I've been struggling with my dosage of NDT and can't seem to get my sweet spot. I started NDT back in November 2018.
I am up to 2 &1/2 grains. The dosages before this didn't give me full relief.
On 2 &1/2 grains I felt fine for three weeks and thought I had cracked it, then I started with high pulse rate, jittery, spaced out and anxious and internal vibrations, despite just laying in bed. The internal vibrations, feels like your in bed and its shaking.
Not wanting to increase further until I had a bloods, I did carry out a blood test on 2&1/2 grains
TSH 0.01 (0.27-4.20)
T4 17.60 (12.00-22.00)
T3 8.29 (3.1-6.8)
Ferritin 90.3 (13-150)
B12 724 (over range)
Vitamin D 125
Based on those results I was advised on here to drop 1/4 grain and then another 1/4 grain as my T3 results were high.
I have now dropped 1/2 grain and I am taking 1 grain at 6am and 1 grain at 2pm.
I realise that as NDT has T4 it is going to take a while for the body to adjust, but, I have started getting freezing cold feet again and my body is really cold like ice cold water running through my veins, I had this before and it seemed to go.
I don't feel as jittery, and my internal vibrations are less, not gone though, but, I can't seem to control my heart rate, its always high in the mornings, 95-100 and then during the day 86-100 despite sitting down. My temp in the morning is 35.6, and as soon as I get out of bed, I'm cold. My chest feels tight and I feel like I have a chesty cough, wheezing.
I have noticed a pattern recently, I seem to feel normal 4 hours after taking my NDT at 2pm and then in the evening I feel normal, this must be something to do with my NDT and the T3 in it, that effects me feeling jittery?
I take my dosage at 6am & 2pm, so in the morning I feel jittery, cold and my pulse is high, this is after taking my NDT, then after my 2pm dosage I feel the same, it appears that maybe after my T3 has worn off in my NDT I feel better, yet I am freezing cold since reducing my NDT.
Do you think I need to do a reverse T3 test, or is this a waste of time? and do you think that I perhaps I need to add some T4 to my NDT?
I know they say bloods are not important on NDT, but, had I increased without a blood test this time, I would of been even more over on my T3.
I do like to do bloods as I want to know what levels I need to be to find my sweet spot.
It appears that maybe the NDT dosage is too much, yet I need something extra.
My neck is also very tight and stiff as well, this was another major symptom as well, which disappeared, but is coming back.
I was on levo via the NHS and I felt awful on it, I followed the procedure increasing by 25mcg every 6 weeks with bloods and my results looked good, but, I felt awful, my symptoms never went and I had more on top of them.
I have high cortisol, morning and mid morning, and Hashimotos
It is the T4 that regulates the body temperature?
Best Wishes
Peanut 31
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Peanut31
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Your symptoms suggest you're still overmedicated. If you drop the NDT further, you might have to add some T4 to resolve the other symptoms, like feeling cold. I would expect your rT3 to be high, because it rises when someone takes too much NDT as a protective mechanism.
Peanut31, how long have you been on your current dose? It sounds like you're having both overmedicated and undermedicated feelings at the same time. This can happen to me when I first change doses.
Another option is to split your dose into 3, which might even things out a bit. I also find plenty of walking seems to soften some of these peaks and troughs. I don't know how much activity you can do, but maybe keeping it close to your maximum.
Although your freeT3 was over range, it wasn't over by loads. Two increases could well have taken you a bit too far.
If you're not sure whether you're over or under I think there's no option but to have another blood test. Make sure you've been on a dose for at least 6 weeks when you do it.
your symptoms are indicating your T3 is not getting to the cells. There are three things that need to be in range for our body to properly use the T3 (from the NDT, or any T3): Glucose level, Iron level and Cortisol level. It sounds like your cortisol is high -one, because your say it is. Second, your heart rate is elevated. Third, you are cold but have over medicated symptoms. Your body is not using the NDT. Taking more only makes things worse. I would expect your reverse T3 (rT3) to be high since your cortisol is not optimum and is depriving the intake of the T3 from the NDT. Ideally you want you FreeT3 to be high and your rT3 to be low. until you regulate your high cortisol (which will also lower your heart rate) you will be chasing your tale. Try to get a Saliva test for your cortisol ASAP, have your Free T3 and your Reverse T3 tested. Note also, it is very common that if our Reverse T3 is high (T3 in our blood pools if not used) we feel bad and have hypo systems. You will need to regulate your cortisol first, then you can dose your NDT properly - only then will you start feeling better, regulate your body temp, heart rate, blood pressure. if the Cortisol is regulated and you still have issue, then NDT may not be for you. But in general, NDT is definitely the way to go. As for the T4 regulating body Temp, the short answer is NO. The active hormone is T3. So if you take more T4 it wont give you the results you are looking for if your body cant convert it to T3. The T4 is slower release - but only because our body has to convert T4 to T3, so basically T4 just gives you some "reserve" as your body can grab some and convert it to T3 as it is needed. The half life of T3 is only 5 hours or so, and the half life of T4 is measured in days. But that is not always accurate either, as those of us who are Hypo have slower metabolism- so each person and their dosage amount and timing will be different, that is something an individual will have to determine based on symptoms and not an exact "etched in stone" script that is "suppose" to work for everyone.
Anyway, get a salvia test and reduce your NDT as it is making you sicker - for now. once you regulate your cortisol then you will feel the benefits of Thyroid medicine, regardless if it ends up being NDT, T4 or a combo of T3 with NDT or T4. Some even have success on T3 only.
I’ve done three saliva tests including DHEA one of which was done via thyroid uk and all have come back high cortisol morning and mid morning, afternoon and stabilising in the evening.
My most recent one March, had improved only slightly, so now I’ve changed to trying Holy Basil instead of Ashwagendha.
As well as increasing vitamin C and magnesium, which i take anyway.
Obviously, there are other aspects that effects cortisol, daily life for example.
I’m not been exercising for a while as felt too ill.
I’ve reduced my NDT by another 1/4 so now I’m on two grains instead of 2 & 1/2.
The lower levels of cortisol in the evenings with improved symptoms later in the day, is/are another indicator the cortisol is causing conversion issues with your NDT doses, causing pooling of T3 in your blood, so I would expect your rT3 level is high - and you feel crummy because of it. Yes, good: Zinc, Holy basil (like you mentioned), DSF herbal (not DSF Formula - this raises cortisol) will help you. High Cortisol could eventually lead to low cortisol so continue to check your levels every three months. Cortisol is difficult to properly regulate without Saliva test because many Hyper-cortisol symptoms are much the same as Hypo-cortisol symptoms. So definitely continue to get the saliva test. I understand you don't feel like exercise, however, try to go for walks, particular during the times when your cortisol is elevated. just FYI, I too tried NDT and after a few years had to go in a different direction. But NDT is the way to go if your body can convert it. I think once your cortisol is regulated and you can get the correct NDT dose and timing you will feel much better. Your TSH number shows you have taken enough NDT (actually too much), you have suppressed the need for stimulation, you body just isn't converting it and the T3 is not getting to the cellular level, hence you are cold and you feel crummy. I can tell you have done some research, it just takes time, just use that rT3 and Free T3 tests to help you dose. your TSH may end up at .5 to 1.5 when you feel your best. I hope you feel better VERY soon.
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First results after switching to NDT. Help pls ... 
To raise or not to raise - case study
T3 Only - 5 Weeks in
