NDT- ERFA 'HELP!!

[Tanny123]

Below is a table of my blood results, November is when I started taking ERFA. I was not weened of Thyroxine, was just told to stop it and go straight on NDT. My private Endo started me on 4 Grains a day, this totally blew my head off! Reduced to 2 Grains a day. whole Grain at 7 am, half a grain 11 am and half a grain 3.30pm. Nearly 4 months down the line I feel no better. I actually feel worse. I have persevered in the hope that one day I will awake to feel less exhausted! He also would like me to start a drug called NALTREXONE. This drug will give me energy he said. Still waiting for a prescription. Surely this defeats trying to sort out my Thyroxine levels? ( I have no Thyroid 24 yrs now) Can anyone please give me some feedback on my levels (below) and also if it is worth persevering with ERFA. I just don't feel very well exhaustion, puffy eyes, hair thinning, skin dry, can't sleep. Foggy mind, Dizzy spells. I was on 150 mcg of Thyroxine for 20 odd years...

Thank you x

TSH mIU/L [0.3 - 3.94] - T4 pmol/L [12.3 - 20.2] T3 0.9 - 2.5 nmol/L

03 Nov 2017- 0.23- 26.5- 5.6

06 Dec 2017- 0.02- 22.7

12 Jan 2018- 0.01- 14.7-

8 Feb 2018- 0.11- 10.9- 6.3

[Clutter]

Tanny123,

How long did you leave between last NDT dose and blood draw?

[Tanny123 in reply to Clutter]

Hi Clutter, 4 hours

[Clutter in reply to Tanny123]

Tanny123,

The T3 in NDT can peak in the blood for up to 6 hours so that may explain why your FT3 is so high. I don't think you can be overmedicated on 2 grains with no thyroid and would expect to see TSH much lower if your normal circulating FT3 was really 3 x over range. What this means is that we can't be sure that 2 grains is enough Erfa.

I can only suggest you continue taking 2 grains and retest in 6 weeks after leaving 8-12 hours between last dose and blood draw.

Hypothyroid patients are often low or deficient in ferritin, vitamin D, B12 and folate which can cause fatigue, musculoskeletal pain, low mood etc. similar to hypothyroid symptoms. Perhaps your GP can test them when you have your next thyroid test.

[Tanny123 in reply to Clutter]

Thank you, Clutter, ferritin, vitamin D, B12, and folate were all Normal back in January. I still felt much the same! Will I get through the day without my grain? 8-12 hours seems a little long! Due to see Endo in 6 Wks

[Clutter in reply to Tanny123]

Tanny123,

'Normal' is a very broad range in all of them. Where in range is important. Ferritin 14 and 299 are both normal in range 13 - 300 but I'm willing to bet the patient with ferritin 13 is likely to be iron deficient.

Arrange your blood draw early in the morning and take your first NDT dose after the blood draw. You manage from 3.30pm until 7am so an extra couple of hours shouldn't make any difference.

[Tanny123]

Thank you, Clutter going to recheck my blood results to see what my ferritin measured