More bl**dy questions : Hi everyone. I’ll try and... - Thyroid UK

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NickP1 profile image

Hi everyone. I’ll try and be brief.

Currently on NDT, total thyroidectomy, hashimotos. went from 150 T4 to 2 grains NDT.

Couple of weeks was feeling tired in the afternoon so in my infinite wisdom added about 7mcg of T3 taken in the afternoon. Have to say I had a surge of energy. Started to feel a bit wired after 3 days of this so stopped. Following week had a blood test.

Can’t remember the exact figures but T3 was slightly over range T4 was only a little higher than T3 and also slightly under range. Over the last week I’ve started to suffer from slight vertigo energy has dropped and brain not pin sharp. . I’m assuming T3 was high due to the extra T3 I had taken in the afternoon.

My question is should I add T4 to NDT to bring up T4. Increase NDT, add a lower dose of T3 in the afternoon or is the increase energy when on T3 telling me I’m better off going over to T4 and T3.

I don’t want to keep swapping and changing but I do want to be the best I can.

Thanks in advance.


16 Replies

....are you saying your t3 was over range and t4 low/under range?...that's the way I am on ndt.. ,and to get t4 up it sends t3 into overmedication. I keep being advised that t4 doesnt matter about being low when on ndt or t3 as long as t3 is good,but I've not felt right all the way up to top of range T3 and overmedication! I've just read a book that states that for some(not all!) need a good level of t4 is to feel well and that would be more in line with a human thyroid and less like a pigs. Once I've settled back on a lower dose ndt again I'm going to try adding some t4 and see if I feel improvement that I haven't yet felt on ndt alone even though my vitamins and iron are ok.Tiredness and brainfog can be a sign of overmedication as well as undermedication ..perhaps your t3 needs to come down a bit and t4 up?apologies if I read it wrong...

NickP1 profile image
NickP1 in reply to Lozzer66

Hi Lozzer thanks for replying.

Just don't feel 100% at the mo. I had vertigo for a long time last year. It has come back in the last week, also feeling cold. Basal under temp last night was 35.5. I know this is not reliable as far as doseage but it does seem low...

Something else which is slightly weird is the outer third of my eyebrows had started growing back on NDT but have started thinning again and itching like hell..

shaws profile image
shawsAdministrator in reply to Lozzer66

You cannot compare blood tests if on NDT or on T4.

Levothyroxine is inactive and has to convert to T3. NDT contains T4, T3, T2, T1 and calitonin. Blood tests were invented for the use of levothyroxine alone so cannot be compared when on NDT or the addition of t3.

NickP1 profile image
NickP1 in reply to shaws

Hi. Thanks fo the reply.

'Can’t remember the exact figures but T3 was slightly over range T4 was only a little higher than T3 and also slightly under range'

Either that doesn't make a lot of sense, or they're very strange ranges. Or, did you mean that the FT4 was slightly under the top of the range?

Normally, it doesn't matter much where the FT4 is when you're taking T3, because the body only hangs on to what it needs, and it doesn't need as much as when you're taking T4 only. And, the ratio of T4 to T3 is irrelevant when you are hypo, because you have different needs to someone who is euthyroid. In short, you need what you need, not more and not less. So, trying to raise the FT4 to a certain number can be a fruitless, frustrating exercise.

I don't think the surge of energy was telling you anything much. If you went on to T4 + T3, what would you take? It would be difficult to take exactly the same dose of each as in NDT. Although you could try 75 mcg T4 - which would be a slight increase in T4 - plus 1 x 25 mcg T3, which would come to more or less the same as taking 2 grains NDT plus 1/4 x 25 mcg T3, which was too much. If my maths is correct - which I won't guarantee! lol I don't think I've been very helpful, have I...?

NickP1 profile image
NickP1 in reply to greygoose

Hi Greygoose thanks for the reply.

I don't have the blood results in front of me now so these figures are a bit of a guess.

T3 8.3 range 3.3 to 6.4

T4 9.5 range 12 to 22

TSH 0.2

And every answer on here is helpful in its way :-) thanks again

greygoose profile image
greygoose in reply to NickP1

Oh! I see what you mean! It would have been better to just say your FT4 was under-range. Not half as confusing! lol No, it often is under-range when you're taking NDT.

I was going to ask the time question, but I see Clutter has already asked it. Looks to me like you took your NDT too close to the blood draw. :)


How long did you leave between last dose and blood draw? If you took NDT prior to your blood draw that would cause FT3 to be over range. It doesn't matter that FT4 is low as long as FT3 is good.

NickP1 profile image
NickP1 in reply to Clutter


It was over 12 hours between dose and bloods.

Clutter profile image
Clutter in reply to NickP1


You are overmedicated then and need to reduce dose to keep FT3 within range.

NickP1 profile image
NickP1 in reply to Clutter

I need to get to a baseline again and stop fiddling.

Clutter profile image
Clutter in reply to NickP1


If you had already stopped taking 7mcg T3 a couple of days earlier then try reducing NDT by 1/2 grain.

NickP1 profile image
NickP1 in reply to Clutter


Nick those bloods are almost identical to mine when overmedicated and although I didn't lose much eyebrow I have lost lots of hair on my head which came with incredible itching and tingling!...this was pretty recent and I was only taking 2-2.5 grain when it all began....I'm back to taking 1.75 at the momen! My temperatures were also dropping low but ironically shot up to 37/38 degrees when I went a week without meds to get t3 down .I'm still not convinced over the low t4 thing not mattering. .I have been speaking to a few people on here recently who have only improved when they added a little t4 to their ndt (which they could not achieve by adding more t4 in the ndt as that then would go over range or ot would simply 'feel too much t3'.In the book I read "tired thyroid " she explains she only got well on ndt by adding t4 and that's when her hair grew back and her brain fog went.Of course we are all so individual but this is the next route I'm going to try myself !

NickP1 profile image
NickP1 in reply to Lozzer66

I’m struggling a little with what is considered normal when on NDT.

I’m assuming normal ranges are as they say, these should be where your T3 and T4 should be when there is no problem. I understand T4 is converted into T3 as and when needed. But I can’t believe the body would produce something that it doesn’t need for it to be converted into something it does. I.e T4 to T3. There has to be a use for T4 as well. Which for me means NDT doesn’t give you every thing the body needs if it gives you T4 under normal range.

Or am I completely barking up the wrong tree.

Lozzer66 profile image
Lozzer66 in reply to NickP1

I completely agree with you and I've been reading recently it definitely has a function and we have t4 receptors .All the way up to high and over range T3 I have still not felt well ...and there's many like me who have bottom t4 and top T3 but still don't feel well when all other things have been adressed! Some on ndt end up adding t4 if it's bottom end and do feel better and that's a fact!

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