Questions on dosing NDT: Wow, what a roller... - Thyroid UK

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Questions on dosing NDT

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Wow, what a roller coaster. I was diagnosed with Hashi's 6 years ago. I finally found a doctor to prescribe me NDT and as of 4 months ago I was feeling well!

Unfortunately, I've had a chronic cough that nobody could figure out and I was exploring the idea that the cough could be due to acid reflux. A GI doc prescribed me a heavy duty antacid and within 10 days my thyroid was angry! It was painful and I was having trouble swallowing. It had to be that the antacid wasn't allowing my NDT to absorb (even though I took them hours apart). So I stopped the antacid.

That was 5 weeks ago and I feel horrible. I got my labs back: free t3 2.7 (1.7-3.7) total t3 88 (58-159) free t4 .68 (.7-1.48) total t4 3.5 ( 4.9-11.7)

I have had shortness of breath, palpitations, panic attacks and severe dizziness. I have continued to take my NDT 1.5 grain in the am as usual and my doc added 25 mcg of t4 for 30 days since my t4 was so low.

I'm so confused, I don't know whether to push through the symptoms or lower my dose for a while. It seems my body isn't tolerating the dose I was feeling well on. I'm sure my adrenals were stressed when my NDT wasn't absorbing but I can't afford the 24 hour saliva test right now.

I'm so scared and angry. Shouldn't the GI doc have known the antacid could affect my NDT? I have had to miss work and I need to support my family.

Any advice is appreciated. thanks

marci319

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shaws profile image
shawsAdministrator

Unfortunately, the symptoms of acid reflux are similar to low acid. If we are hypo it is most probably low acid and antacids also interfere with the uptake of thyroid meds.

sott.net/article/265343-The...

worstpills.org/public/page....

Excerpt:

Antacids often used to treat heartburn and other intestinal distress, including calcium products such as TUMS or ROLAIDS and other antacids, may have absorption-inhibiting effects on thyroid medications. People should take levothyroxine four to six hours before or after taking these antacids.

Many hypo patients have stomach issues such as low acid rather than high. I myself was prescribed a product by the GP and it gave me severe pain so I switched to Betaine/Pepsin tablets - 1 at each meal (max 3 per day) and haven't looked back since.

I also at times take an organic Apple Cider Vinegar a couple of teaspoons in either water or juice. Some just take ACV alone.

Maybe just start afresh with NDT although your blood tests look o.k. Also, when taking NDT our blood tests will be different to taking levothyroxine or T3. So the best way to judge is how you are feeling on a particular dose of medication and just using the blood tests as a guide.

The symptoms above do sound hypo. This is another excerpt:

To get well, some patients must use Armour doses that are high enough to produce TSH and thyroid hormone levels that upset endocrinologists. But the lab values are meaningless in themselves, as long as a patient isn’t overstimulated and has gotten well from her hypothyroid symptoms. What's truly harmful is for a doctor to keep a hypothyroid patient’s dose too low strictly for the sake of predetermined lab values.

web.archive.org/web/2010103...

Clutter profile image
Clutter

Marci, it looks like your GP is trying to raise your FT4 without realising that FT4 often drops because the T3 in NDT means you are bypassing the need for high T4 to convert to T3. Your labs look ok.

Were you experiencing shortness of breath, palpitations, panic attacks and severe dizziness prior to 25mcg Levothyroxine being added?

in reply to Clutter

Thank you both for your replies. Yes, my symptoms started about 3 weeks ago and I only started the extra t4 5 days ago.

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