hello I've not been on here for a while, awake at 4:30 again! Been on ndt since July, had my 6 monthly check up with my endo in February. I told him I was self medicating, didn't get the reaction I expected he said it must be working as I'm looking so well! Since self medicating my symptoms have decreased especially the chronic migraines, aches and pains and no more constipation. Just need a little help with the blood test results I think I need to go back to my go to get retested:

TSH <0.01

Free T4: 16.4

Total T3: 3.8

I still feel a little tired been having insomnia the last month, my heart rate is high between 80/100 the migraines are starting to increase again but my body temperature on rising is still under 37. Maybe I should reduce my dose? Think I need my FT3 checked

I take 28mg of iron, but b12 orally and vit d everyday


24 Replies

  • Hi - have you ranges for those results? And yes you really need ft3 not tt3 x

  • Total T3: *3.8 ref range units 0.9-2.5nmol/L (nmol/L)



  • SO are you sure of this? If so, you are 180% overrange on TT3. If you don't have the option to have FT3 tested right now, I am tempted to suggest you decrease dose. You didn't give us a range for FT4; where are you on that? And do you know if you have Hashi's?

  • free t4 : 16.4 ( 9.0-21.0 pmol/L, )

    had my bloods done in June free t4 was: 8.2 pmol/L( 9.0-21.0) think I need to get my bloods redone no hashis that I know of but endo hasn't tested my antibodies for over a year ta

  • Have come across this pattern before. Your FT4 is in range, but inferring from your TT3, your FT3 is probably well over-range. The T3:T4 1:4 ratio in NDT does that to some people. I have had my FT3 modestly over-range, and although it does not give me screaming anxiety like high FT4 does, there are unpleasant symptoms associated with high FT3. For instance, in my case I know that high FT3 upsets my digestive tract, causing too-low transit time. Have you considered lowering your NDT dose a bit, then perhaps adding in a little T4 so that both FT3 and FT4 are comfortably in-range?

  • Are you sure that is a 'total' t3 result? Only asking as I have never had a total t3 test only total t4. Could that actually be a FT3? As startagaingirl says, we really need the ranges. Do you have results for ferritin, b12, vitd and folate tests?

  • no results for iron or vit b12 think.ill need to ask my gp to test this ta

  • Remember that on NDT TSH is nearly always suppressed, and T4 is fairly irrelevant.

    I suspect that your T3 result is actually FT3 since total T3 is usually a rather higher figure. And in that case you need more, not less. You want FT3 to be towards the top of the range to feel at your best. All of those symptoms are consistent with under-medication.

  • hello just double checked my labs it says total T3: 3.8 this is the first time my T3 been tested so I can't compare it to previous results. Just a bit worried as I'm on 5 grains, and 6 grains is the highest doses i think?

  • Hi Tootired . How much NDT do you take per day, what times, male or female, age, weight (sorry) and height. Are you sporty/active ie you burn up NDT or sedentary. Are you taking any hormone supplements. (testosterone, estrogen, progesterone) . Are you taking Magnesium.



  • hello take 5 grains split over 2 doses one at 7am and one at 2pm. I am female, 5ft 6 1/2 overweight☹ currently 13 stone and dieting however the weight loss has been very slow. I take progesterone only pill for my migraines as they are defo hormonal. I do a lot of walking mostly short walks as I don't have a car and have 2 kids to run after. No I don't take magnesium I tried it in the past to see if it would help with the migraines but to no avail. Ta

  • Hi Tootired. I'm 50 year old 6.2 male and 13.5 stone and take 3 grains spit 3 ways each day. Everyone different and my thryroid may still be working a little, although I doubt it . So 5 grains is probably too much. You need to find attributes that tell you when you are hi or low thyroid. I use, temp, anxiety levels, head ache, tingles in hands and feet. I don't worry too much about my TSH, it hovers around 4 but I feel great 95 percent of the time. I do get the odd night where sleep eludes me but mostly it is good and I don't feel like I'm dragging my body around during the day, so long as I get more than 2 grains per day. I found testosterone and magnesium supplements were the secret to being able to raise from .5 grains perday about 18 months ago.

    I take an extra .5 grains ontop of the 3 grains daily if I'm sailing, playing sport, or I'm out in the cold wind gardening etc. I take extra about 45 min prior to activity and then eat banana 5 minutes prior.


  • hi I started on 2 grains in July and increased very gradually going on how i was feeling / symptom elimination. I don't feel hyper, not anxious, no rapid weight loss or sweating or feeling too warm or manic certainly not jumping out of bed in the morning! I would have expected to feel unwell quickly if I took too much? but maybe my system's so mucked up I won't feel subtle changes. my body temp is still low and I do still get fatigue, not half as bad, but the high heart rate is bothering me

  • I would go to 2-3 grains/day for a week and see if the migraines and heart pulps stop. You can always go back up. Aerobic exercise is important too, 30 minutes a day brisk walk that makes you breath a little. It helps shake up the organs and burn off excess T4. I swim but that's not for everyone.

    Re symptoms - For me

    Feeling cold - take more

    Feeling like I have a flat battery - take more

    temp low - take more,

    temp high I've never managed that :-)

    anxiety - take more

    head ache - take less

    tingles in hands and feet about right but be careful

    crawling scalp take less

    heart pulps take less

    I never feel like bouncing out of bed, I just have to do it to make work and once I've been up and got a double strength coffee and bacon and eggs into me I feel fine.


  • The insomnia thing comes and goes with me too. I've found that the following help (a) with insomnia and (b) with t4 to t3 conversion - I suspect they may amount to the same thing.

    Best advice for the long-term is to go for an adrenal friendly regime so you don't get the sudden rush of cortisol at inappropriate times...I'm working on this for myself and am now getting up at 6.00 am which is better than 4.00 am! The best thing is to avoid cereals /muesli with milk at breakfast and have them as a late evening snack instead. Having eggs and some black-pudding for breakfast with half a grapefruit is a better start to the day. At lunch make sure you have some protein and fat (high in omegas) and salad / fruit. Snack on full-fat yogurt in the afternoon to prevent mid-afternoon lows. Evening meals can be more carb-based with lots of cooked veg and easily digestible protein. I find that fried food, pork and beef always causes me insomnia if I eat it in the evening (slow-cooked lamb is fine though??).

    Magnesium (citrate form is good, so is taurate if you're getting palpitations) - as it serves to relax the body it's better to take this from lunchtime onwards. It also works with t4 to make t3.. this is particularly good if you have muscle twitches or restless legs.

    Niacin (B3) 50 mg 'mops up' unused b12 - best taken in the evening with a bowl of cereal as it causes a warm flush, but I've found that it works better than nicotinamide / niacinamide (other versions of B3) for insomnia. This, I've found, is particularly good at preventing the waking up and not getting back to sleep problem; better if you're doing the adrenal friendly meal plan as well.

    N-A-C (amino acid) also mops up b12 and helps with liver function (cleaning the blood of toxins) - take on an empty stomach at bedtime with enough water to swallow properly - you don't want this one stuck halfway as I've discovered it can cause nasty reflux reaction. This is probably best as a short term solution... and doesn't do you any good if you're on certain meds including antibiotics, so it's worth checking out contraindications. It certainly helps with getting off to sleep, but not so sure about the remaining asleep. Taurine, another amino acid, used as an additive to cat food (they sleep a lot!) is quite good for remaining asleep, but can make you feel a bit hungover - but it's not as bad as valerian which doesn't work for me at all.

  • Try 30mg of zinc about 3hrs before bed I sleep better with that plus an amino acid blend to stop day crashes. I believe in my experiences that crashes, plus need to keep increasing thyroid meds, and poor conversion ratios in thyroid all point back to adrenal fatigue, which is an amino acid deficiency.

  • Interesting. Well I have been taking take zinc in the evening of late, but just because I read that it's a better time to take it...which would tie up with what you say. Not crashing that much in the day though, at all. I'm trying to prevent that from happening.... there's also methylation (often down to too much or too little b-vitamins in the blood) to consider and my view is that our bodies can change gear once we start taking thyroid meds which shocks the body a bit and we can end up for want of a better expression 'metabolically confused'. Improving liver function may be the answer as we must improve detoxification rates if we're running in a higher gear. I've read a lot about glutathione being good, but N-A-C is a precursor to that, and it certainly helped me for a while last year, so I can see where you're coming from...

  • Your methylation problem you most likely low in stomach acid and or digestive enzymes Inc low healthy bacteria too, these are needed for vitamins and minerals to be digested n ingested properly.

    I take them myself low B12 plus a high MCV count can strongly suggest low stomach acid. Hope that helps

  • Perhaps you need an increase in NDT. I got used to a low dose of 1 grain, after 6 months, then had to gradually increase to 2 when my symptoms crept back, including wakefullness & aches.

  • On 5 grains, I doubt it.

    I'd go along with those who have suggested reducing dose.

    Usually around this time of year, we see some people posting that they feel over-medicated. And the reverse in the autumn/early winter. What had been OK until rcently, is now too much. Often only a small change is required.

  • I missed the 5 grains, sorry Helvella!

    I have noticed needing less when it's warm, but also take more some days when I'm active. My UniPharma T3 is weak, so it's easy to jiggle up & down dosage with a split tablet according to need. :)

  • okay so drop to 4 1/2?

  • I do not have personal experience - so difficult to say.

    Might be a good move. Might not be enough.

  • Too tired, Given my experience I'd suggest ndt that high you have adrenal fatigue and need amino acids us vit c@1000mg plus a B complex too as cofactors for amino acids. I believe too that an adrenal. Problem precedes a thyroid problem. Hope this helps

You may also like...