Thyroid UK
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I'm considering going back onto levothyroxine after being on NDT since about March. I just feel like I'm getting know where as I can't get my labs right and can't afford to keep testing. Although I feel pretty good I do get odd days where I don't. My reverse t3 ratio wasn't right. And my 4pm cortisol wasn't right. Also my antibodies weren't which some suggested hashimotos . I feel I didn't have these problems before starting NDT . What my question is that if I do decide to go back on the levo can I just do a swap straight back to them...or maybe I could take some levothyroxine and some Ndt??? As when I first did the change taking a bit of both that's probably when I felt at my best by the way I have no thyroid

Many thanks

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My sympathy for you . How are you feeling on NDT besides your labs ? I don't know the conversion part NDT to T4 but I'm sure there are others that are very knowledgeable that can help you with it . I'm only speaking about my experiences . I dose with T4 and a small dose of NDT for my T3 mix . I tried synthetic T3 but had surges from it and found NDT to be much smoother for me . Nutrients are very important to make our thyroid meds to work well for us . Selenium ,B-12/folate Vitamin "D", Iron if needed it .

Best wishes on the next steps .

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rT3 can be a red herring. rT3 may be too high if you are overmedicated but can also be high if you are unwell. If you post your recent thyroid results and ranges I can tell you whether you are optimally dosed.

How you feel is more important than labs. If you feel better on NDT then don't worry about blood results as long as FT3 remains within range. You can swap straight back to Levothyroxine or you can take a combination of Levothyroxine and NDT. You will need thyroid blood tests to guide you but once dose is stable you should only require testing annually.

High antibodies means you have autoimmune thyroiditis (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.


Clutter are you able to view my lab results from previous post. Thank you for your reply. Think I'm just having 1 of my down days



On 3.5 grains TSH was suppressed, FT4 low which it usually is when on NDT or combination T4+T3, and FT3 is low in range. Most people will feel well when FT3 is in the upper third of range which is between 5.5 - 6.8. I would increase dose in 1/2 grain increments at 2 week intervals then hold at 4.5 grains for 6-8 weeks and retest TSH, FT4 and FT3 before increasing further. You don't have to spend £££s testing rT3.

Whoever told you rT3 21 is too high doesn't know what s/he is talking about. rT3 21 is within range so it's not too high.

rT3 ratio is not a guide to wellbeing - read this link

Thyroid peroxidase and thyroglobulin antibodies were negative for autoimmune thyroiditis (Hashimoto's) as Bluebug advised.

Active B12 >35 is unlikely to be deficient.

Seasidesusie has advised on the other vitamins and minerals.

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Clutter I can't thank you enough for taking the time to help me with this. I was getting very frustrated as I wasn't sure what to do. I've increased to 4grain today and will increase again in 2weeks. Thank you

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