WP Thyroid dosing,: Hi After reading a reply to a... - Thyroid UK

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WP Thyroid dosing,

lucylocks profile image
30 Replies

Hi

After reading a reply to a post this evening, a member stated the instructions for WP Thyroid dosage is that it should be taken all in one daily dose.

I have been taking mine in split doses twice a day. The morning dose been the higher amount and a smaller dose later in the afternoon.

Does anyone know which is the correct way to take it,

Many thanks browny

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lucylocks
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30 Replies
waveylines profile image
waveylines

It's down to what works for the individual Browney. I also take mine in split doses- three infact. If splitting the dose works for you there is nothing wrong in that. If taking it in one dose works then that's fine too. We are all different. Maybe some clever scientist in the future will work out why it is that some of us need to split our dose and others don't.....shall look forward to the read when they do!! 😊😊

lucylocks profile image
lucylocks in reply towaveylines

Thanks waveylines,

to be honest I am having trouble getting my dose right. I worked up to 1 1/2grains then when I had been on that dose for two weeks I felt sort of spaced out and disorientated so reduced to 1 1/4 grains, stayed on this for a couple of weeks, increased again to 1 1/2 grains, felt good for a few days, now not so good.

When I read someone said take it once a day I thought maybe this is why I am having bother as I have been taking it twice a day.

helvella profile image
helvellaAdministrator

RLC post this PDF on their site:

getrealthyroid.com/wp-conte...

So far as I can see, no suggestion whatsoever of splitting doses. If spitting were intended, no doubt that PDF would say so. I suspect that splitting is a patient-led thing that is mentioned so frequently on forums that it becomes the expected and default approach.

lucylocks profile image
lucylocks in reply tohelvella

Thank you,

the link you supplied is the one I read yesterday evening, and yes it did not say about splitting doses.

As I am not feeling a great deal better and have been dosing twice a day, maybe this is were I am going wrong and need to take a daily dose.

thank you for replying.

silverfox7 profile image
silverfox7

I am also on NDT and it was recommended splitting doses. I think mostly because of the T3 and the need to get used to it. I found I couldn't find the best time to take the afternoon dose plus I often forgot to take it anyway-we are all human! So now I thought my body was used to the T3 I started taking it in one dose and it's been fine. It was suggested to me my waking temp should be, on a settled dose, 36.9 and that to take another reading at 3 pm and it should be 37.1. True to form I often forget my afternoon temp as well!

lucylocks profile image
lucylocks in reply tosilverfox7

Hi

I am the same silverfox7, in that I find it difficult to fit the afternoon dose in around everything else. I have not found a great deal of improvement yet, so maybe the once daily dose may suit me better.

Do you feel better taking it in one dose ?

Ruthi profile image
Ruthi

Some people feel better on split doses, but I suspect most of them feel better doing more for their illness, rather than it making a genuine physiological difference.

1)NDT contains T4, so all the rules about taking away from meals apply to NDT too. I don't do well with long gaps between meals, so it would be almost impossible to find a time to take the stuff. I take mine on waking and wait an hour to eat (that is hard enough for someone who spent years taking max 20 minutes to get out of the house in the morning!)

2)The T4 in NDT is going to be metabolised as and when its needed and evens out your T3 levels anyway.

3)Although T3 has a short half life in the blood serum, its action takes place in the cells, where its effects last up to a fortnight. That is how its possible to miss a dose with little obvious effect.

Go for the easy life, and take it once a day!

lucylocks profile image
lucylocks

Hi,

thank you for replying. I also cannot have long gaps between meals and find it difficult to fit my afternoon dose around food and supplements.

As I am not finding much improvement at present maybe the once a day dose may help me feel better.

thank you for the information.

shaws profile image
shawsAdministrator

It is the Manufacturer that states that it should be taken in one daily dose.

I have read that some chew or sublingual NDT and neither is correct. The FDA do not permit doses to be sublingual or split as stated below:-

Excerpt:

No thyroid drug is FDA approved for sublingual usage. Both tablets were formulated to be swallowed whole on an empty stomach with an 8oz glass of water. Use as directed by your doctor"..

If we chew or try sublingual, we might not actually be taking the amount of hormones we think as saliva will be mixed with the tablets and most might be swallowed. Whereas tablets are supposed to dissolve in the stomach and this is from the manufactuer and is for WP thyroid and Nature-throid:

Extract:

A: Use as prescribed by your doctor. Take as a single dose on an empty stomach, at least 30-60 minutes before consuming food or caffeine. Some medications and supplements may lower the effectiveness of WP Thyroid and Nature-Throid when taken simultaneously, so it is important to take WP Thyroid or Nature-Throid at least one hour before any other medication. Calcium supplements, iron products, or antacids need to be taken four hours apart."

What's the point of manufacturers making products but we don't follow their instructions. They must want the product to be successful for the patients.

Also, it is T3 which is the active hormone which is required in our receptor cells in order for our body to function.

Why would I split thyroid hormones - maybe not quite enough (and you'd be unaware of that) or maybe a little too much.

Some may split as they don't take notice of their bodies' reaction to specific doses, particularly when starting. We always gradually increase and when a point is reached that our body doesn't like we drop to the previous dose.

Some people are 'nervous' of T3 and I think that's from a medical source but untrue. An extract:

He will learn that rather than causing strokes, T3 is more likely to prevent them. If he doesn't do this, and correct his beliefs about T3, he himself may be responsible for causing in some of his patients the very harm he fears T3 will do.

Extract:

And finally, why do I specify that the typical patient use one full dose of non-timed-release Cytomel for life? Because extensive testing has shown that this is safe, effective, and most economical—when used within the context of our entire protocol.

(NDT is also included in this method).

lucylocks profile image
lucylocks in reply toshaws

Many thanks for that shaws,

I did not know this, the instructions on leaflet with the tablets is so small I can barely read it. I did look on one site with dosage instruction but it just said take meds. with water 30 - 60 mins. before food and did not stipulate if it was once a day.

Starting tomorrow I shall take one dose a day and hopefully I will find some improvement.

Just thought I would mention, my daughter takes T3 only and has been spreading throughout the day, a member on here recommended taking it all at once, she has been doing this for a week now and has felt better.

Many thanks again for the information.

Best wishes brown.

shaws profile image
shawsAdministrator in reply tolucylocks

I take T3 only and yes, it is recommended one daily dose because it allows the T3 to saturate our receptor cells and then its work begins. Tthe effect of that one dose an last between one and three days. I think people mistake it as 'quick acting' against levo and imagine its better to spread but I think this must be based on rumours. I wouldn't have known unless I had read it.

lucylocks profile image
lucylocks in reply toshaws

Hi shaws,

have you got a link for the info. you supplied me.

I have just had a look on the manufacturers instructions and I cannot seem to find the same info.

Maybe I am looking in the wrong place.

Thank you.

shaws profile image
shawsAdministrator in reply tolucylocks

This is the first link:

rlclabs.com/

second:

getrealthyroid.com/why-get-...

three: cursor down and click on what interests you

getrealthyroid.com/the-real...

lucylocks profile image
lucylocks in reply toshaws

That's great shaws, many thanks.

I was looking at the main manufacturing site where it said about how much to take but did not state when.

Very helpful information, thank you.

I will take full dose in morning.

shaws profile image
shawsAdministrator in reply tolucylocks

Watch temp/pulse. If goes a bit too high, reduce dose slightly next day. It can be slight adjustments/up down to get dose that suits. Of course it might not work for everythone for one reason or another.

I read somewhere that taking NDT (or any drug containing T3) once a day is like putting on the heat for a couple of hours in the morning, then switch it off, and expect it to last all day, the idea being that T3 has such a short half-life that it needs to be spread out throughout the day.

However, I have never believed that to be true. I have also read that T3 has a half-life of +/- 24 hours, meaning it should be enough to take it once a day. I have always taken NDT once a day (in the morning), and have never had any problems. I also prefer it that way, as multi-dosing would be inconvenient. But, as many point out, we are all different, and we all need to find the method that works best for us.

lucylocks profile image
lucylocks in reply to

Many thanks for replying,

I think I am going to try once a day dosing and see if I can improve.

Best wishes browny

ladyinpurple profile image
ladyinpurple

I was told by my doctor and the pharmacist to take my tablets first thing in the morning on an empty stomach. But then another doctor told me I could take them when I ate my breakfast! As a result I still take them first thing in the morning with my coffee.....unless I forget and take them when I eat lol.

waveylines profile image
waveylines in reply toladyinpurple

Lady purple -don't take them with coffee it's a definate no no!! You are best to take them when you wake as ideally it should be on an empty tummy with a glass of water. I put mine by my bed and taken them as soon as I wake before getting up -that way a good period of time has gone by before am up washed dressed etc before I eat my breakfast.

lucylocks profile image
lucylocks

Hi

You are suppose to take them one hour before food or drink, I don't think you should be taking them with coffee as this can stop absorbsion.

I don't know whether to take my dose all in one, in a morning.

waveylines profile image
waveylines

I do think it depends on the individuals response to whether you split or not. My endo commented that I was doing the correct thing for me by splitting my dose. I used to get an afternoon slump when I took mine in one whole dose in the morning. Taking some midday stopped this happening. My endo said it was because Of the T3 content in the tablet....obviously I need a little boost half way through the day!!

Taking thyroid meds sublingual or chewing them is a separate matter. And I agree the tablets are all designed to be swallowed with a glass of water.

Given the new research coming out over the complexity of maintaining homeostasis it will also be interesting to see if future research explains why some of us need a more regular pick up then a one off daily dose.....

I don't agree that the need to do so is linked to a need to feel am doing something to make myself well hence splitting the dose up. There is a definate physical difference in me -when I forget cos I'm busy I still slump and wonder what has happened -then I realise forgot my dose....so it's definately not psychological whatever it is!!

So personally it's a question of trial and error. I would always start with the manufacturers advice as my starting point. Taking the full dose in the morning before breakfast with a glass of water -I take mine as I wake, then by the time I've showered dressed, popped make up on etc....I can eat! Yay!!

lucylocks profile image
lucylocks in reply towaveylines

Thank you waveylines,

I suppose it is trial and error and finding what suits.

I just thought if I was not taking it right by splitting the dose this maybe the reason I am not feeling much improvement with it. Maybe it could be because I have not reached my optimum dose yet.

waveylines profile image
waveylines

I noticed you have changed your dose after 2 weeks. You really need to leave the dose alone for 6-8 weeks -takes that long to get the full effect....lol. Frustrating I know!!

lucylocks profile image
lucylocks

Hi

Not quite sure I understand. I thought when trying to find your optimal dose, you are suppose to increase gradually, say 1/2 grain every two or three weeks until optimum dose is found.

I started as advised on 1/2 grain so if I had to hold this dose for six weeks it would take for ever to get to an optimum dose.

waveylines profile image
waveylines in reply tolucylocks

Well if you were on another thyroid med like Levothyroxine and you've decided to start from scratch but with a NDT instead and you are currently taking less than what it would be in levothyroxine then yes increasing back up towards towards the Levo equivalent in two week blocks would be correct. If it's actually a new dose increase that's higher them you've ever taken before then every two weeks is too frequent and you are best to leave 6-8 weeks before increasing again. What happens otherwise is that you increase too quickly and the effects as I say take a few weeks to kick in so you end up over medicated. I hope this makes sense?

lucylocks profile image
lucylocks

Hi

many thanks for your reply, yes it does make sense.

I did start NDT from scratch, even though I was on levo. previously. I was advised on another forum to do this as the T3 in NDT can be a bit of a shock to the system if you have not taken any before, but I am wondering now if I might have been better just doing a straight switch as I am having difficulty finding the right dose to make me feel well.

I was taking 125mcg. levo. but G.P. reduced to 100mcg. because she panicked about my TSH. I stayed on 100mcg. for two months and felt a lot worse, this is when I decided to try NDT.

So should I take the equivalent of NDT to 125mcg. of levo. and stay on this dose for six weeks or because I was on 100mcg. before actually changing to NDT stay on the equivalent to 100mcg.

I am presently taking 1 1/2 grains NDT. 1 grain am. 1/2 grain around 3.00pm. I have been on this dose for 12 days.

Thank you browny

waveylines profile image
waveylines

There is some debate over whether a straight switch is ok to do from levothyroxine to a NDT. See link below.

stopthethyroidmadness.com/n...

However based on T3 being roughly three times the strength of T4 and WP Thyroid having 38mcg of T4 & 9mcg if T3 in a one grain (65mg) tablet. 1 1/2grains of WP is 97.5mcg and two grain would equate to 130mcg

stopthethyroidmadness.com/a...

However caution is needed because what can't be calculated is how your body will respond to the T3 in the NDT so that's why people often start lower and step it up till they reach the rough dose equivalent of levothyroxine after that going back to steps in 6-8weeks.

Your problem might have been exacerbated by the two months of being on a lower dose of levothyroxine which made you feel so awful. If you felt better on the higher dose of levothyroxine why not work towards the rough equivalent of that with the WP? Being mindful of your symptoms signs. I found keeping a daily record of my temperature first thing and afternoon, pulse rate first thing, signs symptoms and actual meds taken were really helpful to look back on.

Two weeks into this is very early and you will need to give it time. Hard when you feeling rubbish I know......

lucylocks profile image
lucylocks

Many thanks waveylines,

I think I may give the 1 1/2 grains a few more days before increasing,

I am not sure whether to increase by 1/4 grain or 1/2 grain. If I increase by 1/2 grain that would bring me to 2 grains which would be approx. equivalent to the 125mcg. of levo. I was on.

Many thanks again for your advice, very much appreciated.

browny.

Scouser58 profile image
Scouser58

Hello browny,,,,, I was told that and do take my thyroid meds first thing on an empty stomach,,,in good time before food,,,it needs the time to go into your system,,,hope this helps,,,,,ttfn from Karen.

lucylocks profile image
lucylocks

Thank you.

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