Help with dosing please: I’m on 2 grains of NDT... - Thyroid UK

Thyroid UK
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Help with dosing please


I’m on 2 grains of NDT (Thiroyd). I have tried increasing but seem to get more episodes of flushing and increase in pulse especially when v tired (I’ve had ME for over 20 years and well into menopause though). It may have nothing to do with the dose of NDT but I tend to panic and think of my GP’s raising of eyebrows as they disapprove of me self-medicating. They were no help and neither was endocrinologist. They gave up when I was diagnosed with Non-Hodgkin’s Lymphoma as they thought it was the cause of all my woes. But it wasn’t, so my battle continued.

I just got new blood test results –


FREE THYROXINE 12.600 pmol/L 12.00 - 22.00

FREE T3 3.96 pmol/L 3.10 - 6.80

THYROGLOBULIN ANTIBODY 79.100 IU/mL 0.00 - 115.00


In January my antibodies spiked (271.00 0.00 - 115.00) and T’s dipped (Free T4 12.6 12.00 - 22.00 Free T3 3.44 3.10 - 6.80) So I was definitely hypo/ Hashi. Previously I’d thought I was over-medicating so had dropped from 1 and half grains, to 1 grain. I was wrong so gradually increased up to 2 grains once I’d had bloods checked and realised what was happening.

I’m gluten and dairy- free. Little, if any soya.

Rest of today’s results -

ACTIVE B12 *>300 pmol/L 25.10 - 165.00

FOLATE (SERUM) 7.22 ug/L 2.91 - 50.00

25 OH VITAMIN D 111 nmol/L 50.00 - 200.00 Interpretation of results:

Deficient <25 Insufficient 25 - 49 Normal Range 50 - 200 Consider reducing dose >200

CRP - HIGH SENSITIVITY 0.83 mg/l 0.00 - 5.00

FERRITIN 125 ug/L 13.00 - 150.00

I’m seeing a nutritionist who is helping with diet etc. On supplements to help methylation so expected folate to be higher. I was hoping to feel better by now but no sign of that happening. I should be absorbing nutrients better as digestion much improved and reflux is gone.

I still have loads of hypo symptoms – e. g. dry eyes, sore, dry mouth with enlarged tongue, totally exhausted with no energy (virtually housebound), heavy legs with pads of ‘fat’ (not fluid) around ankles despite losing weight (I’m size 8 or 10 now. Ok, a 9). Brain is a total fog. I just can’t retain info even though I’ve read about the subject for over 2 years, when I’ve been able.

My questions are

– do I try and increase NDT again? My pulse rate seems to be an unreliable way to monitor as it has always been a bit high for some reason and gets higher when I’m more exhausted and struggling. Something to do with adrenaline???? My temp was always a bit low but I just couldn’t get reliable readings when trying to monitor progress, even with a mercury thermometer. Can I monitor with resting pulse and ignore anything else/spikes in pulse rate?

-anything else I should be doing?

- also I need ‘ammunition’ as I see GP on tomorrow for an unrelated problem and I suspect she’s sneaked a TSH in with other blood tests. Can I say I’m definitely hypo/Hashi and my self-medicating when they ‘abandoned’ me prevented the situation becoming much worse? The TSH being so low is irrelevant?

Many thanks

6 Replies

Did you check your cortisol? It can happen when there is Adrenal Fatigue.

in reply to Sv_cy

Thank you for your reply.

I did check my cortisol last year and it was a bit high. My nutritionist put me on adrenal support capsules which I didn't feel made much difference until I stopped them. I re-started them a couple of weeks ago.

I really don't know if I get these episodes because I need more NDT or not. Tend to be worse at the end of the day. I crawl up to bed and have to lie down before I can clean my teeth because I can't stand for long and my heart is pounding.

It may be the ME.

No clue. I'll read the link. Thanks.

in reply to Julienew

As I see from results free thyroxine and free T3 are low. According to the results you need to increase the dose. T3 should be in a high range, thyroxine in the middle range. Adrenal fatigue can be the reason that the increasing of the dose make you feel bad. Also you have to take this dose 2-3 times a day

in reply to Sv_cy

Thank you

Last night I finished reading the OAT axis article you have the link to. I downloaded the Fatigued Put Of Life PDF which I will read today. It's very interesting and I feel the picture fits me. I think my oestrogen/progesterone were unbalanced as I had loads of breast cyst but they disappeared as soon as I hit the menopause. No idea what levels they are now.

The thyroid hormones (I take 1 grain early am and another early afternoon) don't seem to have helped me but the antibodies have come down into range. I know there are other things going on but I don't know what.

I'm working through various things with my nutritionist and am continuing to deal with digestive issues. I think I'm not sufficiently Paleo so need to address that.

Can I ask - have you been through this? And any advice on where to go from here? I saw a endocrinologist who was no help at all.


in reply to Julienew

There are seven stages of Adrenal Issues You have to make SALIVA cortisol testing Before to make the test please read this information Two years before I wanted start to take NDT instead of euthyrox. I could not do that as I was feeling VERY bad. And after 3-4 weeks I stoped and continued to take euthyrox. In that time I did not know that before to take NDT I have to support adrenals and put up ferritin. Low cortisol and low ferritin will not let us to feel good. Now I take T4+T3. When I started to take T3 I had this problem but not as before as my ferritin was in normal range and cortisol little bit better. I hope it will be helpful for you.

in reply to Sv_cy

Thank you.

I contacted my nutritionist and I'm going to do a comprehensive Adrenal test.

The links to articles are useful - thank you.

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