Can I take Estradiol and levothyroxine together

estradiol levothyroxine interaction

What is “Estradiol”

Estradiol 1mg & 2mg tablets

Estradiol also known as sex hormone are chemically steroid in nature. Therefore, they are steroid hormones present and produced by the gonads of males and females, more precisely it is 17 beta-estradiol chemically. It is used to treat the symptoms of menopause such as hot flashes, vaginal dryness, burning and irritation. Other uses off the label are also seen like for the prevention of osteoporosis in postmenopausal women, and in hormonal replacement therapy for women with ovarian failure, sometimes it is also used as a part of cancer treatment in women and men. It is sold under the brand name of Estrace( estradiol oral). It is available in various medicated forms like oral, injectables , transdermal systems, topical and vaginal preparations.

What is sex hormone

These are hormones that are produced by the gonads of males and females in the body that differentiates men and women in their characteristics physically, emotionally and mentally. Sex hormones are steroid in nature . The sex hormones produced in males are testosterone and estrogen, and that produced in females are estrogen and  progesterone. This sex hormones plays very crucial role in an individual life, it controls many body functions.

What is menopause

Menopause may be defined as the normal condition that is faced by women with the increasing age. The term “menopause” describes any of the changes a women goes through either just before or after she stops menstruating marking the end of reproductive cycle. The end of reproductive cycle means that women after menopause does not produce eggs and can not get pregnant. The average age when women attains menopause is 40 years or after. Menopause is divided in three different stages that leads to menopause they are as follows:

  • Perimenopause: This starts several years before the actual menopause and it is marked by the less estrogen production by the ovaries. Perimenopause lasts up to 1-2 years and then continues to menopause.
  • Menopause: At this stage its been a year that women has produced eggs and menstural cycle has stopped and at this stage ovaries are dead which means they can no more produce eggs and produce estrogen.
  • Postmenopause: This stage shows the symptoms many years after the occurrence of menopause. During this stage, menopausal symptoms such as hot flashes ease for most women.

Menopausal symptoms are:

  • Hot flashes
  • Night sweats,
  • Pain during intercourse,
  • Increased anxiety or irritability,
  • More often urination,
  • Disturbed menstrual cycle,
  • Abnormal uterine bleeding.

How does estradiol work in the body

Estradiol-17 beta belongs to the class of estrogen ( hormone ) replacement therapy. Estrogen is known to be sex hormones produced by the female gonads along with the progesterone another sex hormone and they are steroids in nature. When women are reach their menopausal age or have reached menopause face certain symptoms due to decreased production of estrogen in the body. The symptoms that are observed at the age of menopause are increased anxiety, increased irritability, more often urination, pain during intercourse, night sweats and chills, hot flashes,etc.

It may also contribute to the prevention of osteoporosis in women when combined with diet, calcium, smoking cessation, exercise and vitamin D.

Mechanism of action of Estradiol

Estradiol enters the target cell freely and interacts with target cell receptor. When the estrogen receptor bounds to its ligands and then it enters the nucleus of the target cell, and thus regulate the gene transcription which leads to the formation of messenger RNA. Now it combines with ribosomes to produce specific proteins that expresses the effect of estradiol upon the target cell. And thus expresses the formation of estrogen.

Normal range of Estradiol

The reference range of estradiol for men is 10-40 mg/ml but the reference range of estradiol for women varies by menstrual cycle and menopausal status. After attaining the menopause status it is 10 mg/ml or less then this. Before menopause, estradiol levels are widely variable throughout the menstrual cycle:

  • Mid-follicular phase:27-123 pg/ml
  • Periovulatory: 96-436 pg/ml
  • Mid-luteal phase: 49-294 pg /ml
  • Postmenopausal: 0-40 pg/ml

Contraindications of estradiol

  • heart disease,
  • risk factors for coronary artery disease ( such as diabetes, lupus, smoking, being overweight, high lipid concentration, high blood pressure)
  • thyroid disorder,
  • kidney disease,
  • asthma,
  • migraines,
  • epilepsy,
  • gallbladder disease,
  • a history of jaundice during pregnancy or birth control pills,
  • changes in calcium levels in the body,
  • long term use of estradiol increases risk for breast cancer, heart attack, stroke or blood clot.

Side effects of Estradiol

Side effects are different and vary from patient to patient but the side effects are allergic. Please seek medical emergency help if signs like hives, difficult breathing, swelling of face, lips or throat appear.

Seek medical  help when conditions are as follows:

  • unusual vaginal bleeding,
  • chocking or symptoms of heart attack-chest pain, restlessness, pressure, generalized pain to your jaw or shoulder, nausea, sweating;
  • sudden numbness or weakness,
  • slurred speech, problems with vision or balance,
  • swelling or tenderness in stomach,
  • jaundice ( yellowing of the skin or eyes),
  • retention of fluid in the body ( swelling, rapid weight gain),
  • nausea, vomiting, stomach pain, loss of appetite, constipation, increased thirst or urinatiom,
  • muscle pain or weakness, joint pain, confusion,
  • feeling of tiredness or restless

Common estradiol side effects are:

  • headache,
  • nausea,
  • seizures,
  • vaginal itching or discharge,
  • changes in menstural periods,
  • increased hair fall or thinning scalp hair,
  • vomiting ,
  • increased retention of fluid,
  • stomach cramps,etc

Estradiol and pregnancy

Estradiol is found to be dangerous during pregnancy. The estradiol use have been associated with urogenital abnormalities in offspring that manifest in the later years of life. The different manifestations that are seen in later life of an offspring as well as individual are vaginal adenosis, squamous cell dysplasia of the uterine cervix and vaginal cancer have been seen in female offspring. Whether in male offspring, the risks of urogenital abnormalities and testicular cancer later life.

Estradiol and breastfeeding

The data available is not enough for the excretion of estradiol in milk. Estradiol is found to decrease the quantity and quality of the milk. Estrogen are indicated for the prevention of postpartum breast enlargement.

Can you take estradiol and levothyroxine together

As it is mentioned earlier that estradiol is contraindicated with the thyroid replacement hormone therapy. If you are using estradiol and levothyroxine together your doctor should be known before as you might need the dose adjustment for low thyroid hormone which might be due the adverse interaction of estradiol and levothyroxine. The symptoms of hypothyroidism such as tiredness, joint or muscle pain, thinning hair or hair loss, dry skin, hoarseness, and abnormal menstrual periods. The dose adjustment may be needed as a regard to attain the potent effect of levothyroxine to maintain the thyroid levels in the body and to maintain the normal functioning of an individual.

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