Thyroid UK
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Blood Results; T3 or NDT? And how about LDN?!

Blood Results; T3 or NDT? And how about LDN?!

Hi All,

I've just received my blood test results from Medichecks, and was wondering if you could advise on whether to go the T3 or NDT route in terms of trying something to help the pain/ brain fog/ memory issues/ exhaustion? I'm in and out of bed like a yoyo at the moment and it's the first day of the school holidays tomorrow - argh! I am really not coping with life as I'm mostly housebound at the moment and I'm huge amounts of pain/ braindead-ness (as you can tell from my choice of words!)

This is what the Medichecks GP wrote just now -

"We note that you are taking this test to monitor your hypothyroidism for which you take levothyroxine.

Your thyroid stimulating hormone is in the upper half of the normal range and you have a low normal level of free thyroxine. Some people who are taking thyroxine feel better when their thyroid stimulating hormone is maintained in the lower half of the normal range. I gather you are experiencing problems with your concentration, energy, memory and that you are experiencing some pains. A slight increase in your levothyroxine may help with these.

Your FT3/rT3 ratio is low which could suggest that you are not getting sufficient free triiodothyronine (FT3) into your cells. There is currently little scientific research into the FT3/rT3 ratio, but some experts believe that this could lead to symptoms of hypothyroidism (slow metabolism) even though your thyroid hormones are at normal levels.

You may wish to discuss these results with your GP although you should note that it may be difficult to get advice and treatment for elevated rT3 or an abnormal ratio through conventional channels.

I also recommend checking your vitamin D levels to ensure that these are not low as this can also cause the symptoms that you describe."

Since these tests I've already been taking Vit D, ferrous fumerate for my low Ferritin levels, and B12 too (see my previous post - thanks all for your help translating them). I am aware of the protocol of how and when to take which vitamins/ minerals and around Levothyroxine.

I am currently taking 75mcg Levothyroxine.

I have in the past made progress on the Nutri Thyroid supplement which contains animal thyroid, so am instinctively drawn to the NDT side of things.

I already have Tiromel T3 in my possession and Thiroyd [sic] NDT is due to arrive later this week/ next week. So I am prepared for either path! Or maybe both can be taken?

Please advise me on what to do next with regards to which medication to follow, when/ how to take it, and... anything else you can think of - especially as I occasionally take Tramadol for pain at night

Also, I am preparing to start LDN for the ME/ CFS side of things - as well as hypothyroidism - and clearly don't want to do too much at once as it would be good to know what is and isn't working.

However, it would be still useful to know how to fit LDN into my new regime you're all going to design for me!

With much gratitude in advance for all your support and knowledge,


4 Replies


You are undermedicated. If you were optimally dosed on Levothyroxine FT4 and FT3 would be higher and TSH lower. However, increasing Levothyroxine will almost certainly raise rT3 so I would add some Tiromel to your current Levothyroxine dose. I would quarter the 25mcg tablet and add 6.25mcg to be taken with Levothyroxine. Give it a couple of weeks to see how you tolerate T3 and, if necessary, add a second 6.25mcg dose at bedtime. I would hold at 12.5mcg for 6-8 weeks and have a thyroid test including FT3 before increasing further.

What level was your vitD and how much D3 are you supplementing?

I can't advise about LDN.

1 like

Thanks SO much for your help.

So, to confirm: stay on 75mcg Levothyroxine for now, and add in T3 as you mentioned, above, starting with taking the Levothryoxine and Tiromel at the same time?

And No NDT? (Again, just checking).

I didn't get my Vit D checked this year so have no official levels to share, but am always told by my nutritionist friend (who first told me my initial bloods last month were out of kilter, leading me to this website), that I should be necking 5000 Vit D3 daily. I haven't been taking any this past year because I had my incapacity benefit taken away and didn't have any money for supplements.

But I've gone into debt for all these tests and meds and have some Vit D3 supplements as of last week, which I've re-added into my supplements regime since the tests, above.

Thanks again for your time :-)



Yes, 75mcg Levothyroxine + 6.25 - 12.5mcg T3.

No to NDT while rT3 is high. Adding the T3 to Levothyroxine should help 'use up' some of the unconverted T4 which is raising rT3.

Your nutritionist friend should have advised you to check vitD level before supplementing 5,000iu which is a high dose because your dose should be guided by your levels. I was prescribed very high loading doses which corrected deficiency. I stopped supplementing for a couple of months and then resumed supplementing 5,000iu daily. 9 months later I had toxic levels of D3 but luckily didn't develop kidney or bladder stones or other adverse effects. Since then 5,000iu per week for 9 months of the year and around 10,000iu per week 3 months has maintained my vitD level between 87 - 120.


Absolutely. I'm not supposed to be on Vit D3 at 5000 for long, it's just to get levels up because like I said, I've just been off it - and everything else - for a year.

So, your story is a good reminder to keep an eye on the high dose and check levels with a blood test soon!

Thanks Clutter, will keep an eye on it :-)


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