First week of Nature-thyroid feel worse.

[Congirl]

My first week of Nature-thyroid feel worse, symptoms of nausea and constant migraines. Endo prescribed 1/2 grain at breakfast and 1/2 grain at evening meal. I was only on 50mcg levothyroxine (which I stopped the day before) I have only been taking 1/2 grain in the morning as I didn't want to rush. Do I need to increase dose? Do not want to feel worse.

[LAHs]

Well, first we would need your blood test results. But while we are waiting for those, please tell me your doc/Endo didn't tell you to take your pills WITH your breakfast and evening meal! Your pills should be taken on an empty stomach one hour before you eat, this maximizes absorption. You could also tell us how you were feeling on the 50mcg, perhaps you were under medicated on Levo and now you are under medicated on NDT. Check your blood pressure, my bp goes high when I take too much NDT - and I get a headache. But, like I say, post your latest blood test results, we cannot pass along our opinions 'till we see those.

Oh and one last little thing. While your Endo may have given you the wrong advice about when to take your pill, at least s/he is prescribing an NDT, maybe you should just be glad that you are getting the right stuff, and don't mention that you are supposed to take it an hour before meals. Getting NDT is the hard part.

[Congirl in reply to LAHs]

Thanks for reply. My test results were done 4 weeks ago. It is a private holistic Dr. who arranged prescription for me. I have been supplementing B12 5000, B complex and vit D for the last 2 weeks and am trying a GF diet.

Biochemistry

CRP 2.70 <5.0 mg/L

Ferritin High 152.7 20 - 150 ug/L

Thyroid Function

TSH High 4.92 0.27 - 4.20 IU/L

T4 Total 108.3 64.5 - 142.0 nmol/L

Free T4 18.72 12 - 22 pmol/L

Free T3 3.60 3.1 - 6.8 pmol/L

Immunology

Anti-Thyroidperoxidase abs High 156.9 <34 kIU/L

Anti-Thyroglobulin Abs 98.0 <115 kU/L

Vitamins

Vitamin D (25 OH) 54 Deficient <25 nmol/L Insufficient 25 - 50 Consider reducing dose >175 Vitamin B12 Low 187 Deficient <140 pmol/L Insufficient 140 - 250 Consider reducing dose >725

Serum Folate 21.96 10.4 - 42.4 nmol/L

[NatChap in reply to Congirl]

1 grain straight after only being on 50mcg levo is a lot. I would possibly even drop down to a 1/4 grain and increase by 1/4 per week until symptoms improve x

[Congirl in reply to NatChap]

Hi NatChap, thanks for reply. Will drop down to 1/4 grain in the morning only, and will see if symptoms improve.

[NatChap in reply to Congirl]

getrealthyroid.com

Have a read of the nature-throid website as well as the 'stop the thyroid Madness' website. Lots of info on how to take it, dosing etc...

[Heloise in reply to Congirl]

The high ferritin may be due to inflammation.

youtube.com/watch?v=FvsqQWU...(Not working as expected?)

[Hidden]

Hi Rosw, I probably don't have the same experience as LAHs who has kindly replied with lots of info below. But I do have direct experience from a week ago almost exactly the same as yours.

I'm 61 and (short story for now) fed up with feeling awful for ages on Levo, been on 75mcg for a long time. Tried an increase to 100mcg but couldn't tolerate it.

Went to see an Endo in London who suggested 2 avenues of treatment which I could try one at a time or together and I trusted his judgement. Out of the two choices I chose the route of NDT and he prescribes Erfa. So I was very pleased to try it but quite apprehensive at the same time.

He also told me to take 1/2 grain (30mg) twice a day but with no indication of when / how to take it. I contacted the pharmacist at his clinic after receiving the Erfa asking lots of questions and he said the Endo will reply personally. No reply yet, but I understand he works other clinics, so will wait patiently.

My husband encouraged me to just follow the Endo's instructions, but my gut instinct was to take a lower dose, despite that this would be less than the equivalent Levo dose. So I looked up dosing in various places and decided to take 30mg early morning (before eating) and 30mg mid afternoon. I did this Saturday, Sunday, Monday and was OK, but realised it may take a while for the med to get into my system. By Tuesday I was feeling quite poorly, I had a rocking headache first thing in the morning, felt very tearful and was telling my husband I think I've done the wrong thing. Also some nausea and I already take BP medication but Tuesday morning my BP was extremely high.

Somehow I got through the working day. I then read information on a pharmacy site which sells Erfa 'if you get any of the following side effects, its most likely you are taking a dose too high. I had a good percentage of the side effects. Also read on the TPA UK site a method of 'titrating the dosing which starts very 'low and slow'

So I dropped the dose that day to 1/2 a 30mg morning and afternoon and the next day began to feel better and BP stabilised. So I continued on that dose until this weekend. On Sunday I increased the dose by 1/4 of 30mg tablet in the morning and continued with just the 1/2 tablet in the afternoon.

Whilst this is still a lower dose than my Levo and I realise I need to get up to a higher dose fairly soon, I shall continue the way I'm doing.

I put a post up here at that time and a couple of people said they'd also increased from a low dose in 1/4 tablet increments. I had wondered whether the introduction of T3 within the Erfa tablets might cause some issues and I think this is what happened. Your body needs time to adjust to it. My Thyroid levels were very similar to yours just prior to starting the Erfa so T3 level is quite low. I couldn't tolerate those symptoms I had last week but now feel rather more confident about going forward.

Of course for some people it transpires after a while that NDT doesn't suit them at all for various reasons such as just not tolerating T4 whether from Levo or NDT. I suppose this will become evident further down the line.

[Congirl in reply to Hidden]

Hi Georgina thanks for the reply. The advice on this site is so helpful. I will try taking a 1/4 grain in the morning, until my body gets use to the T3.

When I dropped to the 1/2 a grain just in the morning I felt the nausea and was a bit shaky in the afternoon and I could not decide if it was because I hadn't taken enough or that I had taken too much.

[Hidden]

I agree I hope you are not taking with food. I am a slow learne3r but after I saw on this board that I shouldn't even take it with coffee I askewd doc, cuz I didn't remember her saying anything about that! Dunno about you, but there is a lot to think about when first diagnosed. BUT she said yes, no coffee either so now I wait almost an hour and I can feel the difference withing the last three weeks.

[greygoose]

You have Hashi's. NDT isn't always he right choice for Hashi's people. But, it's early days. Give it a fair trial, at least. Your TSH is still much too high. And, you're not converting well at all. Your FT3 is much too low for you to feel well.

So, have you been taking 1/2 grain for four weeks? If so, it might be time for you to increase to 1 grain. When did your doctor say to go back for testing? I think you're going to need a few more increases before you find the right dose for you. Hang on in there!

[Heloise]

Hi rosw, your instincts are good. Your doc essentially doubled your dose overnight if you went from 50 mcgs of levothyroxine to one grain of Erfa. Your body has to adjust to the 9 mcgs. of T3 you are getting in the NDT. When things calm down you could increase by a quarter grain. Trust yourself.

[Congirl]

Hi Heloise, thank you for the interesting video link. I had a Skype consultation with the dr. and he has sent me 2 tests to send off to biolab 1 for comprehensive stool and the other for comprehensive female hormone profile. May shed some light on the inflammation, but quite expensive so may have to wait a while.

[M3F8Px]

Most with a thyroid problem also have to treat the adrenals. If you dont feel well that might be the reason!!!