Thyroid UK
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Increasing NDT


The last time I was on here I was advised to up my NDT as not optimal. This I started to increase from 3 grains to 3 & 3/4 but then was told to get my vitamin level up, b12, d, folic acid otherwise the increased NDT would not work so I stopped at 3 3/4. Well I saw my endocrinologist last week for the last time (as I'm stable) and because I had had increased my NDT my blood test showed:

At 3 grains it was

TSH 0.05 0.27-4.20

Free t4. 11.69 12-22

Free t3 4.91 3.1-6.8

At 3 & 3/4 grains

TSH 0.03 0.35-5.0

Free t4 21.3 9-21

Free t3 6.1 3.5-6.5

Now my consultant said in his opinion I should probably be on 3 1\2 grains but I have been told you need to go over active before you can find your optimum dose so I have increased to 4 grains but am a bit concerned at the free t4 over range.

I will take another blood test in June and hopefully my vitamin levels will be up but do you think I should stay on 4 grains until then or increase by 1/4 after 3 weeks? I have been on 4 grains for the last 11 days if it is too much how soon would your body tell you it's too much?

As always very grateful for any help.

6 Replies

I'm just wondering why you didn't go from 3-3.5. What made you decide to go on 3.75?


Hi, yes I did increase to 3.5 then 3.3/4 then I was confused by someone saying I need to get vits up first for the NDT to be absorbed properly so I stopped at 3.3/4. But now unsure of what next to do as my consultant said I was over with the blood results.



You aren't over medicated on 3.75 grains but you will be on 4 grains. It's not true that you have to become over medicated to find your optimal dose. Your optimal dose is when your symptoms are resolved and your thyroid levels are within range.


So if my symptoms still stay the same on 4 grains do I increase by 1/4 even though I will be over medicated?



No, you should make sure FT3 remains within range. Symptoms can lag behind good biochemistry by months and your vitamin and mineral levels will need optimising too.


Many thanks, I will stay on 4 grains for another couple of months when I have next blood test and then see what symptoms still with me and post blood results and we can reassess. It is certainly not a quick process and so much to check.


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