Advice please on disappointing results with Thi... - Thyroid UK

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Advice please on disappointing results with Thiroyd

jwasney
jwasney

I moved to Portugal last year from Canada where I had been taking Erfa with pretty good results. I had been taking 2 grains (two pills) daily and my TSH result in March 2017 was 1.38 with a range of 0.32-4.00 mlU/L. The only other test of interest my doctor performed at that time was B12 which was 361 with a range of 138-652.

Fast forward to Portugal where I was prescribed Levothyroxine at my (pre NDT dose) of 125 mg. Unfortunately T3 and NDT are not available in Portugal so when I didn’t feel well on the Levothyroxine I purchased Thiroyd and resumed my 2 grains per day for 8 weeks before getting tested.

My tests were taken at 9am on an empty stomach. I didn’t take my Thiroyd dose the night before which means I was approximately 36 hours without medication. The results came back as follows:

TSH 3.53 range 0.350-5.500

FT4 0.87 range 0.80-1.76

FT3 2.40 range 2.30-4.20

B12 367.0 range 211.0-911.0

Ferritin 242.2 range 10.0-291.0

Calcium 8.7 range 8.7-10.4

Vítamin D 36.8 range <10 deficient, 10-30 insufficient, 30-100 sufficient, >10 toxic

TBG 12.3 range 14.0-31.0

I wanted to get folate and antibodies tested but it was just too expensive so I’ll hopefully get these tested when I am in London later this year.

My question to the very knowledgeable folks on this forum is: should I increase my Thiroyd by half a grain and retest when I can or should I consider a combination of levothyroxine and Thiroyd? I guess I could also consider locating a supply of T3 and trying this either on its own or with Levothyroxine but I would rather work with the medication I have on hand first before trying this third option.

Any advice would be greatly appreciated.

13 Replies
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shaws
shawsAdministrator

When we take NDT or add T3 to T4 then we cannot really go by the blood tests which were introduced along with levothyoxine (T4)only. So dosing should be by 'symptoms relieved' with small increases until you are symptom-free and taking pulse/temp regularly and if either rises too high drop to previous dose.

This is a link by one of our Advisers (deceased) and he would only prescribe NDT or - for thyroid hormone resistant patient T3 alone.

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

jwasney
jwasney in reply to shaws

Thanks, Shaws. My Canadian doctor had prescribed Erfa NDT because levothyroxine was not resolving my symptoms. It worked much better but did not relieve my symptoms completely. I considered myself lucky and did not request an increase to my dose because my TSH was just over 1. After following this forum I now understand that TSH testing is less meaningful on NDT. I’ll consider a slight increase to my NDT based on Humanbean’s information and see whether it helps to reduce my symptoms.

Thanks for responding. I appreciate your time.

Were you aware that Thiroyd is slightly weaker than most other NDTs?

According to this link : stopthethyroidmadness.com/a...

An email to a patient by Greater Pharma states that “thiroyd” at one grain contains T3 at 8.31 microgram; T4 at 35 microgram, which is 0.013% and 0.058% respectively.

I haven't heard anyone mentioning ERFA for a long time, and am wondering if it is still made. But I think it contained 38mcg T4 and 9mcg T3 per grain.

The lower level of active ingredient in Thiroyd would be enough to make a difference. You could add quarter or half of a tablet to your current dose and see how you feel.

jwasney
jwasney in reply to humanbean

Thanks, Humanbean. I wasn’t aware that Thiroid was slightly weaker but will try an increase to my dose and see if it makes a difference. Much appreciated.

credgrave
credgrave in reply to humanbean

I have been taking EFRA since Feb this year and am doing very well on it. I needed something cheaper than Armour cause I was running out of money. It is certainly available on private perscription in London.

And because it isnt said enough, thanks to everyone for all this information. I read it every day. all best, Constance

You have a false low FT3 there, because you left it too long. It should only be 8 - 12 hours for NDT.

However, that would not affect the TSH, and the TSH says you need an increase in dose. But, only 1/4 grain at a time. Every two weeks. :)

Thanks for the insights on the test/medication timing, Greygoose. I’ll increase a 1/4 grain for two weeks and see how I feel.

shaws
shawsAdministrator in reply to jwasney

One of our Advisers, now deceased, would only prescribe NDT or T3 alone for thyroid hormone resistant patients. He only took one blood test for the initial diagnosis and then it was all about how the patient 'felt' on specific doses with small increases every two weeks taking note of the ones that were relieved and patient was eventually on an optimum dose. Also temp/pulse were taken several times a day and if either rose too high, returned to previous dose.

jwasney
jwasney in reply to shaws

Thanks, Shaws. I’m fine sticking with NDT alone but I have to admit I’m nervous about adjusting my dosage without having testing to fall back on. I’ll monitor my symptoms and post again if I have any questions. I appreciate the support and guidance of everyone on this forum that takes the time to respond to the various requests for help. It has been very educational as well as comforting to know that so many people are dealing with the same issues.

shaws
shawsAdministrator

Blood tests were invented for levothyroxine alone, i.e. T4. Therefore if we take NDT or the addition of T3 blood tests cannot correlate as it contains T4, T3, T2, T1 and calcitonin.

americanbonehealth.org/medi...

HiddenThis reply has been deleted
shaws
shawsAdministrator in reply to Hidden

I think it might be due to fillers/binders in some that affect people as the hormones are supposed to be orthomolecular

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