I was on T4 monotherapy from 1997 to 2014.I started taking my basal temperature in 2012 after reading Dr Peatfield's book.I was on 55mcgs T3-only for 2 years(2014-216)& have had 2 short periods on the T4/T3 combo.I have been taking NDT since the end of August,raising by quarter tablet every 2 weeks.I have been using Ashwagandha for 5 weeks.
This morning my basal temperature was 36.5.This is the first time it has been above 36.2.
Still dealing with low energy but feeling I may be on the right track?
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Naomi8
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So maybe the ashwangadha is helping the temps ? I assume no thyroid medication has helped the temps before.
If the ASH is helping then the reason why you may be seeing some temp improvements is to do with the cortisol supply side of the equation as the AH will be affecting this level.
If people have highish FT3 and 4 numbers it indicates the thyroid is not being used and this is likely a cortisol issue.
my last Genova adrenal test was 2012 & I had 2 low(am),1 high(pm)& 1 in range(pm).This was during a 2 year depression with acute anxiety.I had a repeat episode last autumn & took Sertraline to re-boot my brain(very successful at a very low dose)
Now using Adaptogens,Nootropics & NDT(Nature-throid)Think I may be getting somewhere.Felt very well on T3 but lost huge amount of hair & then had the 2nd meltdown.I believe both episodes were connected to Complex PTSD triggering,which led to cortisol issues which affected my thyroid's ability to work effectively,as you say.
To improve cortisol generation it is best to take T4 at bedtime and maybe a little T3. Normally the T3 would be taken in the early hours of the morning, about 4am, to really boost cortisol generation. It just depends what amount of T3 you use.
If you felt well on T3, but then it went wrong i imagine it would be down to using too much. T3 is very powerful and many people over use it.
It could be worth trying very low doses of T3 to go along with the T4, but i think you are now using NTH so it isn't possible to use low dose T3 with NTH.
By low dose i mean the smallest size we can cut a 25 tablet into and this is approx 3mcg. It would be great if we could get 1mcg T3 tablets but they don't make them i think.
So you would initially start off using just 3mcg T3 per day and see how this went. Not relevant really for you know though, but i thought i would put it out there.
Thanks!You never know!I have plenty of Mexican T3 in stock as well as T4.At present I am trialling NDT.When I was on T3 I followed Paul Robinson's protocol for maximum benefit for the adrenals-taking my main dose more than an hour before getting up.This worked really well for me.Eventually I was able to take most of my T3 in one go at this time.
Marsaday: 1/4 grain of NDT only has 2.25 mcg of T3 (and 9.5 mcg of T4). There are some protocols (i.e. Dr. Blanchard) that call for VERY small amounts of T3 added to levothyroxine meds (he used a 98:2 ratio of T4:T3 meds). With a small amount of NDT + levothyroxine, one can create virtually any ratio of T4:T3 that they want. The Listecki-Snyder protocol uses a 13:1 ratio of T4:T3 meds.
I'm experimenting with a combination of NDT + levothyroxine now after 13-14 years on 100% T4 and several months on 100% NDT. I felt better on the NDT overall, but it still wasn't quite right (and I had symptoms of being overmedicated once I got my dose high enough to relieve other symptoms). Plus my cortisol and free testosterone went well below the range on NDT. This can happen when someone takes too much T3 (along with increases in glucose, SHBG, etc.). I agree that too much T3 is bad for many people and they may not even realize that many of their other labs are being altered in a negative way.
I have Dr Blanchards book and it is a great read. He confirmed what i had already found out for myself that LESS T3 did much more for myself. After reading his book i went down from 6.25 to approx 3mcg T3 per day. I also take 125 T4. At one point i was on 150 T4 and 50 T3 and eventually worked out a 1/4 tablet of T3 per day was the best dose for me at that time. Now i have discovered even LESS is better again.
I have been on all protocols and they all make me well, but not 100%, except for T4 and a little T3 and even now i will still try and tweak because with a thyroid/adrenal issue it is hard to be well all the time. A shift from summer to autumn always has an effect on me for example.
why don't you use T4 and T3 then ? This way you can get closer to the ideal ratio i think. For me i worked out 125 T4 was my best level of T4 only and the addition of 3 T3 has improved things even more. I actually haven't tried even less T3 so maybe i should have a go at seeing what 1.5mcg T3 is like.
I used to take 125 mcg of Synthroid only and my blood work numbers were always great but I still had some hypo symptoms (cold intolerance being the biggest one I have always struggled with). Then I went off the Synthroid and worked up to 3.5 grains of NDT. I probably felt better overall, but worse in some ways.
Right now I'm trying 1 grain of NDT (split into 2 doses per day) which gives me 9 mcg of T3 and 38 mcg of T4. I've added 75 mcg of T4 to that for a total T4 intake of 113 mcg. This is very close to the human physiological amounts of T3 & T4 that a healthy thyroid gland would produce (once you account for the fact that T4 medications have an 80% absorption rate at best). This is similar to what the author of the book "Tired Thyroid" recommends (she is not a doctor but has done excellent research as a thyroid patient).
If this doesn't work, I may try to reduce the NDT again to something closer to Dr. Blanchard's ratios (either 1/4 grain of NDT per day total or 1/4 grain 2x/day with breakfast and dinner to allow for a slower release and steadier levels all day long).
Can I ask, how do you know that the even smaller amounts of T3 work better for you? Have you noticed a definitive change in hypo symptoms as you've reduced your T3 dosages?
It would have been much better to try the addition of some T3 first. Being relatively stable on 125 T4 and adding in a bit of T3 would have been easier for the body to deal with.
I know smaller doses work better because i have tried it. I used to use 150 T4 and 50 T3 and then i started reducing the T3. I also found my last dose of the day (6.25) worked much better than the bigger doses in the rest of the day. So i just tried using less and less T3 until i was using 6.25mcg. Then i stopped it all together and just took the 125 T4 and stayed like this for a year.
I have discovered that adding in a little T3 improved things, but it had to be every so often and was no more than 6.25mcg.
Then i tried the lowest dose i can cut which is 1/8th of a tablet = 3mcg after reading Dr Blanchards book and now use this every day and it is even better for me.
I haven't tried it yet BUT i should look into using 1/16th of a tablet if i can cut it. See what this looks like.
I raised my NDT to 2 grains a week ago & am feeling overmedicated ,too.Felt undermedicated on 1 & 1/2 grains,so am likewise,going to lower my NDT back to 1 & 1/2 & add some T4.I was on 125mcgs T4 for many years.When on T3-only I got tinnitus on too high a dose.This has just returned when raising above 1& 1/2 grains of NDT,despite this only being 18mcgs.
I have read on here that the T3 in NDT is more "bio-available"& that 1 grain of NDT can be equivalent to 75mccgs-100mcgs T4,due to being more available to the body.I certainly feel like I'm taking a lot more than 18mcgs of T3.On T3-only I could take up to 55mcgs without feeling overmedicated.
I think in the real-world, 1 grain of NDT is closer to 65mcg of T4 for most people. The equivalency charts that the manufacturers put out will tell you 1 grain = 100mcg of T4 but that is nowhere close to accurate.
I'm of the opinion that if the thyroid gland only outputs 6-10 mcg of T3 per day (every source will quote a number somewhere in this range) that taking more T3 than this is not beneficial for most people (with rare exceptions). The total daily T3 output of the body is ~30mcg per day according to most sources, but 20-24 mcg of this comes from conversion of T4 - not directly from the thyroid.
In rat studies, they were ONLY able to restore rats to a euthyroid state in ALL tissues when giving the rats a ratio of T4:T3 that closely resembled what a healthy rat's thyroid produces (approximately a 6:1 ratio). No other ratio restored all the rat's tissues to a euthyroid state. Why then aren't we trying to replicate the human T4:T3 ratio? (11:1 to 14:1). Instead we give people 100% T4 (100:0 ratio) or NDT which contains a 4:1 ratio of T4:T3. Makes no sense.
We're all unique and we all convert T4>T3 a little differently, but it seems logical to me that we should be starting with something a little closer to what our bodies would be doing naturally if they were capable. This is exactly what I'm trying now. 1 grain of NDT (split over 2 doses a day - 1/2 grain with breakfast and 1/2 grain with dinner to slow the absorption) + 75 mcg of T4 in the morning (which should be about right based on my weight of 150 lbs/70 kg).
Additionally, absorption rates vary a bit between T4 meds and NDT or T3 meds, so you may need to ingest a little higher T4:T3 ratio than what the human thyroid produces naturally (T4 meds have the lowest absorption compared to NDT or T3 meds). The book "Tired Thyroid" talks a lot about this combination T4 + NDT approach. It's a good read in addition to Dr. Blanchard's 2 books.
Dr. Blanchard's model can be replicated (somewhat) with 1/4 grain of NDT per day + T4. If I were to try his approach (and I may if my current approach doesn't work), I would probably do 1/4 grain twice a day with breakfast and dinner (1/2 grain total) to keep the levels more constant. Taking with meals will also allow for slower absorption which is what Dr. B did by having a compounding pharmacy put NDT into time-release capsules.
I was thinking something similar as I saw Dr Peatfield a few months ago and he diagnosed me with adrenal issues. He put me on Adenavive and after years of fatigue, brain fog and a host of other hypo- symptoms, I'm finally starting to feel normal again. In fact some days are better than I've ever had in my entire life.
Dr Peatfield said I may need thyroid replacement too eventually but first to treat the adrenals as he said it was so obvious they weren't working like they should. I also have 8 cases of hypothyroidism and Hashis on my paternal side (there could be more but I have very little contact with that side of my family) so I really thought my thyroid was the issue. Dr Peatfield now wonders if I just come from a family of dodgy adrenals that progress into hypothyroidism because adrenals are more often than not, ignored by modern medicine.
I've felt so good just on Adrenavive, that I haven't bothered with trialling NDT although I'm aware I may have to in the future. Especially given my family history.
Yes,I had actually given up on raising my basal temp at all,believing that too long on T4 monotherapy followed by/causing adrenal issues caused it to be permanently stuck.During my 2 years on T3 I had a lot of sweating & flushing despite being 10 years past the menopause,but it didn't raise my temperature,even though I think I was taking a bit too much.
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Fluctuating temperature 
Basal Body Temperature
Wild Variations in Body Temperature
Low body temperature 
Advice about low temperature please
