Switching from NDT to T4 + T3: I have been taking... - Thyroid UK

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Switching from NDT to T4 + T3

I have been taking NDT (Armour Thyroid) for 6 weeks. Although my levels improved, I have seen a slight increase in antibodies (Thyroid Pharmacist Izabella Wentz suggests this might happen). My symptoms remain the same (weight gain/low pulse/low body temp). Given the advice of Izabella Wentz coupled with the fact, I can no longer afford the private doctor who prescribes the NDT, I have decided to do a trial of Levothyroxine + T3. I am currently on 1.75 grains of NDT.

What should be my starting dose of Levo + T3?

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My results on NDT: TSH 1.39 / T3 4.28 / T4 13.4 / TG Antibodies 76 / TP Antibodies 355

Previous on Levo (75mg): TSH 5.77 / T3 3.67 / T4 15.7 / TG Antibodies 83 / TP Antibodies 337

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If your symptoms are still the same, it really doesn't matter if your antibodies have increased. They fluctuate all the time, but Hashi's is Hashi's, it doesn't go away, and if the symptoms are still the same, it isn't getting any worse. Although, to be honest, I don't know how Hashi's would get worse.

I think that this self-styled, so-called 'Thyroid Pharmacist' is of the belief that it's the TPO/Tg antibodies that attack the thyroid. They don't. All they do is clean up the traces of TPO and Tg that have leaked into the blood during the attack. So, if you were doing well on NDT, I see no reason to change. :)

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I would prefer not to change but I suspect I need a dose increase and I can’t afford to maintain the prescription cost of 2+ grains a day.

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Cannot you just order NDT yourself online? Many people source NDT themselves from Thailand at a fraction of the cost of prescription brands such as Armour.

If you are doing well on NDT, it would be a shame to switch to synthetic T3 and T4 just because NDT is too expensive when there are cost-effective options available.

There are two brands of Thai NDT available OTC: Thyroid-S and Thiroyd. Both are porcine and they are available as 1 grain/60 mg pills. 1000 pills cost approximately 100 GBP. If you look for online reviews, you will find that many people find them to work just as well, if not better, as brands such as Armour, Erfa, etc.

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That’s expensive. I only paid ~£54 for 1000x of Thai NDT. Even Thyroid-S is showing to be just £78 right now. 😏

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Yes, I noticed it has been on sale lately. But, anyway, the last year I was on prescription NDT (2014), I paid over 1000 GBP for a year's supply (in Belgium).

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Yes, you would need an increase in dose. But, are you likely to get your T3 on the NHS?

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My Dr is considering it but will take some time if so. A friend has leant me a 1 month trial dose of liothyronine which she gets from Greece. Honestly, I’m not sure what to do next

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It is difficult. But, if I were you, I would check out on-line sources of NDT, see if there's anything you can afford.

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Ok thanks. I will try the Thai NDT perhaps.

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I think that's a good idea. :)

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HarrietJW, I've had an increase in antibodies since on armour too, I'll retest again in 3 weeks, but curious if they went more up. What is the corelation between NDT and antibodies that Thyroid Pharmacist Izabella Wentz mentioned?

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Here’s the information I have read:

In contrast, Dr. Alexander Haskell and Dr. Mark Starr report that for some patients, natural thyroid formulations from animal thyroids, such as Armour®, may be perpetuating the autoimmune attack due to containing thyroglobulin and TPO, and they only recommend compounded and synthetic thyroid medications for people with Hashimoto’s. I have heard the same from multiple pharmacists and patients alike.

If someone starts feeling worse after initially feeling better on desiccated thyroid or has an increase in TPO Antibodies after starting desiccated thyroid, switching to a compounded T4/T3 medication is advisable.

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HarrietJW,

When starting NDT with hashi you need to raise quickly to keep TSH low to prevent any thyroid activity.

If thyroid activity is allowed antibodies may increase and even promote a Hashi attack. We all have thyroid antibodies but it is the elevated amounts that can be problematic as tend to encourage inflammation which can be seen anywhere in the body from aching joints to an inflamed GI tract, and can influence thyroid function by suppressing the HPT axis, decreasing both the number & sensitivity of thyroid hormone receptors, and decreasing conversion.

Often people who haven't previously medicated T3 can not raise NDT quickly enough to keep TSH low because their body's rate of T3 acceptance may be slower than the amount of NDT required to keep TSH low/suppressed.

Others with hugely elevated thyroid antibodies that put their immune system into a high state of response (ie higher risks of intolerances) may require such a large NDT dose in order to keep TSH low that it exceeds the amount of hormone actually required for replacement.

Others may find their low iron or adrenal issues prevent them from raising NDT, also resulting in an intolerance of the T3 (in NDT) usually seen by adrenaline rushes and too much heat, or when the adrenals simply can't keep up with the increase in metabolism.

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Thanks very much for your detailed response. I expect that my issues may be adrenal related. Do you have anything you recommend other than the usual rest and digest to help with this. Should I be careful about increasing my dose?

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HarrietJW

You should raise your NDT dose as quickly as your body will allow.

For adrenal support keeping iron and nutrients optimal will help, especially VitD which is an immune modulator. I am presently supplementing high dose VitC, ashwagandha and sea salt.

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thank you, are you going to stay on NDT meds even if it's increasing your antibodies? I started to get bad headaches from armour, I don't know what to do :(

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I am going to stay on it for now as my T4/T3/TSH have all improved. I am not sure about headaches? Perhaps do a post? there are many clever people on this forum that know a lot more that I do :)

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