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Had Complete Hysterectomy Due To Endometriosis. On Synthroid. Noticed T3 Dropping From To 260 To 230. Having Hot Flashes. Remedy?

Posted on Thu, 12 Sep 2013

Question: Hello, I had a full hysterectomy several years ago due to endometriosis and I have no thyroid as of 2006. I am a fitness instructor, 43 yrs old. Things have been fine on 100 mcg of synthroid along with .05 of Estradiol. However, I am noticing some changes in my thyroid levels although I am still in the normal range. My free t3 has dropped from 260 to 230 in an 8 month period (range is 200-440 pg/dl), my free T4 remains the same as last year 1.44, range is 0.930-1.70ng/dl, and my TSH was .71, 8 months ago, and now it is 1.03, range is 0.27-4.20 mcIU/ml. About a month ago, I started to have hot flashes especially at night interrupting my sleep. The dr. that performed my surgery wants to up my estrogen to.075 twice a week minveille patch, but I don't want to become hypothyroid. Does the estrogen increase free t3 or decrease it? I would like to see my free t3 not declining while the TSH is increasing.

Answered by Dr. Dr.Raju.A.T (2 hours later)

Brief Answer:
Stepping up the estrogen will help

Detailed Answer:
Hi,

Thanks for your query.

There is connection between the estrogen and the thyroid feed back mechanism. low estrogen levels can reduce the t3 levels by a narrow range.

Stepping up estrogen can alter the t3 levels and bring it to normal. If this fails then you may have to get the Synthroid medication revised.

Hope, I answered your query.

Please let me know if there are any other concerns.

regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.Raju.A.T (8 minutes later)

Another question related to this--how will increasing the estrogen effect the TSH level or will it? In my case, the TSH seems to be creeping upward in range while the Free T3 seems to be declining. Will an increase in estrogen help both become more in the middle of the range?

Answered by Dr. Dr.Raju.A.T (58 minutes later)

Brief Answer:
Yes, the levels are interconnected

Detailed Answer:
Hi,

Estrogen has influence on the pituitary gland which secretes TSH, low estrogen stimulates increased production of TSH. Also the release of TSH is controlled by free T3 levels in the blood. Lower levels of T3 in blood cause rise in release of TSH.

This is a receptor mediated mechanism and changes in the any hormone reflect very quick in other.

Hope, I cleared your doubt.

regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.Raju.A.T (9 minutes later)

Yes, you did. Thank you for the clarification.

I have one final question--Can an increase in fitness level cause one to metabolize estrogen at a faster rate therefore causing a need for an increase in estrogen? --Just trying to figure out why the change all of the sudden for me.

Answered by Dr. Dr.Raju.A.T (16 hours later)

Brief Answer:
No, fitness level is does alter the levels

Detailed Answer:
Hi,

No, there is no relation between the physical fitness and metabolism of the estrogen or any other hormones.

Regards,

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar