Thyroid UK
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NDT Test Results low T4 help please

I went onto NDT Thiroyd 6 months ago. I take .5 grain early morning and .5 grain late morning and another .25 grain during the afternoon. My test results are - Ferritin 56 (12-230) this has lowered a bit since last taken. Free T4 9.8 (12-22), free T3 4.4 (3.1-6.80) and TSH 1.67 (0.3-4.2). My doctor blamed the NDT from Thailand and wants to put me back on T4, reciting the NICE guidelines to me. I also had high B12 and folate which I had been supplementing. But serum alkaline phosphatase level is 109(35-104), GFR was low 54(60-90) and high serum creatinine level 93 (44-80). Not sure what to do. She was happy my TSH had increased from 0.03 to 1.67. I do ache and I am stiff and I am putting on weight. I also get palpitations if I don't eat enough bananas for some reason and I take 600mg of magnesium citrate.

Any ideas would be appreciated please.

2 Replies


I think you are under medicated. Most people on NDT will have TSH <1.0, or even suppressed, with FT3 in the upper third of range ie 5.5-6.8. FT4 is usually lower than when you were taking Levothyroxine and may be below range if FT3 is high in range.

B12 is usually high when supplementing. I would stop supplementing folate if it is high.

High creatinine and low eGFR can indicate kidney disease or dysfuncion.

Alkaline phosphatase


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.


Why not just add some T4 to your current NDT dose to bring T4 into range? Low GFR and high creatinine are signs of hypo, which suggests you need more thyroid hormone. There's a strong correlation of hypo with kidney disease:

I also had heart palpitations, like a pause, when undermedicated. It can go away when you get to the right dose. The stiffness and weight gain should also lessen when you're on a more optimal dose.


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