Struggling to raise ndt dose: How long should one... - Thyroid UK

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Struggling to raise ndt dose


How long should one continue on a dose if there is a worsening of symptoms? Since raising to 2 grains I have felt unwell so have reverted to lower dose. My iron and b12 are fine, not checked D yet. I have adrenal problems and am on lots of adrenal cortex. I'm thinking of trying ashwaganda for adrenal boost as I've heard good things about it. Please can anyone advise.

17 Replies

It is right that you have reverted to a lower dose as that may be your 'optimum'. 1 grain is equal in its effect to 100mcg of levo and 200mcg might have been a little too much.

I know of one doctor who likes to assist adrenals and another who said the adrenals sort themselves out when optimally medicated and I found the second worked for me.

You should keep to your dose for six weeks and see how you feel at the end of it and get a new blood test. I hope your dose works for you.

As well as knowing your symptoms, we would be better placed to advise if we had your blood test results with their ranges.

Have you been diagnosed with an underactive thyroid? Have you ever taken anything else, i.e. Levo? Are you prescribed Armour of self meficating?

Ask your gp for a print out of your results. If you gp won't test, you, get private tests done. (All tests should be fasting & armour taken after the test.)

hoalarg in reply to EleanorM-G

No diagnosis but have been self-medicating for about 3 months. TSH was 8 then with FT4 and FT3 just below range. Been taking WP thyroid. Before NDT I have took levothyroxine.

Have you been taking Levo and then changing to NDT within three months? If tgat's correct I think you have been doing too much. It can take 6 months to get things going in the right direction. It's a very slow process and sadly we can't speed it up

Never taken Levo.

I could never raise past 1 1/2 grains either because on NDT I did not have enough of the T4 it had to too much T3 for me. I found a lot of helpful in info on

I'm not suggesting this may be true for you. Just hoping some of the hassle I've gone through may help someone else.

hoalarg Did you have your adrenal/cortisol levels checked ? You first need to know if your cortisol are high or low . Before you want to add nutrients to support your adrenals you need to know what needs to be supported . Taking the wrong nutrients can make it worse .

hoalarg in reply to jgelliss

Yes i did. My cortisol was ok but my dhea levels were low.

humanbean in reply to hoalarg

If your cortisol was okay but DHEA was low, then adding lots of adrenal cortex could be raising your cortisol too high.

High cortisol makes it very difficult or impossible to raise dose of thyroid meds high enough without getting overdose symptoms, despite the fact the patient is still hypothyroid.

DHEA supplements can be bought online, although I'm never quite certain of its legal status in the UK.

Have you posted your saliva test results in any of your posts? If you have, could you post a link, please.

hoalarg in reply to humanbean

Here is the link to my flickr account where you will see it.

Do you recommend DHEA supplement?

hoalarg in reply to humanbean

I added a link below. Thanks

In that case DHEA would be recommended . When dosing with DHEA it should be at least two hours apart from thyroid meds . Adding Vit."C" would be very advisable to . Adrenals need vit."C" . Eliminating wheat ,dairy, sugar would be very beneficial too .

hoalarg in reply to jgelliss

Here are my results:

jgelliss in reply to jgelliss

In addition I would also recommend that you eat more protein for adrenal support and to eat small portions and often . By not eating often you are putting further stress on your adrenals .


Your saliva test results :

Sample 1 - 7.5 (2.68 - 9.3) nmol/L

Sample 2 - 1.79 (0.75 - 2.93)

Sample 3 - 1.57 (0.36 - 1.88)

Sample 4 - 0.25 (<= 0.94)

[The reference range for sample 4 is nonsense. It doesn't have a lower limit, suggesting that a value of 0.00 would be absolutely fine. But if there was ever a time when someone's cortisol was actually zero they'd probably be dead. So I looked at the reference ranges for my own saliva tests done ages ago and discovered that for sample 4 the lower limit of the reference range was approximately one third of the upper limit. I've, therefore, arbitrarily set the lower limit for your sample 4 to be the same - one third of 0.94 = 0.31 (approx), just to give me a number higher than zero to work with.]

Optimal results for cortisol can be found here - look at Example 1 :

Optimal levels

• Morning at the top of the range

• Noon approximately 75% of the range

• Evening close to 50% of the range

• Nighttime at the bottom of the range

If we compare your results and the optimal results then :

Sample 1 : Yours = 7.5 --- Optimal = 9.3

Sample 2 : Yours = 1.79 --- Optimal = 2.95

Sample 3 : Yours = 1.57 --- Optimal = 1.12

Sample 4 : Yours = 0.25 --- Optimal = 0.31

Totals : Yours = 11.11 (4.1 - 15.05) --- Optimal = 13.68


To summarise, your total cortisol for the day is a bit lower than the optimal. But compared to the reference range for the totals your total is still more than half way through the reference range, so you don't have an enormous amount of ground to make up. I wouldn't suggest that you take loads of adrenal glandulars to boost your cortisol because you could end up with too much. Instead I would suggest that you go the gentler route of taking supplements that help the adrenals to do their job.

Here's a few links on the subject of the adrenals to get you going :

On the subject of DHEA, yours is a bit low. Some people do take DHEA supplements but they aren't something I've read much about. I think it is illegal to import DHEA into the UK, so if you were to buy it online you do risk having it confiscated by customs.

The Insider's Guide to interpreting adrenal stress tests has info on DHEA. I'll leave it up to you to decide what you want to do about it.

hoalarg in reply to humanbean

Hi. Thanks for the in depth message. Much appreciated. There's a lot of info there and it'll take me a while to get my head round it. I've managed to find some dhea from a UK site so I may get some to try. The adrenal cortex just don't seem to be strong enough for me, so need to do something quickly or else I won't be able to raise my thyroid meds. Ashwaganda is in the post and that raises dhea a little. We'll see... I'll let you know.

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