Binned all my Levo - NDT only now but T4 still low - Thyroid UK

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Binned all my Levo - NDT only now but T4 still low

I was only getting a very low dose of Levo on prescription. I have been using solely 2 grains of NDT for the past few months as the Levo appeared to make my joints ache when I last used it at the end of last year

NDT seems to be working ok. TSH now down to 2.2, Free T3 now about 5.7

Free T4 is still well below range at 9 so I thought I would add in 25mcg of Levo to the NDT to try and boost the T4. After 10 days my joints started feeling as if I was 80 yrs old, ruined an activity holiday for me as I could not move properly.

So, I just binned the lot. It is never going to work for me,

Question is, how do I get Free T4 up using just NDT? is seems to affect TSH and T3 positively but appears suppressive to T4.

12 Replies


The FT4 level becomes inconsequential when medicating T3 or meds with T3 in it.

It is adequate & working FT3 levels that bring well being and the TSH levels that indicate if more meds are required (as long as your pituitary is working).

Your TSH allows room for a dose increase but your FT3 looks adequate, although hard to confirm without range and knowing how many hours meds were taken before blood draw.

Many who medicate T3 or NDT have low FT4 levels including myself. If you confirm test ranges and when meds were taken before the test, members can make more informed comments.


This was about 9 hours after last dose if memory serves. I am afraid I don’t have ranges to hand but it would be fairly standard medichecks ranges.

I might add in another half grain to the 2 I already take.



It is true some people require higher doses of T3 to achieve well being but be aware that elevated FT3 levels can be problematic and especially for men as it may decrease androgens (male hormones). You may want to read "The CT3M Handbook " by Paul Robinson to be aware of the pit falls.

Your TSH does allow room for a med increase but it looks as if you need additional T4, so maybe a different brand of Levo that doesn't contain the fillers that you might have been intolerant of.


I am already on TRT so my hormone levels are very stable. Thyroid testing and initial treatment revealed I had a consistent very low free testosterone level so I got that addressed. I can try another half grain to see where that gets me with regards Thyroid levels.


When did you last test vitamin D, folate, ferritin and B12?

keeping these optimal by supplementing may enable you to tolerate high doses of NDT


My vitamin levels were fine 6 months ago. I guess I am due for another check. I will look into this.


I do hope you didn't actually put them in the dustbin, but took them back to the pharmacy to be disposed of safely. :)

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They are in a storage box. Wasn’t sure what to do with them actually. Would a pharmacy take them?


All unwanted medicines should go back to the pharmacy. We can't flush them, put them down a drain or in the dustbin. The pharmacy will safely dispose of them.

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I have the opposite problem really. To achieve good FT3 I am over range on FT4 (just). High FT4 does not suit me.


The Endo I used to have was very helpful on NDT. He told me ideal results as a guideline were

TSH suppressed. 0.01

FT4 can fall in its range but no lower than halfway

FT3 high in the range

I've kept to that, Endo was only in UK for a year sadly but until the last chap I saw lowered my dose I've been very well.


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