that, so medications can be adjusted adequately. Don't try to jockey the results or you won't get proper medications/dosages.
Fasting is not required for thyroid blood testing, though we do recommend that you not take a T3 med prior to the draw, or may show falsely high FT3 levels.
If you are having other blood tests done, which it looks like you are, from your other thread, you DO need to be fasting.
You want your blood work to reflect what's going on, and if you, routinely, wear the patch, you'd want the blood work to reflect that, so medications can be adjusted adequately. Don't try to jockey the results or you won't get proper medications/dosages.
Fasting is not required for thyroid blood testing, though we do recommend that you not take a T3 med prior to the draw, or may show falsely high FT3 levels.
If you are having other blood tests done, which it looks like you are, from your other thread, you DO need to be fasting.
OMGoodness, I have so much to learn. This all seems foreign to me.
I know that neither of you are "professionals" but I'm asking for an opinion. I took the patch off because I thought it would give a more accurate reading on the test, should I put it back on? Also, should I fast and test in the morning? I'm sorry that I'm so ignorant on the subject, and that I don't completely understand. Also, I'm having extreme brain fog today :(
I did notice that after eating iodine rich foods, I felt a little better :)
Thank you both for your continued support and understanding,
~Sue
I know that neither of you are "professionals" but I'm asking for an opinion. I took the patch off because I thought it would give a more accurate reading on the test, should I put it back on? Also, should I fast and test in the morning? I'm sorry that I'm so ignorant on the subject, and that I don't completely understand. Also, I'm having extreme brain fog today :(
I did notice that after eating iodine rich foods, I felt a little better :)
Thank you both for your continued support and understanding,
~Sue
COMMUNITY LEADER
"Does the Estradiol (HRT) lower the TSH? If I understood that correctly :) "
No - you didn't understand it correctly......... estradiol is a major form of estrogen, and as both goolarra and I posted, estrogens will raise the TSH, because estrogen binds the thyroid medication, so it can't be utilized by the body.
No - you didn't understand it correctly......... estradiol is a major form of estrogen, and as both goolarra and I posted, estrogens will raise the TSH, because estrogen binds the thyroid medication, so it can't be utilized by the body.
I just found this, which I thought was kind of interesting in light of your transderm patch (thyrotropin=TSH):
"Estrogens may increase serum thyrotropin concentration, which could... increase dosage requirements in patients with hypothyroidism receiving thyroxine for replacement therapy. Estrogens are known to increase serum thyroid-binding globulin concentration in a dose-dependent manner. Consequently, there may be a reduction in unbound, or free, thyroxine available for hormone activity, which, in turn, leads to an increase in serum thyrotropin concentration. Normally, thyroxine secretion can increase to compensate for this effect, but patients with hypothyroidism lack the mechanism to adapt. Limited evidence suggests that transdermal estrogen therapy may not affect thyroid-binding globulin concentrations; however, more data are required to confirm that."
"Estrogens may increase serum thyrotropin concentration, which could... increase dosage requirements in patients with hypothyroidism receiving thyroxine for replacement therapy. Estrogens are known to increase serum thyroid-binding globulin concentration in a dose-dependent manner. Consequently, there may be a reduction in unbound, or free, thyroxine available for hormone activity, which, in turn, leads to an increase in serum thyrotropin concentration. Normally, thyroxine secretion can increase to compensate for this effect, but patients with hypothyroidism lack the mechanism to adapt. Limited evidence suggests that transdermal estrogen therapy may not affect thyroid-binding globulin concentrations; however, more data are required to confirm that."
Hi Barb, Thank you so much! Does the Estradiol (HRT) lower the TSH? If I understood that correctly :)
As for the rest of your questions, is there any way you can refer to my previous post? (Should be on page two)
As for the rest of your questions, is there any way you can refer to my previous post? (Should be on page two)
COMMUNITY LEADER
TSH is a pituitary hormone and fluctuates greatly even intraday. TSH is typically higher in the morning and lower in the afternoon. TSH should not be used as the sole factor, in determining thyroid hormone status. FT3 and FT4 are much more important.
"Estrogen will affect your TSH levels, whether you take it for birth control or as a hormone replacement. Estrogen releases a protein that makes the thyroid hormone inactive because it binds the replacement hormone."
Have you been diagnosed with a thyroid condition? If so, which one? Are you currently on a thyroid replacement medication? If so, what med/dosage and how long have you been on it?
Do you have symptoms of a thyroid condition? If so, which ones?
"Estrogen will affect your TSH levels, whether you take it for birth control or as a hormone replacement. Estrogen releases a protein that makes the thyroid hormone inactive because it binds the replacement hormone."
Have you been diagnosed with a thyroid condition? If so, which one? Are you currently on a thyroid replacement medication? If so, what med/dosage and how long have you been on it?
Do you have symptoms of a thyroid condition? If so, which ones?
1 Comments
Hypothyroidism... ..and my new doctor reduced the amount from .100 to .88 now I feel tired all the time. He said the test shows that is what I should be on. My old doctor said my hormone replacement therapy affected my results and raised the amount to .100. I felt great. What can I tell my new doctor to get him to raise my amount again? Thanks, Sandra
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