How should I switch from Levo toThiroyd? - Thyroid UK

Thyroid UK
109,946 members127,798 posts

How should I switch from Levo toThiroyd?


My first order of Thai Thiroid is here. Now how to make the switch? Currently taking 50 mcg Levo and Thiroid NDT equals 35mcg levo and 8.31mcg T3. My Free t3 was 2.50 range just above the 2.30 low range so I'm anxious to improve that (really to begin to feel better!) I'm thinking 1/2 grain for 2 weeks and 1 grain for ? Should I test in 6 weeks and post results for further guidance? My Dr is unaware that I have decide to self treat. Should I just make the switch from one day to the next? Thank you so much for all of your support and guidance. You have made a world of difference!

9 Replies


Do you have a recent FT4 result ?

This will dictate how much you will need to reduce Levo in order to introduce Throid.

It is not advisable to do a straight switch when you haven't medicated T3 before.

marielp612 in reply to radd

Thanks, Radd... my ft4 was 1.3 (.8 -1.8 ng/dl)on February 4. My TSH was .75 (.4-4.50) All tests on same date, fasting before Levo.

radd in reply to marielp612


Your FT4 is exactly half way through range, allowing you room for an increase. If this were me, I would continue with 25mcg of Levo and add half a grain of Throid. This will equate to 75mcg T4 and with the T3 in it, conversion should improve actually giving you a little bit more.

Remember although on the bottle label it says each grain's content is 38mcg T4 and 9mcg T3 = 65mcg T4, manufacturers state that 1 grain is bioactively equivalent to 100mcg T4.

Half a grain will give you 4.5mcg T3 which is a good introduction dose. Initially many complain of a headache and inner heat when introducing T3 which lasts about three days. You must not raise your dose of NDT until your body is tolerating it well.

Hopefully after about a week - 10 days, you will be able to drop the Levo and increase NDT by a quarter grain, (totalling three quarters of a grain) which will equate to a 75mcg T4 with 6.5 T3 within it. Hold for six weeks, retest and post results complete with ranges (numbers in brackets) for members to comment.

50mcg is a low dose of Levo. It would have been easier for you to have just added a little bit of T3, which when adding small amounts is more flexible.

T3 is tolerated better when iron and cortisol levels are adequate.

Good luck.

marielp612 in reply to radd

Thank you radd for such detailed directions. I understand the rationale and will follow accordingly. I'm so glad I asked for help, otherwise I would have found myself in a worse situation. My endo refused to increase the levo to 75mcg, citing toxicity and without regard to my symptoms. Thank you again,,, I will post new lab results in a couple of months


You need full Thyroid and vitamin testing as per reply to previous post

My appt with a new Dr (mine retired) is April 3 and I plan to ask her to re-check what she is willing to order. I was surprised that the Thiroyd arrived so quickly and am anxious to give it a try after having hypo symptoms for 30 years that were diagnosed as fibromyalgia.

It has been a year or so since having all my levels checked, including TPO antibodies, folate and ferritin. My vitamin D was too low 10 years ago and I have been supplementing since and recently increased to 4000 IU from 2000 because after doing the reverse,my levels dropped to 45 from 75 (30-100), I have been supplementing B12 for 7 years and dropped back a bit when my levels were in the 3,000's. I also have been supplementing Magnesium for 3 years, along with B6. None of these made a difference to my muscle and joint pain, brain fog,

fatigue and energy. The B12 did help with peripheral neuropathy. I had an endoscopy 6 weeks ago, including a negative biopsy for Celiac. My thyroid labs are as of 2/4/19. Given all this, I feel confident to begin 1/4 grain of NDT, along with 25 mcg levo. Thanks for reaching out to me Slow Dragon... I appreciate your concern.

SlowDragonAdministrator in reply to marielp612

Essential to test both TPO and TG thyroid antibodies first

recommended to try strictly gluten free diet. Negative test for coeliac doesn't rule out gluten intolerance

About 20% have Hashimoto's and never have raised antibodies as well

Gluten and Hashimoto's

You do look undermedicated as result just on halfway mark and needed to. E in the top third or even the top quarter.

Transferring to NDT. I used the STTM way, if you haven't the book ( Stop the Thyroid madness) you may find out more using a serve engine. I stopped my T4 one day and started on half grain the next. Little bit hazy now as it was 4 years ago so please check it out but I added in half a grain every two weeks up to 2 grains then the instruction said to then continue in quarters so not to miss your sweet spot. I'd also planned to do this so if I had a problem I also had an Endo appointment coming up. My bloods were not good. Now I'd been of NDT when first diagnosed over 30 years ago but I now didn't feel over medicated but I wasn't improving either but had plateaued. My FT3 was over range now so a no no! But he tripped me back to 1.75 which is where I am now. I thought it a bit drop but he was spot on! I think I had to go without for a few days to wash it out. Before I was on 100/125 Levo alternate days if that helps. But whatever you do I would recommend frequent testing.

Thanks Silverfox7, I have seen the guidelines on STTM. I've only been prescribed 50 mcg Levo so I thought I thought it might be good to start more slowly. My ft4 is halfway through the range, a slight increase but my ft3 is 2.5 (2.3 - 4.2) previous 2.65. That's why I decided to try the NDT. It's such good news that you are doing well. My endo won't consider anything about ft3. I will have to use a private lab for full panel testing in 6-8 weeks since my endo won't see me till August and I doubt the new Dr will order more than vitamins. I'm in the US and getting anywhere with Drs here is so difficult. Thanks again and be well!

You may also like...