Endo decides to add 25mcg of Levo to 2 grains o... - Thyroid UK

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Endo decides to add 25mcg of Levo to 2 grains of Nature Throid


I would be grateful for opinions as to why my private endo has decided to add 25mcg of levothyroxine to my current 2 grains of NDT. Their opinion was that my T3 is now ‘optimal’ though I still feel sluggish, low pulse, fairly normal temperature, weight gain, memory still failing etc etc. There has been improvement, but I am longing for some weight loss. Or even for it to stop going up!

Meeting up with endo to discuss will cost more money, so I am wondering if anyone here thinks their decision is a good idea and whether something else might be more beneficial, before I tackle them. I have recently begun taking oestrogen via a transdermal patch which has not made an awful lot of difference to the results.

Really grateful for help so far.

14 Replies


I assume your endo thinks our FT4 is too low and wants to see it higher?

Does your endo know that taking NDT usually lowers FT4 as well as TSH?

I wouldn't say your FT3 is optimal, it's 54% through range, most of us need it in the upper quarter to feel well.

The symptoms you describe tell you that you're not optimally medicated.

Whose decision was it to use NDT? I take a combination of Levo plus T3, that gives a greater degree of flexibility in the individual doses rather than the fixed dose of NDT. From experimenting and tweaking doses over many, many months, I have found that my levels are best for me when both FT4 and FT3 are around 75%. Not everyone needs FT4 that high, but some of us do.

Icicles in reply to SeasideSusie

Thank you SeasideSusie, I thought that too. I was grateful to be given a trial of NDT after being ignored by GP for so long. Now that I am nearly in the upper range, it is frustrating to be held at current dose and have T4 added. I was wondering whether it might be time to go it alone. It’s so expensive!!!!! What difference would having 25mcg more T4 swishing around if it doesn’t translate into increased T3? Would having more T4 begin to affect T3 levels even if it does look like I don’t convert much of it? My endo wants me to test again in a couple of months or so. It feels like such a long time if it’s not going well!

SeasideSusieAdministrator in reply to Icicles


I can't answer properly your question. We are all so different, with differing needs. I tried NDT many years ago and it didn't do it for me, but I now realise that way back then my nutrient levels weren't tested so that may have had something to do with it.

Adding 25mcg Levo to your NDT should increase your FT4. If you have some natural T4:T3 conversion then your FT3 should rise as well. Looking back at your other posts, you've never had a set of results where TSH is down to 1 or below which would show your normal conversion of T4 to T3 if both FT4 and FT3 are tested at the same time. There's a lot of trial and error involved when trying to find the right dose of thyroid hormone.

I've just looked at this previous post healthunlocked.com/thyroidu... and will ignore the Medichecks results because you said about the large dose of Biotin. From the other results posted in the picture, none of your nutrient levels are optimal. Is anything being done about these? They need to be optimal for any thyroid hormone to work properly.

Icicles in reply to SeasideSusie

I take Ferrous Fumarate 210mg

Magnesium Citrate 400mg

Magnesium Bisglycinate 500mg

K2 MK-7 natural natto 100mcg

Vit C 1000mg

Vit B12 (methylcobalamin) 1000mcg sublingual

Selenium 200mcg

Vit D 4000 IU

All Daily since April/May after reading about supplements and considering my results. Mostly reading your posts, SeasideSusie. I thought that I would give it til say October and test again.

I ditched the Biotin. Thank you for looking at this for me, I do appreciate al, the help you have been already (albeit without you knowing)

SlowDragonAdministrator in reply to Icicles

You might change the B12 for a vitamin B complex with folate in rather than folic acid. This would keep all B vitamins higher, including B12

But remember to stop taking 3-5 days before blood tests as it contains biotin

When did you last test vitamin D?

It's trial and error what dose each person needs. Once you Improve level, very likely you will need on going maintenance dose to keep it there. Retesting twice yearly via vitamindtest.org.uk


Were you tested and found to have low oestrogen?

Can you add most recent blood test results for vitamin D, folate, B12 and ferritin

As SeasideSusie says. We need very good vitamin levels for any thyroid hormones to work well

What supplements do you currently take

Icicles in reply to SlowDragon

Thank you for your reply, SlowDragon, I had a total hysterectomy in 2012, so my capacity to produce any oestrogen, as I understand it, is over. I was struggling with hot flushes before the hysterectomy and took combined HRT, but once I had had the operation I decided to try to do without HRT. This summer, I thought that I was going to kill someone though, I was having 24 hour hot flushes. I have replied to SeasideSusie (above) with my current supplement list, which is going well I think. I am no longer having leg cramps at night and I do not consider myself constipated as such, more a little ‘slow’....

Because he doesn't understand NDT or T3? You were definitely undermedicated in March and May, but I'd have just increased NDT. How long between last dose and Aug blood test? That looks good, but you could probably increase by another 1/4 grain and free T3 would still be in range. I'd also want to know b12 and folate, as low levels of those can produced hypo-type symptoms. Oestrogen may affect conversion adversely. You probably also need progesterone.

Thank you AngeloftheNorth

I split my dose and took 1 grain 12 hours before I expected to do my test the following morning. I’m going to test my supplement levels towards the end of September to get a good picture as I have only been seriously and regularly taking them at ‘proper’ doses for 4-5 months. Do you think that I should press for progesterone too? This oestrogen is not really controlling my hot flushes anyway!

Maybe I should email endo and ask for an increase in NDT rather than Levo. Or perhaps I should just part company with them and get on the self medication train!

I think you should get progesterone levels tested. NHS seem to think that the only function of progesterone is to stop post-menopausal women on oestrogen from getting uterine cancer - so not needed if no uterus. They forget we have breasts and brains, and that all hormones work together. You could try what endo suggests and see how you get on. If it doesn't make you feel better, ask for increase in NDT instead (or self-medicate)

I think that I’ll defintely ask for their rationale and give it a go. On the progesterone subject, I’ll approach my GP again. Thank you, so much, for taking the time to help me. X

Why not add another half of NDT this may make all the difference. Not Levo, why is he telling you this?

Icicles in reply to Bunnyjean

Hello Bunnyjean, I was hoping for another slight increase, and this has come as a surprise. I feel like, medication-wise, I was getting to the point where I might reach optimal! Endo thinks that I’m already there!!! They’re shut next week for the bank holiday, but I think I will just ask for an increase in the NDT...thanks, you have given me the confidence to do that!

Good luck

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