Thyroid UK
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Doses (grains) advice after thyroidectomy

Hi everyone!

Sorry for my English, I am Italian, so my English won't be perfect! ;-)

On the 26th April, so last week, I went through thyroidectomy because of a thyroid cancer (a TIR 3a then revealed as a cancer). Before this, I started to be cured with Nature Thiroid because I suffered from subclinical hypothiroidism with all the typical symptoms of hypotiroidism, but surgeons and endocrinologist want me to take Tirosint instead because they say NDT is not a good option being without thyroid.

I want to go on with natural dessicated tiroid because I feel it has a good effect on me.

Is there anyone that hasn't the thyroid anymore and now is living a good life taking nature thiroid? How many grains do you take to feel good?

I actually take 2 and 1/2 grains, how many do you take?

Has anyone switched from NDT to Tirosint or the other way round?

Thanks a lot for your kind help!


11 Replies

Welcome to the forum. Can't answer your question but wanted to say your English is very very good. It may help replies though if you have any recent blood results and the ranges on NDT before and after surgery. I would think that NDT best for you now but not talking from personal experience.


Thanks Silverfox! :-)



Welcome to our Great Forum . Your English is just perfect . I'm sorry you needed to have TT . You would need to run labs on FT3 , FT4 , TSH , RT3 , and with nutrients as well vitamin "D" B12/folate , ferritin . Based on your thyroid lab results will help with your thyroid meds dose . If I may suggest to journal your symptoms as well . Symptoms are very telling and very helpful . My Endo runs labs first but goes by symptoms mostly .

Best Wishes for a successful out come !

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Hello jgelliss! Thanks a lot!!


Hi Serena, hope you are recovering well.

I had a complete thyroidectomy with papillary cancer in May 2017. My doctor started me on Synthroid, but after 2 months I felt worse, and my TSH was rising, so my doctor switched me to Nature throid. I started on 1 grain and have gradually moved up by very small increments to my current dose which is 1 grain first thing in the morning and 3/4 grain in the evening. Total dose is 1 3/4 Grain a day. I always take it on an empty stomach, and I don't eat or drink coffee for at least 1 hour after I take my medicine.

It took 7 months to get to this dose which makes me feel the best. My doctor still takes labs every 8 weeks, but my numbers have finally stabilized. The t3 that is in Nature throid causes me to have a suppressed tsh, but my doctor does not judge the effectiveness by the tsh number.

My labs in April were

TSH 0.116 range (0.45 - 4.500)

T3 free 4.3 range (2.0 - 4.4)

T4 free 1.15 range (0.82 - 1.77)

I think your written English is very good. I hope you can find a method of treatment that works for you. Don't be discouraged because it takes time to get your body adjusted. If one treatment doesn't work after 6-8 weeks, be assertive and tell your doctor you want to try another dose or another medicine.

Best wishes,



Thanks a lot Janice for all the things and suggestions you wrote me!


I would completely disagree with your doctors who say that NDT is not a good treatment for someone who has had a thyroidectomy.

Your thyroid used to produce T4 and T3. The T4 would be converted to T3 as required in various other organs, as and when necessary. Conversion from T4 to T3 takes place in organs like the gut, the heart, the brain, the liver. Some organs are better at converting T4 to T3 than others.

If you are treated with Tirosint, which is T4 only, then you will only have the T3 you need from the T4 converting to T3. And quite a lot of people aren't good at it. And even if you are excellent at it, you would still be working with reduced T3, because you no longer have a thyroid which is producing any.

So, NDT, which contains both T4 and T3, is a much better mimic of normal thyroid function than Tirosint or any other T4 only medication.


Thank you humanbean! Yes, it's what I told them, that's why I decided to find a doctor who prescribes NDT. Thank you! :-)


Hi Serena. I had TT and radio iodine ablation 2016. While I felt ok ish on levo there was something missing and I have just managed to beg a t3 private prescription off my GP. I’d stick with the ndt if you can get it easily as do feel bit of t3 is necessary for us.

English is stunning!! 🌹

1 like

Thank you Hay! :-)


Serena, your English is great. I also had a thyroidectomy many years ago, and am on 2 3/4 grains up from a recent 2 1/2. My resting temp is now 36.5 perfect, and my heart rate is 78 again good. So this is what you want to look at: resting temperature and your heart rate. My hair is still not back to where it should be and I do itch often (skin and hair). We can easily go hyper, and that is just as bad as hypo; have to be right in the middle, good luck,

John (Vietnam)


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