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What birth control pill works best while taking levothroxine?

I’m a 24 year old female and I’ve always had period issues. When I was 15 the docs decided to put me on a progesterone based birth control (Tri-Sprintec) to start my periods and I’ve been on and off that same birth control since then. Tri sprintec has always worked for me, regular periods, no complications. After taking a break from birth control from 2015-2018 (with no periods) I got back on the pill in late March and was diagnosed with Hashimotos later in March (started 75 levothroxine beginning of April) In April my period was heavy, as expected for not having one for a few years, May my period was perfect, started on a decent day and lasted 5 days. In June my period lasted for 6 days but was extremely light and was late, this month I’m late and now I’m reconsidering the brand of birth control I take. I know doctors opinions are best but I don’t have my specialist appointment until August and a gynecologist appointment in September. I’ve done my research of birth control and it’s affects on levothroxine and all that, I just want to experiment with the different brands so I can finally have a normal period.
Has anyone else had these problems? What did you do about it? Do you know what brand of birth control is best to take with levothroxine?
Is an estrogen based pill better or the progesterone?
2 Responses
Avatar universal
Without even getting into the discussion about different birth control pills, I can tell you that I would bet my last dollar that having been diagnosed as hypothyroid from Hashi's,  a levothyroxine dose of 75 mcg did little to nothing for you and that your biologically active thyroid hormones (Free T4 and Free T3) remain inadequate.  When not being treated adequately you cannot know whether the problems are due to continuing hypothyroidism from inadequate Free T4 and Free T3 or the birth control pills.  

The reason I am so confident about this is that when starting on thyroid med, in response the body will react by reducing the pituitary output of TSH.  This then reduces stimulation of the thyroid gland resulting in reduced output of natural thyroid hormone.  Since serum levels are the sum of both natural thyroid hormone and thyroid med, only when med dosage is high enough to essentially suppress TSH, will further dosage increases start to raise the levels of Free T4 and Free T3.    A recent, excellent scientific paper concluded that:   "Hypothyroid symptom relief was associated with both a T4 dose giving TSH-suppression below the lower reference limit and FT3 elevated further into the upper half of its reference range."

So several questions need to be answered.  What, if any, symptoms  do you have besides those related to your periods?   Also, please post your current thyroid related test results and reference ranges shown on the lab report.  If tested for cortisol, Vitamin D, B12 and ferritin please post those as well.
Thank you for replying! As far as symptoms go my thyroid swelling has went down a lot But I do still feel some pressure, I am still pretty tired (feeling like I’m not getting enough sleep) and have trouble waking up. I don’t have my test results and my appointment isn’t until August. He did tell me that my antibodies (and I think cortisol) were elevated in a mild case. In August is when he said he’ll adjust the medicine, where it was such a mild case he didn’t want to give me too much with me taking birth control. He told me he didn’t want me to stop taking it so he could see how it’s reacting with the levothroxine. At this point I don’t care about the pregnancy prevention because there are other ways to be safe. I even considered stopping the BC (with doctors opinion) and seeing how that plays out, I just really want a normal cycle. Unfortunately I don’t have anyone I know that has Hashis other than my mom but her symptoms were completely opposite of mine and hers is a more severe case.
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Lab test results and reference ranges shown on the lab report?
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