Help! Assistance needed with dosing of NDT - going it alone (finally).

[melodypond]

Hello there everyone

Right.... so I have decided to go it alone. Deep breaths....

So I need your advice on dosing if you don’t mind taking the trouble. I have bought WP Thyroid and was thinking of starting with half a grain.

I am not officially diagnosed so have never had any treatment so I am starting completely with WP Thyroid, not switching from levo or anything else.

I am supplementing with the usual Vit D, ferritin, folate, selenium, potassium and B vits. I know to take my iron away from the NDT and not to eat 2 hours aside of taking the NDT or to have caffeine.

I know that dosing has been posted on here before but there’s so much info plus everyone is obviously different. I think I may have Hashis as my TSH, T4 and T3 do go so up and down but I don’t have the antibodies. However I am ANA (anti-nuclear antibodies) positive and it is thought there is something autoimmune going on (investigated for lupus, autoimmune hepatitis etc) but no specific antibodies ever show up so it could be that I am hashis but with negative antibodies (which I didn’t know was possible until this forum). I will look at diet/gluten free etc too but am just taking one step at a time for now. The other thing to consider is that I am tissue resistant – my urine tests of 2 years ago (which shows how your tissues use the hormones) showed very low T4 and T3 only just within range.

My last three lots of results (all done at the same time of day after fasting, aside the doctors one was slightly later at 8am). The ones at the doctors were done following a private consultation with an endo. As they all came back ‘normal’ though and my TSH had dropped back down at that point I think it is doubtful he will diagnose/treat me. He was fantastic in that he listened and acknowledged something was going on and recommended lots of other tests which I was fortunate to get through my GP (the thyroid results are listed below but I also had lots of other tests for pituitary disorders but all came back ‘normal’ so I guess those can be ruled out). I just can’t afford now to go back and pay another 200 pounds only to be told to take a wait and see approach. I thought he would diagnose me on my results of a TSH of 5.2 but he didn’t. I know I should probably follow through with him but he has already told me he would only diagnose levo at first anyway and at least I can now rule out pituitary disorders. As some of you will know, I have been feeling desperate at times and I want to act while I feel brave enough, even though I am also scared about self-treating too!

Anyway I am getting side tracked – as I say help with dosing gratefully received. Thanks MP xx

16th March (Blue Horizon)

TSH 5.21 (high) (0.27-4.2)

T4 Total 103.5 (64.5-142)

Free T4 13.10 (12-22)

Free T3 4.46 (3.1-6.8)

A-Thyroidperoxidase 9.9 (<34)

A-Thyroglobulin <10,000 (<115,000)

Vit B12 407

Folate 15.57 (10.4-42.4)

Ferritin 17.4 (20-150)

28th April (Blue Horizon)

TSH 4.84 (high) (0.27-4.20)

T4 Total 99.5 (64.5-142)

Free T4 13.83 (12-22)

Free T3 4.84 (3.1-6.8)

A-Thyroidperoxidase 7.9 (<34)

A-Thyroglobulin <10,000 (<115,000)

Vit B12 727 (high)

Serum folate 24.18 (0.4-42.4)

Ferritin 21 (20-150)

July 25th (GP surgery)

TSH 3.79 (0.4-4.5)

Serum free T4 10.6 (7-17)

Serum T3 5.7 (3.50-6.9)

Vit D 76.3 (50-250)

Cortisol 441 (250-650)

Thyroid Peroxidase <9 (0.0-9)

September 20th (Blue Horizon)

TSH 4.03 normal (0.27-4.2)

Free T4 13.8 (12-22)

Free T3 4.8 (3.1-6.8)

[Clutter]

Hi Melodypond,

As you've not taken thyroid replacement before starting at half a grain is a good idea. You can increase to 1 grain 2 weeks later and then perhaps in 1/4 grain increments at two week intervals until you are taking 1.5-2 grains. Hold at 1.5-2.0 grains for 6-8 weeks and have a thyroid test including FT3 before increasing further.

Ferritin 21 is very low. I would supplement iron with 1,000mg vitamin C to aid absorption and minimise constipation. Take iron 4 hours away from NDT.

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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.

[melodypond in reply to Clutter]

Thanks Clutter. That's perfect! Here goes...

[radd]

mp,

Thyroid antibodies are variable so you might have had the blood drawn when Hashi was in remission and so low.

Vit B12, folate and ferritin levels are low and some members have found thyroid hormone replacement difficult to tolerate with deficient in these nutrients. Are you supplementing ?

A certain amount of thyroid hormone is converted in the liver, which becomes congested when we are ill. I supplement Milk Thistle daily and have found this (together with optimal supplementing for all deficiencies) to help meds work better.

Also selenium is well known to not only reduce thyroid antibodies but also help convert T4 to T3.

In your sept bloods TSH was just within range (but it is variable) and T3 just below half way through range, having been just over half way through range in july results. As you are new to thyroid replacement meds and haven't been diagnosed, it is best to go very low & slow. I also take WP Thyroid and 1 grain =38 T4 & 9 T3.

Start with a half grain a week but split into two quarters taken am & pm if you can manage it, as this will reduce the rapidity of onset and prolong the duration of the T3 action, hopefully helping your body to tolerate it better. I bought the 2,1, & half grain pills which I now half to achieve a quarter grain as sometimes our bodies require very specific amounts and the margin is small.

If all is well after one week, increase by another quarter and the following week, another quarter. Hold at 1 grain for six weeks and then retest thyroid hormone and post results complete with ranges for members to comment.

Remember you can always add more later but it is truly horrid being over medicated and can't be taken away quickly. You may find everything works better when your nutrients and iron are optimal levels.

Good luck.

[melodypond]

Sorry for slow response Radd! That is all excellent advice. I have actually split my dose, doing a quarter in the morning then again in the afternoon as I do want to take it very very slow. So far so good, though only been a couple of days so too early to tell I suppose yet. Yes I am supplementing with iron, selenium, magnesium, vit d, B12, folate and keeping them well away from when I take my thyroid dose. My liver is very congested, I often feel 'toxic' so I will try the milk thistle. Thanks! I'll no doubt update at some point in a few weeks.

MP x