In need of Advice

[ashley32]

I am currently 35 wks pregnant and on levothyroxine however pretty soon after giving birth I want to go on to NDT. It's important that I am well in order to look after a newborn and a 2yr old as my husband works away 1 month at a time.

I am aware I need to get my ferritin, Folate, vitamins D and cortisol levels checked?? Is this best to get done privately or something my doctor can okay for me? Wasn't planning on telling the doc til I have made the change to NDT. Also do I start of with 1/2 grain for a few weeks and then slowly increase it? Is there anything else I need to be aware of. Any help would be greatfully appreciated as I am still learning! Also are these tests better to get done post pregnancy due to increase in hormones etc would that make them unreliable at this point?

Thank you kindly in advance,

Ashley

[shaws Administrator]

There's no reason why your GP cannot run these tests and also ask for B12 too. Nearly all of the above are deficient in hypo.

When you have a blood test for your thyroid hormones, leave approx 24 hours between your last dose and the blood test. Get a copy of your results, with the ranges for your own records and so that you can post if you have a query.

1 gr of NDT (sometimes called 60mg or 65mg) is equal approxto 100mcg of levo, so it's more or less a straight switchover from levo to NDT.

I hope it works for you but if, after a while you don't think the one you are on, switch to another. I had to switch a few times till I was happy with the result. I am now on T3 only but also know what the NDT is should I ever need it.

Best wishes

[Razornipper]

I was wondering have you noticed your symptoms improve during pregnancy? I only ask because I am 29 weeks pregnant, think I have a thyroid problem but dr has not diagnosed but in the past 2 weeks my symptoms have slightly got better. I'm completely new to this so any advice would be great!

[ashley32 in reply to Razornipper]

In both my pregnancies I have in fact felt better in general and in both pregnancies my meds have never been increased even although I am aware they should. Not sure if it's all the hormones pumping through my body that masks it or not but I know it wont be long til I am back to the harder days of constant tiredness, coldness, sluggishness and brain fog hence the reason for planning ahead. x

[Razornipper in reply to ashley32]

Thanks for your reply. It's just such a mind field trying to work out if I do in fact have this problem. Being pregnant just masks things and my GP's just don't seem to have a clue.

[Clutter]

Ashley, switching to NDT immediately post delivery may not be the best idea. It takes some members months to feel well on NDT after transitioning from Levothyroxine. It's usually advised that one starts on half a grain and increases by half a grain every two weeks until symptoms resolve or on 2 grains, then hold at 2 grains for 4 weeks and have a blood test before increasing further.

Depending what dose of Levothyroxine you are currently on, you may want to decrease 50mcg for every half grain of NDT you introduce to avoid undermedication while you build up NDT dose.

[ashley32]

Thank you both for your advice, I was thinking this too. May give it a month or so in that case. Just to clarify, I need to get all the tests done initially (after pregnancy) and take supplements if needed going by results etc. And then steadily increase the dose every 2 weeks til I get to 2 grains (if needed) and get all blood tests re done again. I a bit anxious about asking the docs to do the blood tests as I will have to explain what I am doing and was worried about them pointing the finger (even although it won't change anything). Am I entitled to ask/get these Bloods done just want to know my rights before I go. Thank you again for the advice!

[Clutter in reply to ashley32]

Ashley, 6 weeks post delivery is a good time for a thyroid test as pregnancy hormones should have settled by then. I don't think self medicating entitles you to more frequent blood testing unless your GP is willing to request them in order to monitor you. If you don't want your GP to know you are self medicating or your GP won't monitor you on NDT you can order private blood tests from Blue Horizon and Genova via thyroiduk.org.uk/tuk/testin...

[ashley32 in reply to Clutter]

Okay thank you for this info!

[Jobez]

What is NDT?

[Clutter in reply to Jobez]

Jobez, NDT is an acronym for natural dessicated thyroid. It is described as 'natural' because the T4 and T3 contained in it is derived from dessicated pig thyroid. Most brands, but not all, conform to pharmacological regulations and are listed in the US or Canadian National formulary. NDT isn't licenced for UK use so is rarely prescribed on the NHS.

[Jobez in reply to Clutter]

Thank you! Do some brands work better than others? I didn't know there were other brands, as I wasn't told.

[Clutter in reply to Jobez]

Jobez, Armour, Erfa, NatureThroid and WP are available on named patient basis prescription or online without prescription. Thyroid-S and Thiroyd are available online and there is another brand NP by Acella but I don't know whether that is available outside of the USA.

[ashley32]

They have tested my thyroid throughout my pregnancy and told me it's "fine" however this is of course the standard test no T4 Results.

[ashley32]

Just to clarify is one grain = 60mg levothyroxine or 100mg of levo?

[Hidden]

I am becoming a record player which only plays one record, but please pay close attention to your iron/ferritin levels during pregnancy, breast feeding, and to the baby's intake in his her first year. Also please look over the information on the internet on early cord clamping - if you think it is appropriate, having considered all this (I am trying not to be inappropriately bossy!!) ask for the cord to be allowed to continue to pulsate after birth until it has delivered the full transfusion of iron and stem cells from the placenta into the babe. NICE guidelines now allow you to demand this.

This is probably especially important if your baby is a boy. Oh, and also, keep a close eye on your vit D intake during pregnancy and breast feeding, keep it optimal (she abandons all efforts not to be bossy).

I remember how ghastly it was when people kept giving me advice when I was pregnant, so please, please forgive me, but oh, how I wish someone had told me this stuff about D and about iron.