Symptoms of needing a raise or reducing doesof ... - Thyroid UK

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Symptoms of needing a raise or reducing doesof NDT


Hi can anyone tell me if these are symptoms of needing a raise on NDT. I started at 1 grain split into two doses. On the 29/12/16.Ive raised slowly and am now up to 1.5 grains in the morning and 1 in the afternoon. It's been hard and Ive wanted to give up as Ive felt awful. last week I started to feel great a couple of days after my last raise. I think Ive jinxed myself as I was saying how good I felt. Now for a couple of days Ive gone tired again and I have a noticeable heartbeat not fast and flutters .But it's worriying me Ive also started bringing up wind I just feel awful and unsure wether to raise or give up and go back to Levo. I missed yesterday afternoons dose to see if I felt better that didn't work. I don't have any recent labs I am going to get them done next week I'd get them sooner but I can't afford it.Anyone?

4 Replies

Hi, you might be on too high a dose if you were on 125mg of Levo previously, but I know that when I moved up to 2 grains I felt odd for a while (a week or two) - fluttery chest and just felt 'off'. I persevered and 8 weeks post increase I feel much better.

I was on 125mg before switching and have held at 2 grains until I get blood test results before increasing (which I think I might need).

Do you track heart rate and waking temp? They can help you spot trends in how your body is reacting to the meds.

Abby77 in reply to Kiwidel

Hi , it's odd because I felt so good at the beginning of the week. I was going to hold my dose and wait for my bloods. I am just a bit scared and it's the school holidays next week I need to feel well for my kids.I don't keep track of my heart rate or temp, it's probably something I should do.

Thanks for your advice x


It's really difficult to say without labs. The Hertoghe doctors in Belgium who prescribe NDT seem to consider an average replacement dose to be 3-5 grains, with some needing more and some less. But 1.5 grains is not that much, after all...57 mcg of T4 and 13 mcg of T3. If T3 is four times stronger than T4, that means 13x4 + 57 = 109. So your current dose should in theory equal +/- 110 mcg of T4.

When on NDT, labs can be a useful indication, but you need to go by symptoms more than anything. Your TSH is bound to be suppressed or at least very low on NDT (by that, I mean <0.2 or whatever the lower normal limit your lab uses), but that does not mean you are overmedicated and therefore hyper. You need to look at your free Ts, and especially your FT3 levels. In my own experience, FT4 levels will be lower on NDT than on T4 only drugs, even if you take the same amount of T4. FT3 levels should ideally be close to the upper normal limit when optimally treated (I have seen "in the upper third of range used as a guideline), even though there are no absolute rules.


What are your levels of vitamin d, b12, folate and ferritin like? These all need to at good (not just average) levels for thyroid hormones (our own or replacement ones) to work in our cells

Have you improved your low stomach acid?

Do you have Hashimoto's? If so are you on gluten free diet?

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