Lab Results on 2 grains NDT - Switching to T3 Only


I have written a few posts about feeling awful on NDT (went as high as 3 grains) and wanting to switch to T3 only with as much advise as I can get. I was advised to post my labs in a separate post, I have them listed below. I have started on 30mcg of Cytomel. I do not feel any better as of yet but I do have this relieving feeling once I stopped the WP Thyroid, I do not feel as though I may die at any second. I am sure I need to increase the T3 but am not sure what are the best times to dose and how much at each dose. Any advice would be appreciated. Thank you.

Lab Results on 2 grains of WP Thyroid

TSH : .01L (out of range) Ref Range: .40-4.50

T4 Total: 4.22L (out of range) Ref Range: 4.5-12.0 mcg/dL

T4 Free: .9 (in range) Ref Range: .8-1.8 ng/dL

T3 Free: 2.4 (in range) Ref Range: 2.3-4.2 pg/mL

T3 Total: 71L (out of range) Ref Range: 76-181 ng/dL

T3 Reverse: 8 (in range) Ref Range: 8-28 ng/dL

Thyroid Antibodies <1

Peroxidase Antibodies 1

51 Replies

Some people don't feel well when T4 is in the mix. You have started on 30mcg of Cytomel and should increase by 1/4 about every 2 weeks and so on until you feel an improvement. Take pulse/temp regularly and if either goes too high, reduce to previous dose. I shall give you a link which may be helpful:-

Thank you this article seems to have a lot of good information. I saw it stated that the T3 should be taken in a single dose. That is kinda of what I am confused about, the dosing in general of the medication. I am not sure when to take it and if I should split the dose or not.

I take T3 only when I get up with a glass of water and I am well now with no clinical symptoms.

Dr Lowe, who wrote the article, would never prescribe levo - only NDT or T3 for resistant patients.

He, himself, took 150mcg of T3 in the middle of the night and he could function normally, write books, do research etc etc.

I have a life. I forget I have hypothyroidism. I know there is a bit of 'fashion' about splitting doses but why waste time unnecessarily.

Also, when you are increasing doses, your body lets you know whether you've taken a 'bit too much' so you drop back to the previous dose next day and you may well have reached your optimum dose.

All of his patients took one daily dose, whether NDT or T3.

If people split doses, the stomach has to be completely empty. You've got to have alarms set etc etc carry tablets about. It's such a waste of our time, energy.

People also make a mistake by saying that 'T3 goes quickly'. It is true, it is absorbed quickly but it's job is to get into our T3 receptor cells and then that one dose lasts for between one to 3 days .

Dr L was also director of the Fibromaylgia Research Foundation, Dr John Lowe and Thyroidscience and an Adviser to He also relinquished his Licence so that he couldn't be pursued like our UK, Dr Peatfield and Dr Skinner who were, due to them practicisng how they were trained as medical students.

Thank you, for me I do see how splitting the dose could be an issue. I have verrryyy bad digestion and I doubt my stomach is ever actually "empty" during the day. I will try tomorrow to take it all in the morning. I just want to be normal again.

What dose are you starting on? As it is best to start on an equivalent dose or slighter lower than your NDT.

I have been on 30mcg, I take 20mcg in the morning and 10 later in the afternoon, around 5ish, it has been 5 days (was on 2 grains NDT). So far it feels good to not be adding any more T4, I can tell something is a little different in a good way. But my constipation has worsened and there is no real signs of improvement, though I know it is early. I feel I may be able to increase my dose quite a bit more, when it is time. I have ABSOLUTELY no signs of too much medication, I really can not even tell I have taken anything.

Re your stomach problem, which is very common in hypothyroidism as our system is 'slowed' due to hypo and when we eat we most probably don't have enough stomach acid to dissolve food in general and protein in particular. So we supplement with either Digestive Enzymes or a good Apple Cider Vinegar mixed with water or juice to provide acid with meals.

My dose of 50mcg T3 is once daily but members may need different doses.

Do you follow any specific diet? I do not seem to digest any foods very well and am always bloated. I avoid dairy, gluten, and animal proteins in large amounts. I do not eat many raw veggies and try to keep fruit sugar low, I avoid all other types of sugar. I am hoping some of the food sensitivities that I have go away to some degree as I get better from the T3.

Due to hypo our system slows right down and we usually don't have sufficient stomach acid to dissolve food, so most of us take either Digestive Enzymes or a good Apple Cider Vinegar mixed with water or juice during meals.

Thank you! I have dabbled with the SCD diet before, I think I may have even more success with it while on T3 treatment. On NDT and SCD I had the most insane food cravings. I would be strict for a while then would eat like a half a jar of coconut oil for some reason.

To eat half a jar of coconut oil you must have been desperate.

Yes, I have no clue what is wrong with me. In the last 5 months of doing very poorly on NDT, I developed these binge eating tendencies. I east a pretty strict diet so I would binge of the foods I allow myself, almondbutter, coconut butter/oil, sprouted nuts/seeds. All high fat calorie dense foods. Its like I am always tired and I feel like my body thinks food is the answer for energy, then I overeat and become more tired, and gain more weight. Its a horrible cycle but my body/mind is desperate to feel something.

Have you got the latest results of your blood tests, with the ranges you can post.

Reasonable answers need blood test results.

Lab Results on 2 grains of WP Thyroid

TSH : .01L (out of range) Ref Range: .40-4.50

T4 Total: 4.22L (out of range) Ref Range: 4.5-12.0 mcg/dL

T4 Free: .9 (in range) Ref Range: .8-1.8 ng/dL

T3 Free: 2.4 (in range) Ref Range: 2.3-4.2 pg/mL

T3 Total: 71L (out of range) Ref Range: 76-181 ng/dL

T3 Reverse: 8 (in range) Ref Range: 8-28 ng/dL

Thyroid Antibodies <1

Peroxidase Antibodies 1

Hypothyroid...your FT3 should be in the upper 1/4 range of reference. When on T3 your FT4 will be very low as will your TSH. I would NOT take all you T3 at once and when you test your serum, make sure you have not had T3 for 12 hours//=) Im on T3 only and have been for 5 years. 50 mcgs only

I have only been on T3 only for less than a week. My doctor decided to go the T3 only route based on these blood tests.


I posted blood tests below. I am taking 40mcg of T3 in one dose in the morning, is there any reason that I seem to be gaining weight pretty quickly? My face is very puffy. Is this an issue of coming off the t4 I was on? I can't tell if I need to take less T3 or increase? I have no real hyper signs, my heart beat is pretty low still and temps are normal.

I shall give you a link which might be helpful. I myself take T3 and if I go up by a 1/4 I know it doesn't suit and drop to previous dose. I have even gone 1/4 down and, again, this isn't for me.

Thank you, I am reading now. I am just having a huge issue with dosing. I am taking 40 mcg t3 all at once but am not feeling any benefit, just weight gain and more brain fog. I just do not know what direction to go, up or down?

I should have said I am on a perfect dose as I have no clinical symptoms, feel energetic and normal health.

Very interesting indeed, Shaws! You seem to know a great deal about Dr. Lowe. Do you know what he meant by "resistant patients"? Patients not feeling well on any amount of NDT, or patients simply requiring very large doses of NDT to rid themselves of all symptoms? I seem to belong to the second category...I have tried T3 only in the past and it did not work for me (I felt extremely tired and hypo within 72 hours after stopping T4), but I don't rule out trying again in the future if that seems like the right thing to do. Right now, I am doing well on NDT (Thyroid-S), but I seem to require a lot to achieve that. That has nothing to do with Thyroid-S, though; I required large doses of Armour and Erfa as well in the past.

I also am feeling VERY hypo Anna! It is horrible! According to Paul Robinson's book, Recovering with T3, it is to be expected to feel somewhat hypo while any T4 medication clears from your system. NDT did not really work for me so this is the next treatment to try, but it is soooo hard I want to give up everyday! I can barely get through a day of work. This is the worst I have ever felt in my life!

I hope you work it out, whatever is causing it! Members here are very helpful and knowledgeable so you are in good hands.

Do you have Hashimoto's disease (autoimmune hypothyroidism)? Some claim you can feel worse on NDT as that tends to perpetuate the autoimmune attack. These patients often do better on a combination of synthetic T4 and T3. Some do better on T3 only, but not everyone. Have you tried taking synthetic T4 along with T3?

From what I've gathered, synthetic T3 is more powerful than the T3 in NDT, meaning you are likely to need less. I have read about patients previously taking 5 grains of NDT daily (45 mcg of T3) who felt fine on 20-25 mcg of T3 daily after they switched to T3.

I do not have Hashimoto's disease, my antibodies are actually very low. I do have very flat cortisol however so definite adrenal issues going on. I am just in a very bad place and do not really know how to fix it. I need a lot of help and am having trouble finding any. I am just not sure if I am supposed to tough out this time on T3 while my T4 clears or give up and go back to NDT, I was not doing well but not nearly as bad as I am doing now! I have tried synthetic combo and did not do well on that either.


I think Paul Robinson advises to take T3 around 5.00am (wake to take it then go back to sleep) as this helps boost the adrenals.

My daughter had bad adrenal fatigue and she used this method and it did help her.

Yes I do this, I even did it with my NDT. I think it may not work bc as soon as I get up I do a rather aggressive HIIT work out. Maybe I should stop that? I just want to get back to a healthy state I have always been healthy and in shape! I always have eaten a healthy diet so I don't get how this happened ! I'm not doing ok and don't know how to get better ! I'm on day 6 of T3 only from 2 grains NDT and I'm taking 50mcg all at once and feel aweful? Is there any advice you can give me ?

what is a HIIT workout?

High intensity interval training like circuit training where each circuit is a high intensity cardio

Well all I have heard is that whilst trying to recover from thyroid problems, is to go easy with the exercise.

My daughter was just delighted that she could get on her bike and take her daughter to nursery when she started T3, maybe you are doing too much.

Dr L was an Adviser to before his untimely death. He was humane and resigned his Licence to protect himself from those who didn't like his viewpoints on Thyroid Resistance etc. Also, so that he could put down the truth and helped patients get well.

This is a link and there are other topics at the top of the page (some links within may not work). Dr Lowe also invented his own NDT which doesn't need a prescription to make it easier for people.

Did you build up to your dose of T3 that you are now on? I am on only 30mcg of T3 but suspect it is far too little. I am gaining a lot of weight and still feel pretty horrible. Paul Robinson's Facebook group, "recovering with T3" stated that I can not increase yet bc it has to be very slow. I am just wondering how long I have to live so under medicated.

I didn't following Paul Robinson's method but Dr Lowe.

I started on 25mcg of T3 which was about equivalent of the previous doses I took i.e. levo, T4/T3, NDT (several) then T3. I then increased by 1/4 tablet about every 1 to 2 weeks until my symptoms were relieved and (everyone is different) that was just under 50mcg. I went to 50, then reduced by 1/4. I am happy with that and take (have always taken whatever) once daily when I get up. The dose doesn't matter so much but how we 'feel' that's the 24 thousand $ question.

This might be helpful:

I have read that but did not find any suggestions for increasing dosages. Though I am having a hard time reading anything in my foggy state. Im just curious if it is normal to feel this absolutely horrible on T3 only treatment. If not should I not be going this route? I am so confused and feel so beyond horrible.

It all depends how your body reacts to fillers/binders which may be in the product or if your dose is too low.

This is an extract from the above which refers to Thyroid Hormone resistance - most of us don't have this but for non-resistant patient the method is the same alt-ough we get relief of symptoms with smaller doses:-

We can’t give a specific starting dose for patients in general. It varies for different patients, depending on their health status, severity of their symptoms, and other factors. Many patients, however, start with what the clinician calculates to be a full replacement

dose—one that provides all the thyroid hormone a normal thyroid gland would produce to regulate me

tabolism. The patient’s doctor should help her calculate an appropriate starting dose.

From the starting dose, the patient gradually increases the thyroid hormone at intervals that may vary from several days to a week or two. She increases her dose based on her doctor’s calcula-

tions; the amount of each increase is most often small. Gradually, through these increases, she reaches what we call her “therapeutic window”—the dose at which she has no symptoms of overstimula-

tion, and her hypothyroid-like symptoms improve or disappear altogether.

Alexa, re your post below:

Hi Clutter,

I know this post is very old but I need some kind of guidance! I have switched to T3 only starting last Friday. I felt better the first day but now feel absolutely horrible! I can barely get through a day of work and my brain fog has gotten so mad I cant stand to be in my own body! I have also put on some serious weight fast! Is this to be expected? will this getting better? or is this a sign this is not the treatment course for me? I switched bc I was not doing well on NDT but this is far worse so far! I am so frustrated and confused and have no guidance! I do not know how to do this T3 treatment and am not sure if I am supposed to wait out this period of time.

Your rT3 is low so this is not your problem or why you are feeling unwell. I think you were under medicated on 2 grains NDT because both FT4 and FT3 were very low in range. Most people on NDT need FT3 in the upper third of range ie >3.55 - 4.2 to feel well. 2 grains NDT is equivalent to 50mcg T3 so I think you will be under medicated on 30mcg T3 too. Perhaps you could increase T3 to 50mcg split into 2 x 25mcg doses initially and check FT3 level after six to eight weeks to see that 50mcg dose is sufficient.

Thank you clutter. Would it be worth trying NDT again and working up to a higher dose? I am gaining a lot of weight on cytomel and not feeling great at all!


Well you will gain weight and feel unwell because you are undermedicated on 30mcg. Either increase the T3 dose to 50mcg as I suggested or switch to 3 grains NDT.

Yes I feel under medicated. What are your thoughts on combining NDT with T3 ?


I don't see how you can know whether you need to combine NDT with T3 when you weren't optimally medicated on NDT in the first place.

I have been on 3 grains before and felt good energy wise and lost a lot of weight. My brain fog ever went away tho and I did not feel great mentally. I was also over exercising at the time and eating very unbalanced (vegan and not carbs or sugar, not even fruit )


What were your results and ranges on 3 grains?

TSH: .01 (.27-4.2O)

T4: 5.8 (4.5-11.7)

Free T4: 1.19 (.93-1.70)

T3: 81 (80-200)

T3 Free 2.3 (2.0-4.4)

RT3 15 (8-24)

Iron 94 (37-145)

Ferritin 64 (13-150)

Those were on 3 gains of NDT. I felt great at first as I was getting up those grains but then everything just stopped working. I started to gain a lot of weight and began to get even more foggy headed than before. Nothing compares to how bad I feel now though under medicated on T3.

the "recovering with T3" facebook group told me I can not go too high wiht the T3 and to stay here a awhile. Its so annoying though as I can barely get through my days.


Most people taking NDT need FT3 in the upper third of range ie >3.58 to feel well so I think you were under medicated on 3 grains.

As I've said, you are probably undermedicated on 30mcg T3 and if you are to remain on T3 I would recommend increasing to 50mcg.

Can I increase to that amount all at once? Or is it a better idea to work my way up with NDT as it is an easier treatment?


If you are sensitive to dose increases try 10mcg increase and if you tolerate that without problems for a week increase by another 10mcg.

If you want to switch back to NDT you can start with 3 grains as you are already taking 30mcg T3.

Hi Clutter,

I ended up switching back to NDT, 3 grains as suggested. I couldn't take how much weigt I was gaining on T3 only, even once I increased I was still blowing up! I still do not feel well on the NDT either! It has only been a few days but I just do not know what to do! I am sooo foggy headed, my digestion is crazy, I get bloated after everything I eat, I am beyond disassociated with reality, and my weight is just out of control at this point. I feel broken and am so scared there is no way to fix me! Do I just give this more time? I am so confused. I also can't seem to stop eating or thinking about food.


None of these things are an instant fix. The T3 in NDT will have an immediate effect but it will take 7-10 days to absorb the T4 before it starts working and up to six weeks to feel the full impact of the dose. You should have a thyroid test to check levels after six weeks in case dose needs increasing.

Try drinking a glass of water to fill your stomach instead of reaching for food.

I drink lots and lots of water. I also eat very healthy. Lots of veggies, berries, minimal animal protein (all grassfed and hormone free). Everything organic. I do not eat grains, gluten or dairy. I just find it strange that absolutely nothing makes me feel better ever! I am so confused as to why my body seems to rebel constantly. I know its not a quick fix, but find it strange that I go downhill when trying new treatment. I have also been trying for ten years to only find temporary fixes that all end up failing at some point in time.


I don't have any appetite so I'm not the best person to advise on coping with constant hunger or weight gain.

You may also like...