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Thyroid UK
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Adjusting NDT dose from 2 grains to 2.25?

Hi there!

I'm struggling again with NDT dosing. It's been a long haul, since swapping over ( from 75mcg thyroxine plus 20 mcg T3) back in early August (so it's been 4.5 months on NDT).

My GP felt I had raised to 1.5 grains too quickly in the beginning (although it was raised over 6 weeks, I had added in some T3 also, on advice of my compounding pharmacist) and had me drop back to 1 grain for the 3 weeks. She wanted me at 1 grain for 1 month, but I was very hypo, so I continued with my raising (mindful of the danger of 'negative feedback loop???' From staying on low dose too long) So, more recently, I have been on -

3 weeks 1 grain (dropped back after raised to 1.5 over 6.5 weeks)

10 days 1.5 grains

8 days 2 grains

4.5 weeks 2.5 grains (4 days on 3 grains in middle, was too much so dropped back to


2 weeks 2 grains (after 4.5 weeks on 2.5 grains, I felt suddenly hyper, so dropped back to 2 grains)

Bloods drawn after 1 month at 2.5 grains were good (sorry I don't have them on hand) and doc thinks I may be optimal on 2 grains with 2.5 grains maybe twice a week.....I saw doc a couple of days after dropping back to 2 grains.....the clinic has the attitude that I am far too impatient, and want to see me staying on each dose for 4-6 weeks (to allow for full T4 conversion) Slow and steady......so she wants me on 2 grains now for 5 weeks then draw bloods.....she did say that I would probably feel 'a bit hypo' but DONT CHANGE dose.

I understand the need for patience, allowing for T4 conversion, but I also wonder about the negative feedback loop (Broda Barnes I think?) caused by staying on low dose too long.

After just over a week on the reduced 2 grains, I started feeling hypo, more and more each day. As it has been 2 weeks on 2 grains, I am tempted to increase to 2.25, and stay there for the 5 weeks....and risk GP irritation!

I am a single mum, and it's been 4 months of up and down, impacting our lives severely! I felt wonderful during the month at 2.5 grains, best I've felt in years, and am so disappointed to be back in the hypo horror again (though not so bad as the early days on 1 grain!)

Any advice would be greatly appreciated, thanks very much for this wonderful community, and happy new year!

Sophie x

5 Replies

As someone who got up to 3 grains and then uoldxto drop back to 1.75, which worked, I'd go slow and steady if I were you!


See if this guide helps:


1 like

What are your hypo symptoms? I am at 2 grains NatureThroid for almost two weeks and feeling very hypo. I was feeling good at 2 1/2 grains before, but probably needed to raise to 3 grains. The company got behind on production and caused me to have to try other thyroid medications, which were a disaster. When I could finally get NatureThroid again, I basically had to start over. My symptoms are jitters, crying, and insomnia. Are those the issues you are having? I don’t want to raise to quickly, but I can’t stand myself right now. When you hit your sweet spot and then it is taken away, it seems doubly hard getting there again.


Your last sentence is strangely true. That is why I had to give up on Levo. I had been perfectly stable for 5 years then my brand went "belly up" and I couldn't get that one anymore. I never did get a brand of Levo that worked again, I tried for two years getting sicker and sicker. I never really found out why. But that is history, I am on NDT now and I'm never looking back.


I understand! I am staying on NatureThroid and trying to be patient while I build my dose back up. The first time I got level, I was so sick and then all of the sudden I felt well after several weeks. I didn't know what I didn't know. haha Now that I know what it feels like to feel well, I am very impatient! Take care and I am glad you are doing better!


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