Thinking about switching from Levo to NP Thyroid - Thyroid UK

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Thinking about switching from Levo to NP Thyroid

Rachel357 profile image
13 Replies

I currently take 31.25mcg of Levo daily. I started on 25mcg a year ago and about 6 weeks ago I increased my dosage by a quarter of a tablet. I have never felt well since taking Levo and would like to change to NDT.

Please could anyone advise me on the equivalent dose that I would need to take of NP Thyroid?

Thank you.

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Rachel357
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SeasideSusie profile image
SeasideSusieRemembering

What are your current thyroid test results?

25mcg is a very small starter dose, usually for children, the elderly or patients with heart problems. To have only just increased to 31.25mcg is ridiculous, that should have been done 6-8 weeks after originally starting Levo. And it is still a very small dose. An average dose of Levo is around 100-150mcg, with a lot of people on more.

Before considering whether NDT is the right way to go, you need to be on a decent dose of Levo and see what your results are like. So please post your most recent results, with reference ranges.

Also, if you have had thyroid antibodies tested and Vit D, B12, Folate and Ferritin, please post those also.

Rachel357 profile image
Rachel357 in reply to SeasideSusie

Hi, these are my results from last month:

TSH 1.41 (0.27-4.20)

Free Thyroxine: 18.7 (12.00-22.00)

T4 100.0 (59.00-154.00)

Free T3 4.98 (3.10-6.80)

Thyroglobulin Antibody: <10 (0.00-115.00)

Thyroid Peroxidase Antibody: <9.0 (0.00-34.00)

Active B12 103.3 (25.10-165.00)

Folate 18.35 (2.91-50.00)

Vitamin D 147 (50.00-200.00)

CRP- high sensitivity 2.3 (0.00-5.00)

Ferritin 23.9 (13.00-150.00)

I have been taking an iron supplement and eating chicken liver once a week since I was tested.

Thank you.

SeasideSusie profile image
SeasideSusieRemembering in reply to Rachel357

Your results actually look pretty good for such a low dose of Levo, and your conversion of T4 to T3 is spot on. Good conversion takes place when the FT4:FT3 ratio is 4:1 or less and yours is 18.7/4.97 = 3.75: 1

The only thing I would say about them is that most people feel best when TSH is 1 or below with free Ts in the upper part of their reference ranges, and that would be 19+ and 5.9+ Personally, I would try a slight increase in Levo to get your results to that level and then see how you feel.

Folate could do with a slight nudge up, at least half way through range is best so that would be 26.5+ (a good B Complex will take care of that and is recommended for us Hypos anyway) and of course your ferritin needs to be at least 70 so that needs continuing work. Has your GP seen your ferritin result? I would be wanting an iron panel and full blood count with that level to see if there is iron deficiency anaemia.

Rachel357 profile image
Rachel357 in reply to SeasideSusie

Thank you for the advice. Last year my TSH was 0.98 and free T4 was high and I still felt quite unwell.

My GP didn't think there was anything wrong with my Ferritin result. I had a full blood count not long ago and that was fine, so she didn't think that I needed an iron panel tested.

I sent you a message with my blood test results in January and you suggested that I increased my dose to 31.25mcg. Do you think i should increase my dose by half a tablet instead of a quarter? Do I have to wait until after I have my next blood test in March to increase my dose? Thank you.

SeasideSusie profile image
SeasideSusieRemembering in reply to Rachel357

So the results you've posted here are from on 25mcg and not 31.25mcg and you don't actually know what your results are on the increased dose?

How long have you been on the extra quarter of a tablet? If it hasn't been 6-8 weeks you may not yet be feeling the full effect although it is such a small increase it may not have made a lot of difference - it's hard to know because you seem to be doing OK on a small dose anyway so a small increase could make a lot of difference in your case.

Rachel357 profile image
Rachel357 in reply to SeasideSusie

I've been taking 31.25mcg for the past 5 weeks. The results are from when I was taking 25mcg.

SeasideSusie profile image
SeasideSusieRemembering in reply to Rachel357

Then you may not have yet felt the full effects of the dose change and you don't know your current levels. It takes 8 weeks for me to stabilise after a dose change.

If your GP is doing your blood test in March you could see what your levels are like then and how you feel, then maybe there will be some wriggle room to increase your Levo and you can see how that goes.

Rachel357 profile image
Rachel357 in reply to SeasideSusie

Ok thank you.

Clutter profile image
Clutter

Rachel357,

How on earth do you achieve a dose of 31.25mcg Levothyroxine?

1/2 grain (30-32.5mg) NP is equivalent to 32.5mcg Levothyroxine.

Rachel357 profile image
Rachel357 in reply to Clutter

Thank you.

I use a pill-cutter to cut the 25mcg into quarters.

As others have said you are on a very low dose oflevo and levo does work well for most people.Changing to NDT will be an added cost and recently both T3and NDT have had supply issues that can be very stressful and harmful if you are unable to obtain your usual medication. Levo is reliable and free.

You blood results do look good considering how low a dose you are on but ideally your T4 needs to be at the top of the range even if this means your TSH is suppressed. There is room for a small increase of levo I would say.

Rachel357 profile image
Rachel357 in reply to

Yes I'm put off by the cost of NDT and how it's difficult to obtain. Since I've been on Levo I've had symptoms which I didn't have before taking it. One sympton which is strange, and doesn't bother me too much, is that it makes my stomach stick out and it feels hard. It happened as soon as I started taking the Levo and I was really skinny at the time. I stopped taking the Levo for a few days last year and my stomach went flat and the day after I started taking it again my stomach was hard and sticking out again. I don't know if I should be concerned about this.

weird symptom. You could maybe ask for a different brand of levo and also you might be able to get liquid levo which I believe tends to have better results. Someone called diagones posts a lot of reasurche on here a did post something about liquid levo being more effective recently. Us thyroidly people are very sensitive about additives and stuff in our medication so another formulation might suit you better. I don't think tummy is anything to worry about but it is a strange one.

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