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Dr. Andrew Rynne
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Dr. Andrew Rynne

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What does my thyroid test report indicate?

Answered by
Dr.
Dr. Rakhi Tayal

OBGYN

Practicing since :2001

Answered : 13710 Questions

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Posted on Fri, 18 Aug 2017 in Women's Health
Question: Hi, this question is for a gynaecologist or specialist who can advise on female hormones. I am 44 yr old female, have been on the pill for close to 30 years. Currently on Dianne 35Ed. No previous problems but for last 3 months I am getting sweaty and hot skin surface and now body odour for the first time in my life. These symptoms haven't been everyday and they occur in the afternoon for about 4 hours then stop. Thyroid test was normal although I am type 1 diabetic with Hashimotos Disease. Is this menopause? Note my hormone bloods were as follows -
FSH - 3 IU/L
LH - 2.7 IU/L
Oest 2 - <70 nmol/L
Prog - 1 nmol/L
My Gp said likely menopause is cause.
But I was told earlier that when on the pill you don't get menopause symptoms. Also I thought levels are meant to be low when on the pill and I thought to do accurate check of hormones you have to be off the pill for a minimum of 3 months before testing.
Please advise whether these symptoms and tests show menopause and also if there is any other reason for this on off days of sweat and odour in the afternoons. I take insulin, Pravachol, Oroxine, nexium and dianne 35Ed. Have never had odour issues in my life, always shower 3 times a day and maintain strict hygiene methods and now I look sweaty, feel all sticky and clammy in armpits, neck and head and have bad odour which smells like armpit odour yet my armpits smell of deodorant so I can't even work out where smell is but it isn't good. Nb clothes don't stink either. Please help.
doctor
Answered by Dr. Rakhi Tayal 1 hour later
Brief Answer:
Not related to menopause.

Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
Elevated follicle-stimulating hormone (FSH) levels are measured to confirm menopause. When a woman's FSH blood level is consistently elevated to 30 mIU/mL or higher, then it is considered that she has reached menopause. In your case the FSH levels are low. You are correct in pointing out that you have to be off the pill for 3 months before getting accurate hormone level results. Also you do not get menopausal symptoms while on the pills regularly.
The symptoms that you are having can be related to anxiety stress or dehydration. These can be related to hypoglycaemia too. It is best to consult a physician and get yourself properly evaluated to find out the cause.
Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Rakhi Tayal 35 minutes later
Thank you for your reply. With regards to the other hormones I think they are low too, so in addition to FSH going higher in menopause would the other ones also increase in menopause?
Are mine low because I am on the Diane 35Ed pill? Does this particular pill prevent menopause symptoms? Also if I remained on the pill indefinitely when menopause does start would I still have a period when taking the 7 day sugar pill?
Ok so if we look at other options, yes I have diabetes but not hypo at these sweating times. Also whether they are call hot flashes I am having they are on many days but not everyday yet they are basically as midday starts my body temp increases even though I am sitting in an office, my face gets red, my skin is hot to touch and I feel clammy on neck and armpits. And my armpits are sticky till I shower. I never used to sweat in armpits more on chest, back and scalp. So I can't understand why in winter this has suddenly began several hours of overheating in the day, not at night, and now sweating underarms that never occurred before. My TSH was 3.0 and FT4 was 17 are they ok? Around 3 months ago my Oroxine dose was increased from 75 to 100mg so I wonder if this is related but my dr said my thyroid tests were normal so dose is working but maybe that causes sweating and over heating? Or is there other internal problems that I wouldn't know that could cause this? I know anxiety does create various symptoms but normally I get palpitations never sweating. Any other suggestions or tests I could do?
doctor
Answered by Dr. Rakhi Tayal 3 hours later
Brief Answer:
Details below.

Detailed Answer:
Hello.
Thanks for writing again.
LH estrogen and progesterone have low levels during menopause. Birth control pill will suppress the level of natural hormones. It also prevents menopause symptoms. If you continue taking the pill you will have some bleeding during the 7 days of sugar pill.
The symptoms that you have are like hot flashes but are not due to hormonal changes. Your TSH and FT4 levels are normal but increase in dosage of oroxine can aggravate these symptoms. Lowering the dose back to 75 can help.
You can also get a good ant anxiety drug prescribed with low day time sedation and see if it helps.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Rakhi Tayal 7 hours later
Hi,
So basically blood tests are not able to confirm menopause whilst on the pill and menopause increases hormones? So if I stopped pill and hormones increase then have menopause. But still could have menopause and period but pill causes levels to appear low. Is this correct?
On different side could the pill be causing sweating and should I change pill? Are there any other hormones that could be out of whack causing sweating? Is sudden onset sweating only from female hormones or thyroid nothing else?
I can try going back to 75mg Oroxine but that may affect thyroid levels. What if I got 50mg and took 2 per day would that make a difference?
My skin feels clammy on neck, underarms only can there be something affecting my body not being able to adjust to changes in temp?
I have actually taken my temp several times when I'm flushed and clammy but my temp is 36.5, if meno does your actual body temp increase or you just feel hot but temp normal?
Nb my symptoms are for several hours then stop they are not on off sweats. I stay hot, flushed and clammy for 4-5 hours in afternoons only then skin goes back to normal by 6pm


doctor
Answered by Dr. Rakhi Tayal 3 hours later
Brief Answer:
Changing the pill will not help.

Detailed Answer:
Hello.
Menopause increases only FSH while rest of the hormones are decreased. You understood correctly that after stopping pills if you get all the hormone tests done again only then can we diagnose regarding menopause.
Changing the pill is not likely to help. Apart from thyroid and female hormones catecholamines like adrenaline and variation in insulin levels can also cause such a problem.
Taking 2 tablets of 50mg Oroxine is same as taking 100mg Oroxine. Taking 50 mg at night can decrease the effect during the day and might decrease the sweating to some extent.
Try wearing cotton clothes and use a dehumidifier around you. The body temperature during menopause remains normal. Only you feel the hot flashes. You can also get your vitamin B12 levels evaluated and see your intake of fluids and electrolytes is adequate.
Best regards.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Rakhi Tayal 1 hour later
You mention adrenaline- what symptoms and problems exist with adrenaline? And what about pituitary can that cause my problem? What about hypothalamus can I have a problem with that?
I will still decrease Oroxine and change to night time. I assume there is no problem with thyroid nodules turning cancerous and causing sweating?
Still seems odd to start in may suddenly.
Even though I smell faint odour it doesn't appear to be in armpits as directly they don't smell, so can skin in general be secreting some kind of odour? So if not thyroid and FSH is not menopause then stress?
doctor
Answered by Dr. Rakhi Tayal 9 hours later
Brief Answer:
Can be related to stress.

Detailed Answer:
Hello.
Adrenaline causes increase in anxiety palpitation and hot flushes. Any problem with pituitary or hypothalamus is not likely.
If the thyroid nodules turn cancerous then it will cause other symptoms and increase in thyroid hormone levels.
Skin always has some bacteria on it that can cause smell in presence of sweat.
If all other reasons are ruled out then stress is the most probable cause.
Regards.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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