Thyroid UK
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Overmedicated on NDT - should I stop for a few days or lower dosage

Hello - haven't been here in awhile posting. My daughter takes compounded NDT. In June she saw Dr after labs - Free T4 was below range, free T3 mid-range, TSH 1.9 - she increased the medication from 90mg to 110mg due to labs and still feeling cold at times and depression. She also has an anxiety disorder. About 3 weeks into increase she became extremely anxious, OCD increasing, hot and sweaty, shaking, etc. Had bloods drawn (waiting to see actual results) but Dr called and said her TSH was suppressed, but neither FT4 or FT3 were out of range, but she may be overmedicated for her body. So here is my question: the Dr is somewhat of a cowboy and a bit cavalier about making changes. Initially he said to stop it for 2 weeks and then start up again at 90mg dose. I said I was concerned that she was going back to college in 2 weeks and was afraid she would bottom out hypo. So he said to stop for 3 days and call on Monday. Is this typical for treatment of over medication? Would a decrease down to a lower dose (I have 60's and 75's here) be more prudent? I am afraid of making her worse. Thank you!

7 Replies


Suppressed TSH does NOT mean over medication when FT4 and FT3 are within range. As your daughter *feels* over medicated skipping dose for 2-3 days will speed up washing out the higher dose and she can resume 90mg. If she feels under medicated on 90mg she can quarter a 60mcg tablet and raise to 105mg in a few weeks.


Thank you for such a quick reply Clutter! Just wanted to be sure it was a pretty standard way to do it.


Is it common to feel over medicated on NDT despite blood tests that show an increase is needed. I've tried splitting my dose to manage smaller amounts but still don't seem to be able to tolerate it very well. I've cut down now to I grain but should be on at least 2. My FT3is only 3.6. I wondered if this is something that many people have a problem with?


I did just got her labs - and they really don't look bad at all (first number is June 2016 and second is August 2016 on higher dose) - she does not have antibodies

TSH 2.1/.523 (range .45-4.5)

T3 121/141 (range 71-180)

FT3 3.0/3.9 (range 2.3-5.0)

T4 5.9/5.3 (range 4.5-12)

FT4 .82/.92 (range .93-1.6)


Her free T3 is still really low. How are her sex hormones, esp progesterone and her B12? Is she supplementing magnesium? If you don't have enough T3, you often pump out adrenaline instead, giving you that hyper feeling. Progesterone is the hormone that makes you feel calm and happy, but it needs to be in balance (so don't start taking without testing - not even creams). Magnesium esp threonate also makes you feel less wired and more laid back.


Ellen, it's often a sign of a nutritional deficiency - most commonly low ferritin. It seems to be hard to tolerate too much T3 when iron is low. Would probably be worth checking B12 and Vit D too.

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Great! Hadn't thought of that I will ask if they will check those. Thanks


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