have Hashis (10 yesrs) . on Levo 88.5/day. but no energy etc. Have not been able to successfully increase dose as become 'over medicated '. Tried aeveral times to add synthetic T3 but either cant get dose right or can't tolerate it.
I have some Nature Throyd to try - can you please suggest starting dose ? And whether to split or not. Also when I start it, if I feel over medicated should I carry on to enable body to get used to it, or stop it immediately?
Also don't understand what 'feedback loop ' is and how to deal with that.
many thanks
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Daffers123
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You said in your post, 11 days ago, that you couldn't tolerate T3 'in any form'. You do know that NDT contains T3, don't you?
Before attempting to change to NDT, you need to make sure that your nutrients are all optimal. It will not 'work', otherwise. But, if and when you do start, I think you should try half a grain, to begin with.
The feed-back loop is between the pituitary and the thyroid (to make it simple). When the pituitary senses there is not enough thyroid hormone in the blood, it secretes TSH, which stimulates the thyroid to make more hormone. When the hormone levels rise in the blood, the pituitary reduces its out-put of TSH. But, it's not an infallible system, so when you're on thyroid hormone replacement, it's best to ignore the TSH unless it goes high. And, if you're on NDT, the most important number is the FT3.
thank you GG. Since my last post I apparently now have problems with high blood pressure. ..was scouting around Internet for info on this...came across STTM info saying basically that many of us on T4 only will get high BP and indicating that adding some T3 is the answer. I think I just panicked as I so wanted T3 to work. Thanks for explaining the feedback thing. probably I should hold fire till BP and cardigans tests resolved.
High blood pressure is a symptom of low T3, I don't think it's anything specifically to do with being on T4 only. But, of course, if you're on T4 only and don't convert very well, your T3 would be low.
87.5mcg Levothyroxine is equivalent to 1.25 grains NDT. You could start by halving your Levothyroxine dose and introducing 1/2 grain of NDT to see how you tolerate it. After two weeks stop Levothyroxine and increase NDT to 1 grain. You can increase in 1/4 grain increments each week/fortnight. I would hold at 1.5 grains 6-8 weeks and have a thyroid test including FT3 before increasing further.
1.25 grains (47.5 mcg T4 & 11.25 mcg T3) or 1.5 grains (57 mcg T4 & 13 mcg T3) of NDT is roughly the "equivalent" of 80-100 mcg of levothyroxine, assuming T3 is 3x stronger than T4 (which is the conversion factor I would personally use). This is a much more accurate conversion than the manufacturer conversion charts which would tell you that the equivalent is in the range of 1 grain (or slightly less).
That said, most people need 2-4 grains of NDT for full symptom resolution according to most top thyroid docs. 2-4 grains is the typical NDT dose range for most patients according to MULTIPLE docs whose opinions I respect including: Dr. John Lowe, Dr. Henry Lindner, Dr. John A. Robinson, Dr. Dean Ward, Dr. Mark Starr, etc. with the "average" dose probably being somewhere around 3-3.5 grains (Dr. Mark Starr quoted this amount in his book). Some need less, some more. We're all individual.
Feedback loop: This is the reason it's hard to "supplement" with thyroid hormone. Even if your own thyroid can theoretically still output 75% of what it once could, here's the problem with supplementing: Let's say a human thyroid outputs 100 mcg of T4 per day. If your own thyroid could still output 75 mcg (there's no perfect way to measure this), you might think you'd only need to supplement 25 mcg. Well, this is wrong for a few reasons. 1.) We don't absorb 100% of the medicine we take. Levothyroxine absorption rates are 80% at BEST and probably closer to 60-70% for most people. 2.) Once you start taking thyroid medicine orally, your body senses a sudden influx of medicine once or twice a day (depending on how often you take it). These large doses of medicine cause your pituitary glad to sense an abundance of thyroid levels and sharply decrease TSH as a result. TSH stimulates your thyroid to make hormone. By taking a smallish dose of meds (less than the full replacement dose), your thyroid will slow its own production of hormone way down due to this feedback loop - the pituitary gland is no longer calling for increased production. As a result, you may end up MORE hypothyroid than when you started after a couple of weeks of medication (it takes a few weeks for things to stabilize). For this reason, many have to either take FULL REPLACEMENT doses of thyroid hormone or none at all. On NDT, this could be 2-4 grains according to many docs. More conservative docs and manufacturer conversion charts will tell you that you need much less than this. Again, you may require more or less - we're all individual.
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please advise/help on my blood test. Want to try T3. Thanks
How to take NDT, advise needed.
Stick with T3 or try NDT
Anxiety trying to change to NDT
