NDT vs Nutri Thyroid

[lmquilt]

I'm new to this forum, am from Stevenage UK and I hope you can help me. I was diagnosed with hypothyroidism (TSH 4.9 and fT4 12.0 - normal TSH should be no more than 4.0) two months ago. I started taking Levothyroxine 25ug but within a few days I developed flu-like symptoms as well as a urinary tract infection, things I haven't suffered from in more than 10 years. I took the Levothyroxine for more than a month before replacing it with Nutri Thyroid, glandular tablets from New Zealand. I have been taking the Nutri Thyroid for less than a month. My understanding is that this is exactly the same as the Armour Thyroid except that the Armour is from pigs whereas Nutri is from cattle. Can anyone tell me the difference between NDT and Nutri Thyroid?

[SeasideSusie Remembering]

Imquilt

NutriThyroid is classed as a "Food Supplement", it is described as a hormone free glandular extract. This effectively means there is no thyroid hormone in that supplement and this is why it can be sold without a prescription. If it stated that it contained any hormone it would have to be a prescription item.

Armour Thyroid and other NDTs have a stated amount of thyroid hormone - T4 and T3 - usually around 38mcg T4 and 9mcg T3 to each "grain" (60mg tablet).

I'm wondering what brand of Levo you were started on? Was it TEVA - that brand causes adverse reactions/side effects for many people.

[lmquilt in reply to SeasideSusie]

It's definitely TEVA. What can I take in place of this type which, as you point out, has so many adverse reactions and side effects. By the way, I'm 66 years old.

[SeasideSusie Remembering in reply to lmquilt]

Not every brand comes in 25mcg dose tablets. The others which do 25mcg are

Mercury Pharma (who make Eltroxin and Advanz) and Wockhardt so you could ask the pharmacy for one of those brands. Or you could have a 50mcg tablet (not Teva brand) and either cut the tablet in half or take alternate days.

Here is the list of thyroid replacement hormones available in the UK

thyroiduk.org/tuk/treatment...

I think it's definitely worth trying a different brand.

Bear in mind that Actavis, Northstar and Almus are all the same brand - Northstar is Actavis rebranded for Lloyds Pharmacy and Almus is Actavis rebranded for Boots but the box will have Actavis on it somewhere, and the foil back on the blister pack will also have Actavis written on it.

[lmquilt in reply to SeasideSusie]

Thanks. I'll try Eltroxin or some other brand.

[SlowDragon Administrator]

Standard starter dose is 50mcgs Levothyroxine unless over 50years old

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards

Essential to retest bloods 6-8 weeks after each dose increase

This continues until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Guidelines on eventual dose required is somewhere around 1.6mcg per kilo of weight

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

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, on 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

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

[lmquilt in reply to SlowDragon]

I've been taking Inessa Advanced Multivitamins which have 2000 IU Vit D, 500 mcg Vit B12, 400 mcg Folate. I've also been taking 2 tablets Nutri Thyroid which amounts to 280 mg thyroid concentrate. I'm also 66 years old so a starting dose of 25ug Levothyroxine would have been okay were it not for the side effects. I doubt that my GPs would be willing to test for vitamins etc. My request would be seen as challenging their authority. Is it possible to see a private endocrinologist and where would I find one ?

[SeasideSusie Remembering in reply to lmquilt]

Imquilt

Check your multivitamin. I think it contains 150mcg iodine if it's the one I'm looking at (Inessa Advanced Daily Multivitamin). Iodine shouldn't be supplemented unless tested and found to be deficient, and then supplemented under the guidance of an experienced practioner.

Iodine is anti-thyroid, it used to be used to treat hyperthyroidism so it can make hypothyroidism worse.

Seeing an endocrinologist privately isn't always that successful, many members have been disappointed and feel they have wasted their time and money. If you want to see one then send for the list of thyroid friendly endos from Dionne at ThyroidUK then ask on the forum for feedback by private message on any that you can travel to.

[e-mail]

But to test vitamins and minerals, the cheapest way is to do a thyroid/vitamin bundle with one of our recommended labs, costs £79-£99 depending on whether the test is on offer.

Medichecks Thyroid Check ULTRAVIT medichecks.com/thyroid-func... You can use code THYROIDUK for a 10% discount on any test not on special offer.

or

Blue Horizon Thyroid Check PLUS ELEVEN bluehorizonmedicals.co.uk/t...

Both tests include the full thyroid and vitamin panel. They are basically the same test but with the following small differences:

For the fingerprick test, Blue Horizon requires 1 x microtainer of blood (0.8ml), Medichecks requires 2 x microtainers (total 1.6ml)

Blue Horizon includes Total T4 (can be useful but not essential). Medichecks doesn't include this test.

B12 - Blue Horizon does Serum B12. Medichecks does Active B12.

Serum B12 shows the total B12 in the blood. Active B12 shows what's available to be taken up by the cells. You can have a reasonable level of Serum B12 but a poor level of Active B12. (Personally, I would go for the Active B12 test.)

When doing thyroid tests, we advise:

* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

* If taking thyroid hormone replacement, leave off Levo for 24 hours before blood draw, if taking NDT or T3 then leave that off for 8-12 hours. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it will give false results (Medichecks definitely use Biotin, they have confirmed this and the amount of time to leave the supplement off).

These are patient to patient tips which we don't discuss with doctors or phlebotomists.

[lmquilt in reply to SeasideSusie]

Thank you so much. I never really thought about Iodine and whether I really needed it. In retrospect, I actually don't. I'll have an NHS blood test in the next month then I'll see about the labs you've recommended. This will also give me a chance to really test the Nutri Thyroid.

[SlowDragon Administrator in reply to lmquilt]

We ALWAYS recommend getting full Thyroid and vitamin testing BEFORE considering seeing any endocrinologist

Getting vitamins tested and supplement to improve to optimal and testing for thyroid antibodies are essential first steps

[lmquilt in reply to SlowDragon]

You are quite right. I will have to go to the private laboratories to do that. I will, in a month's time. However, I am hypothyroid, according to the NHS endocrinologist, even if they only considered the TSH and fT4. Based on those results, I was put on a small amount of Levothyroxine. I will follow your recommendations in a month's time. Thank you very much for your help.

[silverfox7 in reply to lmquilt]

Just a quick comment. TEVA apparently was for lactose free patients so that probably why it didn't suit, for some reason it seems to be handed out to anyone!

[lmquilt in reply to silverfox7]

I didn't know that. Thanks for letting me know.

[lmquilt in reply to SeasideSusie]

I've been reading up on iodine and I'm not sure that I don't need it. I've got to calculate the amount that I do need. Thanks for bringing this to my attention.

[SeasideSusie Remembering in reply to lmquilt]

Have you tested then and found to be deficient?

Iodine deficiency is rare in the UK, it's easily obtained from food , particularly milk, yogurt, haddock, cod

bda.uk.com/foodfacts/Iodine...

It's in levothyroxine (not as an added ingredient).

The British Thyroid Foundation discusses kelp and iodine here

btf-thyroid.org/information...

[lmquilt in reply to SeasideSusie]

No, I did not test for iodine. I'll read the references you gave. I did have a partial thyroidectomy, in the 70s, to remove an adenoma. In those days there was no such thing as subclinical hypothyroidism. Even now most doctors don't recognise it. So I take most reports with a pinch of salt. I've only just been diagnosed as being hypothyroid and yet I suspect I've been that way for many years. The same problem will probably occur with iodine especially when some doctors recognise its deficiency and others do not. I'll take what I know about iodine, so far, with a pinch of salt.

[Angel_of_the_North]

Nutri thyroid is not the glandular supplement from New Zealand - that's Thyrovanz - it's a UK glandular supplement that might or might not contain any thyroid hormones. I've tried most the thyroid glandulars at one time or another (mostly a few years ago) and found Nutri thyroid did nothing - unlike most of the others. If you want real NDT it can be bought quite cheaply from Thailand. Otherwise, glandulars Metavive (EU), ThyroGold (US) and Thyrovanz (NZ) work for many people

[lmquilt in reply to Angel_of_the_North]

Hi Angel_of_the_North

Thanks for your reply. I know about Thyrovanz. Nutri Thyroid is also from New Zealand, is a glandular concentrate and is readily available in the UK. It's a shame that it doesn't appear to have any hormones.

[Angel_of_the_North in reply to lmquilt]

The cows are from New Zealand, the supplement is not. Nutri Advanced Ltd is a UK supplement company (in Cheshire, I think). "Nutri Thyroid is a hormone-free glandular extract providing 140mg of thyroid concentrate from a bovine source. Nutri Thyroid tablets do not contain any hormones"

Try Metavive or Thai NDT.

[lmquilt in reply to Angel_of_the_North]

I'll definitely try the Metavive or Thai NDT.

[fibrolinda]

Try a different Levothyroxine first, it's a lot easier getting a nhs prescription than buying privately and the majority are fine on Levo. Still a great idea to get the private tests recommended by Seasidesusie if you can manage the cost, save up if necessary, I do, as they give a much better picture of whats going on and what you need to correct. Hard to get GP to do all of them but worth asking.

[lmquilt in reply to fibrolinda]

A very good idea! I'll try the Eltroxin first, maybe the pharmacist will try a different manufacturer. I'll follow up with the private tests in a month.

[silverfox7]

I would leave it at least 6 weeks, it takes 6 weeks for it to get fully into your system.

[lmquilt in reply to silverfox7]

Thanks.