New doctor started me on NDT and is gradually increasing the dosage (currently 75mg) but hasn't reduced Levothyroxine (100mg). I feel great now but not sure if I should be taking both. Any advice?
Taking Levothyroxine and NDT together - Thyroid UK
Taking Levothyroxine and NDT together
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JaniceJ7
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I never understood the logic behind taking both together, they donT work exactly the same because they arenT the same product......
Even if you stop the levothyroxine today, it's going to take it a few weeks to get out of your system. presumably you have ndt because the levo wasnT working for you, so where is the point in taking it?
i would ask your doc why you are mixing both meds, and have a read of this link.... thyroid-s.com/natural-desic...
X.
sorry but what is NDT?
Im taking Levothyroxine 25 mg daily and Nutri Thyroid plus Nutri Adrenal tablets after feeling totally spaced out on 5omg of levo daily for a year .
I was prescribed 100mg by an ignorant doctor as soon as i was diagnosed with sub-clinical hypothyroidism 3 years ago ,which totally overwhelmed my system so that i could hardly get out of bed I felt so ill and dragged myself around for 5 weeks with palpitations getting worse each night .Fortunately a homeopath /GP I went to for advice told me I should have been started on 25mg levo and needed tests to check other things heart /bone density / that could have been affected by this large dose of Levo. Hashimoto's disease showed up during the tests . I would like to find someone to advise me how to get onto natural thyroid as i am still not right and my TSH blood test recently was 0.01 still tired and no energy and depressed.
Actually the starting dose is 50 mcg. With a blood test every 6 weeks and dose increased by 25 mcg until all symptoms are gone. But, this is a huge subject, and we don't want to squat Janice's thread, do we? I suggest you ask your own question - saying exactly what you said there - copy and paste into a new question - and lots of members will reply and help you. 
NDT is Natural Dessicated Thyroid, make from pigs' glands. But that is a huge subject, too. lol I'll watch out for your new thread.
There's nothing wrong with taking both . . . I feel best that way. You just have to calculate how much T3 and T4 you're getting in total from whatever combo you're taking, so you don't end up overdosing on T4. Your current dose is too high in T4 FOR ME, but that doesn't mean it's not the right dose for you. I've posted this before as one way to calculate a combo: tiredthyroid.com/blog/2014/...
Hm interesting about calculation but I do not know how to calculate, years before when I was healthy my weight was 90kg, now on levothyroxine It is 110kg. Compared to what kg's I needs to calculate(90 or 110kg)?Just on levo I do not feel well, I need a little T3.
I want to take both(ndt+levo). HIFL, may I ask you what are your combo dose you take now and wath was your levo before? You are take both at oance or separately?
Like you, I take 75 mg NDT, but only 50 mcg T4. I think you'd use your current weight to calculate a BALLPARK dose. As helvella said, it's just a guesstimate. I posted the link because I thought your dose sounded so high, especially compared to mine.
Interesting, but I do not know how should I start this whole thing. Now I add only 1/4ndt to my levo dose(125mcg). If I drop the levo I feel worse in a few days(aprox.3days) even I increase the ndt in the same time and proportion. I don't know why. In your opinion wath is the optimal combo dose that I should take .
OMG, I don't know! What is helpful when trying to figure out your optimal dose is labwork. Make a change, such as adding in 1/4 grain, hold the dose for 6 weeks, then get labwork. If either T4 or T3 is now above the reference range, then you know which to decrease. Likewise, if one is low, that tells you which to increase.
I might be completely wrong about this, but I understood that the ratio of t4:t3 in humans is 10:1. In pigs (NDT) it's 4:1. Therefore, adding NDT to your Levo should be fine. The point of adding NDT to Levo, for me, was just that my doctor was keeping me undermedicated and I hadn't yet made the jump to NDT only.
Although my spreadsheet only concerns itself with levothyroxine, it does use several different published approaches to dose calculation:
dl.dropboxusercontent.com/u...
Please read the warnings. In my view, such calculations only have two roles. Immediate post-thyroidectomy best guess and "is this person on a surprisingly low or high dose". No-one should adjust based on calculation alone.
Tank you helvella. I had RAI 4 yrs ago. Pff, It is quite complicated . I don' t know if T4 in ndt has the same effect as levo.
Please read this link it explains it all very well , the goal is to optimise both FT4 and FT3 and relieve hypothyroid symptoms
Dr Dommisse has used the combination very successfully in thousands of his patients
It doesn't matter what is in a healthy gland, because ours are unhealthy! lol No, seriously. The T4/T3 ratio in the pill you take is irrelevant, because most T3 comes from conversion in a person capable of doing so. If there is more T3 in the pill, the body will just convert less. After all, if you take T4 only, that is totally unnatural, but the body copes by converting that T4 to T3, if it's able. The body has remarkable powers of evening things out. However, the problem comes when you can't convert very well - and that's why most people turn to NDT. In that case, it doesn't matter how much T4 you sling in, it won't be converted. You'll be living off the ready-made T3.
I suppose adding T4 to NDT might work for some people, but it didn't work for me, and I imaging there are a lot of other people it doesn't work for. It's all very well calculating ratios and all that, but the body can't read!
Deiodinase enzymes perform conversion in the body. Some of these enzymes are stimulated by the presence of T3. That is why people feel so much better adding even just a little bit of T3. It gets the conversion process started. The T4/T3 ratio is extremely relevant to many people, though it may not affect you personally.
"If there is more T3 in the pill, the body will just convert less." The problem with this statement is that it doesn't account for the T3 overdose SOME people get when taking NDT. Sure, you can convert less, but what do you do with the excess T3 you already ingested? This imbalance causes both hyper and hypo symptoms in some people. Heart rate and blood pressure rise (from the high T3 levels), but thin hair and brain fog are still present (from the low T4 levels).
• in reply togreygoose
Given that I put on nearly 3 stone on T4 Levo only when first diagnosed and now on Armour Thyroid I can control my weight as well as feeling good........no contest.
greygoose• in reply to
Sorry, Marfit, but was this a reply to something I said? It's so difficult to tell when the replies appear all over the place like they do.
• in reply togreygoose
No...not at all greygoose.My replies are always just from personal experience which is a bit limited.. We are all in the same boat aren't we ? trying hard to find something that works for us and as we all know there is no" one size size fits all" Oh that there was....it would all be so simple.I have often wondered about the possibility of adding some extra T4 Levo when on NDT as people are so rightly saying that the ratio of T4/T3 is seemingly not right being 4 to 1. However,on 1 1/2 grains of Armour my TSH was 0.16. FT4 12.1 and FT3 not done even though it has been done for the last 2 years since being given T3 .However,the phlebotomist couldn't cope with me telling her that I was on 1 1/2 grains........... What's that? Levo comes in mcgs!!......the lab will be confused........
I realise that my FT4 and FT3 need raising but more Levo will send my TSH down further and my Endo won't be happy with that and then we get the worry of strokes and heart attacks thrown in.
I asked whether anyone successfully returns to T4 Levo only after having been given added T3 and was just told that they would have to prescribe enough to deal with your symptoms.......Well,that's not rocket science is it?........Oh that it had been done 14 years ago !! I am mindful of the fact that many GPs won't prescribe T3 because of cost and I didn't have a good feeling anyway from my last 2 batches of Mercury Pharma Liothyronine so decide to use Armour thyroid that I had in store. I can't justify taking MP T3 at great cost to the NHS if it doesn't help. If only there was more choice here in UK I think it would be much easier for us all to get suited rather than self medicate from abroad. Let's face it ....this is what's bringing all the questions. We don't yet have a well balanced combination pill of T4/T3 available to us.Why is it taking so long for someone to produce one I keep asking myself ? We also need to get universal.
Mcgs....Mgs.....Grains? If the labs get confused ,what chance have we got in trying to discuss what exactly people are taking?
greygoose• in reply to
As lab technicians they should understand the difference between mcg, mg and grain. They are, after all, just measurements. But, I suppose, these days, these lab technicians do everything in machines, they no longer have to weigh or measure anything. But, if we can understand it, why can't they?!? It's ridiculous. It shouldn't be the lab technicians job to judge our dose, anyway. That's what we have doctors for!
It would be absolutely impossible to have a 'well-balanced' combination pill, because we all need different ratios. It all very well to say that 'in a healthy gland the ratio is such and such' - as some people do - but we don't have healthy glands. Our glands are sick, our bodies are sick, our needs are different.
And I, for one, don't want a combination pill. I took one many years ago, and whilst I was a bit better with the added T3, I was still ill with the T4. I need T3 only - which has absolutely nothing 'natural' about it, I agree! But, that's what my sick body needs and can deal with.
So, my opinion is, rather than striving for a perfect combination pill, people should be free to have T4 and T3 separately, and combine them in the dose that suits them, individually.
Yup, that's what I take. Any form of T4 is poison for me.
It worked for greygoose, but it didn't work for me. We need to present patients with ALL options, not just the one that worked for us personally.
Totally agree. I always say it's a question of trial and error, and we won't know if something works for us unless we try it.
I tried adding T4 to my NDT. I tried adding T3 to my NDT. But no combination of NDT worked for me. Neither did T4 only. Nor T4 + T3. People should be aware of what might not work as well as what might work. Otherwise, they think there's something wrong with them. People go on and on about NDT is the only way, but it isn't. But you won't know if it's the only way for you unless you try it. I'm all for experimenting, as I always say.
I'm sure he doesn't. That's not physically possible.
rT3 is made by removing the wrong iodine atom from T4. If you wanted to make T3 into rT3, you would have to add back the missing atom of iodine, and then remove another one. There is no process that I know of in the body to do that. rT3 is made from T4, not T3.
Correct... but a balanced t3 t4 for post full thyroidectomy patients to track tsh levels is neccessary.. i switched to NDT.. feel loads better ..but my t4 went down and my TSH went way up... 1.5 to almost 6... that number needs to be as close to zero as possible so the Endo can track levels for further illness,,, adding Synthroid (don't like it much as i don't convert well and get severe leg cramps on it) may correct the balance issue... as we should be as close to 14:1 as possible ... anywho.. thats what i am trying...
Ratios are for healthy people, not hypos. When you are hypo, you need what you need and ratios are unhelpful.
It's perfectly normal for FT4 to go down when you start taking any form of T3. The body only hangs on to as much T4 as it needs, and it doesn't need as much if you are taking T3 'ready made'. The rising TSH is more likely to mean the over-all dose is not high enough. Not that you need more T4. Keep trying to raise the FT4 when on NDT is really not helpful at all. Especially if you can't convert it properly.
But this thread is two years old. Not much point in replying to it now.
Good for me Greygoose..i am having bizarre blood levels since switching... My Naturo increased my NDT.. feeling a bit better after 1 week..lets see where it goes
I see you've not long been with us. So, if you need advice, the best thing would be to post your own question, giving all the details, rather than attaching comments on to 2 year old threads, which no-one will read. Or are you just trying to 'educate' me?
Sorry? I don't understand? I did say thank you to your reply... not sure where the sarcasm is coming from...I appreciate all the advice on here and I didn't realize that post was that old when I originally replied to it...
The sarcasm wasn't intended. Sorry. But, I don't really understand what you're trying to say. It didn't sound like a question, so I was wondering why you were commenting at all. Can't see anywhere that you said thank you, though. Not that that matters, but you did appear to be arguing with me.
Sorry you're having 'bizarre blood levels', but who said they were bizarre? Endos only know how to interpret blood levels for people on T4 only, so anything else appears to them to be bizarre. If you post a new question, do give the exact numbers - results and ranges - and say what exactly you are taking now, how long you've been on it, and what you were taking before, how much and for how long. All the little details are important for understanding. Also, if you've had antibodies and/or nutrients tested.
I mean the 2 year old post was good for me....however I will post new questions away from this old post...
Thank you for all your comments and advice - lots to digest and mull over. It's so kind of you to take the time to reply.
When I have doubts about drugs, I go to my pharmacist. Most (American) doctors have less information about drugs...both otc and prescribed. Pharmacists train extensively in pharmacology and know lots more about the drugs we all take. They have helped me enormously. I don't know about UK pharmacist policies about sharing their info but At least give it a shot... Good luck.
Pharmacists in the UK can be anything from totally ignorant up to very well-informed. I came across an ignorant one yesterday who didn't impress me at all.
If I want information about drugs I consult the following :
The emc - electronic Medicines Compendium (a UK website I think - I don't know if it is available outside the UK) :
The above site has free electronic copies of Patient Information Leaflets and Summaries of Product Characteristics.
I would also look at :
I would read the consumer/patient information and the professional information on drugs.com. I've always assumed drugs.com was US-based.
And if I want to know about something that is named different things in different countries then I would start with wikipedia, which is often helpful with brand and generic names :
The reason for taking both simultaneously is precisely because they each do different things. If they did exactly the same thing, there would be no point to taking both, now, would there? The goal is for them to complement one another in particular thyroid situations. Synthroid does more for T4 than does naturethroid, and naturethroid does more for T1, T2, and T3 than does synthroid.
Some doctors prescribe only Synthroid and don't stray from their script. It is good to have someone thinking outside the box .
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