Fastest way to step down 1/4 grain NDT - Thyroid UK

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Fastest way to step down 1/4 grain NDT

ak_83 profile image
11 Replies

I need to decrease my dosage of NDT from 2.75 grains of NDT to 2.5 grains. I've heard it was always harder to decrease the dosage due to the 10 day half life of T4.

My idea is, instead of decreasing the dose and waiting for weeks (2 months?) for everything to adjust, is to stop all NDT for 3 days and then resume but the adjusted lower amount. Hopefully this should stabilise the blood levels within 2 to 4 weeks.

Can anyone confirm or have a better faster way?

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ak_83
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11 Replies
shaws profile image
shawsAdministrator

It is very simple, just start taking the lower dose from tomorrow. Remember to leave a gap of 24 hours between dose and test and to get the earliest test, fasting (you can drink water) which should give a lower blood test result.

meme profile image
meme in reply toshaws

I thought it was a 12 hour gap before testing when on NDT?

shaws profile image
shawsAdministrator in reply tomeme

Sorry - my fault. I was on automatic pilot :)

ak_83 profile image
ak_83 in reply toshaws

Interesting. I've always done 24 hours. It also means no adjustment to the time of the dose other than taking the morning dose straight after the blood test.

radd profile image
radd

ak_83,

T4 has a long half life. Hence your body would have a delayed reaction to the absence of your daily dose.

Unfortunately T3 has a short half life and so the daily administering is imperative so as not to allow T3 levels to become depleted. Remember it is the T3 that brings well being and allowing levels to become too low, even for only 3 days, will stress the adrenals and may take a long time to recover from, even when biochemistry is recovered.

If thyroid hormone levels are too high, reducing slowly will be more progressive long term.

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SilverAvocado profile image
SilverAvocado

Unfortunately, all these things take time. I've heard it suggested to take 1 day without medication, but never more than that. The half-life of the T3 in that NDT is more like 6 hours, so even skipping just 24 hours will get you to a very low percentage of your dose remaining. And when on NDT we are really living off the T3 rather than the T4.

You don't mention why you want to reduce so quickly? Are you experiencing very frightening overmedication symptoms? That's really the only time to think about trying to speed up a dose reduction. Even then, it is gentler on your body to reduce as normal and just hang in there for a few days of discomfort.

Hypopotamus profile image
Hypopotamus

2.75 grains to 2.5 is a small step. I am not sure what the issue is in simply reducing the dose from one day to the next. I have done that many times without a problem.

ak_83 profile image
ak_83 in reply toHypopotamus

The issue is, I want it done as fast as I can without waiting the full two months and then retest.

teenarocks profile image
teenarocks

Although I don't take NDT (I take both T4 and T3), I was in your same boat a year ago. And I did exactly what you are proposing. I stopped my hormone completely for a little while and then started on a lower dose. It threw me off completely and as Radd has said above, it took me a very long time to recover from it. I would not do it again. I agree with Hypopotamus it seems like a small change. I would just decrease the dose but continue with your medication.

shaws profile image
shawsAdministrator in reply toteenarocks

One of our Advisers (now deceased) stated that he only took one blood test for the initial diagnosis and thereafter increases were according to how the patient 'felt' and relief of their symptoms. Doses were once daily with 1/4 tablet increase every two weeks until symptoms were relieved. I shall give you a link - just for information. This is some information which you might find helpful. He would never prescribe levothyroxine, only NDT or T3 for patients who were thyroid hormone resistant. Always take note of your pulse/temp and if either goes too high, drop to previous dose.

naturalthyroidsolutions.com...

ak_83 profile image
ak_83

Thanks all. It looks like there is no shortcut I was hoping for. I'll reduce and retest in two months.

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