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Old 03-08-2003, 05:01 AM   #1
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Question can birth control pills affect thyroid test results?

Hello All,

I have been lurking for some time now trying to "self diagnose" to see if I have a thyroid disorder.

I recently read the Thyroid Solution and for the first time a major lightbulb went off in my head like "Wow...that's me".

Anyway, my question is this: Could my thyroid test results be affected by the use of birth control pills? I finally got my Dr. to order the test but I am actually feeling o.k. right now. I go through "spells" of feeling poorly and that happens most often during the week that I am off of my BCP's.

Do you think that the pill has an affect, good or bad?

Also, I really relate to the post with regard to the neck and back pain....wow!

Thanks so much for any feed-back. Your opinions would be welcome and appreciated.

B

 
Old 03-08-2003, 09:59 AM   #2
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Yes, BCP CAN affect test results. Here's how. Higher levels of estrogen cause more binding of thyroid hormones to proteins in your blood. Since they are bound top proteins and not immediately available for your body to use, your need for thyroid hormones is greater.

If your need for thyroid hormones is greater, your TSH will be higher. Since TSH is what most doctors go by when diagnosing thyroid problems, this problem will show up on a lab test.

Even if your BCP doesn't contain estrogen, it CAN affect estrogen levels, theoretically, since it affects the balance of other hormones.
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Old 03-08-2003, 04:21 PM   #3
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O.K., with that said, if I feel that I am hypo and want the best possible results from my lab work, should I be tested while on the pill or during the week that I break??

Thanks so much!!

B

 
Old 03-08-2003, 07:40 PM   #4
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I don't know how much of a help I'm going to be because I'm a pretty good example of how confusing things can get. I had asked the same question you're asking a few weeks ago and I got the same answer. Here's what my experience was:

2-21-03 (final week of birth control pills, period started early): TSH was 4.1

3-7-03 (end of first week of birth control pills): TSH was 1.5

In two weeks, my TSH levels have dropped 2.6 units. I'm rather confused by the yo-yo effect, too. I have three ideas if this has *anything* to do with the birth control pill:

1) it might be that when the first test was done it was on the final week of pills and perhaps the highest concentration of estrogen in my system, and this caused interference with my TSH. The problem with this is that I'm on a monophasic pill and there's no fluctuation of hormones throughout the cycle. I don't know how the body processes a steady amount of estrogen throughout the cycle, but my guess is that it either stops producing it's own estrogen and relies totally on the synthetic estrogen, or it keeps cranking out estrogen in addition to the synthetic estrogen. So if the former is true, it should make no difference when the test was done because the same amount of estrogen was present in my system the whole time. If the latter is true, then it could mean that by the end of the last week of pills, I had triple the estrogen content as the first week of pills. To complicate things further, I had started my period a week early than scheduled, so maybe my body was going on it's own hormonal cycle at that point and therefore the pill had nothing to do with it.

2) Time of day. My highest TSH test was taken at 7 PM, and my lowest was done at 9 AM after fasting 12 hours (for a cholesterol test). Supposedly, the optimal time to test TSH levels is in the morning, when they're the highest. Well, I flat out proved that wrong.

3) The fluctuation is normal (ie. not abnormal). I've been told that TSH levels will go up and down by about 3 units throughout the day, so maybe I was at 1.5 at 9 AM, but by 7 PM, I'm at 4.1.

The thing that I'm keeping in mind is that I don't feel normal and that my TSH levels are bouncing all over the place and I'm starting to feel like a human yo-yo. Hopefully, if I find the right specialist who understands the delicate balance we're dealing with here, they can sort through the conflicting numbers and figure out what to do with me.

On a side note, I've asked a few doctors both online and in person whether or not being on the pill will skew TSH tests drastically in one way or the other and the concensus has been that it shouldn't affect it either way. This is from both respected thyroid specialists and my annoying doctors who continue to treat me like a hypochondriac. The weird thing is that when women are on the pill or HRT and are being treated for a thyroid condition, they typically have to up their thyroid meds to compensate for the estrogen in their system. It says nothing about people like us who are undiagnosed and on the pill but trying to get treatment. Add to this that certain women experience marked symptom relief from being on the pill when they're hypo or hyper and you've got a lot more confusion happening. I guess the bottom line is that for some people, being on the pill will negatively affect their thyroid symptoms, and for others it will mask them both physically and in the bloodwork. Everyone is different.

If you're really concerned about the pill and the possibility of it interfering, I'd get tested on your off week. But be careful if you're anemic, because giving blood and being on your period at the same time isn't pleasant.

Sarah

 
Old 05-24-2007, 05:51 AM   #5
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Re: can birth control pills affect thyroid test results?

I recently had my thryroid tested. I am also on birth control pills. I am currently taking the Apri tab and have been since June, '05.

My T4 was high and my T3 uptake was low but my TSH was within range. Since my TSH was within range the PA at my general doctor's office said that there was nothing wrong with me that my T4 was high b/c of my pills. I also have checked the leaflet that comes with my pills which says nothing about having an effect on Thyroid.

My husband and I don't have insurance and are trying to buy a house so I really can't afford to go to a specialist.

What can I do?

 
Old 05-24-2007, 01:27 PM   #6
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Re: can birth control pills affect thyroid test results?

BCP's do not affect the thyroid. They increase the thyroid binding proteins that carry the thyroid hormones throughout the bloodstream. This shows up when they test TOTAL t4 levels coupled with the t3 uptake. It will always result in a higher total t4 with a low t3 uptake. It's the body's way of dealing with it to keep everything the way it should be. There are no excess unbound thyroid hormones circulating in the blood as it would appear at first glance.

The only way that you would not see this would be to have the FREE T4 tested which is now the more accurate method of testing actual thyroid function. It's also more expensive.

Why did you have your thyroid hormones tested to begin with?

Helen

 
Old 06-04-2007, 11:39 AM   #7
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Re: can birth control pills affect thyroid test results?

A friend of mine is a nurse and noticed that I have a "hump" in the back of my neck. My mother and grandmother also have this "hump" and my grandmother is on thyroid medication. My friend suggested that I have my thyroid tested because of this "hump" and because I'm *always* tired and am unable to lose weight.

 
Old 06-04-2007, 12:11 PM   #8
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Re: can birth control pills affect thyroid test results?

The thyroid is in the front of the neck but if you have a family member who has thyroid problems, it is always good to have your thyroid checked. Now, the only things I can think that can cause a hump in the back on the neck are osteoporosis and what's know as a buffalo hump that a person can get with excess cortisol. Do you have osteoporosis or have you had your cortisol level checked?

 
Old 06-04-2007, 12:22 PM   #9
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Re: can birth control pills affect thyroid test results?

No, I don't have osteoprorosis and have not had my cortisol levels checked either. I'm only 24, so when I asked my dr. about the thyroid results being low T3Uptake and high T4 I was told simply that my bcp can affect those results but since my TSH was within range I was fine and to be retested in 6 months. If the numbers are different then he'll look into it.

 
Old 06-04-2007, 01:25 PM   #10
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Re: can birth control pills affect thyroid test results?

Stephanie, you have an ignorant doctor. It's true that the Pill can skew the T4 and uptake results; that's why an intelligent doctor would order a free T4 test instead of total T4 + T3 uptake. Free T4 is an accurate test, even in women who take the Pill. Insist that he order this test instead of the ones he ordered the first time around.

Since you have a family history, you're more likely to have the autoimmune form of hypothyroidism. TSH alone won't diagnose it. If Dr. Dumbo won't order the right tests - a combination of TSH, free T4, free T3 and the thyroid antibodies (TPO and Tg), find a better doctor.

 
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