Hi, I would like your advice changing from thyroxine to Nature Thyroid please.
I asked my GP if I could trial Nature Thyroid as for many years I have struggled with my thyroid. I am taking 150 mcg levothroxine and 10mcg Liothyronine. I collected the meds today and have been given 32.5 mg and 65 mg to be taken once a day. I have been told to stop my previous meds and to take the new pills.
My question is, do I start on the 65 mg for a few days then add the 32.5 mg or go straight into the full dose?
Many thanks in advance 😀
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Deb59
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The reason we go slow is to get used to the T3 but you have already been taking that but have you any results and rangesyou can share on your present medication as it may shout out other problems and I'm also confused by the different strengths between the two-are you sure thstcis right?
Deb59, your results show you are quite under medicated on your current dose - the goal is to get freeT3 into the top third of the range, and yours is in the lower third.
The dose you've been given is a substantial dose reduction. I'm saying this off the top of my head, but one grain of NDT is about 38mcg of T4 and 9mcg of T3. And T3 is about 4x as strong as T4.
In that case you might as well start on all of it. You may feel undernedicated even so, all though we're all different and the body processes all these things differently. I prefer the approach, when switching over, of starting a bit low, so you can rise slowly to your ideal dose. You will likely need several dose increases to get your freeT3 to the top
I have looked at conversion charts and they say 1 1/2 grains is the equivalent of taking 150mcg thyroxine. I am taking 65mg (1 grain) at the moment as I find taking the full dose is too much for me, I am sensitive to t3. Do you know if you can add thyroxine to nature thyroid dose? I seem to be doing ok on the 1 grain, but it's only my 4th day on nature thyroid and no doubt will need more as time goes on, but I just can't stand the racing heart etc. With taking the 1/2 grain. I was thinking of adding 25 mcg / 50 mcg of thyroxine??? Or do I just take it slowly and add the extra 1/2 grain in a month or so?
I think I'm aware of the charts you're talking about, I think they're a bit of an over-estimation of the strength in relation to Levothyroxine. Here's the working:
A grain contains 38mcg of T4, and 9mcg of T3. So because we know there is definitely at least 38mcg of T4, and the only thing under discussion is how potent the 9mcg of T3 is.
It's known that T3 is more potent than T4, but there is loads of debate as to how much more potent. I've seen published papers saying it's as strong as 10x, and also seen 6x, but patient groups consider it more like 3-5x as strong. Personally in my dosing I've always assumed 4x, but I've noticed the experts around ThyroidUK have started going even lower and assuming 3x
So in the end, if you call 1 grain equiv to 100 mcg, you're saying 9mcg of T3 is equiv of 52mcg of T4, so just under 6x as strong.
If you go with the thyroid UK consensus of about 3x the strength, you're saying that the 9mcg is equiv 27mcg of T4, so the 1 grain strength is about 65mcg of T4.
Using the rule of thumb I've always used, 1 grain is equiv to 73 mcg of T4.
This works out as quite a large difference once you start adding grains together! Although really all of this should be taken with a pinch of salt, because these are different chemicals that are processed differently by your body. These are just rough guidelines.
You can look at the actual amount of T4 and T3 in the tablets. Your old dose was 150mcg of T4, and 10mcg of T3, and your new NDT dose is 57mcg of T4 and 13.5mcg of T3. A tiny bit more T3, but a large reduction in T4. Even this isn't completely comparable, because these chemicals are bound in different ways in the NDT tablet, so will be processed slightly differently. Just as a guide.
I've also just noticed you were hoping they would be equivalent to 150mcg of T4. But if you change over to 150mcg of T4 that would be a considerable dose reduction in itself, because you used to also take 10mcg of T3, which is the equivalent of about 40mcg of T4, so quite a substantial proportion of your dose.
Started a new post to address the second part of your question - racing heart, etc. This is a very common problem with introducing T3, and its come up quite a bit on the forum recently with adjusting doses containing T3, for those that struggle with it.
This is thought to be an adrenal problem, with vitamins contributing. You've been on an extremely low dose for probably a long time, and your adrenal glands aren't able to cope with increasing metabolism.
The first step is to get copies of those vitamin tests and check they are optimal. Not just what your doctor calls 'fine'. You need ferritin, folate, vit D and vit B12.
The next thing you can do is get a 24hr saliva cortisol test. These aren't available on the NHS, so you'll have to self medicate with it. The ThyroidUK website has set ups of how.
And in terms of your current tablets, just go super slow. Take whatever dose you can have without getting a racing heart, stick with that for a couple of weeks, and then try to raise again. Cut up each tablet, and find out what size raise you can manage without racing your heart.
You may be better off returning to your old dose of T4 and T3, and making the change across very slowly. This is the recommendation for people who are starting T3 for the first time and can't manage it. Usually with someone who is already taking T3 the assumption is that they will do fine taking T3 in another format, but that hasn't worked for you.
Maybe go back to your old dose until the racing heart subsides, then get a razor blade and start cutting tablets very small. Reduce by a tiny piece of your T4, and replace it with a small piece of the NDT. Sounds like you've tried 1 grain and its caused racing heart. So maybe try the half grains and see if you can manage those. If not cut those in half and try those instead.
This is trial and error with finding a small enough increase to not bring on symptoms.
Make sure you drop off an equivalent amount of the old dose when you add something new. You can use the long post I just made about equivalencies to judge how to compare them!
Thank you very much for your reply, your time is much appreciated. I will follow your advice re dosing and I will get blood work done for the Vits/iron etc. I am really hoping the nature thyroid will work as my poor body has been through a lot! I am also reading up on low dose naltrexone and wondering if this will help with my antibodies and pain and all the problems Hashi presents us with. Trying out LDN will be further down the line once I have given nature thyroid a good go.
You're very welcome! Good luck! When we've been through a lot it can take a while to get everything in place. I've had a lot of success with Nature-throid once I got properly started, I hope you do, too
You can chuck them both down at once. It seems quite a low dose just 1.25 grains but that was all I needed at first I was on 125mcg levo so another 32.5 dose migh be needed but give it a whirl. I found it quite powerful compared to ThyroidS. They suited me very well - good luck ☘️🍀☘️
I have been on levothyroxine for years and I cannot say that I am really satisfied with my treatment. I might well have been better to have done what you are doing, but stumbling blocks such as GPs attitude makes it a mine field. Good luck with your efforts..
As nothing is seemingly dropping into place I would look at Vits and minerals first. I found whilst still on Levo that I had developed a conversion problem so I decided to address that first and foremost. Well you can't tell it that's a problem when you add the T3 into the mix as results are read differently. It took me around 5 months to get it right but then I found it really easy to change over to NDT although I missed my seeet spot! I was following the method of stopping Levo-remember that still leaves some T4 in your body and then very raise the NDT following the advice in STTM. I got up to 3 grains feeling good but not perfect but I was due a test so my new Endo did this and dropped my dose down to 1.75 after a few days without. I felt that would be too much. I had started NDT at the start of my thyroid journey given by the NHS and never had any problems though I don't have antibodies so may be thatchrlps. So starting again didn't worry me and I found the much reduced level was in fact right for me. I had been on 125/100 Levo. My biggest problem had been remembering to take the second dose so as I had not adverse problems I decided to try dosing in one go. So had missed my seeet spot as it was under 2 grain and then I dropped back to quarter grains as suggested but wasn't quite right. It was only then I realised I had felt OK briefly so that must have been when first moved to 2 grains from 1.5. I would get an up to date test done as well as a lot can happen from your test 3 months ago. Your racing heart may well be too much NDT. When in doubt now I always try dropping down firstcas it's the only logical thing to do. When I kept increasing I wasn't getting a better result and kept going up without any benefit so unwittingly I was adding to the problem but if you lower your dose and it feels fetter then you are going in the right direction. It it feels worse then dropping. Ack was not the way to go. Ok it takes time doing this but it's so easy, like I found, to keep raising. Take things very slowly and learn to listen to your body. Being on a higher dose previously doesn't mean you must do that again. You were 't experiencing wellness before so may have made the wrong decision some time ago. More doesn't always say better so bare that in mind. A
Thanks Silverfox, I too have a conversion problem. I am going to order adrenal plus vit/thyroid test. It's day 5 since starting Nature thyroid and This morning is the best I have felt for many years, not waking with brain fog and bad body aches is wonderful!! I even managed to have a good walk yesterday without the usual breathlessness, extreme tiredness. I asked my GP to do a prescription yesterday for 1/4 grain so I can play around with my doses over the next 3 months. Yes I will go slowly and I will take note of what you have said. I think this site is brilliant as I have learnt by other people's experience and advice. Thanks for your help 😀
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