Hi any help would be great.
My 21 year old daughter who has been on T4 for 11 years wants to take NDT it's not in grains but 60mg tablets , she currently takes 150mcg T4 and wants to know the best way to convert ...It's all so confusing so many different opinions .
Thanks
Typing error it's NDT lol
I would Edit your heading from net to - NDT ... more will respond 
I agree!
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I have changing the predictive text error from NET to NDT
LMJ65
"it's not in grains but 60mg tablets"
1 grain tablets of NDT = 60mg for most brands (I think there is 1 brand that is 65mg).
Each 1 grain tablet contains 38mcg T4 and 9mcg T3, except for Erfa brand which contains 35mcg T4 and 8mcg T3.
Full details of each brand here:
stopthethyroidmadness.com/a...
T3 is approx 3-4 times as "potent" as T4 so 9cmg T3 is approx equivalent to 27-36mcg T4.
So 1 grain NDT is approx 35 + 27 = 62mcg T4 or 35 + 36 = 71mcg T4.
So she can work out how many grains to swap over to. She wont get an exact equivalent, just an approximate equivalent, and personally I'd start lower rather than higher and increase if necessary by 1/4 grain increments so as not to miss her sweet spot. If that was me I'd start with 2 grains, wait 6 weeks to see how things are, retest to see what hormone levels are like, then adjust dose if necessary.
I'm not medically trained, this is just my opinion based on experience and reading/research.
Thanks for info x
Has she had FULL Thyroid and vitamin testing recently (or ever?)
Couldn't see any vitamin test results in previous posts
As she has Hashimoto's low vitamin levels are EXTREMELY common
For full Thyroid evaluation she needs TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).
If/when also on T3, or NDT make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
thyroiduk.org.uk/tuk/testin...
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
obviously once she's been on constant unchanging dose of NDT 6-8 weeks she will need FULL Thyroid testing of TSH, FT3 and FT4
Yes full tests paid for privately several times and all levels of everything bad..Iron was so low we went to the Iron clinic I in London last Summer for an Iron infusion was meant to go for Vitamin D infusion in October but too unwell to travel .
Rt3 was awful( need to look put results )
She is dairy free and went Gluten free in November and has lost 3 and half stone but still has no energy and sadness...all a nightmare .
So it's incredibly important to regularly retest vitamin levels and supplement like mad to keep them optimal
How low was vitamin D?
How much vitamin D is she supplementing?
Better You vitamin D mouth spray is good as avoids poor gut function of Hashimoto's
GP will only prescribe to bring vitamin D up to 50nmol.
Aiming to improve by self supplementing to at least 80nmol and around 100nmol may be better .
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
Retesting twice yearly via vitamindtest.org.uk
Is she taking a good quality daily vitamin B complex?
Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.
chriskresser.com/folate-vs-...
B vitamins best taken in the morning after breakfast
Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).
Or Jarrow B-right is popular choice, but is large capsule
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
Working hard on maintaining iron levels?
Eating liver or liver pate once a week, plus other iron rich foods like black pudding, prawns, spinach, pumpkin seeds and dark chocolate, plus daily vitamin C can help improve iron absorption
FERRITIN
healthunlocked.com/thyroidu...
drhedberg.com/ferritin-hypo...
restartmed.com/hypothyroidi...
Post about iron supplements
healthunlocked.com/thyroidu...
Is she supplementing selenium?
Daily vitamin C to support adrenals
Can you add most recent vitamin D, folate, B12 and ferritin results and ranges
Thanks for all the info . I will pass it on bit she is vegan and its taking ndt as she is too ill on Levo
Extremely difficult to maintain good levels of ferritin when vegan
She will most likely need ongoing iron supplements, but extremely important to test full iron panel regularly as iron is extremely tricky
One tablet of 65 cmg NDT we call one grain. i.e. two tablets = 2 grains.
Transition from T4 and T3 to NDT
Switching from NDT to T4 + T3
Switching from NDT to T4 and suffering...
Switching from T4-T3 combination to NDT
Switching from a NdT to bioidentical t4 and t3
