I know this has been discussed before, in various posts, but I just wanted some feedback and advice anyway:
There is conflicting advice concerning the free T levels to aim for when on NDT or synthetic T3 and T4 (this does not concern those on T3 only at all). Some say FT4 levels are unimportant when on NDT or a synthetic combo drug, and that only FT3 levels matter. Some say you need at least midrange FT4 levels along with high in range FT3 levels. Others claim both FT levels need to be high in range for complete symptom relief.
I have tried almost every available brand of NDT (prescription or NDT), and the one I feel best on is Thyroid-S from Thailand. Last summer, I felt great on the dose I was taking at the time. However, my lab results made me worried (I went to the lab 24 h after taking NDT):
FT3 2.9 (ref 1.7-3.7)
FT4 0.9 (ref 0.8-1.5)
TSH below range (0.04; ref 0.2-4.0), but I don't care about that.
Based on my FTs above, I decided I had to be under medicated, and have since tried to raise NDT by adding 1/4 grain or even 1/2 grain...every time, I end up with symptoms of being overmedicated (so hyperthyroid): rapid heartbeat, excessive sweating, etc.
I know Thyroid-S contains a lot of fillers, and I am not happy about them...however, I cannot deny that I do much better on it than on any of the prescription brands of NDT that I've tried (Armour and Erfa). When taking the amount of Thyroid-S that I was taking last summer, when my FT3 levels were midrange (24 h after taking it) and my FT4 levels low in range, I had no hypo or hyper symptoms whatsoever. I have tried other brands of NDT that are supposedly "cleaner", with less fillers, including Thai brand Thiroyd, but I keep coming back to Thyroid-S because I really feel good on it...
Considering how much money I've spent these past few years on NDT that did not work or did not work optimally, I have been asking myself lately: how much do the lab results matter?
Believe me, I wish I could switch from Thyroid-S to a "purer" drug. I don't like the list of +/- 20 fillers in Thyroid-S. But, even if I hate to admit it, it's the best thyroid replacement drug I've tried so far, and I have tried both T4 only drugs, Novothyral (synthetic T3+T4), Thiroyd, Armour, Erfa...Novothyral, Armour and Erfa have been prescribed by doctors. I don't want to waste more money on drugs that may or may not work. WP and NP Thyroid are not readily available where I live, and I try to avoid depending on a drug that I may not be able to find when I need it...at least Thai NDT is always easily obtainable.
I have to admit I don't know why Thyroid-S works so well, as it contains more fillers than any other brand of NDT I've seen, including Armour, which many patients abandoned after its unappreciated reformulation...but I cannot deny the obvious: Thyroid-S works great for me.
Any thoughts, ideas or input would be greatly appreciated.
I enjoyed reading your post 😊 very informative especially to me who is making the switch to NDT soon!
I don't know a real answer for you and I'm sure some of the experienced members will help but my opinion is, if you feel great then don't worry about blood results!
We already know that most of the thyroid blood tests are more to satisfy the doctor that you are 'treated'. 🙄
T3 has a short life in the body, so given you took meds 24 hours before blood draw will mean you have little left in your system I would of thought. Your T3 levels ordinarily,when taking meds, are probably optimal. 😊
'Optimal' has nothing to do with numbers on a page, and all this talk about 'should be' in such and such a position is irrelevant, really. You need to increase your dose until you feel well. Blood tests are just a guide to help you know which way to go. But, if you are taking any form of T3, your T4 is going to be low, because the body doesn't hang on to so much, because it doesn't need it. And trying to raise it is a bit pointless - although so many endos do!
If you left 24 hours between your last dose and the blood draw, then you have a false low, there. You normal circulation T3 is actually higher than that. I believe you can calculate it by adding on 20 % of the result. So, it's not surprising that an increase gave you hyper symptoms. Next time, just leave 12 hours.
All in all, if you're good on the dose you're on, stay on it. And don't listen to people who try to dictate to you where your FT4 'should be'.
This also explains why so many people who tried to add T4 to NDT or synthetic T3 ended up feeling lousy...simply because they did not need the extra T4...! It all sounds so simple when you explain things...!
Yes, but not extra T4, right...? I think too many hypothyroid patients mistakenly believe (and I was one of them, until very recently) that you need more T4 than T3, as that is the way the human thyroid gland normally works, while pigs produce more T3 and less T4 than we do...
It's irrelevant, because most people can convert that T4 into T3, most T3 comes from conversion, as and when they need it. But, we hypos don't always function like that. So, we need what we need : the right form and the right quantity.
I know, Armour is incredibly expensive nowadays...I considered ordering it (as I can get a prescription for Armour from my doctor), but it turns out one bottle of 100 3 grain pills costs ca 160 GBP...there is simply no way I'd be willing to pay that much for a drug that is not even covered by health insurance where I live...! I have never understood why Armour has become so expensive whereas other prescription brands of NDT have not...?
The fact is that it's hard to find any negative reviews on Thyroid-S, whereas the reviews on Thiroyd and TR are more mixed...many who have tried at least two or all three of the Thai brands seem to find Thyroid-S stronger and more consistent than the other two.
I seem to be having a lot of success with Thyro-Gold. It is a little expensive, but I've just ordered six month's worth for £95 including postage. I have recently asked for info where I can get cheaper brands, but after my blood results yesterday, I've decided to stick with Thyro-Gold for the time being. There is only one additive and that is from a plant. It would seem, after some advice I received here, that my results are bang-on. And they were rubbish on Levo. (I have no connection with the people at Thyro-Gold other than as a customer.)
Interesting, thanks for the info! I have considered Thyro-Gold in the past, but decided against it because it comes from cows and not pigs......I have nothing against cows, don't get me wrong, it's just that I've read over and over again that thyroid powder from pigs is closer to human chemistry than thyroid powder from cows...but what you say makes me wonder if I should indeed give Thyro-Gold a try. In any case, it's not as expensive as Armour or Erfa, and I like the fact that it's sold as a supplement and only contains one filler. Dr. Lowe, who created TG, seemed very knowledgeable when it comes to the treatment of hypothyroidism, so I would expect him to formulate a great product.
Would you mind posting your results here, just to give me an idea? How much are Thyro-Gold are you currently taking?
Here are my results from yesterday after a couple of months on Thyro-Gold. Before, I was on Levo and my results were getting worse and worse. I can't say, but I reckon if Dr Lowe went with bovine it must have been for a good reason. Also, Thyro-Gold comes from New Zealand cows where there is no GM, Mad Cow disease or any of the other nasties... However, all this is very individual and one Hypo's meat is another Hypo's poison! Best. Stevie.
From what I can gather; 1 x 150mg of Thyro-Gold is the equivalent of 100mcg of T4. (Bearing in mind it contains (apparently) around 50 mcg of T4 and 12.5 mcg of T3. But don't quote me...
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optimal labs on desiccated thyroid?!
