Thyroid UK
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Switching from combo T4 + NDT to straight NDT

Hello All,

After quite some time on Synthroid (and after it stopped working for me), I was put on WP Thyroid 2 grains, as well as 75mcgs of Levoxyl. There were definite improvements across the board – except in the weight department. I was still unable to shift any of the water weight. I felt like I was drowning in myself, which was extraordinarily uncomfortable. I missed a dose of Levoxyl and within two days, five pounds of fluid flushed out. That led me to try out NDT only, which is what I am experimenting with now. Here are my labs on the T4 + NDT combo before the switch:

TSH 1.4 (0.450 – 4.500)

FT4 1.4 (0.82 – 1.77)

FT3 3.7 (2.0 – 4.4)

I dropped the 75mcgs of Levoxyl three days ago, and added another 3/4 grain of WP Thyroid – bringing my dose up to 2 3/4 grains of WP Thyroid split into two doses. The switch hasn't been very comfortable. Headaches are returning, as well as body aches and pains – especially lower back pain, and joint pain. My mood has also dipped, and I'm cranky. Water retention has increased slightly, to my dismay.

The question is, are these just uncomfortable side effects resulting from the switch? Will they pass? How long does it usually take, and at what point can I do labs again? I know the 4 - 6 week range, but is it the same with NDT only? I almost want to go back to the combo, but I feel like I need to give this a chance. I just hate the idea of going too far in the wrong direction and losing that much more time. I also can't afford to gain any more weight!

Sorry for the long-windedness. Thanks in advance for reading!



6 Replies

Hypoman, you've increased WP too much, too quickly. Half grain increments every 2 weeks is recommended but quarter grain adjustments may be better as you are already on 2 grains to avoid overshooting your 'sweet spot'. You're probably a little overmedicated as the Levothyroxl will take another 4-5 days to wash out.

Reduce to 2.25 grains for 7 days then increase to 2.5 grains. If you don't feel overmedicated increase to 2.75 grains two weeks later. If you don't feel good at any increase go back to the previous dose for a week or two and then try again. Hold at 2.75 or 3 grains for 6 weeks and have a blood test.


Good to know. I thought because I dropped the 75mcgs of Levoxyl, that I could just replace it with the rough equivalent in NDT. That's what I did when I switched from Synthroid, and I didn't have any problems.

Could taking too much too soon cause these symptoms – even the fluid retention? I fear taking too little and swinging Hypo as well.


Hypoguy, headaches, musculoskeletal pain and low mood can be due to overmedication. I don't think overmedication causes water retention. You're getting an extra 6.75mcg T3 from the increased WP which may be tipping you over while the Levoxyl is washing out.


Copy that. I will reduce and take it slower. Thank you for the responses.


Another thing I've noticed since I've switched to NDT is that my veins are much more prominent – is this due to the increased blood-flow? I would imagine this means things are working as they should?

1 like

Starting to feel hypo again – fluid retention, tired etc. I'm so frustrated trying to get things leveled. Not being able to shift this fluid retention is so demoralizing.


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