Can you let me know why you take T3 with NDT?

[cc120]

As NDT has T3 and over range T3 is dangerous, unless you have tissue resistance (not sure how this is diagnosed) why would you feel the need to take T3 with NDT?

[shaws Administrator]

Some who are on NDT and feeling nearly better, instead of increasing the NDT add some T3 hoping that it will give them the little bit 'extra' and make them well. You could also increase the dose of NDT instead if you wanted to.

T3 isn't dangerous - any thyroid hormone is dangerous in excess, whether levo, NDT, or T3. T3 is the active hormone every cell in our body requires. We can live without T4 but not without T3. This is an extract from the following link.

You asked, if we don't have T4 receptors, "then why do we need T4 supplementation rather than just T3 alone?" With rare exception, we don't.

No one can rationally defend T4 supplementation on scientific grounds. I say this because the widespread use of T4 supplementation is not based on scientific studies that show it to be safer or more effective than the use of T3 alone. Instead, its widespread use is the result of a financial venture between the endocrinology specialty and corporations that profit from sales of the most commonly prescribed brands of T4.

Our long clinical experience shows that in general, patients respond far better to T3 alone than they do to T4 alone. Moreover, our safety monitoring of patients shows that the responsible use of T3 alone is as safe as the use of T4 or T4/T3. By "responsible use," of course, I mean employing the same precautions that are appropriate to the use of any thyroid hormone product.

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

[helvella Administrator Thyroid UK]

Desiccated thyroid does indeed have some T3. But how can anyone know precisely what proportion of T4 to T3 is optimum for them? The fact that careful mixing of pig thyroid powders happens to produce a ratio of something like 38:9 (by weight) does absolutely nothing to support that ratio being optimum for anyone. Some people will need more T4/less T3, others will need less T4/more T3.

Taking more T3 doesn't automatically make your T3 over-range. All sorts of things happen. Like the body might reduce the rate of conversion of T4 to T3. Or perhaps it can excrete more of the thyroid hormones to reduce the amount retained. A complex picture with lots of things happening - but little clarity because the science is still being discovered.

I actually suspect that taking slightly more T3 than is strictly needed, in the context of carefully managed taking of desiccated thyroid, might have little negative effect.

[Brubru in reply to helvella]

Hi helvella, your last paragraph is not very clear to me. If adding t3 to NDT might have negative effect? I'm on NDT only now but was thinking of experimenting with extra t3

[helvella Administrator Thyroid UK in reply to Brubru]

If your body really, really wanted to have 38 micrograms of T4 and only needed 7 micrograms of T3, then taking desiccated thyroid with 38 T4 and 9 T3 is unlikely to be a problem. That is what I was saying.

If your body really, really wanted to have 38 micrograms of T4 and 14 micrograms of T3, then you can only get there by adding T3.

[cc120 in reply to helvella]

But won't the T4 become T3?

[faith63 in reply to cc120]

Sometimes, for many reasons, t4 does not become t3 for some people, it turns into reverse t3 for me.

[cc120 in reply to faith63]

Hi faith, were you able to get a rt3 reading?

[faith63 in reply to cc120]

Yes, for 16 months i followed it and it was too high. I spoke to several Functional Medicine doc's who told me to go on t3 only, since i don't convert well.

[cc120 in reply to faith63]

Hi faith63, are you in the US as I don't think the medices measure/recognise RT3 in the UK?

[faith63 in reply to cc120]

Yes, i am in the US. My doc did all the tests that i asked for and yet just used TSH for dosing, leaving me ill. If you can get a free t4 and free t3, you can use that to see if you are converting well or not. But, in my case i was still making too much rt3, with my ft4 under range!!!

[cc120 in reply to faith63]

My TSH was suppressed, FT4 25 (12-22) and FT3 8 (2-6) but I had no way of knowing if any of this was RT3, as medics here seem to think its a myth.

[helvella Administrator Thyroid UK in reply to cc120]

The human thyroid produces some T3 (but mostly T4). And we see patient after patient reporting how different they feel when some T3 is added to their intake. If it were as simple as all T4 getting converted to T3 (or even a fairly stable fraction of the T4), then the standard levothyroxine monotherapy would make sense, and would work. Afraid things don't work as simply as that and different tissues appear to require different amounts of T4 and T3.

[cc120 in reply to helvella]

I guess as my FT3 rose over range when FT4 became over range, that I am converting satisfactorily. Unless some of the FT3 was RT3, which I would have no way of knowing as UK NHS doesn't recognise RT3 as a 'thing'.

stopthethyroidmadness.com/r...

[marmaris in reply to helvella]

Hello Helvella your input is interesting. I have just started on Nutri throid after being on T4 alone for the past 19 years (T4 100mcgs) and 20mcgs added one year ago of T3. I have tried every combination. T4 only, not good T4 and T3 synthetic not good. I have finally taken the plunge with Nutri Throid, started a week ago on 1 grain ie what you stated 38mcgs T4 and 9 mgs T3. Upped just after one week to 1 and 1/2 grains (as I was fearful as lower dosage that I was on. Then I will up after another week another 1/2 grain. No big difference yet, as I realize it takes time. Would you agree that this is the correct protocol to follow?

[helvella Administrator Thyroid UK in reply to marmaris]

I am somewhat concerned for you. Nutri Thyroid is claimed to have absolutely no thyroid hormone content. I really doubt it has the 38 T4/9 T3 of prescription desiccated thyroid even if it actually has some T4 and/or T3. (Whether or not it contains any thyroid hormone whatsoever has been an ongoing discussion from the very early days here.)

I'd be so very much happier if it were Nature-Throid, WP Thyroid, Erfa, NP Thyroid or Armour you were taking.

[marmaris in reply to helvella]

Wow sorry helvella I have just read my typing mistake it is Nature-Throid that I am taking and not Nutri Thyroid. Wheew

[helvella Administrator Thyroid UK in reply to marmaris]

Phew! Sorry - should have looked back at your posts before replying.

I am absolutely no expert of desiccated thyroid dosing. You seem to be somewhere around right but rate of increase is the difficult and controversial question.

[marmaris in reply to helvella]

Thanks Helvella yes it is all trial and error. Hope it will help me.

[cc120 in reply to marmaris]

stopthethyroidmadness.com/n...

How do I move from taking T4-only to NDT?

Many patients do their T4 one day, then stop and start on desiccated thyroid the next with a safe beginning dose, usually one grain (see below), with no problems whatsoever. Some doctors guide their patients to lower T4, such as by half, start on desiccated thyroid, then continue lowering the T4 as they raise the NDT. But the former works well. Work with your doctor.

How do patients dose with natural desiccated thyroid?

Thyroid patients and their doctors have found it wise to start on a smaller dose of desiccated thyroid than they will ultimately need, such as 1 grain (60/65 mg). Why? Because the body may need to adjust to getting direct T3 again, and there may be other issues which can reveal themselves, such as sluggish adrenals or low iron levels. Those who start on natural desiccated thyroid have discovered that it can be wise to RAISE by 1/2 grain every two weeks or less to prevent hypothyroid symptoms from returning due to suppression of the internal feedback loop in your body, which can happen if you stay on a low dose too long before raising. Most patients start to slow those raises down in the 2-3-grain area to give the T4 time to build (which can take 4-6 weeks) and show its conversion results..then inch their way up if needed. Some patients end up in the 3-5 grain area when optimal, some on a lot less, and some on more. It’s individual. (Janie Bowthorpe is on 3 1/2 grains, for example)

[Jackie in reply to cc120]

Yes, T4/levo takes about 4 weeks to get out of the system. In fact longer as if having a parathyroid nuclear scan it has to be 6 weeks. Hence to change over at a low rate eg grains to start with.It is only at this time a FT3 test will show if T3 is needed.

Jackie