Adding T3 (Liothyronine) to NDT: After a really... - Thyroid UK

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Adding T3 (Liothyronine) to NDT

Hypopotamus profile image

After a really good spell in 2017, I have gradually come down, and am feeling so tired again.

If I reduce my dose of NDT (ERFA, Thiroid or TR) I am not so tired, but the hypo symptoms come back, most noticeably oedema.

So I am wondering about dropping the dose of NDT, and adding some Liothyronine. Any comments?

14 Replies

Maybe you need to raising your dose a little bit.

Hypopotamus profile image
Hypopotamus in reply to hipolion

But raising the dose makes me more tired.

Although labs are not the be all and end all of dosing NDT, they are a guide. When did you last have any done?

Hi greygoose,

I have my tests done four times a year by my endo. All of them bar one where I reduced to 1 grain of NDT were in the 'normal' range so my endo is not concerned.

shaws profile image
shawsAdministrator in reply to Hypopotamus

I really don't know why the specialist pronounce our results 'normal' if we take anything other than levothyroxine.

Blood tests were introduced along with levothyroxine alone which is T4 and an inactive hormone (it has to convert to T3).

If we take NDT which contains T4, T3, T2, T1 or any other addition, i.e. T4/T3 or T3 alone results cannot compare and all the emphasis should be on the relief of your clinical symptoms.

Read the following 'Safely getting well with Thyroid Hormones' which might be helpful. Dr Lowe was an Adviser to TUK before his accidental death. He would never prescribe levothyroxine. Only NDT or T3 alone for patients who were thyroid hormone resistant.

Hypopotamus profile image
Hypopotamus in reply to shaws

Perhaps I should have said 'normal for me' shaws. My endo does understand that my TSH will be fully suppressed. But as regards the rest, as far as he is concerned, I am OK, although he is sympathetic when I tell him how bad I feel.

I guess that given that he prescribes me NDT he doesn't know what else he can do. Hence I am having to think outside of the box.

If it is too much T4 that is making me tired, then the logical step is to reduce NDT and as some extra T3.

shaws profile image
shawsAdministrator in reply to Hypopotamus

That's sounds right and we have to 'guess' as individuals what may relieve symptoms. At least, as you say, he prescribes NDT.

Well, maybe so. We wouldn't expect anything else. But what do you think about your results? Do you get copies? Just being 'in-range' isn't always good enough. It's where in the range the results fall that counts. :)

He will let me see the results if I ask. I used to all the time but could see nothing that alarmed me so I stopped asking. For me, the symptoms are a better indicator anyway.

Not always, because so many symptoms can be both under-medicated/hypo and over-medicated/hyper. And, knowing about the level of your FT4 and FT3 can help you decide if you need to reduce your NDT and add T3, or if there's some other avenue open to you. Personally, I would have thought it was invaluable to get a print-out each time, and keep your own records, noting what you're taking at the time of each test, and what your symptoms are. One can forget so easily.

Good idea about a print out. I'll do that from now on. I wonder if I can also get a print out of past results?

You should be able to, yes. Depends on the attitudes of your doctor and his receptionist! But, the law says you're entitled to them. :)

I think it’s impossible to do from a test result. When it comes to mixing T3 with NDT it really is necessary to follow your instinct. I recognise the feeling of knowing the NDT is too high. I take NDT with T3 and find that NDT T3 feels very different to synthetic T3, but I seem to need both!

Thanks for that. I also believe that sometimes we have to experiment and see how something works for us. Could I ask you to PM me with where you get your T3 from please?

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