NDT to thyroxine

[fixit]

I have been on 3 grains of NDT for 5 years and am toying with the idea of switching to Thyroxine. I have tried various brands and various doses and I just wonder if the balance of T3 in NDT is too much for me. On NDT I feel really hot all the time & have diarrhoea. Has anyone successfully switched from NDT to Thyroxine?

[shaws Administrator]

You should be able to switch from one to another quite easily. Depending on the dose of NDT usually it is said 1 gr is approx 100mcg of levo. I'd take a bit less of levo to begin with. Also take note of the symptoms you still have and as they are resolved that should be your optimum dose.

[fixit in reply to shaws]

Thanks shaws

[RedApple Administrator]

fixit, Sounds as if your dose of NDT might be too high. Have you had FT4 and FT3 tested recently? If so, post the numbers

If you think the balance of T4/T3 is wrong for you, you could try reducing your NDT and adding some T4. It would probably take some trial and error to find your best dose regime, but worth a try rather than jumping to a total swap.

[fixit in reply to RedApple]

Maybe I will try that first RedApple. I regularly test my bloods but even when they look good & are within range I don’t feel well.

[RedApple Administrator in reply to fixit]

Can you post your most recent ones?

3 grains is actually quite a high dose. If you post your last set of results, members can offer suggestions as to how much T4 to add and how much NDT to take away

[Kell-E in reply to RedApple]

I thought 3 to 5 grains was an average dose?

And official charts aside, there is no way that 1 grain is bio-equivalent to 100mcg levo.

[RedApple Administrator in reply to Kell-E]

Many people do better on a lot less than 3 grains.

It's not actually possible to get a true bio-equivalence because it depends so much on the individual and how they respond to the T4 and T3 content of the NDT, as well as the brand of NDT itself. Having said that, I usually guestimate 75mcg levo to 1 grain of NDT.

[RedApple Administrator in reply to RedApple]

So, if you take 75mcg to be roughly equivalent to 1 grain NDT, then 3 grains would be around 225mcg levo. Most people do not need such a high dose.

[Kell-E in reply to RedApple]

I was previously on 150mcg levo. TSH suppressed, fT4 at the very top of the range, fT3 slightly above bottom of range. When I switched to NDT I was taking 2 grains and my fT4 was below range, my fT3 was rock bottom in range. So, when you look at the math those doses should have been approximately the same. But not so, in my body at least.

[RedApple Administrator in reply to Kell-E]

We all have our own unique digestive systems, so absorption will vary from one to another, even ignoring the difference between brands. The T4 and T3 in NDT are bound together so that can affect how it's absorbed too. Hence any equivalence dose should be taken as a starting point only. Generally better to err on the cautious side than dive in at the deep end immediately.

FT4 at or below bottom of range is quite common with NDT, which is why some people do better by adding even a little T4 (e.g. 25mcg).

[KT77 in reply to Kell-E]

Interesting. I'm on 2 grains ndt too. Ft4 below the range, t3 low in the range and yet feeling 2 grains is more than enough for me. Can't raise any higher. I'm gonna add levo to my ndt and see if the blood test look better. Are you still taking 2 grains?

[Kell-E in reply to KT77]

How do you feel on 2 grains?

[KT77 in reply to Kell-E]

Good but jittery : ) Tried decreasing but felt tired. Feel like too much t3 in 2 grains for me. I could be wrong though.

[Kell-E in reply to KT77]

I don't believe that the low T4 is anything to worry about when taking NDT. Though some feel better with T4 added. I do wonder if your adrenals are robust enough for the T3 in NDT. If you've been hypo for a while it may take them time to recover.

[saroseox]

You could be young for all I know but im 25 and have menstrual/hormone issues. Around periods I often have hot flush as though its a menopause symptom.

Have you tried a different brand of NDT? It may be that you are taking too much or that one of the fillers is having an effect on you. How long have you had the problems?

Ive just moved from thyroxine to NDT and I wont ever go back after feeling so vile from levothyroxine.

[Rapunzel]

Hey fixit, I thought you'd fixed it! Is this any help ? Read across...

thecompounder.com/thyroid-c...

I thought I might reintroduce 25mcg levo about 2 years ago...cue rheumy intensely painful fingers inside of a week... As RedApple says we're all different. Good luck whatever tinkering you decide on