Changed to NDT and still feeling very poorly and depressed.

[WinnieH]

I have been on Levothyroxine for 25 years but over the last 6 months have been feeling very unwell. I posted here a few months ago with blood test results and have since decided to go onto Nature-throid on my own as my drs. are just not even prepared to discuss it. I have read quite a lot but am still a little confused (ME brain!).

I really would like to know if I'm doing things right as I'm feeling increasingly depressed since beginning NDT and am seriously considering the anti-depressants my dr. is suggesting (but don't really want to).

I was on 100-125mcg T4. I dropped to 50mcg and added 1/2 grain for 10 days.

Then dropped the T4 altogether and added another 1/2 grain. After another 10 days added 1/2 grain. So am now on 1and 1/2 grain after 30 days.

I thought after just over 4 weeks I would be feeling a little better but can barely function and am weepy all the time.

I have had no side effects from the 1 and 1/2 NDT, e.g. no palpitations, sweating etc.,

I am taking Iron, B12, Folate, D3, Selenium and zinc.

Should I raise 1/2 again? and just keep raising every couple of weeks until I feel better.

Am I expecting too much too soon?

At what point would I wait and get blood tests done again?

Any advice from people who have been through this would be very welcome.

[marsaday]

Why would you not try the intro of a little t3 first instead of going over to nth?

Your body was and is still low in t4 and t3. The easiest course of action was to stay on the 100 t4 and then introduce some t3. Because you have cfs you will not be producing enough cortisol to meet your thyroid needs.

Nurturing the relationship between cortisol and thyroid is a key weapon to getting better.

If it was me I would have stuck to 100 t4 and then worked on the t3 increasing slowly and also introducing it in the early morning around 4am. This is a natural way to increase cortisol. You will find it hard to get better just by upping the nth. With the t4/t3 option you have more scope to play with the ratios depending on your cortisol availability. Over time with the correct thyroid level your cortisol will come up to meet your new thyroid level but this is a relationship which needs nurturing.

[WinnieH in reply to marsaday]

Hi Marsaday

Thank you for replying.

I did consider the addition of T3 over the NDT and decided against it for 2 reasons.

Firstly I have tried it before, about 5 years ago and couldn't seem to get past about 3mcgs without feeling 'jittery' and so didn't feel up to trying again. I was taking it about 9a.m. with my T4. At that time I was particularly poorly with ME and couldn't cope with the side effects.

Secondly I just felt NDT was a more natural way to go as it includes T1,2,4, along with T3 which I thought may be better for me. If I have it correct 2 grains of NDT has 18mcg of T3.

I do think my Cortisol is low although have not done a recent Saliva test. I did one through Dr. Myhill a few years ago and both Cortisol and DHEA were low and I felt the same then.

I can find very little information on introducing T3 but will give it some thought.

After 4 weeks trying to up NDT I don't feel it practical to go back to T4.

[marsaday in reply to WinnieH]

Trying a small dose of T3 and becoming jittery is indicative of low cortisol. This is the area which needs attention longer term.

1 grain = 36 T4 and 9 T3.

See how the NTH goes but if you still have problems the issue is not the type of thyroid meds you are taking but the ability of your body to use the thyroid.

Read Paul robinsons book on using T3, he talks about the issues of low cortisol. So many thyroid patients have this issue because low thyroid goes hand in hand with low cortisol usually. Using a little T3 at specific times can have big results. I would try it with your NTH, and take 1/2 grain at 4am.

This is a natural and easy way to increase our own cortisol production. Many don't notice improvements, but many do. It is worth tinkering with this method.

[Clutter]

WinnieH,

You are undermedicated. 125mcg Levothyroxine is equivalent to 2 grains NDT. I would increase to 2 grains and hold for 6 weeks and have a thyroid test including FT3 before increasing further. Ideally FT3 will be within the upper third of range.

[WinnieH in reply to Clutter]

Thanks Clutter. That's what I was considering doing but I'm also going to look at T3 again.

[silverfox7]

Just to add to what Clutter has suggested. Once you reach 2 grains then increase in quarters. I actually got up to 3 grains and realised that I was now feeling worse than I did a few weeks back. Endo tested and told me to drop down to 1.75 and to my surprise he was right! I found it very difficult at first as being slightly over felt the same as slightly under but now if in doubt I drop down a quarter to see if I am already over before I concider adding more!