question about NDT lowering and raising

[julie11]

Hi, all. I have been on various combinations of thyroid meds for about 4 years, and always felt terrible (probably due to adrenal issues that have tended to make med tolerance and raises difficult). For a long time, I was on a combination of NDT and T3 (having tried and done worse with other med configurations). About 3 weeks ago, I removed all T3 and was left with a daily divided dose of 3 grains NDT. Suddenly, I felt more comfortable in my body than I had since starting thyroid meds--I no longer felt like I was plugged into an electric socket, and my body just felt comfortable and softer, and I was able to physically relax for the first time since I started on thyroid meds, particularly since I added in T3 years ago. It was wonderful.

The problem was that the 3 grain dose also didn't seem like enough: I started losing hair like crazy and also felt the need to nap again all day--something that hadn't happened for a few years, since I was able to get to a decent dose of meds--and I developed lots of those eye twitches/flutters that are usually reserved for times of major exhaustion or stress. So, after suffering with all that for 2.5 weeks, I decided to increase by 1/4 grain. After a couple days (or less?) I went back to feeling like I had before, constantly uncomfortable in my body, more emotionally sensitive, etc. So, the next day I went down to 1.5 grains, still felt bad all day but perhaps a touch better, and then after that I skipped meds entirely for a day, and as that day went on, I started to feel much much better again. The day after that I went back to 1 grain, and then yesterday I took 1.5 grains. Still doing fine (though I want to nap all the time). My main question is this: I have the feeling that I need something like 3 grains or more (?), but I am not sure now how quickly to get there after this recent reset. Since I tolerated 3 grains well 3 weeks ago, can I just move pretty quickly back to that dose, or do I need to hang around at a lower dose for a while and build up slowly again?

Sorry this got so long, and thanks for reading this far!

[julie11]

P.S. I also had significant heart pounding for years on my previous doses of medicine. It went away when I was on 3 grains of NDT but came back at 3.25 grains. Now, during this reset, the heart pounding is still gone.

[shaws Administrator]

You can increase every two weeks on NDT. Maybe you were a bit overdosed on 3 grains plus T3 (pounding heart). 3 grains NDT is equal 'in effect' to around 300mcg of levo. It's better to go up gradually because if you begin to feel overstimulated, you can drop down to your previous dose without much effort and may find your 'perfect' dose.

[julie11 in reply to shaws]

thanks so much for replying, shaws. i guess my next question is: which dose do i drop back down to? i was doing fine on 3 grains, so do i really need to drop back down to 1.5 grains, as i've done so far, and then build up 1/4 grain (or 1/2?) grain every two weeks from there? or can i start higher now, like on 2 grains or 2.5 grains and see how those feel for a couple weeks? i hate the thought of staying hypo for any longer than i need to, as it's such a difficult state to be in.

[shaws Administrator in reply to julie11]

You will have to be the judge. You are already taking 1.5 gr. I can only say what I would do - go up by 1/2 every two weeks (6 weeks to get to 3 gr). Someone else may have a different opinion but your body has to adjust again.

[julie11 in reply to shaws]

thanks for the feedback; much appreciated.

[Clutter in reply to julie11]

Julie, whenever you raise dose and feel uncomfortable go back to the dose you were previously taking and on which you felt well. You should have reduced from 3.25 grains back to 3 grains. If its only a few days since you reduced to 1.5 grains you can try 3 grains. If you feel overstimulated reduced by half a grain and try to increase by half a grain in another week.

[julie11 in reply to Clutter]

thanks so much for the feedback--much appreciated!