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.