Would appreciate some feedback/advice about my most recent thyroid bloods.
* Im self medicating my thyroid meds and am also on TRT.... Though I now have an endo in the US who I’m working with.
11th of Feb I switched from 31.55 of T3 to NDT (Thyroid-S) as my new endo thought it would be a better option. From 11th Feb - 28th April slowly increased dose up to where I am now which is 3 grains. I’ve been monitoring my blood pressure and pulse and BP is good and pulse slightly higher than pre thyroid meds. 120 over 72 and pulse of 76. (Pre thyroid meds pulse was 60-70)
Symptoms - Not been feeling too bad. Apart from worsening join pain and slightly shaking fingers.
Sorry to appear dumb, but how do you work out that 3 grains of NDT is equal to approx 60 mcg T3? I've tried the maths every which way, and I can't get that result.
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No, it certainly isn't. Because it's not just a case of dividing T4 by T3, it depends how well the person converts. Considering the OP was on a high dose of T3, that would suggest to me that she converts very poorly. So, it's pointless to try and convert NDT to a T3 equivalent. I'm actually shocked that this endo considers it suitable to change some one who was on 31.55 (how on earth do you get to that number, anyway?) to just 3 grains of NDT. It may not sound like a big difference, but it can make a hell of a lot of difference to the body.
I thought it had been decreased. I didn't understand if he was taking T3 only or taking some levo with it. If it was T3 only, then there's no guarantee he'll be able to convert all that T4 to make up the difference in the T3. And, it would all be easier to understand if he'd put in some lab results and ranges. I'm hoping he'll get back to us and fill in the details.
Sorry to talk about you as if you weren't there, Flatdanny, but we have your interests at heart.
Good morning guys and thanks very much for all your input. There seems to be a little confusion which may well be because of me not being clear in my original post. Apologies for that.
I originally wrote I was taking 31.55 mcg of T3 (* T3 only) before I moved to NDT. That was a typo! I was on 31.25 actually. Each tab was 25 mcg and I cut into four. So I was taking 1 & 1/4 tabs.... I then moved to the NDT and started on a low dose and increased the dose over time. Maybe I should have started on a slightly higher dose of NDT at the start.
OK, so now you're taking 3 grains of NDT. But, I'm still not convinced about those results on 3 grains. Your antibodies are low, there, but that doesn't actually prove anything. You can have Hashi's without ever having high antibodies.
Have you ever been on T4 only? If so, do you have labs from that time?
And, how do you feel on that dose, compared to how you felt on the T3 only? Why did your endo think you'd do better on NDT?
I didn’t know that about hashi’s. So how would you diagnose hashi’s if one does not have high antibodies? Curious...
I did trial Levo back in September for only a short time. About four weeks but felt really awful so stopped. In hindsight I should have probably given it more time to see how I felt on a higher dose. I was on 50mcg a day... unfortunately I don’t have labs for that time.
- Did not feel good on Levo.
- Felt much better on T3 than I did on Levo.
- Feel much the same as I did on T3 on NDT.
At the moment I’m not noticing many negative side effects of being over medicated. Only thing is slight shakes in my fingers and increased joint pain. No issues sleeping, no increase in BP, only slight increase in pulse. Just taken my temperature and was 97.6f
US Endo basically just said he would prefer me start with a combo thyroid med (NDT). He did not give me much of an explanation as to why that was, just that he was not a fan of Levo and that ‘it’s a marathon, not a sprint’. So he’d rather I did not start with T3 alone... Not very helpful I know.
Hashi's people with low antibodies are often diagnosed by an ultrasound, where the damage done to the thyroid will show up clearly. But, if your levels tend to swing about, that's a pretty good indication.
Well, you could try reducing your NDT by 1/4 grain, but no more than that in one go. See how it feels, see what your next labs are.
I agree with your endo that it's a marathon, not a sprint, but I fail to see what that's got to do with taking T3 only. Whatever type of thyroid hormone replacement you take, the rules are to start low and increase slowly, so that doesn't sound like sprinting to me. I take T3 only because I didn't do well on levo, and was very ill on NDT. But the last thing I'm capable of is sprinting! lol
Okay thanks. Will reduce dose as you recommend. How low do you recommend I reduce it to before running more bloods? I know you say reduce 1/4 grain but should I just reduce by 1/4 then retest? Also how long till bloods? 6 weeks okay?
Just reduce by 1/4 and retest in six weeks. You're not on a very high dose, you don't want to reduce too far. And, as you don't really have any symptoms of over-medication, you should take it very slowly. I like to err on the side of caution.
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