low FT4

[Eliize]

Hi,

three months ago i was on 5 grains NDT but my FT4 went to 11 (12/22). I took some advice and I lowered my dose to 4 grains and now my FT4 again has lowered to 10.

Should i go back to 5 grain or should i put some t4 to it?

Best regards,

Elsa

[Eliize]

T3 is 1,7 (1.3-3.1)

[shaws Administrator in reply to Eliize]

Your T3 is on the low side.

In general, the blood tests were introduced along with levothyroxine alone, i.e. T4.

Therefore sometimes a blood test wont correlate i.e. if on levo alone, or T3/T4 combination,, or T3 alone or NDT So. I think the best way to judge if your dose is optimum should depend upon your clinicals symptoms and are they being relieved.

One of our deceased Advisers only took one blood test for the initial diagnosis and thereafter the prime aim was relief of all clinical symptoms. Of course vitamins and minerals should also be optimum too.

[greygoose]

It doesn't look as if you are absorbing your NDT very well. To have results like that on 5 grains is rather unusual. So, how do you take your NDT? Do you take it on an empty stomach, leaving at least one hour before eating and drinking anything other than water? Do you take any other supplements/medication at the same time?

Also, how long did you leave between your last dose of NDT and the blood draw?

But, I would have thought it was obvious that if you reduced your dose of NDT, your levels would go down. Who advised you to reduce it? And why? Was that FT3 on 5 grains or 4?

Sorry about all the questions, but without the details it's rather hard to advise.

[Eliize in reply to greygoose]

Thanks for responding.

I take my ndt 30 minutes before eating and i don't take anything with it.

3 months after the change from 5 to 4 grains i did this lab and it was

the same lab on an empty stomach.

I got the advice to lower ndt from a dutch website/forum same like this.

The idea was that the (overdose of) T3 lowered the FT4, so when i lower my dose of ndt

my FT4 should go back in range. (but it doesn't )

So what do you think, what can i do to get better absorption.

I take iron, vit c, b12, a mix of zink and selenium...

of course i'm going to start taking my dose one hour before eating now...

regards Elsa

[greygoose in reply to Eliize]

That was rather a large drop. We should only reduce by 1/4 grain every two months, really.

Taking T3 in any form will reduce your FT4, of course, but the FT4 is not the most important number. I don't think that advice was very intelligent. Could they not see on that forum that you're not absorbing your NDT?

Do you leave four hours between your NDT and iron? And two hours for the rest? Do you know if you have low stomach acid?

[Eliize in reply to greygoose]

I don't know if i have low stomach acid though sometimes i think i do.

My supplements, i take in the afternoon of evening.

What's the most important number? And should i take for instance apple vinegar

in het morning, together with ndt or not, to reduce atomic acid?

What should i do with my dose of ndt? Just wait an see what happens, although i'm not feeling too well...

again a lot of questions...

[greygoose in reply to Eliize]

The most important number is the FT3. T3 is the active hormone. T4 is a storage hormone. But, when you're taking NDT, you don't need as much storage hormone because you have the T3.

No, you shouldn't take apple cider vinager with your NDT - and if you have low stomach acid, you need to raise it, not reduce it.

I think it would be a good idea to increase your NDT by 1/4 grain. You're not feeling well because reducing your NDT by one grain reduced your FT3. And, your FT3 was already too low. I cannot get over how stupid that advice was that you received! You really have to be careful just what advice you act on. Waiting to see what happens is not a terribly good idea because nothing much is going to happen, you're just going to continue being very under-medicated.

I would suggest that you try the home stomach acid test at the end of this article:

scdlifestyle.com/2012/03/3-...

If your stomach acid is low, you could try taking your vit C at the same time as your NDT, and see if that helps. Then take apple cider vinager before your meals.

[Eliize in reply to greygoose]

Thank you a lot! This is really helpfull information.

(If you would give a course I would really want to be part of it!!!)

I take your advice to heart and get started with the test.

Until later...

Elsa

[greygoose in reply to Eliize]

You're welcome.

[Hidden]

When on NDT, you need to go by symptoms, not labs.

NDT is bound to suppress your TSH, making this a useless test. Don't let any doctor or anyone else tell you that a suppressed TSH is dangerous. It does not mean you are hyperthyroid unless you have symptoms indicative of excess t3.

FT4 levels are not as important when taking meds containing T3. Like Greygoose points out, you need less T4 when on NDT as it also contains T3.

If you add T4 to NDT, you risk ending up with more T4 than you need, and that will increase the risk of reverse T3 dominance. Remember, NDT is 80% T4.

Many turn to NDT because they cannot convert T4 to T3. If the conversion process is impaired, taking a lot of T4 won't do you any good as it will not convert to free T3, but instead float around unused in the body and eventually be converted to the inactive rt3. Too much rT3 in relation to free T3 will keep you hypothyroid regardless of how low your TSH is or how much T4 you take.

The only way to know if you are overmedicated is to go by symptoms. Do you tend to sweat profusely, do you feel agitated most of the time and have a racing heart? That could be signs of too much T3.

If not, don't look too much at individual labs, but rather at the whole picture. Many only feel well and end up symptom-free on NDT with a completely suppressed TSH and FT3 levels in the top third of range, or even at the upper normal limit.

Also, don't decrease by a whole grain at a time, but rather by 1/4 grain.

[Eliize in reply to Hidden]

Thank you for the helpfull information! I know what to do now.

Best Regards,

Elsa

[SilverAvocado]

Eliize, sounds like you have had excellent advice! I am also on a pretty high dose of NDT. There is not much that can be done if you happen to need a high dose. Everyone is different!

I also take Apple cider vinegar for low stomach acid. I take a little in a glass of water before every meal. Of course making sure it is well away from my NDT dose!

Good luck!

[Hidden in reply to SilverAvocado]

SilverAvocado,

Can I ask how much NDT you are taking? And which brand?

[Eliize in reply to Hidden]

i take 4 grains of Thyroid-s

[Eliize]

Thank! And good luck to you too!

[SilverAvocado in reply to Eliize]

Oh yes, one other thing. I was saying there's not much you can do if you need a high dose, but making sure vitamins are optimal is one thing to do. Ferritin, folate, vitamin D and vitamin B12 are the ones to check out.

These need to be optimal, which is different from 'normal'. Most need to be at least halfway up the range, and some can be better near the top or over the top of the range. If you have some results and want advice make a new post with them in so more people will see.

[Eliize in reply to SilverAvocado]

Hi, yes i'm going to check them too next time!