How to mix levothyroxine with NDT: A bit... - Thyroid UK

Thyroid UK

119,321 members138,586 posts

How to mix levothyroxine with NDT

Boon79 profile image

A bit desperate now and need advice!

I've struggled with NDT (Thiroyd 2 grains) despite my blood results being fairly good on 2.25 grains (I dropped to 2 because TSH was severely suppressed and Ft3 slightly over range, plus still symptomatic), and I'm wondering whether I would be better on levothyroxine with added NDT?

Should I take 50mcg levothyroxine with 1 grain NDT?

I was previously on 100mcg of levothyroxine before the NDT route a few months ago and felt decent on the Actavis brand with some slight lingering symptoms.

I'm splitting my NDT doses am and PM, and have low Vit D which I am addressing, so at a loss and just feel that NDT alone isn't for me!

I feel like I've been turned inside out and the tiredness is crippling 😞.

Does anyone else mix levothyroxine with NDT?

27 Replies
shaws profile image

One of TUK's deceased Advisers only prescribed NDT or T3 for thyroid hormone resistant patients.

He did not recommend splitting doses of NDT (or T3). and I will give you some of his links which may be helpful.

Dr Lowe started his patients on NDT and every two weeks the patient increased dose by 1/4 tablet always taking note of the symptoms and the relief of them. Also taking pulse/temp before beginning and if either went too high dropped to the previous dose.

Dr Lowe died through an accident but his widow now runs their site and if you copy and paste the echapters on the following you may find them helpful:-

Boon79 profile image
Boon79 in reply to shaws

I started off NDT slow and did everything right. I think I'm sensitive to T3 and seem to convert T4 well. NDT isn't doing it for me unfortunately and I think I need a higher ratio of T4.

prussianblue profile image
prussianblue in reply to Boon79

Follow your instinct, it’s the most reliable guide, better than tests. If you were well on 2.25 grains then go back to that. My tsh has been suppressed for 25 years! Tsh not helpful once you’re taking hormones.

Boon79 profile image
Boon79 in reply to prussianblue

I felt better on 2.25 grains but probably slightly less better than when on 100mcg of levothyroxine. I think I'm in the low percentages of people who do better on T4 only. I had the odd day of tiredness and bloating but I guess that's the disease, full stop. It's Russian roulette buying my NDT from Thailand without a prescription, and here in the UK it's practically impossible to get it on prescription. I'd like to thank everyone for their replies to my last few posts as there has been some good advice.

I just imagined that NDT would be this miracle cure, but like Paul Jones said on his blog, it's not ground up fairy dust for him either.

I'm going gluten free to address my hashis and back to the Actavis brand of levothyroxine 🤞.

TSH not helpful even when you are not on hormone replacement, due to undiagnosed hypothyroidism among the people who make up the reference range!

Boon79 profile image
Boon79 in reply to shaws

I read up a lot about Dr Lowe which is why I started the NDT journey, and I even tried Thyrogold for a good few weeks without success. Again building up slowly.

shaws profile image
shawsAdministrator in reply to Boon79

I think it is the 'building up slowly' (every two weeks) and taking note of relieved symptoms is better than blood tests . After all it has taken years for us to be, finally, diagnosed due to doctors no longer knowing or prescribing due to clinical symptoms any more.

Boon79 profile image
Boon79 in reply to shaws

Yes Shaws. I think you've hit the nail on the head in saying taking note of relieved symptoms.

I took Actavis levothyroxine at bedtime and no NDT and I feel much better today.

jgelliss profile image
jgelliss in reply to shaws

DIDO !!!!! Shaws We as thyroid patients need to learn to *Trust* our inner voice /Guts and go with it . Ultimately we are our own *Best* judge as to what feels right for us . BW is just a snap shot of the moment . *Cellular* is much more telling . That's why I learned from a very smart thyroid member a few years ago to *journal* my symptoms . It really works very well .

shaws profile image
shawsAdministrator in reply to jgelliss

That is supposed to be the main reason for substituting thyroid hormones when our gland has failed i.e. to remove our clinical symptoms. It seems that the endocrinology haven't caught up and have never learned about 'symptoms' and rely upon the whereabouts of the TSH - whih should be 1 or lower.

I have tried it but no success. Everyone is different it could work for you. I have tried most combinations apart from Levo plus T3 which works well for some people.

Boon79 profile image
Boon79 in reply to Bunnyjean

I take it you're still on levothyroxine then?

Bunnyjean profile image
Bunnyjean in reply to Boon79

No Levo never agreed with me and made me ill. I have been taking NDT since 2016.

I had my thyroid removed whilst living in France and could, therefore, easily buy T3.

I tried it together with NDT and on it's own without much success. Everyone is different though you may do well on this combination.

If the GP's were not so obsessed with us taking a mix of Levo and T3 I would try it.

Next on my list is having a D 102 test to see if I can convert T4 to T3.

I take both. No reason why you couldn't try it. My body doesnt like ndt only. Too much t3 for me. Ratio not correct. Levo only is ok but adding a bit of ndt to the mix seems right for me. Experiment a bit ☺

Boon79 profile image
Boon79 in reply to KT77

Thank you. Did you drop your levo slightly, and if so, how much? Also how much NDT?

KT77 profile image
KT77 in reply to Boon79

I went from taking 2 grains to 75mcg levo. That was too much of a drop so added half grain of ndt. Currently taking that. I also tried 1 grain plus 50mcg levo but that was still too much t3 for me. If I were you I would drop to 1 grain plus 50mcg levo and take it from there. See how you feel and do blood test to check your levels.

I recently posted about this if you care to read it- Personally, I am starting to feel better since switching back to t4 with a very small amount of NDT.

Boon79 profile image
Boon79 in reply to jjyankee

You sound just like me. I'm not quite there on just T4, but way too there on NDT.

I might drop to 75mcg of T4 and 1/2 grain of NDT. For me, 2 grains was a similar effect to 100mcg of levothyroxine, with my blood tests only being slightly over on 2.25 grains.

jjyankee profile image
jjyankee in reply to Boon79

That’s sounds like a good plan- my plan is to raise my t4 very gradually but keep the NDT very low- I’m super sensitive to t3 but have found that just a tiny dose makes a huge difference in the way I feel. The worse stuff for me was Cytomel- that synthetic t3 was so much harsher than the NDT- it made me sooooo irritable and downright angry! Good luck to you .

jjyankee profile image
jjyankee in reply to jjyankee

But as jgelliss said I’d go even lower on NDT - I have to increase by 1/8 grains or I get too hyper -

jgelliss profile image
jgelliss in reply to jjyankee

Dr Kenneth Blanchard Bless His Memory was a very big advocate for T3 but for very low T3 with a good T4 . He wrote a great book you might be interested to read "The Functional Approach To Hypothyroidism ". He was very against high doses of T3 . He felt that 5mcg T3 was simply to much for any human being .

It would have been great to know what Dr Blanchard thoughts where with thyroid patients that do not do well with synthetic T4 ? I guess Dr Blanchard would have suggested Tirosint . Pure T4 with no fillers at all . Or Dr Blanchard I would guess would have suggested compounding . Dr Blanchard is a great loss for thyroid communities around the world . He was based out of Boston Massachusetts in US . There are some members on this forum that where his patients . Unfortunately I was not privileged to be one of them .

jjyankee profile image
jjyankee in reply to jgelliss

I read did read his book, and after having bad results and tons of side effects with everything I tried, I started taking t4 with a very small amount of NDT (could not tolerate the harshness of Cytomel). My blood tests still look bad because I still need to increase the t4 dose but I'm feeling much better! Have to wait and see how the next set of tests look but I'm pretty sure I'm onto something good.

I've tried other meds/combos and have read many books on thyroid treatment. None of those protocols worked for me until I followed the advice of Dr. Blanchard and had an "aha!" moment. I thought there was something else seriously wrong with me because I could not take what others considered an average or even low dose of t3- I did feel over-dosed.

RIP Dr. Blanchard and know you are still helping people.

jgelliss profile image
jgelliss in reply to jjyankee

It's very exciting and I'm so Happy for you . His Theory makes so much sense for me . I know that just before I had my RAI after my TT I was dosed with Cytomel only . I was so ill from it . I couldn't wait to get back on the T4 . However having had TT and not being a good converter and having palpitations on T4 only . I now know that some T3 was missing . I'm still trying to figuring for myself which low dose NDT is the best plan for me to go with . I respect other thyroid members that higher T3/NDT work for them best . It's very individual and ultimately we as individual thyroid patients are the best judges as to what works best for us . Go slow with T4 raises so that you don't miss your sweet spot . T4 is a longer acting hormone to figure how it feels . T3 is short acting and we can figure out sooner .

Best Wishes for great days ahead .

One must reduce first T4 prior to adding T3/NDT . Other wise many hyper symptoms happen . Lowering 25mcg T4 increments at a time or just skipping a couple of days of T4 dose before introducing low dose T3/NDT with a lower dose T4 .

Boon79 profile image
Boon79 in reply to jgelliss

Perhaps reduce T4 to 75mcg then and 1/4 NDT, then up to 1/2 NDT 2 weeks later.

jgelliss profile image
jgelliss in reply to Boon79

I would go slow and steady . Lowering 25mcg T4 first and adding not more than 1/4 grain NDT at a time . Some even add 1/8 grain at a time to see how it feels . 1/2 grain NDT is a huge jump at once . It's about 4.5 T3 and 19 T4 . I like to go slow so I go between 1/8 to 1/4 grain NDT dose increases . You have to realize that adrenal /Cortisol are involved . Thyroid and Adrenal /Cortisol work in unison . You might consider supporting your adrenals prior to dosing with any T3/NDT . Vitamin "C", Iron if your ferritin is low . B-Complex , B-5 , B-12/Folate , Vitamin "D"/K2 , Magnesium , Celtic Sea Salt , Minerals .

Thank you all for your advice. Seeing as 1/2 grain of NDT is considered a starting dose, I've taken 50mcg levothyroxine before bed and 1/2 grain NDT this morning.

Since going to T4 only a few days ago, I've been very moody and depressed. NDT did improve my mood despite feeling turned inside out! Fingers crossed I'll see how I go on this dose for a couple of weeks and then add another half of NDT if I feel I need it.

You may also like...