Advice for starting NDT?: Hello everyone, I've... - Thyroid UK

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Advice for starting NDT?

Emstar1892 profile image
21 Replies

Hello everyone,

I've never taken thyroid before, and am a little nervous! Do any of you have advice as to what dosage I should start with? I've heard a lot of stories about people starting TOO LOW, and feeling hurrendous until it's brought up a bit - is this true? Any help or stories welcome :)

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Emstar1892 profile image
Emstar1892

For reference:

TSH 2.29 (0.27-4.20) mU/L

Free T4 12.9 (12.0-22.0) pmol/L

Free T3 3.4 (3.1-6.8) pmol/L

Which are all according to my doctor "normal." Yet I've gained a stone, feel hurrendous, have a swollen face, a sore neck and jaw, dry peeling skin, hair loss, very low heart rate (36) and temperature (35), and am having a heavy menstrual cycle every 2-3 weeks to the point of anaemia.

HarryE profile image
HarryE in reply toEmstar1892

It's all in here

stopthethyroidmadness.com/n...

Emstar1892 profile image
Emstar1892 in reply toHarryE

I see, thank you very much HarryE!

HarryE profile image
HarryE in reply toEmstar1892

I actually started on a quarter twice a day, but I wasn't taking anything before starting NDT. I improved from 4 days in & never had any setbacks. Good luck :-)

in reply toHarryE

I have always been intrigued by the starting dose and although there is a great push for it to be the same whether it is really applicable to everyone? Mind me to please ask you, Harry, What dose are you at now, Harry? did you have somewhat similar lab results as Emstar?

HarryE profile image
HarryE in reply to

It is always best to start low, if you have never taken anything containing T3 before it can be quite a shock!

I am optimal at 3.25 grains.

My TSH was 4, but FT4 & FT3 similar. I was so unwell I was off work for 4 months but was still refused any treatment at all. My TgAb were 100 times above range

in reply toHarryE

Thanks, Harry. Absolutely, I am sure Emstar will benefit fro your experience and advice. Indeed, it is best to start low and increase rather than shocking her system with t3 and with t4 flood if she is not a converter. Cheers.

Emstar1892 profile image
Emstar1892 in reply to

Thanks melanie london. I'm so nervous!

in reply toEmstar1892

You are welcome, Emstar. I am also assuming you are not taking any thyroid medications/replacement such as L-Thyroxine ie Levothyroxine.

Start with 1/4 grain once a day for 7 days and see how it goes.

If no reaction. Add another 1/4 and wait 2-3 weeks before adding more, unless you feel hypo symptoms, then increase after 2 weeks. See this link, tpauk.com/main/how-to-use-n... slightly different approach to STTM.

Perhaps you ought to add some iron supplement due to the bleeding (low thyroid function).

I usually recommend iron bisglycinate, gentle and highly absorbed. Take iron with Vit C 3-4 hrs after you've taken NDT.

There is also a great possibility that you might be deficient on B12, Zinc, Vit A, D, most B, selenium, and Magnesium.

Your T4 is also very low, may be also deficient on the raw material, iodine.

These deficiencies should all be addressed for you to feel very well.

I hope this helps with all the best wishes

Emstar1892 profile image
Emstar1892 in reply to

Thanks Melanie, and no, I've never taken anything before - how many mg is a grain? I've been planning to buy Armour so it's only stated in mg.

Also, thanks for the link - how do I know if I have "adrenal cortical insufficiency"? Is this something a GP can confirm?

in reply toEmstar1892

1 grain of Armour is 60 mg.

Each grain (60 mgs) of Armour contains 38 mcgs of T4 and 9 mcgs of T3.

1/4 grain is 15 mg (9.5 mcg T4 and 2.25 mcg T3)

Here is an information link for Armour

pi.actavis.com/data_stream....

The usual recommended starting dose for Armour is 30 mg, with increments of 15 mg every 2 to 3 weeks.

I guess a 1/4 grain for a week, as explained before, will just give you that dose of trial and hopefully some confidence to increase to 1/2 grain and see how you feel.

The usual adrenals tests are conducted on 24 hrs saliva or 24 hrs urine tests to assess the levels of cortisol. GPs are reluctant to go down this route unless they have clinical reasons to investigate.

I would not worry at this stage as 1/4 grain or even 1/2 grain will not make that toll on the adrenals.

Perhaps what will most certainly help, due to your bleeding is to take 15 mg to 25 mg of iron bisgylcinate with 500 mg of vitamin C with biflavonoids twice a day (helps the absorption of iron, gives you a kick of energy, and also help the adrenals)

A good B-complex with high b5 will also give a boost to the adrenals (usually sold as stress b-complex.

B12 as methylcobalamin 1000mcg for a few months, Vit D in winter up to 5000 iu and then reduce to 2500 iu, Zinc 15 mg-30 mg safe to take daily , selenium 100 mcg, again safe to take daily, magnesium 300 mg elemental a day and Vitamin A (taken from Cod liver oil will help you get the omega 3 too) are also complementary and often lack in our systems.

All of the above are tried, validated, and safe recommendations; however, the call is yours. I fully understand and appreciate your apprehension. It is a big decision depending on the severity of the symptoms and the desire to move towards better health.

I hope this helps, anything else, please get in touch.

Hi what is NDT? And where can you get it? Is it ok to take unsupervised? Have you had a thyroid autoantibodies test. My thyroid was within normal range , however, the antibodies were raised.

Emstar1892 profile image
Emstar1892 in reply to

natural dessicated thyroid. and no i haven't tested antibodies as it's £120 :(

in reply toEmstar1892

You should be able to get that on the NHS. I has mine tested due to my miscarriages

Emstar1892 profile image
Emstar1892 in reply to

I'm sorry to hear of your miscarriage. Since nothing like that's happened to me my doctor just said it's a "dodgy" test that he wouldn't take seriously

Sorry I'm not much help. But may I ask what NDT is. Can you tell me a little about it. Thank you

Oh ok sorry to hear that. It's so frustrating isn't it :( but we shall get there!

kathy1029 profile image
kathy1029

hi,

I started on 1 tablet in the morning, but everyone is different, i was afraid to stop the levothyroxine because its so ingrained in our head that we need it, but after about a week, i stopped the levo, i also have a journal, which helps a lot, i write the exact time i take my NDT, im now on 2 tablets a day (60mg each) and its been about 6 months now, but the headaches and nausea i would have with the levo are gone, i still have fatigue and brain fog, but i think in my own situation, i could use the extra T3 for that. good luck and so glad you ended up on this site, it has helped me more than i can even put into words.

Shredder profile image
Shredder in reply tokathy1029

Hi Kathy can you please tell me how much levo you were on and how do the doses relate as I have read conflicting reports. I'm currently on 100mg of levo should I then be taken 1.25 grains or more of NDT

serenfach profile image
serenfach

I too was shaking when the order of NDT arrived - anyone would have thought it was TNT!

I just went for it, worked out my dose (wrongly) and was taking too little. I still felt so much better than the years on T4! I have slowly worked out my dose, went a little over and had an internal shake, and dropped it slightly. I cannot say I feel 100% but that could be that I am getting on a bit, but I certainly have more energy and best of all, I have found my brain again.

Just work out your dose, take a deep breath and go for it - you wont regret it, and welcome to the much better health!

in reply toserenfach

Hi Serenfach, I realise I'm reading this post 7 months down the line but as I'm also just about to start the NDT journey I've been looking around for as much information as possible. I just laughed so much when I read 'TNT' that just about sums up how I've been feeling about taking the first tablet too. I saw an Endocrinologist in London on 1st September and whilst I said to him I didn't go to see him with 'tunnel vision' about wanting NDT, I wanted to explore the possibility.

He suggested 2 avenues of treatment, NDT (Erfa) and / or hormonal patches (as in HRT not thyroid related) I'm 61 and this came as quite a surprise to me as I felt I'd done with menopause at last period 9 years ago, but he said some of my symptoms are meno related. I deemed it better to take one or the other initially in order to monitor what effect each might have. He gave me a private prescription for the patches and I bought them a week later.

However after much thought, I just had to tell him that I didn't want to use the patches for several reasons and asked to try NDT. He agreed but asked me to keep the patches (' I think you'll find you may need them later') so I have NDT arriving in the post from his clinic today / tomorrow. I spoke to the pharmacist and had said I thought I would start them on Friday so that if any startling side effects, I would only have end of the working day to get through and see how I coped with it over the weekend. I mentioned that I realised adding in T3 suddenly might come as a bit like a lightening bolt, but think TNT is a very apt description! :-)

The Endo suggest 2 x 30mg Erfa each day, stop Levo one day (I'm on 75mcg) and start Erfa next day. But I thought I might half the dose initially.

This is slightly off topic from the original post but sometimes other experiences can help with the original post.

Interested to know how you are getting on Emstar?

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