Hi I’m on ndt my Endo just raised my dose from 2 to 2 1/4 grains. On 2 grains Tsh was high t3 right at top of range and t4 right at bottom of the range. I’ve been on new dose 4 weeks and feel like crap I do more blood work in 4 weeks. Will this new dose not push my t3 over?
Tsh 4.42 (0.27-4.20)
T4 13.40 (12-22)
T3 6.68 (3.1-6.8)
Yes, it will. But that's not always a problem. You'll have to see how you feel. 
Ok thank you don’t seem to be able to raise my t4 I suppose I need more
See how it is six weeks after the increase in dose. It may come up. If it doesn't, you need to evaluate if you really need it any higher. There are not rules that say the FT4 has to be in a certain place when taking NDT. It's up to how the individual feels. Certainly don't increase it before the six week point, because that would throw everything out.
Ok thank you certainly not feeling good at moment
When on NDT we can add 1/4 tablet increase every two weeks always taking note of your symptoms being relieved and that pulse doesn't increase too much or temp.
Your Endocrinologist may not like you to do this and it is our clinical symptoms which should be the priority - not blood test results. Blood tests were introduced along with levothyroxine (T4 only). Before that we were given NDT which was slowly increased with more emphasis on the relief of clinical symptoms.
It could be that NDT doesn't contain the right balance of T4/T3 for you. This is where some of us do better with synthetic Levo plus T3, which is what I take in a ratio of approximately 6:1 of Levo:T3 whereas NDT is nearer 4:1. This gives me both FT4 and FT3 where I need them to be feel well, which for me is 75% through range for both. TSH is suppressed, but it was on just Levo anyway.
My only problem is I didn’t tolerate thyroxine very well. Could I add a small amount to ndt?
Could I add a small amount to ndt?
You could do, anything is worth trying so give it a go.
Thank you
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