Up a 1/4 grain NDT? Or hold steady? 🤔

Hello good people of the forum

I'm unsure of the next step with my NDT dosage. About a month and a half ago I tried upping dosage to 1 1/2 grain (90mg) from 1 grain, but experienced an adverse reaction similar to hyper symptoms. However it now feels that 1 grain is just not cutting it and I have been sliding backwards with very low energy and other hypo symptoms. I feel under medicated, but don't trust my math on the correct T3/T4 ratio to look for.

Recent labs are:

TSH: 0.3 (0.4 - 4.2)

Free T3: 4.4 (3.7 - 6.9)

Free T4: 11.4 (9.7 - 25.7)

Should I push for just 1/4 grain higher and retest? It seems a paltry dose but I'm scared of the same reaction again!

Your thoughts appreciated! 🙂

[NatChap]

I used to increase by 1/4 grain a week so i think you'll be fine. If you are struggling to get your dose any higher it might be wise to get your cortisol levels tested. I had problems increasing when I got to a certain dose and found I had high cortisol. I started taking Holy Basil and after a while I was able to up my NDT dose without any issues. Also if you are low in ferritin it can cause issues so maybe get that checked too if you haven't already?

[Hidden in reply to NatChap]

Ferritin is very low so I have been supplementing, but perhaps not enough. Have been adding Rhodiola to regime but not familiar with Holy Basil. . that's one to look up. Still feel like I'm testing the water with Erfa so I appreciate the feedback from NDT users like yourself 🙂

[shaws]

NatChap has made good suggestions and going up by 1/4s is easier. If your pulse/temp goes too high on a particular dose, drop to previous one.

[Hidden]

Thank you for weighing in here RFU. TSH usually is suppressed with NDT, but those low numbers scare GPs with little experience in this medication 🙄 . I think splitting the dose is def worth trying tho as the 30 mg (1/2 grain) pill just does not split well at all!

[Hidden in reply to Hidden]

Hi spitting the dose maybe a good idea for you. I take 3 grains taken:- 2 in the morning and 1 grain in the afternoon. You could try it and see how it pans out.

[serenfach]

I have been fiddling with my NDT dose and thought I may be a wee bit overdosed on 3 grains. I dropped to 2.5 and after a month has a blood test. My results were much the same as yours, so I am now splitting the difference, and taking 0.75 at bedtime. (Wonderful colourful dreams!)

A new GP at the surgery happened to see my results and told me to come in and see her. I thought that the low TSH was what was worrying her, so I asked if there was a problem. She had diagnosed me with HypERthyroidism. I must admit I went into ice queen mode and slowly ripped her to bits, mainly because she had not bothered to read my file.

Anyway - back to your change in dose - yes, I would go up a bit and take stock of how you are feeling after a couple of weeks. It is a right old funny business, this!

[Hidden in reply to serenfach]

Hi after I had my thyroid removed the surgeon's letter stated that my TSH needed to be suppressed. It is now 0.005 and I feel fine I have had the same result for over one year now. I am in France and it's different maybe?

[NatChap]

I have to say that I have tried taking my dose all in one go and splitting it and honestly it made no difference to me. I find taking it first thing in a morning best as it makes it easier to fit in all my supplements (and meals and drinks) x