Help with medication

[Gwelos]

Hi, I have Hashimotos for 10 years and have been treated with different variations of thyroid replacement. I am trying to stabilize myself with a combination of thyroxine and NDT.

When I did my last increase I was on 1/4 grain of NDT and 75 Eltroxin

When I repeated my bloods in 6 weeks my results were

TSH 1.78 ( 0.27- 4.20 )

Free t4 18.0 (12 - 22 )

Free t3 3.4 ( 3.1 - 6 .8 )

I don’t feel well at all. I increased my NDT to 1/2 grain and continued with the 75 eltroxin. That was 12 days ago with little improvement.

I’m wondering how long it should take to feel the effects of the increase

Thanks for reading

[Saggyuk]

Hi Gwelos

It normally takes a minimum of six weeks to feel the affects of any increases or decreases to your dose which is why tests wouldn't be done any sooner. However, I normally take nearer three months to feel the full effect or minor changes so leave it a little longer as everyone is different

[Gwelos in reply to Saggyuk]

Thanks Saggy UK, it's good to know😊

[shaws Administrator]

Blood tests are when we are on levothyroxine alone (T4 only). When we add in other hormones i.e. T3 or NDT, the blood results don't correlate, so it is all about how 'we feel' on particular doses. I shall give you some links. Copy and paste the tiny-urls onto a new page.

When we take NDT it is usual to start on a dose then every 2 weeks add 1/4 tablet (1gr). Information is on the tiny-urls and copy/paste into new page.

web.archive.org/web/2010103...

[Gwelos in reply to shaws]

Thanks shaws I will do some reading🙏

[shaws Administrator in reply to Gwelos]

Apologies I missed out the tinyurls:-

tinyurl.com/ya5blrr2

tinyurl.com/y7ejh9sh

web.archive.org/web/2010112...

[Gwelos in reply to shaws]

Not sure what that means?

[helvella Administrator Thyroid UK in reply to Gwelos]

I have edited the tinyurl links in shaws' reply so that all you have to do is click on them.

[shaws Administrator in reply to helvella]

Thanks very much Helvella. I have just looked and had to have done something wrong as the first two don't work. I'll re look at the links. I think maybe I can only use the tinyurls for a short time. (I assume).

[shaws Administrator in reply to Gwelos]

Because the name was too long. It was shortened into tinyurls except last one which I couldn't shorten.

[greygoose]

Why all that Eltroxin? Why not cut it out and just increase the NDT? You obviously don't convert very well, and your FT4 is high. 1/2 grain NDT only contains about 4.5 mcg T3, which is nothing much at all. I don't understand how you decided on your dose, it doesn't make sense. You need more T3 and less T4.

[Gwelos in reply to greygoose]

Hi greygoose, I was attending a doc by Skype which wasn't satisfactory. I was on NDT AND at one point I was on NDT and t3 in the pm for rt3. She sorted my adrenals also. When I was on NDT my t4 was always low and my t3 on the top end of the range. I never felt well on that so 2 years ago I went back on t4. I felt a change in my brain and feel I need to have my t4 on the upper end. That changed so I decided to add some NDT as my t3 was always low and if I upped my t4 I would feel hyper. That's my own doing but I'm not sure if I go to another doc what to ask for. I don't seem to feel well on anything but I feel it is all thyroid related. Thanks for your reply😊

[greygoose in reply to Gwelos]

Well, you probably don't feel well now, because your FT3 is too low.

It's perfectly possible that you do need your FT4 quite high, but you still need your FT3 higher than that.

t3 in the pm for rt3

Taking T3 doesn't lower rT3. Reducing T4 lowers rT3. If you continue to take too much T4, it doesn't matter how much T3 you take, your rT3 will still be too high.

[Gwelos in reply to greygoose]

I probably need to check rt3 again and find a new doc.. thanks