Thyroid UK
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can't tolerate NDT?


I started Nature-Throid in May. I have been on 2.5 grain for 2 weeks now. Tried increasing to 3 grains 2 days ago but got chest pains so went back to 2.5. But I'm still feeling quite bad. Very tired and sleepy, lack of motivation, hair loss, irritable, head aches (rarely got them in the past).

When I was on 2 grains a month ago (2 months into ndt) I did blood test and the results were:

TSH - 19,30 (0.27 - 4,2)

FT3 - 2,42 (2 - 4,4)

FT4 - 0,78 (0,93 - 1,7)

TPO - 345,9 (0 -34)

My iron, ferritin, B12 and vit D were ok, and I'm still supplementing. Also supplementing adrenals.

I didn't feel great when I had my tests done, but now I'm feeling even worse, day by day. I have Hashimoto's.

Could it be I don't do well on NDT and need T4 + T3? Are there many people who can't tolerate it?

I have endo appointment at the end of October, but not sure what to do before then as I can't go feeling like that for 3 more months! Should I change back to T4?

Thank you!

9 Replies

You may be someone who can't tolerate T4. I would suggest trying T3 only.


But before switching to NDT I was on T4 only for 7 years. Never felt great (even though my tsh was low) but not as bad as now.


Massao, You were very undermedicated on 2 grains to have such high TSH and low FT3. If you can't raise your NDT have you considered adding some T3? How did you feel on Levothyroxine? People who don't tolerate Levothyroxine (T4) on its own can do well on T4+T3 combination but if you don't tolerate T4 then T3 alone is another option.

Not everyone does well on NDT, some do better on synthetics, especially when they have Hashi's. The similarity of pig thyroid to human thyroid can encourage lymphocyte attacks on the thyroid gland.

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Thank you Clutter. Before NDT I was on 125 levo, so I thought 2 grains would be about the same in terms of a dosage.

When I was on Levo I had to increase the dose every six months and with every increase I felt okish, but after 6 months I was back to feeling tired and sleepy, did blood tests, TSH was increased so my endo increased the dose. The same routine happened every 6 months. But I never feel good or refreshed after sleeping, just never right.

Now my iron, vit b12, adrenals etc are in much better shape than in the past, so a bit disappointed that NDT doesn't seem to work for me.

I could add some T3 but I would have to ask if someone could PM me where I can get some.

One of the reasons I wanted to try NDT is that it gives us all 5 thyroid hormones. By taking T3, I'll get T4, but not the rest. I'm worried about my bones density as my mum (who also has Hashimoto's) has osteopenia, and I don't want this happen to me. how can it be prevented while being on T3 only?


Massao, It might be better to try a little T3 in addition to NDT, sometimes the proportions of T4 and T3 aren't quite right. If that doesn't help in 2/3 months then try Levothyroxine and T3 combination.

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2 months ago, you say, you were on 2 gr on NDT but your TSH was 19,30. How high was your TSH before you began?

2.5gr may be the dose for you at present as you got chest pains when you increased to 3gr. 2.5 gr is equal to 250mcg levo so maybe if you stay on 2.5 gr for a little longer till you settle into a dose. You have been on NDT for 3 months so it's not very long.

I don't know whether you've seen this link and if you go to No,3 it may be helpful.

I suppose having hashi's also complicates things a little bit too.

It is disappointing when you change and it's not working as you expect, but I doubt you were better on T4. T4 has to convert to sufficient T3 but with NDT you have all the hormones of a natural thyroid gland.

I do hope you feel better soon.


Thank you shaws. Before I started NDT my THS was tested in Dec 2013 and it was 1.13.

I thought it takes about 3 months to settle into NDT, or does it take 3 months to settle into a dose after increasing? I've read some people feel better soon after they start ndt.

What do you mean by "I don't know whether you've seen this link and if you go to No,3 it may be helpful." There is not link in your post.


Apologies, omitted link.


You are suppose to start low and go slow. Too much too fast will make it even harder to monitor you.

Most people need 6 months with 3 visits to get it right


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