Switching from a NdT to bioidentical t4 and t3 - Thyroid UK

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Switching from a NdT to bioidentical t4 and t3

Missydoo82
Missydoo82

I am about to switch to a compounded t4 and t3 medicine from NDT.

I would like to know will adding more t4 hormone to the compounded thyroid improve the status of my t4 levels without raising the t3 levels over the range? My t3 levels at the moment is not the top of the range but close. I have found that while on NDT my t3 always goes to the top range when I raise the medicine, and t4 is always below the range. I do feel that I am quite sensitive to t3 and although my other symptoms improve I feel nervous and have high pulse rate when my t3 is top of the range and t4 not even mid range. I do think that it does have to do with my t4 not being optimal. I have Hashimotos. Thank you so much for your help!!!

35 Replies
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Very confused by your 2 posts first one asks if you need medication on those blood results, the second states that you are on medication, ndt and want to change to t3/t4 combo. Not sure why the 2 questions giving 2 different scenarios.

Ndt has different t3/t4 ratio to human levels therefore it is normal for ft4 to be below range. The consensus seems to be as t3 is the active hormone and that is high in range low t4 is not a problem. There may be others who are more experienced with ndt who will also comment.

Hi yes, sorry for the confusion. The first post I wanted to see what everyone thinks about those results, and that is before I started any medication about a year ago. I am very interested because I am mostly self diagnosed, and what I mean is not until I raised the matter through my own research and paid a very expensive specialist did I get any treatment. But still struggling to get a clear answer and with finding the right dose and being completely symptom free so I am very interested to know what would everyone say about my results before the treamtnt. Thanks?

Taking T3 in any way will lower your FT4. That is normal. You could try raising the FT4 by adding more T4 but there's no guarantee that will work, or that that will make you feel better. But there's no fixed answer to that question, because our bodies are all different, with different needs. You have to find what your body needs as an individual. :)

Missydoo82
Missydoo82 in reply to greygoose

Thank you greygoose. I would like to know if I raise the t4 while my t3 is top of the range is there a chance that I might go hyper?

greygoose
greygoose in reply to Missydoo82

No. You can't go hyper because you're hypo. The thyroid doesn't work like that. You could become over-medicated, but that's not something you can predict. You'd have to try it to see. It depends how well you convert, and how much T4 the body hangs on to, and various other things. But, even if you did become slightly over-medicated, it's not a catastrophe. You'd feel it and reduce your dose. :)

Missydoo82
Missydoo82 in reply to greygoose

How should I go about this, should I lower my t3 a little bit and raise t4 if it does affect the t3 levels? Or I dont have to worry about t3 going over the range. What I am trying is to make is similar as I can to the human gland ratio since I do think that this might be my problem with NDT.

greygoose
greygoose in reply to Missydoo82

I don't really understand compounded thyroid hormone. Do you chose how much T4/T3 goes into it? Or are you proposing to add extra levo to your compounded hormone?

When taking T3 it's not the ranges the most important, it's how you feel. Some people need their FT3 slightly over-range to feel well. Maybe you do, but you won't know until you try. But, for a short period of time, until your next test, it really won't be a problem if your FT3 is over-range if you feel ok. :)

Missydoo82
Missydoo82 in reply to greygoose

Yes I can decide how much of each I want. It is more expensive but in my opinion if it works you cant put a price on that. They do also have pre made ratios which costs less which I am trying first as it is similar to what I am taking at the moment ( 57 mcg t4 and 9 mcg t3) but thinking in the future I might try adding more t4 to my ratio. Can't you get compounded or bioidentical thyroid where you are at? I think its the same thing , bioidentical and compunded? I am also new to this but my doctor has suggested we try it as I might have less reaction to it swith the antibodies since I have Hashimoto. ☺

greygoose
greygoose in reply to Missydoo82

All you can get here in France is levo and T3. No NDT, no compounded hormone. Where are you?

So, anyway, thank you for explaining that to me. :) And, if you want to try and raise your FT4, that one you mentioned sounds good. But, as I said, you can't predict how your body will react to that ratio. You just have to try it and see.

I have heard that NDT isn't a good choice for Hashi's people, and can increase attacks on the thyroid. But for me, I think the reason it didn't work is that it didn't have enough T3 in it. Right now, I'm taking 75 mcg T3 and 25 mcg T4, so a totally different ratio to yours! But, we need what we need, and that's all there is to it. :)

Missydoo82
Missydoo82 in reply to greygoose

I am in New Zealand 😊

No, bioidentical and compounded aren't the same thing. Bioidentical means the hormones in the product are chemically identical to those your body produces; and compounded is taken to mean combining ingredients to create a medication tailored to the needs of an individual patient (all drugs are in effect, compounded, but the term is generally used to differentiate those 'ready made' and those made up for a specific person).

would bioidendical then be a better option for Hashimoto patients? Thank you.

Missydoo82
Missydoo82 in reply to greygoose

The thing is my doctor cant really give me a clear answer. I know Hashimotos is complicated and there will always be ups and lows and flare ups, but there must be a clear line somewhere. He thinks I am overmedicated as you say, but I am not convinced. I have only started medication a year ago and surely it takes time for the body to adjust to medication and also find the right dose. Sometimes the symptoms can be similar when hypo as well as overmedicated. What I undestand is when there is not enough hormone you can also have some symtpoms like high pulse rate, anxiious, insomnia etc. Which is similar when overmedicated as well.

greygoose
greygoose in reply to Missydoo82

You're absolutely right, a lot of symptoms can be both hypo and hyper, but, you know if things suddenly change that something is up. Symptoms rarely disappear - or even appear - over-night, naturally. So, a sudden change means something. And, that's when you need labs to confirm one way or the other - in an ideal world! Not always possible, I know. But, unfortunately, it's difficult for anyone to understand this without experiencing the disease, and doctors don't even learn that much about it in med school. So, the odds really are against us from all directions.

And, you're right, it can take years to get the dose right. And having Hashi's means that the goal posts are always moving. Your doctor is just going to have to accept that you live in your body, and he doesn't. So, in that respect, you are the expert. And, you need to be able to experiment to find what make you well. And, if you go a little over-range, it doesn't automatically mean you are over-medicated. If you feel well, that's what's right for you.

I'm not sure there ever is a clear line. Not while you still have some working thyroid, anyway.

Missydoo82
Missydoo82 in reply to greygoose

😊 the doctor I am with at the moment is good. He is an integrative doctor although he is a GP. I have switched GP's since my last one didnt even want to acknowledge that NDT exists! 😂 But this doctor at the moment is open minded and he does know a lot, but as you say we always need to be our own doctors. I am also very stubborn and will not do as my doctors tell me too unless I am completely certain that it is the right thing, and I am aware that sometimes I am wrong and they are right! My doctor at the moment thinks that I should be on t3 medication only and then later introduce t4 in little doses if I wanted to. Similar to what you are taking at the moments . But I am very reluctant , since I am trying to get pregnant and I understand that the t4 is very important in pregnancy ( although t3 is the active hormone). In my understanding tt3 only therapy is the last option for people who have tried everything else and nothing seems to help and who are very symptomatic, which is not my case. However I have a friend who got pregnant and sustained the pregnancy on t3 therapy only after being in NDT so it seems that it works in some cases. 😊

greygoose
greygoose in reply to Missydoo82

I must confess, I'm very ignorant about thyroid and pregnancy. Isn't it something about the T3 not being able to cross the placenta, or something? I don't know. But, I can understand your reluctance. Why does he think you should be on T3 only? In my case, it was because I tried everything and nothing worked. But, now, I tolerate T4 much better.

Missydoo82
Missydoo82 in reply to greygoose

yes i think so. In my reasoning I guess it could be that t4 levels once they are good it is much easier to deal with any changes during pregnancy then with t3? Since t3 has a very short life in the body? And yes t3 cant cross the placenta so they say. But ofcourse t3 levels are just as important its just that it is more risky to manage t3 therapy in pregnancy. But I dont know its just my feeling.

greygoose
greygoose in reply to Missydoo82

Well, that's what they say. But this short half-life of T3 isn't as short as they imagine. It stays in the blood for 24 hours, but what gets into the cells, stays there for three days. I just don't know.

jgelliss
jgelliss in reply to greygoose

I'm so excited for you greygoose that your tolerance for T4 improved . I for one feel better with a higher dose T4 and just a small dose of NDT for my T3 mix . It's important that one understands and knows what works *best* for themselves .

It's Not One Size Fits all .

greygoose
greygoose in reply to jgelliss

It's only improved slightly, I can only tolerate about 25 mcg. And, so far, I haven't found any benefits - I'm a lot more tired than I was on T3 only, although that could just be coincidence. So, I don't think it's anything to get excited about. :) I'm only giving it a second chance - or is it a third chance? - in the hope that it might do something for my hair.

jgelliss
jgelliss in reply to greygoose

What I had to learn and master with my thyroid Journey was that Patience is a Virtue . And Slow and Steady wins the Race . Wanting to feel our very Best and *Optimal* does come with a price . Hopefully The Payoff is all Worth It .

Wishing You Your *Optimal Real Soon* .

Missydoo82
Missydoo82 in reply to jgelliss

what dose are you on? Have you ever tried the way around, higher t3 and lower t4 dose ?

jgelliss
jgelliss in reply to Missydoo82

I tried dosing with higher dose NDT (splitting dose) + low dose T4 . I felt lethargic muscle weakness insomnia , weight issues , aches/pain . That does not mean that others don't do well or even better with higher doses of T3/NDT and just a small dose of T4 . It's best to know one self what works well to feel their *Optimal*.

Nutrients are very important too they help our thyroid hormones work better for us . Vitamin "D" /K2 , B-Complex , B-12/folate , Iron if low , magnesium , Vitamin "C" , Celtic Sea Salt for Adrenals/ Electrolytes .

Wishing you your *Optimal* very soon .

jgelliss
jgelliss in reply to greygoose

Love your *Passion* . Very few Endo/Dr's *GET IT*.

Missydoo82
Missydoo82 in reply to greygoose

can i ask how do you know that you are converting well? If my blood test shows that my t3 easily goes to the top of the range while on NDT ( even on smaller doses like 1.5 grains) then that would mean that I dont have a problem converting right?

greygoose
greygoose in reply to Missydoo82

You cannot tell how well you convert when taking NDT. You need to be on T4 only. On T4 only, with a TSH of 1 or under, your FT4 should be just slightly higher in range than your FT3 if you are converting well. But, if your FT4 is right at the top of the range, and your FT3 mid-range, then you know you don't convert well.

Missydoo82
Missydoo82 in reply to greygoose

so even though my t3 goes over the range that doesnt mean that I am converting well? That is just so confusing. In my case the t4 levels are the same as in when i was not medicated, and on some days even lower, but the t3 is always much higher then when I started medication. Also when I was on a higher dose it was over the range. I was certain that that would show that I am converting well. Thas why I wanted to add more t4 to raise my t4 levels since it appears I dont have problems with raising my t3 levels, but rather the t4 in my case.

greygoose
greygoose in reply to Missydoo82

Well, that's because you're now taking T3. You would expect your FT3 levels to be higher. It doesn't have any bearing on conversion.

shaws
shawsAdministrator

Considering, Missydoo82 that blood tests were introduced along with levothyroxine (i.e. T4 only) so when we add or take other thyroid hormones the blood results cannot correlate.

Before the introduction of levothyroxine and blood tests, we were diagnosed upon our clinical symptoms alone and dose of NDT was gradually increased until we were symptom-free.

The following doctor who was also an Adviser to Thyroiduk before his early demise only took one blood test for the initial diagnosis and thereafter it was all about relief of symptoms. If you read the following, it might be helpful for you, i.e. Safely Getting Well.

naturalthyroidsolutions.com...

Missydoo82
Missydoo82 in reply to shaws

Thank you!

interesting.... I run a thyroid group in the US where we can get any type of medication from anywhere. The grass isn't always greener on the other side. I feel terrible on both hormones listed above with fatigue, heart palps and weird chills which seem to be worse on NDT. Would love to say NDT is the answer to the world... I was actually considering a compound at this point myself and your post came up on google. Hope you get the answers!

well I thought compounded and bioidentical was the same but its not. So I will be taking bioidentical homones to correct my mistake. I think that it is possible to get compounded hormones in Australia I believe. But I am not sure about New Zealand. Maybe I should correct my post so not to confuse people. 😶

What thyroid group do you run Bruce?

its on facebook. a local group to dallas, texas

im pretty sure it is the same thing. there are really only 3 types of meds.... synthetics, NDT and compounds. compounds are made from either NDT, synthetic or combining the two together.

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