Transition from T4 and T3 to NDT: Hi all, I’m... - Thyroid UK

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Transition from T4 and T3 to NDT

Hi all,

I’m currently taking 29mcg T3 (sustained release and standard) plus 150mcg T4 daily and feeling pretty good. My bloods are stable and showing optimum in range for T4 and T3.

I have just ordered an updated blood test from medichecks which I intend to take prior to transitioning.

I have bought some NDT and would love your advice/experiences of moving over. Dosing intervals etc.

I’ve worked out that 150mcg T4 is = to 4 grains and 29mcg T3 = to 3.25 grains.

Any thoughts on how much to take?

I’m thinking I can just stop one protocol and begin the other as I’m already on both?

Thanks :)

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I'm on a very similar status like your starting point. I've also wondered "what if..." in relation to NDT switching.

I have no real input for you but will keep on eye on this topic and would appreciate also updates after you start with the switched HRT.

Thanks,

C.

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Ha ha, yes of course I’ll keep you posted! Where are you in uk?

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Thanks! Not even close to the UK....Romania :)

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Not exactly close!! 😂

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If you are feeling pretty good on your present dose, I don't know why you want to change.

I also don't know how you have worked out your dose as 100mcg of levo is around 1 grain of NDT (in its effect). 25mcg of T3 is around 100mcg of levo.

You can switch from one to another.

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Thanks shaws, I’m taking both t4 and T3 currently, so was working out both elements based on the amounts shown on the website I bought from. They stated 1 grain equates to 9 T3 and 38 T4 for their product.

I’m looking to change as doing so will save me around £1000 in medical and hormone costs per year, so now I’ve found a stable dose it’s a good time to try transition. If it doesn’t work for me I’ll have to go back to the expensive route, but I’d much prefer not to!

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I get T3 , Tiromel, for £21 for 100x 25 mcg tablets from Turkey...have you thought about cheaper form of T3 long term?

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It is not the 'numbers' in the tablet but the 'effect' of the T3 within it and T4 converts to T3. T3 is the only Active thyroid hormone. T4 is inactive and has to convert to T3 - we have millions of T3 receptor cells in our bodies and all need T3. This is a better explanation of conversions and many have made similar errors and wonder why they are feeling worse:-

getrealthyroid.com/conversi...

It's better to be cautious and always take note of how you are 'feeling'. When you reach an optimum dose for you - you should have no clinical symptoms and feel you have 'normal' health. You can increase tablet by 1/4 every two weeks taking note of pulse/temp before beginning and when adjusting and if either goes too high drop to previous dose.

I certainly don't blame you for trying to ease the cost of your treatment.

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@shaws you are basically right, if feeling rather good, why switch ?!?

But please don't forget that this very restless struggle & search got us here, both as status (better than yesterday) and as community.

I would deem his quest as legit. :)

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I am not saying he doesn't have a reason and he has explained it it is the cost and I am not disagreeing with it. We all know how difficult it is to get to a dose which suits us and a sensible question is 'why change'.

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Sadly, yes.

It takes a lot of courage to switch while stable, especially after facing years of misery due to ineffective treatment.

I have also given a lot of thought in doing so myself and can confirm it's not easy to decide and act on it.

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I wish you well and I know we can reach a plateau as I have gone through all of the stages from remaining undiagnosed, feeling far more unwell on levo and if you've never been ill before it is a whole new and horrible time. Doctors seem to be completely unaware what is going on below our skin and are also unaware our whole body from top to toe is affected. :)

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1 grain = 36 T4 and 9 T3mcg.

So 4 grains = 144 T4 and 36 T3

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Thanks! It’ll not quite equate to what I’m on, so I’ll see my blood results and make a call on whether to go as high as 4 grains initially :)

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I would be more inclined to stick with the T4 / T3 and adjust the T3 to suit. Firstly i would be looking to go downwards as you are on quite a lot of overall meds.

Some people need a very different ratio of T4:T3. Some need more T4 and less T3, some need more T3 than T4. This is an area you can work on to help fine tune your meds.

The bloods will help guide you, but the aim is to have the FT4 at the mid to higher teen level and the T3 in the higher third area. This is usually in the 5's.

The TSH isn't going to be useful when on the T3.

If you have never used a small amount of T3 with the T4, this needs to be tried. So many people go straight past their sweet spot because they jump onto what they think is a low starting dose of T3, but really it is a lot.

A good starting dose of T3 is 2.5 - 3mcg per day. Have you every tried using these small amounts ?

If you are still not balanced it maybe worth trying.

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I am in the uk but I had a brilliant Endo who helped me with taking NDT but after one year he went back to Romania! He was over here on his own with family back home and he loved the hospital but not the place plus he would no doubt be missing his family as well.

I know it's a long shot but I'll PM you his name in case he is 'just down the road'. I realise we can be all different but I was previously taking 125/120 T4 and he stabilised me on 1.75 grains. I was taking 3 grains having started treatment myself and was feeling reasonably but realised morcquite right. He suggested this dose and I thought it was too much a drop but he was spot on! Before I made the switch I made sure Vit D, B12, folate and ferritin were optimal as well so well worth checking those as well as they help the Thyroid work better but they must be optimal and it can take some time getting there if some/all are pretty low.

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Would you please PM his name to me too ? It would be easy for me to see him (I'm from Bucharest) and would like his opinion. My star university endo (he is really good) is not a NDT fan, he calls it a two centuries old treatment.

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Will send PM

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Hi

I switched from levo to NDT because I was starting to feel unwell. NDT made me feel sluggish. An administrator on here suggested that I needed to increase the levo & she was right.

I feel like the others on here that if you feel well, why change?

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I know what you mean. I am stable on my current T4 and T3, but saving £1000 per year from my early 40’s till whenever I keel over is huge.

This is why I’m considering the switch as I know what good feels like, I’m already working well with the combo.

If it doesn’t suit I’ll switch back and suck up the cost!

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Sorry it is causing you such a lot of expense. We have all paid out in one way or another trying to get well.

I hope you can come to a happy medium.

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I know what you mean, years of being left to suffer and then having to pay through the nose as NHS are not good in this area. We’re all in the same boat, but good to know we support each other x

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Hi

Good luck with whatever you decide. I’d say yours is not a high dose- roughly 3 grains would equate the same. One is equal to 25 mcg of t3 and 74 of t4.

You take the t3 and x it by 4 do 36 and add it to the 38 of t4 therefore 74.

Hope that makes sense. Unless you go for Thai ndt the rest is expensive too.

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Many thanks Howard, I agree that I’m not on a high dose, but simply on a dose that is suitable for me to feel well - and that’s the aim of the game!

I’ll begin the transition after seeing my blood work and when I’m on holiday in case I feel horrid.

Fingers crossed and thanks 😁

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