Blood test after 6 months on NDT

[laura91725]

Hi- can somebody help me interpreting these results? I had a blood test done this week after 6 months on NDT, I don't know what to make out of them.

I've posted the results along with previous ones, my Free T4 seems very low at 0.94 (0.7-1.48), also THS is below the minimum range 0.08 (0.35-4.94), happy with T3 at 1.45 (0.58-1.59).

I swapped to NDT hoping for an increase in energy, which hasn't happened, also I'm putting on weight and can't lose it. But also to improve my mood, which has happen and I wouldn't like to lose that.

I'm thinking it may make sense going back to Levo, and maybe add T3 instead, Or maybe taking half levo and half NDT?

I'd really appreciate any comments, I'm really not sure what to do

[Clutter]

Welcome to the forum, Laura91725.

FT4 is usually lower when taking NDT or T4+T3 and as long as FT3 is good it doesn't matter. Your FT3 is good at 1.45 and close to the top of range. TSH is mildly suppressed because your FT3 is high in range and is nothing to worry about. You appear to be optimally medicated on your current NDT dose.

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

thyroiduk.org.uk/tuk/about_...

Ferritin is optimal halfway through range or around 70-100. You can raise ferritin by supplementing iron with 1,000mg vitamin C to aid absorption and minimise constipation.

Have vitamin D, B12 and folate been checked?

[laura91725 in reply to Clutter]

Thanks again Clutter! very good info.

My ferritin tends to be very low, and after that test I upped my intake, so hopefully is ok now. I also checked folate and vitamins and C and D, all these were low, B12 was good. I've been supplementing and hopefully all is in line now.

That's why I'm thinking I need T4

[Clutter in reply to laura91725]

Laura91725,

I'm not sure I'm understanding you. NDT has T4 and T3 in it and your results don't indicate you need more T4. T4 won't do anything for low vitamins and minerals.

[laura91725 in reply to Clutter]

Did you not think my T4 is low?

I'm taking vitamin supplements (not counting on T4 for those)

[Clutter in reply to laura91725]

Laura91725,

0.94 isn't very low and I've already explained that FT4 results are lower on NDT than Levothyroxine and that as long as FT3 is good it doesn't matter that FT4 is low.

[laura91725 in reply to Clutter]

Yes, I realise what you said about T4 not being an issue when T3 is good, and I've read the links you sent. The point I was trying to make is that I think they do matter to me, I guess everybody is different and we need to try to find the right combination. Thanks again for all the info, I've learn a lot these last 2 days

[steviecat]

Am I reading this correctly? I can see 'Free T4' but I can't see 'Free' T3. Just T3 and total T3... Does the 'T3' mean, Free T3, do you know?

[greygoose in reply to steviecat]

Yes, just what I was thinking. There isn't a result for T3, anyway, just for Total T3, and Total T3 tells you nothing useful. You need to have your FT3 tested, as that is the most important number when on NDT.

[laura91725 in reply to steviecat]

I don't really know, I know it sounds dumb, but my doctor gave me the results by phone and I didn't think to ask at the time (it was the first time T3 was tested.

[lucylocks]

Hi

I am in a similar position as you.

My levels were very similar to yours until this last month, were I have found my FT3 has dropped right down.

I have been taking NDT for 16 months and have only felt a slight benefit over levo. In hindsight I wish I had stayed on levo. and added some T3 but I switched from levo. straight to NDT.

I think the T4/T3 ratio in NDT does not suit everyone and with T4/T3 combination we can alter the ratio to suit.

You maybe interested in this site tiredthyroid.com/

The lady who runs it takes NDT and T4 as she feels she needs both to make her well.

I hope you get some more replies as I will be interested as I do not know which is the best way forward myself.

Best wishes.

[laura91725 in reply to lucylocks]

Thanks for the link, fantastic info, I think that is exactly what I need, I've only just realised that was an option, I've ordered the book, I'm very hopeful with this option.

When I first started NDT I felt great, but that wore off after a few weeks, in hindsight I think that was the time when I still had residual T4 and the new T3, so this new approach of taking both seems to make sense.

I'm going to start levo + NDT just because I have a load of tables left, and see how I get on.

Good luck to you, I hope you find the right combination, I will let you know how I get on if you're interested

[lucylocks in reply to laura91725]

Yes please let me know how you get on. I think this is my way forward also.

I do hope it works for you.

Good luck.

[laura91725 in reply to lucylocks]

will do!

what was your levo dose? and NDT? I was on 150 levo and swapped to (eventually) 2 grains of Thyroid-S

[lucylocks in reply to laura91725]

Hi

I was on 125mcg. levo. but Doctor reduced to 100mcg. because he panicked about low TSH, as they do.

I felt a lot worse with the reduction so decided to try NDT (W.P. Thyroid) but I could only work up to 1.5 grains, if I increased I got palpitations and high B.P. I still had hypo. symptoms though.

My FT3 was at a good level but FT4 below range. A lot of members say low FT4 does not matter if FT3 is good when taking NDT but Barbara at tiredthyroid.com says otherwise.

It is only the last month or so my FT3 has dropped but I have had a bad virus and apparently this can happen.

I increased to 1.75 grains ten days ago, after a three days I felt some improvement but the last couple of day gone backwards again.

I have Barbara's book so I need to re read it to find out how much NDT to reduce and how much levo. to add.

[silverfox7]

How much NDT are you taking? The reason I asked is that when I changed to NDT I slowly increased and yes I felt better but not as good as I was hoping. I started my thyroid journey on NDT and was hoping for the same success. I then had bloods done by the Endo and he suggested I dropped down from 3 grains to 1.75. I did this gradually I think mostly. Ecause I didn't think he was right but I've had to eat humble pie because he was! I'm just wondering if line me you had sailed past your sweet spot and I found being slightly over medicated the same as ring slightly under. If all else fails consider dropping back and see what happens.

[laura91725 in reply to silverfox7]

I did think about that, I was on 150 levo, and changed gradually to 2 grains. I know the equivalent is 1.5 but endo suggested 2 as I wasn't feeling great. I didn't think I could split the tablet in 4 pieces though! it's hard enough splitting it in halves (I have a pill cutter, but still...)

[silverfox7]

I split mine into halves and then quarters with a Pill Mate that was recommended. Doesn't always get it right but I take the pieces as the 1 it started at! I was on 100/125 Levo but I had spent a lot of time correcting my conversion problem first and I think I have been more stable for doing that.

[matty220 in reply to silverfox7]

Hi Silverfox. What do you mean about 'correcting your conversion problem'? How did you do that?

[silverfox7 in reply to matty220]

I looked at the issues that help conversion, B12, Vit D, Folate and ferritin. And was a little low in some and some of the other things I take. So I added in or increased and after 6 months I had lost half a stone without trying and. Inversion wasalmost spot on. So at this point I then changed to NDT and apart from minor hiccups I'm pretty good. You can't tell though if conversion is a problem though unless you are taking Levo as with that the FT4 and FT3 are reliable but when on NDT then only FT3 is reliable and needs to be high in the range. Even though I had been on NDT before I still followed comments on here to get up to date with symptoms/trouble shooting etc and also people self medicating as I knew that was my only option. I don't think it's a decision to be taken likely.

Whatever you end up doing though make sure the readings for those 4 tests are good. Post the results and ranges for comments as this is another area where doctors think if you are in range you are fine but like the Thyroid it's where in the range that is important.