Switching from levo to ndt symptoms : Hello... - Thyroid UK

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Switching from levo to ndt symptoms

DonnyJam profile image

Hello everyone.

I've recently started switching from levo to ndt.

I was on 275mcg levo and with advice from Clutter I dropped 75mcg of levo and added 1 grain of ndt.

I've been doing this for 4 days and the last couple of days I've felt really lethargic and just generally drained/tired and struggling to wake up in the morning.

Is it to be expected I'll feel a bit crap while I switch with my body needing to get used to ndt or should I maybe add more ndt or levo back in?

I suppose I could have coincidentally picked up a bug or something as I'm feeling achey at times as well.

Any advice/thoughts would be greatly appreciated as usual.


12 Replies
shaws profile image

My personal view (as levo didn't suit me at all) would be to ditch levo altogether and take 2.5 gr of NDT and every 2 weeks increase by 1/4 or 1/2 until I felt well with relief of all symptoms. 2.5 gr is around 250mcg of levo. 

I would take my pulse/temp several times a day before I began and continue for a while till I felt I was on a level dose with relief of symptoms. I would also take one daily dose and if pulse/temp increased too high I'd drop back slightly.

DonnyJam profile image
DonnyJam in reply to shaws

Cheers shaws.

Are you sure 2.5 grains is = to 250mcg? I thought 250 would be around 4 grains?

I'm not frightened by the idea of dropping levo altogether and starting ndt but I was advised before I started that it's better to phase of levo and onto ndt at the same time.

Pastille profile image
Pastille in reply to DonnyJam

However you do it, it seems to be quiet common on this site for people to write of the same experience. It seems that people tend to feel worse before they feel better with NDT  

shaws profile image
shawsAdministrator in reply to DonnyJam

Yes, I'm pretty sure :)

That's why it's always best to check and double-check otherwise things can backfire.

You can start at a lower dose if you are concerned in anyway. If you've never taken any thyroid hormones previously, you'd start off with a low dose of levo and/or NDT and the GP should gradually increase. If we've already been on levo or on NDT  you can switch to whichever the equivalent would be. 

You can start at a grain lower and after two weeks increase by 1/4 or 1/2 gr and so on until you feel well. Always being aware of how you are feeling and if symptoms are improving. Any palps etc drop back to previous dose.


DonnyJam profile image
DonnyJam in reply to shaws

hello again shaws

I'm sorry to come across like I'm questioning you but can you explain how 2.5 grains is equal to 250mcg levo when 2.5 grains would only be 95mcg T4 and 22.5mcg T3

shaws profile image
shawsAdministrator in reply to DonnyJam

I don't mind you asking questions and that's why some people don't get the best out of their 'change' of hormones.

Levothyroxine at 100mcg is only T4 (the inactive hormone) and it's job is to convert to sufficient T3 but the effect of T3 will be different on each person .  

If I swallow 1 tablet of T3 which is 25mcg the effect is equal to between 75mcg to 100mcg of T4.

NDT is either 60mg or 65mcg but it is the action of the T3 within it which (being the active hormone which doesn't need to be converted) is more potent than T4 and the effect of this T4+T3+T2+T1 will be around 100mcg levo. 

If someone can explain more clearly they will respond. :)

T4 is only beneficial if it converts to sufficient T3.

DonnyJam profile image
DonnyJam in reply to shaws

Thank you very much. No need to be clearer, I understand lol. I think I'm going to make the switch all at once now as there does seem to be more that suggest doing it all at once from what I can see while Googling 😊

shaws profile image
shawsAdministrator in reply to DonnyJam

:) Any fast heart rate, too hot drop down 'slightly'.

It's a big learning curve - isn't it! As long as we improve and feel well that's the aim.

greygoose profile image
greygoose in reply to DonnyJam

My doctor told me to phase out the Levo, but I really wish I hadn't! I wish I'd made the complete change in one go, as Shaws says. I found the slow change-over very hard. 

DonnyJam profile image
DonnyJam in reply to greygoose

Thanks greygoose

I think once I've gotten my head round what dose of NDT is equal to the dose of levo I was on im going to swap all at once. I'd rather just get it over and done with.

greygoose profile image
greygoose in reply to DonnyJam

I know exactly what you mean!

You should have started on a low dose of NDT such as a 1/4 grain and build up over a few weeks.  This is crucial as the T3 'hit' can be quite a shock to the system. Much as there is a chart with dosages on its useless if you do a direct swap. 

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