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Old 02-17-2012, 08:11 PM   #1
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Unhappy Abnormal uterine bleeding....is this thyroid related??

a little hx- have had some more extreme thyroid issues over past year and half, which include 3 surgeries to remove thyroid, introduction of armour thyroid med and only three dosage adjustments since start of meds. Have had no issues with my cycle until the last few months....

Had last surgery 11/18/2011. Had started period the 15th or 16th. Normal timing, no problem. Ended up starting again two weeks later. Had some fluctuation in my TSH due to the surgery (TSH 0.031 week prior to surgery- 5.4 week after surgery), meds readjusted so didn't think much of that one. Started again two weeks later when my regular period would have been due so thought all was good, back on schedule. Seemed as much, as didn't start again until Dec 29, again, right on schedule. However, next cycle started on Jan 18, a week early. And haven't stopped bleeding since.

My last blood work was Jan 17. TSH was something like 0.137 (lab norms 0.4-4.0) so obviously running a little hyper. Dr said it was ok, we'd leave doses unchanged and keep me a little on the high side as long as I didn't have any hyper symptoms. Currently on Armour 120mg 4Xwk and 90mg 3Xwk

Everything I read indicates the usual menstrual response to thyroid issues is to have decreased cycle time, not increased. So, I am a little worried that this might be something not necessarily thyroid related. Additionally, my eating habits aren't the best.....not that I eat badly, I just don't eat much. Have decreased appetite most of the time, though worse since this last surgery and med increase. Have also had and continue to experience weight loss but not at an extreme rate. Have lost total of around 27 lbs since starting the meds in Nov 2010. That loss doesn't concern me much as I am back to close to my start weight approx 6 yrs ago prior to all my thyroid issues really starting. Also, sleeping habits horrid, with lots of insomnia, but I am a nurse who works 3pm-3am....I work long stretches on (6 days out of 8 with two drop days placed in there, though not together) then I have a stretch of 6 days off. Wasn't sure how much effect these factors might have on my period but none of these are really new.....been on this work schedule for almost 2 years, though the severity of the insomnia is new since a few weeks prior to surgery in Nov. Wasn't sure if or how these other factors might play into my menstrual cycle normalcy.

just not sure what to do or if need to be concerned. Obviously, I am quite inconvenienced and annoyed being a constant bleeder, and the consistency and odor of the discharge concerns me a little, but I have no pain, no other reasons to be concerned that its anything hostile. Just not sure what is going on. Would appreciate any insight or advice.

Thanks.

 
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Old 02-17-2012, 10:26 PM   #2
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Re: Abnormal uterine bleeding....is this thyroid related??

Armour and other natural dessicateds and T3 meds should never be dosed according to TSH alone. It's normal and expected for TSH to be suppressed while taking a T3 med, so it's imperative to use the free levels of T4 and T3 (while watching symptoms) to guide dosage requirements.

My own TSH has never been higher than .02 in the 8+ years I've taken natural dessicated hormone, which in no way means I'm "a little hyper". Far from it. My FT levels have never been higher than 65% of their ranges, and I've had no hyper symptoms. Proof that suppressed TSH is not always a sign of hyper-medication.

I suspect you're likely somewhat hypOthyroid, not hyper at all. HypoT generally causes heavier, more frequent periods. (HyperT tends to cause the opposite.) To know for sure, insist that your MD order the free T4 and free T3 tests.
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Last edited by midwest1; 02-17-2012 at 10:29 PM.

 
Old 02-18-2012, 12:02 AM   #3
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Re: Abnormal uterine bleeding....is this thyroid related??

OK. Let me clarify. I knew that T3 and T4 were required to truly know if its hyper or not but couldn't find my labs to post. Could only remember the TSH numbers. Did some digging and here are what I have from recent past.....

11/8/11 prior to last surgery...
TSH 0.031
T3 4.74
T4 0.92
With these results, based on what I read and what md said, I was hyper and suppressed. He inquired about sx none of which I had except new onset of WORSENING insomnia. NO palpitations etc. And not dysfunction with period until right at the two week mark at which time I had labs done and came up with the following results......

11/30/11 approx 12 days post surgery....
TSH 5.39
T3 2.05
T4 0.63
With these results, based on what I read and his course of action I believed I was hypo....at this point in time we increased armour from 90mg daily to the current 90mg 3xwk and 120mg 4xwk After the dose change however, had period again in two weeks, but that was on schedule to my regular period. And after that everything leveled out a bit. Following two cycles normal until just following the lab results I obtained next.....

Last results on 1/17/12
TSH 0.164
T3 he ordered but lab didn't bother to run it apparently.....
T4 0.81

He commented that the lab apparently didn't run the T3 but asked if I was feeling any sx of hyper....and opted to just keep me on the same dose for now. Didn't want to adjust up or down without the T3 I guess but also didn't order for future labs yet. Also wasn't having issues yet so nothing to report to him to cause concern that levels were low. Have an appt on 28th of this month to see him...but I don't wanna wait and keep bleeding for two more weeks if I could adjust dose now and fix this.....maybe I should go ahead and call him Mon see if I can get some blood work done this week.

Prior to being placed on this med I didn't know anyone taking armour. What is a normal dose? I realize that its gonna vary individual to individual but what would you commonly expect a dose to be? Does my current dose seem high or low? Obviously after three surgeries I have absolutely NO thyroid left, or that was the plan at least. Awaiting followup US in April to determine presence of any residual tissue to decide if I have to have iodine radiation.

Anyway, let me know what you think please. And thanks again.

 
Old 02-18-2012, 12:27 AM   #4
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Re: Abnormal uterine bleeding....is this thyroid related??

We need to see the lab's reference ranges for T4 and T3 to tell you anything. Your result has to be compared with the range used for the test.
And are those free T4/T3 or total measures?

From what I can tell with the limited information given, if that's your free T4 level, you are hypo and undertreated.

My MD says that his women patients need 120 - 150 mgs as an average, full replacement dose. I take 120. These doses are just the average. Many need more; a few will need less. It takes what it takes.
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