Switching to Synthetics from NDT and need advice/experiences:

Hey everyone,

As many of you are aware, I've been on NDT for six months now with mixed results. I've been having some moderate success (not feeling so 'manic' as I had on levo + cytomel as I believe was more the dosage) but I have been feeling much worse physically. I don't have the zeal and energy to muster myself to do anything, really. I haven't even tried to run and force myself to go to the gym but feel lackluster, my sleep has been non-existent the entire time (and the majority of this post-TT) but i don't stay asleep nor can i sleep more than a few hours at a time.

I am miserable.

I have two deciding factors, I am seeing a rather well known naturopath in a few days and he is an expert in thyroid care, so I will see what he says, the other is that an endo I have seen recently feels that my TSH is too low and to be fair, I agree.

It feels like the T3 is the only thing my body gets to coast throughout the day and it may sound strange, but I feel like my body *needs* to convert something. The brain fog has been horrible, I've lost weight yet have no appetite, hair loss is still a tragedy, and the tinnitus I've accrued since my RAI prep is still a constant.

Oh, I've finally found out I have Hashi's, too. And I've had more tingling and aches and horrible pains in the past two months.

So, I digress, trying to be as descriptive as possible of this, this endo said she feels that it's best that I am treated as someone with hypothyroidism and not someone that had thyroid cancer so as to raise my TSH to at least .5 and I'm ok with that. Once I gather the info from the naturo I'll have more confidence....

Hoever, has anyone/any of you here transitioned back to synthetics from NDT? Any feedback? I'm on 1.75 grains and would be looking at 125 T4 with 5mcg T3 to start and I'm fully aware of the drastic T3 difference but you know, I'm just desperate to try and get that zing back and my gosh, my sleep...

Thank you, everyone.

5 Replies

  • MissClio, TSH really is a red herring. It's FT3 which is important. Low FT3 will cause the fatigue you are experiencing, not low TSH. TSH will usually rise when FT4 and FT3 drop but not always. My dose was reduced but TSH didn't shift even though FT4 and FT3 dropped.

    What is your FT3 level and range? 1.75 grains is a low dose and you may feel better increasing dose rather than switching back to Levothyroxine. 1.75 grains has 66.5mcg T4 which you will be converting to T3 in addition to the 15.75mcg T3 it contains.


    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Thanks for your response!

    I've been on al sorts of doses, with 2.5 being probably the highest I could stand...

    I can offer my most recent labs:

    FT3: 3.7 (range 1.4 - 4.4)

    FT4: 1.0 (range .8-2.2)

    TSH: 0.02 (range .35-4.3)

    I had just lowered my dosage too because that's when I had started noticing the really bad aches... but my gosh, the no sleep, the hair loss... it's become worse since being on NDT. I'm feeling that maybe my FT3 is also too high for me....

  • MissClioCat, 3.7 isn't high in range but if you feel better on a lower dose maybe it is too high for you. Some patients don't do well on NDT and prefer Levothyroxine and T3 combination.

    You might check ferritin, vitamin D, B12 and folate as low/deficient levels can cause musculoskeletal pain, fatigue and low mood.


    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Firstly low TSH is NOT a threat. I hope you didn't directly swap? Its not a good idea, start slow and keep increasing till the symptoms dissappear.

  • no, i know.... and i know many do good with a low TSH. i've just noticed that since mine had gone down to zero, i don't feel as good as i did when it was a bit higher... i don't know why, possibly my body just feels too on the go, hence the sleep and the hair loss... and i am beyond scared to switch back... but i feel like even though my body accepts the NDT better, the T3 amount tends to be the ebb and flow factor to me... ughhh. but no switch yet, probably next week. 125 mcg was the suggested starting amount with 5mcg of T3, so I'm hoping that this is a good start...

    just scared, guys.

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