Reducing NDT add in T4

[Ashanat]

Hi all,

I’m taking 3 Thyroid S NDT, my vitamins are optimal and I have no hyper symptoms. My energy is Ok, however I don’t tolerate exercise well and can ‘crash’ for a few days after - I’m gaining weight due to this.

It could be that my over range T3, although not causing hyper, is holding me back and causing muscle weakness and low exercise tolerance?

My T3 is over range and T4 top quarter. I’m thinking of dropping to 2 NDT and add in 50mcg T4.

My question is, has anyone had a similar experience? Any thoughts or advice would be great.

Many thanks 😍

[Greybeard]

I wouldn't drop by 1 tablet in one go. 1/4 tablet every 2 weeks would be kinder to your body. The general advice is not to let your ft3 go over range so a reduction is probably in order. You will need to experiment with your ft4 level, some need it up at or near the top of its range. It can take a couple of months for levels to settle so don't rush your changes.

[Ashanat in reply to Greybeard]

Thanks GB, I’ve done 4 days of just dropping 1/4 tablet, felt dreadful by 4pm yesterday, but slept 14 hours and feel good today 😁.

I’ll aim for the 1/4 every 2 weeks then - then I’ll check in with my T4, or do you think add on a bit as I reduce over the next 8 weeks?

[Greybeard in reply to Ashanat]

If it were me I would add in some now, the excess t3 will leave your system over a few days it will take a few weeks for you to convert the extra t4 into t3 if you are able. If you are crashing in the afternoon you could try splitting your dose.

I split mine, 2 grains first thing then 3/4 at 3pm then 1/4 when I go to bed. The reducing dose is an attempt to mimic what would happen with a healthy thyroid. Even after taking ndt for about 18 months now I am still feeling a subtle improvement as time goes by. It took us a long time to become ill and it may take a long time to get well.

[Ashanat in reply to Greybeard]

I’ll do that. I know what you mean about it taking time, I’ve been on NDT for just over a year now and it’s better but clearly still some tweaking to do. I really appreciate your suggestions.

[Hidden]

I have not done it yet, but have been considering it. I'm currently on 3 grains of Thyroid-S, feeling slightly hyperthyroid so, if labs show I am currently overmedicated, I will cut back on Thyroid-S and add some T4. I'm due to have labs on Monday.

I know it's often recommended not to combine T4 and NDT as NDT is 80% T4 anyway...however, some people seem to need more T4 than that to feel optimal without hyper symptoms. I see no harm in it; it seems humans produce T4 and T3 in a 90/10 ratio, whereas pigs produce hormones in a 80/20 ratio, so adding some T4 to NDT makes sense to me.

I belong to the category of patients who seem to need quite a lot of T4, even on T3...some say they need less T4 when taking direct T3, but my FT4 levels do seem to matter regardless of my FT3 levels.

Will let you know more once my labs are back!

[Ashanat in reply to Hidden]

Thanks! Sounds like we’re in a similar boat then, and what a fun boat it is 😂.

Remember the 12 hour gap between last dose NDT and blood draw.

Looking forward to hearing how your labs are next week - feel free to PM me 😁