Thyroid UK
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How to split my dose of NDT

For now, my morning dose it' s 1/2 grn.ndt +75mcg T4(sintetic levo) and I do not feel fully recovered yet (I feel fine in the morning but towards afternoon it spoil everything). The levo dose was 115mcg (aprox) and had obvious symptoms of hypo...

I intend in the future to switch totally to NDT and I want to split my dose but I don' t know how.

Few questions; at what time should I take the second dose, the second dose should be less than or equal to the first dose, when I want to increase should increase both doses at once ?

Thank you.

5 Replies

Why do you want to split your dose of NDT. Many, I know split T3 but I believe NDT is to be taken like levothyroxine - once daily. If you want to separate I would take NDT in one dose and take T4 later on, remember to have an empty stomach and leave about 2 hours after eating to take T4. I think the T3 in the NDT will be better utilised in one dose.


I saw that many here do the same(split doses).

I suppose it is more easily tolerated the T3 in the NDT.


T3 is the most gentle of thyroid hormones and is the Active hormone required in every one of our receptor cells. Each receptor cell has to be saturated and then its work begins after that and lasts between 1 to 3 days. This is an excerpt:-

Dr. Lowe: First, let me clarify an important point: Our treatment protocol does not consist solely of patients using T3. Only two groups of our patients use T3. One group is patients who appear to have thyroid hormone resistance. The other group is hypothyroid patients who fail to benefit from desiccated thyroid. Our other patients use desiccated thyroid as part of their metabolic rehabilitation regimen. (We don’t, of course, waste time any more trying T4 alone; it’s too seldom of any use.)

Now, to address your rheumatologist’s assertion that T3 is dangerous, and his implication that amitriptyline is not. I think the best way to reply to him is to quote publications that are available to him. In the USA, when patients get their prescriptions filled for T3 (usually the brand Cytomel), the pharmacist usually gives them a leaflet on the product. The leaflet contains the following statement:

"NO COMMON SIDE EFFECTS HAVE BEEN REPORTED with the proper use of this medicine." (Medi-Span, Inc.: Database Version 97.2. Data © 1997.)

This statement makes a fact perfectly clear: When used sensibly, T3 is extraordinarily safe among prescribed drugs. When I say extraordinarily safe, I’m comparing T3 with drugs such as the amitriptyline which your rheumatologist prescribes for you. Below is a list of potential harmful effects of amitriptyline. This list comes from the Physician’s Desk Reference, 53rd edition, Medical Economics Company, Inc., Montvale, 1999, page 3418.


This means that without the researchers or patients knowing when, the patients were switched from T3 to placebos and back again. The studies showed clearly that in general, when patients were taking T3, their status improved, and when taking placebos, their status worsened.

These clinical and experimental findings argue against that idea of "cycling" enabling patients to maintain improvement after stopping their use of T3. With increases and decreases in dosage, the only thing that has cycled in our patients is their fibromyalgia status. So, do I believe that "cycling" will "cure" cellular resistance to thyroid hormone? Unequivocally, no!

Third, the leaflet on Cytomel pharmacies give patients when they fill their prescriptions states, "POSSIBLE SIDE EFFECTS: NO COMMON SIDE EFFECTS HAVE BEEN REPORTED with proper use of this medication." This information is accurate—when plain, full-strength, one-time-per-day doses of T3 are used properly, there are no adverse effects. The only adverse effects occur when a patient takes a dosage that for her is excessive.

Of course people can please themselves in whatever they want to do.


Thanks for the good information .

It might not be bad to take a little dose of NDT in the morning and the my levo in the evening...

pff it's hard, I do not know what to think...


Adin, Many people split NDT dose x 2 because it spreads the T3 more evenly. It's fine to take Levothyroxine and NDT together in the morning. Add a second dose of half grain NDT an hour or two before you experience your afternoon slump. If you increase NDT further add half grain to morning dose or split into 1/4 grain added to each dose. You'll need to experiment to see which suits you best.

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