I'm considering taking some eltroxin along with my NDT dose. My latest bloods ( a limited test run by my gp) showed my TSH has fallen again to 0.25 from 0.47 last month (range 0.40 -4.5) also my freeT4 has fallen from 12.7 to 9.0 (range 12-22)
I have started to experience some hyper symptoms ( trouble sleeping, chest pressure & joint pains again)
My ft3 was at top of range a month ago.
I love some advice as to whether I can slightly reduce my NDT from 2 grains per day to 1& 3/4 grains & introduce some eltroxin (T4) or if anyone else has tried this?
Any opinion appreciated.
Thanks
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Luna100
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Ya I'm on AIP diet for the last 5 months. Taking gluten out of my diet was a huge step forward for me 🙂
I had some t4 added to my ndt some years ago. It didn't affect how I felt but it did make my numbers prettier. I dropped it a while ago and upped the ndt and a symptom improvement but I'm now in perimenopause so thins have changed.
Results are read differently if on any form of T3 so if correctly treated then I would expect TSH to be suppressed, mines 0.01, FT4 can fall but FT3 should be in the top quarter, mines 80% through range and happy with that. I would drop the NDT down a quarter but also get vits and minerals up to scratch-SeasideSusie expert at advice for that but needs to be optimal. Given time depending how low things should help with readings and feeling much better so I would get that up and running and retested after a while before adding in T4 as I don’t thing it’s a given to still need that.
Recently I did this. I was on 3,5grain Thai-ndt and I didn't feel very good on that, nor could I raise the dose due to the hiper symptoms. So, I lowered the dose to the 3 grain and slowly I added 6,25mcg of levo then 12,5mcg and seems I feel better.
It's all trial and error at this point, really. With that freeT3 right at the top of the range you've got your blood tests looking ideal. If you don't feel well at that point, blood tests can't tell us too much more.
All you can do is make really really good notes on your symptoms now, go back over all the symptoms notes you've got from other doses, and take stock of everything you've already tried. Then it's a judgement call of what thing you want to try next.
Lowering your NDT, or swapping some out for T4 are both reasonable things to try if you haven't trailed them before. Go in tiny increments becsuse you are probably close to your sweet spot, now. Theoretically freeT4 is irrelevant once freeT3 is high, but some unusual people do feel better with it higher in range.
Make sure your vitamins look optimal at this point, too. And adrenals are worth looking into, too. Everything needs to be in good shape to make best use of thyroid hormone.
Your so very right SilverAvocado . Knowing ones lab values FT3 FT4 TSH Vitamin "D" Iron B-12/folate is very essential for the thyroids to work well for us . In addition as you so well stated it's so Very Individual . Some of us feel better with higher FT3 and lower FT4 . Some feel their optimal with higher FT4 a lower FT3 . TSH is not very relevant when one is on any T3/NDT . T3/NDT is a very good TSH suppresser. TSH is a pituitary marker and not a thyroid marker . Lab values are a snap shot of the moment you had labs done . The most *Important* is the Cellular Results . Cellular results are what makes us feel *Optimal*.
When taking any form of T3, it's normal for your FT4 levels to drop, sometimes below range. Given that T4 is an inactive hormone and its job is to convert to T3, your FT3 levels are the most important thing when on NDT. Many need them at least 75% through range to rid themselves of symptoms, some even higher.
You could of course try to decrease NDT and add a little T4, but it may not have any effect since it's an inactive hormone and you are already getting a lot (if not all) of the T3 you need from NDT.
Don't worry too much about numbers, go by how you feel! In the past, I used to worry all the time about what my lab results looked like and where they "should" be, but that never enabled me to find the right dose.
The symptoms you describe could be a sign of low cortisol; the adrenals must work optimally in order for thyroid hormone, especially T3/NDT, to be properly used by the body. Many with adrenal fatigue seem to develop hyper symptoms (without being even close to the upper normal lab ranges) when they switch from T4 only to NDT. That is not a sign of being overmedicated but of insufficient cortisol.
PS. If you switch to NDT because you are a poor converter, lowering NDT and adding T4 may not help if you cannot convert the T4 to T3. That is how it works for me - in the past, I've tried adding T4 to a lower dose of NDT but it did nothing for me (labs from before I went on NDT showed I was a very poor converter, with FT3 levels at the bottom of range in both blood and 24 h urine on as much as 200 mcg of T4 daily).
I'm sorry your experiencing hyper symptoms . They are very unpleasant . If you would like to try some T4 with NDT . It would be advisable to lower your NDT especially if your having already hyper symptoms . I dose with both T4 and NDT but I need more T4 with just a bit of NDT for my T3 mix . I'm not a good converter T4 to T3 and this combination works well for me .
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