I've attached my latest Saliva test. I have gone from too low cortisol to too high. It happens straight after I take my NDT. I have been taking 110mcgs x 3 times a day. I was taking the first dose 2 hours before I got out of bed. This was the strategy to get my cortisol up but now it's too high and I feel agitated and anxious. I feel over stimulated, I have diarreha and body pain and weakness. I have tried supporting my adrenals with supplements and now using Holy Basil to bring it down again. I am so upset because if I go back onto Levo then I will have brain fog again and I can't function. But I have struggled since last September with NDT and am just a wreck. I can't take enough to be therapeutic. I tried T3 only and ended up in hospital. with a TSH of 78. I couldn't get past 15mcgs without adrenaline rushes.
My last bloods showed that I was undermedicated, but I just can't take more. Please help?
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Sally56
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Have you ever thought of combining T4 with NDT? If you have diarrhea, you're clearly overmedicated. T3 raises cortisol, so you have to lower your NDT dose if you want to bring that back down. But then you'll probably feel hypo, because your T4 will be too low. To get around that, some people are combining T4 with NDT. There are some examples here: tiredthyroid.com/blog/2014/...
Thanks for answering. This makes a lot of sense to me. I think this is a great idea. My NDT is compounded (in Australia) and is 38T4/9T3 per 100mcgs. I weight 66 K's (shock have put on 3 k's in 3 weeks) so I need 100mgs T4 Plus 10mcgs of T3. I take 110mcgs in one capsule, But have been taking 25mcgs and still having cortisol problems so I seem to be intolerant of very small amounts at the moment. I'm going to go back onto T4 to settle my adrenal glands but then introduce NDT slowly. I definitely need T3 for my brain fog but maybe, as the page advises I need less T3 and more T4. Thank you so much.
Sally56, this is a slightly strange weight. Hai lot when people talk about NDT it will be 1 grain = 65mg. Whereas you're having the same amount of active hormone in 100mcg?
Do you have any blood tests showing whether you're undermedicated on your current dose?
It may be that you have no choice but to treat the adrenals in tandem, and go only very slowly with thyroid dose. Its easier to do this with T4 as its gentler on the adrenals.
Have you looked into vitamins as well? Ferritin, folate, vit D and vit B12, you need at least these optimal to support the adrenals.
Unfortunately dealing with adrenals can be a longer road then getting onto thyroid hormone, as its a lot more trial and error and advice is less clear cut.
Yes, you made me re think. I found some figures given to me when my dose was 120mcgs. It was T4 66.5 and T3 16.6. so those other figures must be wrong. So going on that 110mg would be approx T4 60 and T3 15mcgs. I have made an appointment with my Adrenals specialist concerning my Primary Aldosteronism hyperplasia.. I found an interesting study published after I saw him last. It confirms what I have been trying to tell im and my Endo that my adrenals also over produce cortisol (as well as the aldosterone. ) "Cortisol Excess in patients with Primary Aldosteronism impacts Left Ventricular Hypertrophy". It confirms my findings with the saliva test that I over produce cortisol. So no matter how I treat my adrenals, nothing is going to stop it unless I take something else other than the Aldosterone medication. I'm very complex with this rare disorder and no thyroid. (Which are obviously connected though I have to see two different specialists). But thank you for your response. I have stopped my medication completely to wash out the T3 which I suspect is causing issues. I will start back on T4 tomorrow and then go form there.
Unfortunately with a slightly more complex adrenal issue you may find it difficult to find much conclusive advice about what to do. I've found just trying to look into adrenals alone its already quite confusing.
Are you doing all the lifestyle things to treat your adrenals? Rest more, reduce stress, meditate, sleep well, eat well (and gently on the adrenals, not dieting or missing meals), exercise only gently, etc.
Looking at your 24hr chart, it doesn't look absolutely terrible. Your two elevated items are only just out of range, and your total daily cortisol and DHEA are both inside the range, although they are on the high and low side respectively. It is possible this is on the mend if you've previously had low cortisol.
Can you say more about your difficulties on NDT, and have you got any blood tests to show? It's possible your doctor had just not done a good job of introducing it and adjusting your dose. All too often people have been suffering and its just because they've been left on the wrong dose.
It's one of the simplest things to rule out. At the moment you're taking 60mcg T4 and 15mcg of T3 3x a day? This is 180mcg of T4 and 45mcg of T3 per day. It's quite a substantial dose, so it's possible this is close to your ideal dose, or that you've gone over, which could cause very unpleasant symptoms.
Usually on the forum we advise, tune your thyroid replacement until your blood tests look perfect, and make sure your vitamins are optimal, and only after that think seriously about any other complications. Because these are the simplest things to get perfect, and give a good grounding to work on other health conditions.
No I odn't have very recent ones but see my GP on Thursday and will ask for a blood test form. Previously my last blood work (6 weeks ago) was indicating that I was under medicated. But it's only been stopping the NDT (and I believe T3) that my adrenals are getting better. I was having constant adrenaline rushes again. The high cortisol and adrenaline give me lots of confusing symptoms and whilst the blood tests say 'Under-medicated" I have symptoms of too much. I have been on NDT since last September, I was fine, though under medicated on 90mcgs, then pushed up to 120mcgs, which saw me spiraling out of control again. I have not taken anything now since last Thursday. I feel so much better. I know though that with no thyroid I need to quickly get some T4 into me.
Another question I have: I have in the last few months added Zinc, selenium, B12 and Multi B's to my iron and Vit D. I am curious about whether I have started converting better? Blood tests will advise.
Re the dose. I was taking just one dose of 60mcgs T4 and 15mcgs T3 a day.
Thank you from the bottom of my heart for your guidance.
You don't mention how you got started on NDT, but perhaps an option is to start very cautiously. Start on 1 grain, or even as low as half a grain, stay on that for 6 weeks and have a blood test. Then adjust dose based on the test, hold for 6 weeks then test again, and so on.
Or having felt bad on NDT, maybe you should try T4 + T3, or T3 only?
My own experience (I've also had a thyroidectomy), is that I was taking T4 + T3, and went off it completely and felt better. I'd been advised to stay with nothing until I started feeling worse. But after 2 weeks I chickened out even though I still didn't feel any worse! I tried NDT at that point and almost immediately felt an improvement from what I'd been taking before. But everyone is different and different formulations suit different people.
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