Laura’s Questions: I am on 25 mcg of Levothyroxine for 6 yrs with hypo symptoms, every one! My endocrinologist just took a panel, and the results are the following:
Should we up my dose of Levothyroxine to 50 or should I just switch to Synthroid or Armour? Thanks!
Short Answer: We typically don’t recommend or prescribe Levothyroxine or Synthroid for our patients. Both of these medications only contain the T4 hormone. This is referred to as T4 Monotherapy. These medications do a good job of lowering the TSH level but do not always help the patient feel better. We like to prescribe thyroid medication that contains both the T4 and T3 hormones. In our experience, our patients tend to feel much better on a combination medication, rather than on a T4-only medication.
In our opinion, we feel that sustained-release compounded thyroid medication is the best option most of the time. This type of thyroid medication gives the doctor many dosing options, which is certainly good for the patient and their overall symptom profile. Because this medication is compounded, the T4 and T3 hormones can be changed independently of the other hormone. With a commercial prescription, there are only so many dosing options, and both hormones are affected when raising or lowering the dosage. Also, the sustained-released nature of the medication helps to reduce any unwanted side effects that are common with commercial instant-release thyroid medications.
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If you have questions about your thyroid or any other hormone related issue, feel free to contact us.
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Episode 052 – What Biest Ratio is Best for Menopause?
This is such helpful information. I have often wondered who 80:20 is good for and who 50:50 is good for.
One thing I'm still confused by is the estrogen weight gain component. You said that estrogen (as well as menopause in general) could be the cause of her weight gain. I can relate. I was very thin my whole life, now 53 and about 30 lbs overweight. But you also said she might benefit from getting her estrogen balanced, and she was not using enough.
If too low a dose made her gain weight, won't an increased dose cause more weight gain? I have heard other podcasts and read articles that in menopause, we gain weight because our estrogen falls. Estrogen seems to be blamed for weight gain, whether it's high or low. Can you help clarify? There's something I'm not understanding. Thank you! Tracy
Often estrogen has been the scapegoat for weight gain. I'm sure you have heard too much causes weight gain. Too little can pack on the pounds. It can be pretty confusing. So which is it? Is too much estrogen causing my pants to become uncomfortably tight? Or is it too little estrogen that has given me the gut I never had?
Well, it’s not that simple. Estrogen levels do have a hand in weight gain and weight loss. But it is not the only variable. It really is the combination of the balance of estrogen with other hormones in your body. To name a few main players, progesterone, insulin, and cortisol, as well as enzymes, lipoprotein lipase (LPL), and hormone-sensitive lipase (HSL). Okay, I know that sounds vague and doesn't answer the question. Let's back up a bit and look at what women are saying about estrogen.
As soon as menopause hits, women complain that they are instantly 15-30 lbs heavier. Not because of diet or lifestyle. It's like menopause adds an unwanted 15-30 lbs overnight. Then some women are on hormone replacement therapy, taking estrogen, and are horrified because the HRT caused them to gain 10 lbs in a month. So what is it? Did the lack of estrogen in menopause cause that 20 lb weight gain? Or did that hormone replacement estrogen create rolls that were never there? Well, actually, both are true. Before you throw out your jeans in favor of high-waisted yoga pants, let’s learn about the other players in weight gain.
Progesterone will buffer estrogen. Estrogen does like to grow things'. That is why in puberty, you grow breasts and hips. Progesterone helps to balance some of the growth' that estrogen can cause. That is why in perimenopause, when the progesterone drops and the estrogen is running the show, the weight gain begins. That is also why when a woman starts estrogen therapy for menopause but not enough progesterone, there is weight gain.