Please recommend whether I should try T3 or NDT first, according to these blood test results -

Please recommend whether I should try T3 or NDT first, according to these blood test results -

I have been taking Levothyroxine for the past 15+ years and it has become increasingly ineffective - if indeed it's helped much at all. This past 1-2years I've been going to my GP to ask for more thorough investigations into my thyroid because I can feel it's not working and the Levo isn't doing the job of medicating my hypothyroidism properly. I believe my thyroid levels also drop in the run-up to my period when my symptoms are at their worst

Thanks to a well-informed friend and to you guys, I'm now aware my Ferritin levels are through the floor and my Folate and B12 levels are low. So, once these deficiencies are being addressed, which should I start with: T3 or NDT?

In the past I know that the supplement Nutri Thyroid has helped, so I was leaning towards self-medicating with (probably Thiroyd or Thyroid-S) NDT first.

Obviously, with the summer holidays coming up next week (eek!) I want the quickest results so that I can actually muck in with the kids.

Given it'll take a fortnight - at the very, very least - to receive any meds from abroad, I figure my blood levels will be slightly better by then. Luckily, I don't actually mind eating liver!

My main symptoms are...hmm...where to start: chronic pain, feeling utterly empty of energy, terrible memory issues, poor concentration, slow and forgetful speech, brain-fog, weird menstruation, constipation, always cold, always sleeping, exhaustion, under-eye dark circles, etc etc! A lot of symptoms indicating big crossover with the ME/ CFS I have which I think followed undiagnosed hypothyroidism (although actually I have post-viral ME and get terrible post-exertion malaise and brain-fog after exercise - i.e.: walking!).

Anyway. I appreciate that you guys may not be medics but you are still far, faaaaar more experienced than me in this area. So, any thoughts and recommendations as to go the T3 or NDT route first would be gratefully received!


13 Replies


I would advise you have FT4 and FT3 tested before self medicating. TSH 1.42 is normal and rules out primary hypothyroidism although it doesn't exclude central hypothyroidism.

You can raise ferritin by supplementing iron with 1,000mcg vitamin C to aid absorption and minimise constipation.


GP Wouldn't do T3 test but am waiting for T4 results, due shortly.


You still need to know FT3 level before we can advise whether you should be taking T3 or NDT. You can order thyroid tests via Medichecks have #ThyroidThursday discounts.

Thanks for this. Money in super-short supply so was hoping to avoid any private tests and save my pennies for meds instead. Doesn't sound much point, however, if it's a job that needs doing!

Thanks for #thyroidthursday tip. Will sort mañana! Great timing :-)


Do I need my Reverse T3 tested too , or is that already ruled out because my TSH is within range?

Please advise while it's still #thyroidthursday!

Thanks for your patience,



If you're not taking Levothyroxine it is very unlikely you will have high rT3. I wouldn't bother testing rT3. It is expensive and you will also need to pay for a phlebotomist to draw blood for a rT3 test.

Thanks for your reply - very much appreciated.

However, I've been on Levothryoxine for 15+ years, and have been complaining to my GP for the past 1-2 years that I feel it's not working, as all my thyroid symptoms have flared-up in steadily increasing ways.

In this situation, what would you suggest I do with regards to blood tests? Don't know anything about this stuff and very much need to get it sorted. Am in a physical mess at the mo and in and out of bed all day.

Thanks for your input; my GP just keeps layering on the painkillers and refuses to refer me to an endocrinologist!


You've said money is short so I wouldn't order the rT3 test. I would order

Do the test early in the morning when TSH is highest and fast (water only) as TSH drops after eating and drinking. Take Levothyroxine after the blood draw.

If you are taking a B Complex vitamin or Biotin you should stop taking it 2 days prior to the blood test.

Thank you so much!

Your results above don't show B12 as being on the low side - in fact it is very unlikely that you are B12 deficient on the results above.

If these results are after being treated for a B12 deficiency then suggest that you post on the PAS forum

Thanks, I haven't been taking B12 vitamins, but was told on this site that my B12 levels could be better - only with regards to my overall thyroid health and the Levothryoxine I'm taking.

sorry about the double posting - had a problem when hit submit - will delete the duplication.

aware that people tend to be told B12 should be at lhigh levels - however this seems to be based on quoting some remarks about B12 levels out of context - ie the context of having been treated for B12 deficiency caused by an absorption problem

That genuine B12 deficiency used to be me many, many moons ago, so I'm glad at least one side of things has been improved!

And yes, it's always better to be clear and take one's information from a relevant source. Best to check!

Thanks for your input,


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