Thyroid UK
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Using NDT - guidelines?

Hiya! I have just started using Thiroyd and am not sure whether it is helping. I developed diarrhea and cramps on 2 grains, so am back down to 1, taken sublingually. But I still feel fairly fatigued. My bowels have been moving better but that might be because I was overdosing!

I am concerned that my adrenals are under stress. Do I really need to get a saliva cortisol test done in order to determine what is happening with my adrenals? I have identified a few supplements (liquorice, rhiodola rosea, ginseng) that could help and I'm tempted to just go ahead and start taking them. But it so hard to tell what has an effect and what doesn't!!

My TSH test revealed my thyroid to be operating just above the threshold for NHS treatment. My liver function is not good, however, and I am wondering whether that's connected to my thyroid.

This all seems like a minefield at times, so any help will be greatly appreciated!


4 Replies

Welcome to the forum, Moowens.

Can you post your recent thyroid results with the lab ref ranges (the figures in brackets after results) and say how much Levothyroxine you were taking prior to Thyroid-S?

It is a minefield if you go in dosing and supplementing willy nilly.

Usual advice is to start NDT at half a grain to see how you tolerate the T3 and to increase in half grain increments so you don't over shoot what might be your sweet spot and periodic blood tests to check FT3 isn't over range.

Low thyroid can affect kidney and liver function. There may be improvement when you've been opimally medicated for a while.

You need a saliva cortisol test to tell you at which points cortisol is high or low. Based on results members can recommend whether and what to supplement.


There's actually a big jump between 1 grain and 2 grains. If you want to try an increase again, go to one and a half, or even one and a quarter first - and stay on that dose (unless there are side effects) for at least a fortnight before attempting to raise it again. Some find it helpful to split the dose into two - half of it at night, half in the morning. But go slowly - T3 in particular is potent stuff, and your body needs to learn to get used to it.

Symptoms lag behind medication - it can be several weeks before you start to feel better. If you've been underactive for a while, it can take your body a while to heal. Meanwhile, it might be worth considering the possibility of gluten/wheat intolerance, especially if you have Hashimoto's. As Clutter said, post your results if you have them.


Thank you Clutter and Jazzw!

I have been waiting to speak to my GP about results in next day or 2, to discuss thyroid results and liver function. My most recent blood tests revealed my thyroid to be 'normal' but my symptoms suggest otherwise. The ones before that had me just on the threshold. When I have the results in front of me I will post them.

Have you guys found that you are able to receive much support from your GP re self medicating and all that jazz?

This is the first time I have taken anything for my thyroid. For years I have believed my symptoms stemmed from other conditions but the more I learn, the more I believe it all to be about the thyroid! Based on what you have said, I guess I should sit on 1 grain for a few weeks to see if I notice any changes?

Should I expect to see any change in weight or is this person dependent. I'm not extremely overweight, but enough to bother me. I do try to avoid gluten, but will up the ante with that too.


So, I got my T4, TSH and Gamma GT (liver function). My T4 is 14.1, my TSH is 3.17 and my Gamma GT is 80, when it should be between 30 and 50. I know my T4 and TSH read normal, but my symptoms suggest otherwise and in conjunction, I cant put them down to anything else!

GP is not too worried about my liver function, just keeping an eye, and has invited me to get a referral for a specialist if I am still concerned about my chronic fatigue, constipation etc. I have had a colonoscopy (third of the way up) before, but all was healthy. Ihave had 3 colonics in the past 6 months, with very little excretion and they were all pure agony!

I have told my GP I am self-medicating with NDT to see if it makes a difference to my symptoms. She was a wee bit concerned but supportive.

I still haven't found any difference in my symptoms on 1 grain. Due to move to 1 and a half this Friday!

Seeking clarity, please help!!!



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