Thyroid UK

Follow NDT protocol or Drs advice

I have read about people taking NDT and gradually increasing their dosage until their symptoms are gone or vastly reduced.

Currently I'm prescribed one grain (was on alternating 50/75 Levo). I've started taking 1.5 grains - awaiting blood test results - but as a month ago my TSH was 5 and T3 very bottom 3 just scraping in the range on Levo - I feel I am due a bit of a boost.

My symptoms have all gone - just tiredness really. Had brief experiences of heart palpitations and dry skin but now gone for the last month. Even the monthly depression has not been so bad (took the pill for 5 days).

All that remains that I could put as a symptom is being one stone heavier than pre-pregnancy four years ago now. Have a good diet - Thyroid friendly - gluten-free and eat loads of bones and meat. Have lost about 4 kilos since starting NDT about 6 weeks ago.

Should I continue the increase at least until I am symptom-free i.e. Pre-pregnancy weight? Or take the doctors approach testing every 6 wks? I think I am losing puffiness / retention as opposed to body fat.

9 Replies

Starting at 1.5 grains was rather a high dose to start with. I would have suggested a starting dose of 1 grain, and some people are even more cautious.

You should test every 6 weeks. It's very easy to overshoot your ideal dose if you raise more quickly and don't test often enough. Read this link to understand why :

1 like

Thanks. I will revert back to 1 grain. I was prescribed 1 grain but just took it upon myself to up the dosage as TSH was still 5


If you've been doing okay on 1.5 grains I would stay at that level now, no point in going backwards. Stay on that dose for 6 weeks then test. Assuming you need a raise in dose then raise by 1/2 grain, wait 6 weeks, then test again.

Raise by 1/2 tablet at a time until you get to 2 grains, then raise by 1/4 grain steps after that, always testing after 6 weeks.


I ended up going over and as over and under are some similar it confused the issue. It offered a test I would take it to check where you are.

Make sure your doctor puts on the form what you are taking and so you need FT3 reading.


Had another blood test yesterday. He tests TSH, T4 and T3.

I could only view the results quickly as any more and it's a paid visit!



As you are feeling well I would stick with your GP's prescribing protocol to avoid over shooting your 'sweet spot'. Tiredness is one of the symptoms which can lag for a while after you are optimally dosed. If you increase dose your prescription will run out anyway.


Yes I feel well. Mentally alert, no tiredness and happier without trying. I don't feel at all unwell - better than in years mentallyans I think that is how my thyroid issues reveal themself - mentally not so much physically!


Your doctor will try to get you back on levo only. If you feel OK then ignore him or her its all about how you feel not numbers.


You're probably right. Oh well let him waste his time.

My private GP works well for now but if I should be one who needs 5 grains of NDT then I'll become a T3 health tourist or go online!


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