T4 & T3 combo Vs NDT

Just wondering regrding the T4 and T3 combo versus NDT. I have recently introduced T3 to the Levo I am taking and wondered what peoples thoughts were regarding the two?

I am also just beginning to look at vitamin and mineral deficiencies (while I try to find a good Endo who will test my levels) and wondered what supplements people were taking. I am thinking I will need some sort of Vit D complex through the winter months in any case..

19 Replies

  • Jacqui, it's not a good idea to chop and change thyroid meds frequently as it upsets your metabolism. It can take several months on a stable and optimal dose of medication before your symptoms resolve.

    NDT doesn't suit everyone but others find it better than synthetic T4+T3. I haven't tried NDT as T4+T3 combination works for me.

    Ask your GP to test ferritin, vitamin D, B12 and folate as hypothyroid patients are often deficient/low and these deficiencies can cause musculoskeletal pain, fatigue and low mood similar to hypothyroid symptoms. Post your results with the lab ref ranges (the figures in brackets after your results) in a new question and members will advise whether supplementation is required.

    You can order private blood tests via thyroiduk.org.uk/tuk/testin...

    Ultraviolet light is too low to stimulate vitamin D during Oct-Apr so most of us need 1-2,000iu vitD3 to maintain levels during that time but you will need more if you are very low or deficient.

    I supplement 1,000mcg B12 sublingual lozenges, B complex, vitD3 5,000iu, Magnesium 300mg, Zinc 15mg and vitamin C 1,000mg.

    If you buy from Amazon please use the TUK affiliate link as TUK earn a small commission from your purchase thyroiduk.org.uk/tuk/go_sho...

  • Thanks Clutter, very informative (as usual)

  • I guess many are doing the combination since it appears easier to get than NDT but this is what Stop the Madness Now website says about it:

    THINKING THAT SYNTHETIC T4 ALONG WITH SYNTHETIC T3 IS JUST AS ADEQUATE AS NATURAL DESICCATED THYROID Adding synthetic T3 to your Synthroid or other T4 brands is definitely a step up from being on T4 alone! We applaud that addition. But….to say it’s equal to being on desiccated thyroid t’ain’t so. Too many patients who have been on the synthetic combo, and switched to desiccated thyroid, report that the results were even better. That’s impressive. Besides, with desiccated thyroid, you are getting exactly what your own thyroid gives you–T4, T3, T2, T1 and calcitonin. Makes a difference.

  • Heloise, For those who are self medicating it's no more difficult to get NDT than T4+T3. It's very difficult to get T3 prescribed in the UK and almost impossible to get NDT prescribed. There are members who don't do well on NDT but do on T4+T3 or T3 only.

  • I have an endo appointment on Monday, but the minute I down my dose of NDT my symptoms especially the itching and loose bowels comes back like the plague. He does not know I self medicate but I would rather drop dead than not. At least I have a life now. I tried hard to lower the dose for Monday but I guess I will just have to wait till the night before, and how do I ask the endo that I want my bloods at 7am. Sorry if I am off topic but NDT has saved my bacon, tho I still fall over allot. I only take NDT a and it works and I know that I won't have to go begging to a Dr that usually do not care about you. X

  • Rita, have you tried taking an antihistamine an hour before your NDT? Itching may be due to an allergy to one of the fillers. Westhroid Pure is hypoallergenic and may be worth trying.

    Your thyroid blood results won't tell the endo what form of thyroid hormone you are taking just that you are optimally or otherwise medicated. Take your NDT and the patient information leaflet with you to the consultation if you intend to tell your endo you are taking NDT as UK doctors often don't understand what it is.

  • Hey clutter, thanks honey, I have had the itching way before I self medicated, once I started the pills it all went away. But I am afraid to tell my doc because I am afraid they will , heck I don't know. But if I take one grain less I am in the world of the fiberglass suit. I am mostly concerned about the goiter in my throat and just want a FNA so I can relax if you know what I mean. I know it is not real common for Cancer, but there is sooooo much cancer in my family, my mom has the same thing and can barley walk, my dad just died of brain cancer, my niece has a tumor on her brain, so the worry is running round my head like crazy. I do take anti hystimines but once the NDT kicked in my life changed. I wish you could go to the doctor with me clutter, I am so stressed out and scared. I will never stop the NDT because at lease I can live, my fave stopped going red, the itching stopped, big problem is balance, I fall allot. I can't see my endo knowing a thing, when I went private he didn't either, then I got my next blood test and that was whT I was looking for. AND how do I insist that I get my bloods done at 7am at a different hospital, as you know that late in the day bloods will not be accurate. It took two nurses to get a vein, can I just say I would prefer queens where it only talks one jab instead of five. God I am stressed. But it is my life, I wasted ten years feeling crazy itching tired going nuts because they wanna call it everything except what it is. I might tell him my mother sent me some pills after my father passed. But I threw away the leaflet.......ah honey.....I am all alone, my husband left me, just scared and stressing. My own GP said I had thyroiditis but said he could not read the results nor would he even be concerned......thing is I could get a worse doctor, I have had two worse then him. I live in a sorta poor area.....sorry rambling. It is not taking the pills that makes the fiberglass suit occur. But I won't take any the night before ..... What are my rights to have my blood taken at 7am by a nurse who can spot a vein? Thank you honey. X x x

  • Rita,

    FNA is usually required for a large single nodule. Multi nodular goitres are nearly always benign so FNA may not be necessary or desirable.

    Explain your concerns to your endo who will be able to reassure you if FNA isn't warranted.

    Dehydration and anxiety can make blood draws difficult. Drink plenty of water prior and try to have a gentle 30/40 minute walk beforehand.

    I don't think there is a 'right' to have bloods drawn at a particular time. The advice to have it drawn early in the morning when TSH is highest is particularly directed at people seeking a diagnosis or those feeling they need an increase in Levothyroxine. If someone can only have a blood draw later in the day it doesn't mean the thyroid result isn't accurate. Thyroid levels vary throughout the day so just try to have the blood draw at roughly the same time of day every time. I have my blood draw between 1pm and 3pm when levels are low because my TSH is suppressed and I'm not looking to increase my meds. I think you are self medicating so you can increase/decrease your meds according to how you feel as long as FT3 remains within range.

  • It says on my first scan FNA may be advisable. Thank you hon, appreciate the time you take. Hopefully it will all go ok, I should have done the blue horizon test first. I will deffo let you know what they say. I have all my past test results, so that will help. My goiter is becoming more visible. I do have nodules, lots and a goiter on my right side. I will be surprised if they even do FT3. This is the NHS after all.

    Do you self med? I have bought a different brand and it feels the same as my other one. Yà know I would be still one very sick gal if not your you, this site, the members. Bless you honey. X x x x

  • Rita, mention to the endo that the scan suggests FNA may be advisable and ask the endo whether s/he agrees and, if not, why s/he thinks it isn't necessary.

    I self medicated for a few months with T4+T3 and T3 only when I felt very ill on T4 only. T4+T3 suits me and has been prescribed since Feb. I'm thyroidless and need suppressive doses so I'm not undermedicated. I found being overmedicated in the first few months after thyroidectomy very, very unpleasant. FT3 is done by the NHS hospital lab except once when my TSH wasn't suppressed.

  • Well I am dressed and ready to go. Got my papers and hope I get an endo that know anything about real thyroid stuff. Thanks again honey x

  • Good luck, Rita.

  • He treated me like a number, didn't even listen to anything I said. I did tell him my mother sent me some pills because she also has thyroid disease. He scoffed. I have a blood test tomorrow but at 9am, something about cortisol. I begged him to let me have the test at 7 but would not budge.i feel like giving up. Why bother, especially when they do not even treat you as a human. Just a number that doesn't matter. This was Brentwood hospital. I told him both my parents have Cancer one dead just recently the other near death cancer, he gave me some smart as$ remark. Very disappointed.

    Guess this is a fasting, he never even bothered to tell me. Really he can kiss my back side. Rude and arrogant. Typical.

    Thanks for the good wish. X x x

  • Also he poopooed folate, b12 all the things one is meant to be tested for, he did put Vit D when I started mentioning all the other things needing tested. Man, I give up. After this I am done with the doc,s it is too stressful and they DO NOT CARE!!!! :-(

  • Rita, sorry it wasn't a helpful consult. No doctor is likely to approve of taking medication your mother supplies or anything you self medicate. Don't worry about the difference between 7am and 9am testing it really won't make a deal of difference.

    Ask your GP to test ferritin, B12 and folate next time you have an appointment.

    When you get the results of this morning's blood tests post them up in a new post for comment/advice.

  • Thanks Clutter, I will. I am just too honest and fact of the matter I am just gonna keep taking NDT and save up for a blue horizon thing, you should see my arm, they must have taken at least eight vials. So we shall see. Thank you for your support. WE, ALL of US could not make it without your help and compassion. X x x

  • Rita, listening is something forum members can do which some (not all) endos aren't always good at. Endos can't generally share experiences and advise on what may help either. :)

  • Hi Clutter, can you message me with details about Westhroid Pure please? Where I can buy please?

  • Hi Clutter, sorry I don't need info I have found all I need, many thanks!

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