Thyroid UK

Need advice on switching from Cytomel to NDT

Hey guys!

28 year old male here. T3 and T4 have been low for the past few years, always with normal TSH (1.5-2.5ish). A few months ago I started using 1/2 grain NDT + 12.5 mcg cytomel BID. I wasn't able to afford lab work during these months but for the last month I've just been taking 25 mcg cytomel BID. I just got lab work done and my FT3 is 3.8 (2.3-4.2), my FT4 is 0.8 which is a bit under normal, TSH 0.01. My ultimate goal is to get to the root of the hypothyroidism, which is likely due to years of bulimia, adrenal dysfunction, inflammation, MTHFR compound heterozygous, etc. But in the meantime, I'm feeling like I'd prefer to be on NDT as opposed to cytomel to provide myself with the spectrum of thyroid hormones. Although T3 is clearly much more important, T4 actually serves a function as well.

What do you guys suggest? Switch to a higher dose of NDT? My HR is up a bit from high 50s low 60s to 70s and 80s. Crushing fatigue, which was most distressing symptom, is quite improved.

Any and all advice would be greatly appreciated!

5 Replies
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Josh1989,

25mcg Cytomel is equivalent to 1 grain NDT. It would be a good idea to have a thyroid blood test including FT3 to check levels 6-8 weeks after you switch to NDT.

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Thank you Clutter! I'm taking 25 mcg cytomel two times daily. So I should take 2 grains? Is once daily okay or split it? I will likely continue cytomel for a couple more months due to having the prescription but this is good to know for when I switch!

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Josh1989,

Yes, 50mcg T3 = 2 grains NDT. It's entirely up to you whether you split dose x 2 or take it once daily.

Josh1989,

If you feel well on 25mcg T3 I don't think there is any necessity to switch. T4 will be low because you are taking T3 only. It doesn't matter as long as FT3 is good.

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P.s. Is it necessary to make this switch in your estimation? It has been helpful. My testosterone has actually improved a great deal as well. My t4 is still low but I'm unsure if that's a huge problem or if it signals a pituitary issue.

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Josh1989,

If you feel well on 25mcg T3 I don't think there is any necessity to switch. T4 will be low because you are taking T3 only. It doesn't matter as long as FT3 is good.

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