Adding levo. to NDT.

[lucylocks]

Hi,

I am presently taking 1.5 grains NDT.

I have gradually increase but cannot get further than 1.5 grains.

Previously I was taking 125mcg. levo. and felt O.Kish but my Doctor kept altering my dose according to my TSH. and when she reduced to 100mcg. I felt worse.

I did the Genova 24 hour urine test whilst taking 100mcg. levo. which showed I was converting the T4 in levo. to T3 reasonable well but I was just not taking enough of the levo.

My G.P. would not increase back up to 125mcg. so I decided to try NDT.

I have had a pretty rough time raising to 1.5 grains and cannot get beyond this dose.

I feel marginally better at this dose than I did on levo. but still feel there is room for improvement. I did have a pretty good few weeks in the summer but this month have felt some symptoms return. I have tried an increase but got palpitations and racing pulse.

My Doctor has since spoken to an endo. and has now said I can go back to 125mcg. levo.

I think because of the slight improvement on NDT I think the T3 in it has helped and it is near top end of the range but my T4 is below range. I realise T4 can be low on NDT but I have read it should not be below range.

I am thinking of adding a small amount of levo. to the NDT but not sure whether to keep NDT at same dose for now or reduce and add the levo.

I am wondering if when adding in levo. and keeping the NDT at the same dose I will not know how much T4 in the levo. will convert to T3 and bring the T3 above range. I supposed if I feel worse and think the T3 is the culprit then I can then reduce the NDT and the T3 should get out of the system in a day or two.

Latest results on 1.5 grains W.P. Thyroid,

TSH 0.42 range 0.35 - 4.7

T4 7.6 range 7.8 - 21.0

T3 5.2 range 3.8 - 6.0

Could anyone offer any advice please.

[Clutter]

Lucylocks,

FT3 is in the top third of range so adding 25mcg Levothyroxine might send FT3 over range but 12.5mcg might be okay. It's a bit suck it and see really and it won't do you any harm if you decide to add 25mcg and go slightly over range for a few weeks.

[lucylocks in reply to Clutter]

Thanks Clutter,

I will try the 12.5mcg. and see how I go.

If I then feel over medicated would it be wise to cut the NDT by 1/4 grain?

[Clutter in reply to lucylocks]

Lucylocks,

If you feel over medicated it would be better to stop taking the 12.5mcg Levothyroxine.

[lucylocks in reply to Clutter]

I was hoping to gradually increase the levo. and reduce the NDT so I can eventually get back onto levo. and add synthetic T3 as I do not think the ratio in NDT is right for me.

[Clutter in reply to lucylocks]

Lucylocks,

You can switch straight over to Levothyroxine or Levothyroxine and T3 if you want to.

Alternatively, reduce NDT by 1/2 grain for each 25mcg Levothyroxine added.

[lucylocks in reply to Clutter]

Many thanks Clutter.

If I switch straight to levo. and T3, do I switch to the equivalent amount of T4 and T3 in the 1.5 grains W.P. Thyroid that I now take.

1.5 grains NDT. = 57mcg. T4 and 13.5 mcg. T3

[Clutter in reply to lucylocks]

Lucylocks,

You've said the proportions of T4:T3 in NDT don't suit you so is there any point in switching to equivalent doses? If yes, the nearest you'll manage is 62.5mcg T4 and 12.5mcg T3.

[lucylocks in reply to Clutter]

Oh yes I see, I mean't initially change to that dose than alter it, maybe a week or so after starting it.

I don't think I need anymore T3 but more T4 so your estimate would be a good starting point.

The thing is if I then need to add more T4, some of it will convert to T3 so if I then feel over dosed I could cut the T3 down.

[Glynisrose]

TSH is irrelevent your doctor may go by this reading but it can be irrelevant when taking ANY form of thyroxine. Use the broken record method if you need to and DEMAND a full examintaion rather than blood tests alone.