How changin from combo t4/t3 to NDT erfa

[Nattysmith]

Hi. i'm from Spain, Hashi's from 2006, living near France and Andorra.10 years in 125mcg T4 feeling like a turtle, but I'm actually in combo 100mcgt4 +25mcg t3. I feel so well, I want to change in NDT erfa. Just ro know 2 grains its correct dose for me ?

[greygoose]

Two grains of Erfa would give you just 76 mcg T4 and only 18 mcg T3, so 2.5 might be better. Or even 2.75 grains.

[nataliagrizzly in reply to greygoose]

Thanks about your reponse. I wait for my labs in 5 march, and again consulting to starting in erfa.

[greygoose in reply to nataliagrizzly]

You're welcome.

[SeasideSusie Remembering]

I feel so well

I'm wondering why you want to risk possibly upsetting the apple cart. "If it ain't broke, don't fix it" is my motto

[nataliagrizzly in reply to SeasideSusie]

Thanks for your reponse.Yes, I think too about it. But before felling like a turtle during 10 years taking 125 mcg t4, i leavegluten in end July 2018 and starts to add t3, (folate, b12, liver cleanse, selenium, probiotics...) feeling much better, loosing 5 kg, more energy, better mood, my body up temperatures, now I can support cold (i live in ski resort stopping to be ski instructor, because imposible for me for low energy) ; how I can mesure how much better I feel, feeling bad year after year, I feel ok now, but perhaps not really perfect. Then i think : I can feel still better. Really I can feel diference from NDT or sintetic t4/t3? I´m worry about perhaps It´s better to have some calcitonin for posible osteoporose for my supresed TSH (last labs 0,06)? It´s better natural compound from synthetic. Really NDT it´s expensive compared to synthetic form, but just to try to be better....if no diference perhaps returns to synthetic form? I´m not rally sure to change...Sometimes, health no price.

[greygoose in reply to nataliagrizzly]

Suppressed TSH does not cause osteoporosis, and there's no guarantee that there is any calcitonin in NDT. So, if that's the reason you want to change it's really not worth it.

There's nothing wrong with synthetic. Myself, I couldn't tolerate NDT, and I'm better on synthetic. Besides, NDT isn't all that natural. Agreed the T4 and T3 come from a pig, but there are also some very unnatural fillers in the tablets - you can't make a tablet without fillers.

I agree with Susie, why take the risk if you're feeling well on T4+T3?

[Nattysmith in reply to greygoose]

Uff. Now I have a great doubt about...if it's good idea to change to NDT. NDT erfa 60mcg its 1 grain? i can buy erfa 60mcg /100pils 85€, maybe for 40 days taking 2.5 grains at day. And euthyral 100t4+20t3, 50 pils one at day, for 3€, adding cynomel 25mcg (30pils 5 euros), 1/4 or 1/2 at day, deppending if I do sport, I like go to skiing, in winter or hiking or biking Then NDT 2.1 euros at day vs t4+t3 0.14 euros at day. It's a big diference in price, to change if I Cant feel a big diference or beneffits to be better......anyway, i must to wait to my labs 5 march, to verify if I'm adjusted in my actual combo.

[greygoose in reply to Nattysmith]

And euthyral 100t4+20t3, 50 pils one at day, for 3€, adding cynomel 25mcg (30pils 5 euros), 1/4 or 1/2 at day, deppending if I do sport

I'm a bit confused about your dose, here. You take 1 Euthyral + 25 mcg Cynomel a day? That 45 mcg T3 a day. That's not exactly what you said in your original post. So, that makes it even more complicated converting to NDT. To get 45 mcg T3, you'd have to take 5 grains. And that would give you 190 mcg T4, which is a lot of T4! So, then you'd have to go down the route of adding T3 to your NDT.

To get to 100 mcg T4 plus 45 mcg T3 you'd have to take 3 grains plus 3 grains NDT plus 3/4 tablet Cynomel. Which works out a lot more expensive!

Also, it's not a good idea to add in the odd 1/4 or 1/2 tablet T3 here and there. You should be on a regular steady dose every day, or you will confuse your body.

[Nattysmith in reply to greygoose]

Hi. i try to explain better. My regular dose everydays is 1 euthyral at 6/7 am. But perhaps in winnter I need a litle bit more because I live in ski resort in the pyrenees, cold wheather, snow, ice, ..., and I go to ski 3/5 days weekly in the morning, every how I can, i need tonbe happy, and If feel I need a bit more of T3 to cant finish day being exaust at the end day and repair my fatigue. If start to feel my muscles cant being contracted more time or extremely cold , my body are telling me need more t3, then at 12/13pm I ad 1/4 cynomel, and if I feel I need more at end afternoon I ad 1/4 cynomel at 18/19h. No problems to slepping , and controling my heart rithm and temperatures every morning, like I learn at STTM. You can think its a madness, but I do only days doing sport (maybe all days). I love to skiing, and I leave my work like ski instructor 12 years ago, because imposible to suport extremely cold, and low energy avery days. T4 dont give me enough energy. These is my first winter adding T3 and I feel abgreat diference, changing my life, I can ski more time, without cant wake up at the next day. I supossed it's difficult dossing doing ski, or neing sportist and with days with extremely cold. But doing sport I feel and I can suposed the levels in T3 goes down...and my body need adding litlle more dose. I have a much feeling learning to hear my body all these years with infra treatments with Hashi's.

[greygoose in reply to Nattysmith]

The T3 level won't go down each time you ski, it will be pretty stable. So, why don't you just increase your dose of T3 by 1/4 tablet every day at the beginning of the season, then lower it at the end of the season if you feel the need. Lots of people need to increase their dose slightly at the beginning of winter, when it's cold. It would give your body a smoother ride than keep changing your dose like that. It may be what you read on STTM, but I don't have much time for a lot of the stuff they recommend, I'm afraid.

[Nattysmith in reply to greygoose]

Yes, really I can add 1/4or 1/2 cynomel every day,. But I dont want excess the dose T3 and feel hyper. I have a doubt, T3 life is 7hour or more? Cynomel is direct T3, or release t3, what is the diference? I try to search my labs in june, august and october, while changing from t4 to combo and I show you, to know if Im doing ok. My endo dont help me more with the dose, because all is ok in the labs, all correct, but i change my dose about my simptoms in accord with the doctor, (she dont like my suppresed tsh), but almost she help me and support me trying to understand me and doing me the labs I need. But in spain doesnt exists euthyral and cynomel, then my endo cant prescribe me, and i medicate myself because I can buy by my own, in France and Andorra. Thanks again for your help.

[greygoose in reply to Nattysmith]

I very much doubt a 1/4 extra a day in winter will make you feel 'hyper'.

The half-life of T3 is 24 hours, but what gets into the cells is there for about three days.

Cynomel is direct T3. The difference is that direct T3 is all absorbed into the blood from the gut at once. Slow release is absorbed little by little.

Your endo should know that taking T3 is going to suppress your TSH, and it doesn't matter. It is suppressed because you don't need it anymore. Does your endo know you take T3?

Just because all your results are 'in-range' doesn't mean that you are optimally medicated. It would be best if we could see your labs.

[Nattysmith in reply to greygoose]

Yes, I try to teach my doctor about T3 and TSH, haahah, but is an ingnorant like the majority. But I try to learn together, and mutual help,for the labs. I take both, euthyral and cynomel, in sublingual. I search my labs, i think they are in my car. I go to ski now. Have a good day. I put my labs soon. Thanks.

[greygoose in reply to Nattysmith]

Thyroid hormones are not designed to be taken sublingually. The molecules are too large to get into the blood. They need to be swallowed with a large glass of water, to make sure they don't get stuck on the way down, and then they need the stomach acid to separate the hormone from the sodium molecule they're bound to. Taking them sublingually will compromise absorption.

[nataliagrizzly in reply to greygoose]

upp, then is better not sublingual? this means if I drink the pils with water will be more effective, because I can absorbe much better?. When im in Eutirox 125mg, i do drinking water, but i start to take sublingual when I change in combo. I really agree about your help and your comments. Finally I decided not change to Erfa, perhaps yours comments make me think about, and is to much money Erfa and all suplements,without any guarantee about I can feel better. My medical assurance dont pay me anything, (only Eutirox and Folic Acid), but I´m taking methylated form with a Bcomplex. I still searching my old labs. I do my next labs 12 march, I understand than I must to stop all suplements I week before?, I do labs at 8 .30 a.m, then my last dose t3 cynomel?

Thanks again for your help.

[greygoose in reply to nataliagrizzly]

It's better not to take them sublingually, yes, just swallow them with water and wait to eat.

Take your last dose of Cynomel 8 - 12 hours before the blood draw. Leave off all supplements with biotin for a week before the blood draw. Don't take anything on the day of the test until after the blood draw.

[Nattysmith in reply to greygoose]

Hi. I have my new labs. I'm Hashis, from July 2018 I'm doing free gluten diet, and changin for Euthyral (100t4+20t3) at 7.00am, and 1/2 cynomel added only in winnter season at 3.pm. i feel so ok, only sometimes tired and some problems with stress, but much better from the past. I take, a liver cleanser (solaray) biotine 1.000 mcg, and methylb12 1000mcg, methylfolate 400mcg, and B6 1.5mcg, (jarrow formulas) 5.HTP 50mg and digestive enzymes. Results;

TSH, 0.01 uUI/ml (0.27-4.20)

Ft4 14.5 pmol/L (12.0-22.0)

Ft3. 3.8 pg/ml (2.3-4.2)

Ion Sodium 140 mmol/L (135-150)

Ion potasium 4.58 mmol/L 3.50 -5.0

Calcium 8.91mg/dl 8.60-10.30

Protein 6.5 g/dl (6.6. -8.7)

Antibodies tiroglobulina 183.1 (-4.1 UI/ml)

Antibodies tiroperoxidase (tpo) 501.0 (-5.6UI/ml)

Hemoglobine 13.9 g/dl (10.5/16.0)

Eritrocites 5.11 (4.0-5.60)

Hematocrit,h 40.9 % (35-50) 87

Ferritine 72 ng/mL (13-150)

B12 cobalamines 788 pg/ml 180-914

Folate 10.6 ng/ml (4.4-31.0)

Glucise 98.1 mg/dl (74.0-105)

Triglicerides 38.5 mg/dl (50.0-200)

Total colesterol 179 mg/dl (150-200)

HDL 84.5 mg/dl (45-65)

LDL 87.2 mg/dl (30-100)

My folate and b12 is high from my last labs in october whhen are down outside. Triglicerides and TSH too low, some problems with ? And glucose is some high? And HDL high too? I must to continue with methyl B? How to do to down my inmune issues for tiroglobuline, and TPO. How about take Iodoral? Thanks for coment.

[greygoose in reply to Nattysmith]

Your TSH is not too low, it's fine. It's bound to be low because you are taking T3, and it doesn't matter.

I don't know about triglycerides.

I think your glucose is ok, it's not over-range, but I'm not an expert.

Your HDL is high, but that's probably because your FT3 is still a little low - could be higher. But, nothing to worry about.

Continue with a lower dose of B12 for maintenance.

DO NOT take iodoral. That's the worst thing you could do with Hashi's. And, it certainly won't bring your antibodies down. Don't worry about the antibodies. Even if you got rid of them completely, you would still have Hashi's, because it's not the antibodies that do the attacking, it is the immune system itself. There is no way to get rid of Hashi's, I'm afraid.

[Hidden]

I have been offered Novothyral by my doctor. It's a synthetic combo drug and each pill contains 100 mcg of T4 and 20 mcg of T3 (pills can easily be split in halves and quarters for fine-tuning of dosage).

I've been on NDT since 2011 (before that, on T4 only for eleven years without much symptom-relief; diagnosed with Hashimotos in 2000).

I have tried prescription NDT (Armour and Erfa) as well as Thai NDT (Thyroid-S). I find Thyroid-S to work as well if not better than Armour/Erfa, at a fraction of the cost.

However, as Greygoose points out, there is nothing magical about NDT.

I have been considering giving Novothyral a try, and your experience with synthetic drugs gave me new hope. It would be easier to get Novothyral from a pharmacy with a doctor's prescription, and it is as cheap as Euthyrox and covered by my health insurance. Thai NDT, while being much less expensive than Armour/Erfa, is still something I have to pay for myself.

I have been wondering lately if NDT is really that much better than a synthetic T3+T4 combo...? It's sometimes said that NDT contains calcitonin, T1 and T2 along with T3 and T4, but there seems to be no consensus as to what those hormones actually do...

[greygoose in reply to Hidden]

or even if they are actually present in NDT…

[Nattysmith in reply to Hidden]

I think novothyral is the same dosage like Euthyral. I'm diagnosed Hashis in 2009 and in Eutirox t4 125mcg only during near 10 years (only pregnant with my second baby im in 175mcg). With t4, i can live, but not in my normal wheigth, cant doing sport by fatigue, tired, dont suport cold temperatures, and too in summer, at the beach in Spain!! Muscular and articular , headbpain and many problems with stress and irritabiliti, premenstrual simptoms very high. I change to combo euthyral and 1/2 cynomel from july with some suplements, and feel much better, lost 6kg , no problems with cold this winnter, and low fatigue if compare with last winter. Only I must to pay, euthyral and cynomel is not prescribe d in Spain. I can buy in France, because i live in the border. I hope you can be lucky with the change. Best regards.

[Hidden in reply to Nattysmith]

Yes, as far as I know, Novothyral and Euthyral are the same drug only sold under different names.

It's good that you can buy it where you live. If you do decide to try NDT, I'd recommend Thai NDT which is much cheaper than prescription brands and works just as well IMHO.

[Nattysmith]

No, finally i dont chage to NDT, too much money, and greygoose tell me arguments to continue with synthetic. Almost my antibodies are still too high, then perhaps ndt dont works for me, or any diference about money only. Too much money in suplements.