HRT and thyroid coordination
Oral estrogen raises TBG and can lower free T4; retest thyroid 6 to 8 weeks after starting.
The interaction
Estrogen increases thyroid-binding globulin, reducing free hormone.
Fix
Retest TSH and free T4, adjust levothyroxine if needed.
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Written and medically reviewed by the Kindr Health Clinical Team · Published 2026-06-19 · Last reviewed 2026-07-01. Compounded medications are prepared by FDA-registered 503A pharmacies and are not FDA-approved drug products.