I am interested in how NDT vs synthetic thyroid hormone is absorbed by and ultimately affects the body.
It's often said (on the STTM and other pro-NDT sites) that NDT is the closest thing to what the human thyroid makes when healthy, and that the other hormones in it - T1, T2, and calcitonin - have additional benefits. T2 especially is said to have fat-burning properties.
But...the question is: how do we know this, if they are not measured so, presumably, not standardised?
Another big advantage of NDT is said to be that the hormones in it are attached to thyroglobulin so not immediately released after swallowing.
But...are those arguments enough in favour of NDT?
This may sound strange as I'm on NDT myself, after years on T4 only. I think you've all figured out by now T4 only did not work that great for me or I would not have considered switching to NDT.
But...when I did, it was mainly because I was convinced NDT was the closest thing to human thyroid there is, and because I had read that there are other hormones in it not measured but still important for optimal health.
With the exception of Thai NDT, and the ever-decreasing number of brands available, prescription NDT is horribly expensive where I live. The only brands I can get are Armour and Erfa and both have been reported to be problematic. Even other brands once said to work great, such as Naturethroid, NP, and WP, are now said to be inconsistent.
Given all this, I have been considering giving synthetic T4 and T3 a try. If they work just as well as NDT (because T3 is the truly important thyroid hormone), I see no reason to waste a fortune on NDT.
But...and this is the most important question of all: does NDT work differently in the body compared to synthetics? Meaning: does NDT possess properties that synthetic thyroid drugs do not, making NDT superior? Or is the most important thing for a poor converter to take T3, not necessarily NDT...?
I hope you all understand what I mean. I have been giving this a lot of thought lately as I am no longer 100% certain Thyroid-S is something I want to be on for the rest of my life, prescription NDT is both expensive and unreliable according to many websites (plus posts here), and synthetic drugs are both available by prescription and cheap where I live (also covered by health insurance unlike NDT).
However, before considering making that switch, I'd like to hear more from others, especially those who have tried both NDT and a synthetic T3 + T4 combo. Did NDT bring you any extra benefit? Did it seem to be absorbed more slowly (because of the thyroglobulin) etc? Any input would be most welcome!
With NDT you are getting the other T's as well..T2 etc but it comes with a fixed ration of T4 to T3. with combo T4/T3 you can alter the doses so that your T4 and T3 is in a ratio that suits your individual needs.
I’ve tried synthetic T4 alone and with synthetic T3, synthetic T3 only and with NDT, and NDT alone. My conclusion is that synthetic T3 and the T3 in NDT are different, and similarly synthetic T4 and the T4 in NDT are different. I am only well on synthetic T3 with NDT which of course is both T3 and T4. To me, the T4 in NDT is less harmful and the T3 in NDT softer in its action, with less spike than synthetic T3. If I could have got well without NDT, I would never have taken it, I don’t really like the thought of it!
OK, so I take it you are on a combination of NDT and T3...may I ask which one? And can I ask just how the synthetic T3 is different...? Or the T4 in synthetic meds and NDT for that matter...?
I’ve really explained it as much as I can, sorry, NDT seems to have a stabilising effect as compared to other combinations. For me that is. I take Armour.
Like you, and after much experimentation as well, determined combo NDT + T3 is the best fit for me too (+ for the exact reasons you described so perfectly)
Hey did you try synthetic T4 with synthetic T3? I’m on levothyroxine 75 mg and thought about taking adding some T3 liothyronine. Or instead taking Ndt.
What is your free T3 Reading now that you’re happy with. It’s all so costly yes.
Yes, I have tried Novothyral (synthetic combo) in the past and did not do as well on it as on NDT. However, that was before I was treated for adrenal fatigue which may have had something to do with it...I am not sure what my FT3 is right now, as I have not been tested in a while.
What the thyroid makes and releases into the bloodstream DOES NOT have the same effect as swallowing the exact same thing(s).
Direct release into blood is obviously different to digestion and absorption in the gut. (If only exposure of the gut to massively high levels of thyroid hormone as it is released from whatever carries it.)
Desiccated thyroid might have some T2 and T1 - as you say, if not measured, amounts will not be known and could be variable.
Also, the amounts of T2 and T1 would be far lower than those of T4 and T3. Yet remember that T4 and T3 eventually get converted to T2 and T1. The amount available from desiccated thyroid must be far lower than we make by conversion (deiodination) of T3 to T2, and T2 to T1.
And any T2 and T1 it does contain might get affected by the processes or the excipients.
As for calcitonin, which has been researched and in some forms used as a medicine, it was supplied as a nasal spray as it is prone to being digested in the stomach.
No-one has, to my knowledge, identified any difference between T4 and T3 from desiccated thyroid, from synthetic sources, or from our own thyroids, as a substance in our blood. No test can distinguish them.
Desiccated thyroid might deliver more slowly, simply having T3 might be the major factor, or other factors not yet properly understood. We simply do not know.
I have nothing against desiccated thyroid, but nor do I against synthetic. Whichever works best for each of us.
I truly believe it depends on the person. Myself, I have tried so many combinations of T4/T4+T3/NDT, and a whole range of different brands of each, and the only thing that makes me well is synthetic T3 only. In fact, NDT made me very ill. I was ok at first, taking Armour, the original, before the price went up! But, when they changed it, I couldn't tolerate it anymore. Nor could I tolerate any of the others - although I haven't tried Erfa, it's true.
And, yet, there are so people that swear by NDT and wouldn't take anything else. Good for them. But, I do think the hard-sell of NDT by certain factions is deeply flawed. Helvella has explained about the T2/T1. Others have mentioned the fixed T4/T3 ratio. Which is fine for some, not so good for others. And it has been said that the fact that it's attached to thyroglobulin can be a problem for some Hashi's people, because it triggers immune system attacks. So, it's definitely not for everyone.
It may very well be that it's the closest match you can get to human thyroid hormone, but then it's also said that synthetic T4 and T3 are exactly the same as human thyroid hormone. So, I think the ideal is to try it and see what suits you best as an individual. There is no one-size-fits-all with thyroid hormone.
Thanks, GreyGoose! It's true that the price of prescription NDT is prohibitive...plus, what's happening to so many brands right now (reformulations, unavailability) the situation is quite worrying.
The situation is not much better with T3. The whole hypo climate at the moment is worrying. It's like they just want us all to die off and be done with it.
It's Very Concerning to say the least the way the thyroid meds are now affecting many with hypo symptoms or back orders. We must stand strong together to make sure this stops and that we get the very best thyroid meds that work *Optimally*for us. *United We Stand Divided We Fall*.
I believe for starters that we need to be vocal firm but nice .We need to take our cause public and make the public *aware* of what thyroid patients *Need* go through and put up with to want/need to feel well and be productive.
And to vote in Politicians that truly understand and are very willing to fight for thyroid patients causes including *Potent* thyroid meds T3 /NDT/T4. We don't need reformulations when the meds work well . No back orders .To lower Costs of thyroid meds. Dr's need to retrain how do dose with T3/NDT/T4 and Lab testing including FT3 FT4 . And not fall for BIG PHARMA Lobbyists .
Those are all great ideas. Just not practicable. A lot of us are very vocal, and there are petitions flying around all the time. And it is sometimes talked about in the press - but let's be realistic, people who don't have the disease really aren't interested.
As for politicians… Well, they're politicians, aren't they. They aren't interested in things like that. Politicians in the UK, at the moment, are only interested in selling off the NHS! They certainly don't care about the minority of an already minority group of patients. And manufacturers aren't going to listen to our concerns unless we stop buying their products. And the problem there is, if we stop buying all their products, we die! We've got to take something. And doctors already believe we're a bunch of hysterical attention-seekers, anyway, so they're not going to listen to us. Plus, they just do. Not. Care.
And, of course, the majority of us are too ill to do things like protest and march in the streets, and make a fuss, or even stand up to our doctors. We are the most vulnerable group and everybody takes advantage of that. Everybody.
However, that doesn't mean we're not already doing the best we can.
Yes, doctors' attitude is a big problem. Like you say, they don't take us seriously. They've been taught levothyroxine works for everyone, and those of us who claim it doesn't are often dismissed as hysterical or delusional.
I've seen many doctors over the years who did not even know that the thyroid gland produces two hormones known as T4 and T3. They think the TSH is a thyroid hormone and tells them all there is to know.
The doctors who prescribe T3 and NDT tend to have the disease themselves (like the Hertoghe doctors in Belgium and the late Dr. Lowe).
This is NOT to say we shouldn't fight for the meds we need. Far from it. The day we stop caring is the day we run out of options. But we need to know what we're up against.
I have read conspiracy theories claiming that NDT brands are being reformulated to work less well so that patients will be forced to go off them and switch to T4 only drugs. Well, if that was true, that would mean that the manufacturers of NDT were corrupted and taking orders from the FDA and/or levothyroxine manufacturers. The same would supposedly apply to synthetic T3 as well. But, since some of these manufacturers produce both T3 and T4, I prefer not to believe those rumours as I find it hard to believe they would deliberately make one of their own products useless.
But the situation is worrying, and the last thing we need as thyroid patients is to worry about the drugs we need suddenly no longer being available or no longer working. I remember reading about some brand of T3 being problematic as well (working less well so possibly reformulated) but cannot remember which one.
Hi there! You said that you take T3 only. Do you have Hashimoto's or hypothyroidism? I am wondering if you have Hashimoto's if you would benefit from taking T3 only? Or would there be enough T4 in it to sustain you? I hope I am not confusing. Thanks in advance.
If synthetic works for you then take it. If it doesn’t, and NDT works then take that! It’s that’s simple in my view. Do what works for you as we’re all individuals - what works for one, doesn’t for another.
The thing is both can work for many people, so then it's more a question of availability and price as prescription NDT is terribly expensive. That's why I was interested in the opinions of people who have tried both synthetic (combos) and NDT and can compare them.
ASanders69, I agree with others. It's not worth thinking about whether one form of thyroid hormone is better or more perfect than others. The only really important thing is what works for you personally, and the only way to figure that out is by trial and error. You can't work it out by making theoretical arguments about any being better than others. And of course there is a lot of nonsense spoken on the topic.
I'm a person who found NDT very different from synthetics when I first tried it, I immediately felt an improvement in how my brain was working. But as I've gone on adjusting my dose I've found I need to supplement with additional T3 and recently have actually felt improvement while reducing my NDT (without swapping in any additional T3). This is something I've had to discover the hard way - by trying out all the options.
Yes I know! One problem is that NDT is not always available. Two out of three Thai brands have been discontinued, leaving only one and God knows what will happen to it. One pharmacy I contacted about prescription NDT told me they can get 30 and 60 mg pills of Erfa, but that all their suppliers are out of 125 mg pills and nobody knows when or even if they'll have it in stock again. How come nobody knows...if they are making 30 and 60 mg pills, why not 125 mg pills? Same thing with Armour: they can only get it in some strengths, the other ones being unavailable.
This has happened to other brands of NDT as well, and it worries me because at some point NDT may not be available anymore. Another reason to look at alternatives.
Interesting what you say about adding T3 to NDT; it makes sense as many who switch to NDT do so because they are poor converters and NDT may not contain enough T3 for their needs.
ASanders69, I agree with you, not being able to get hold of a hormone is a big fear when self medicating. Recently I've liked to keep six months worth in the house, but I have picked up even more with Brexit looming.
I take Naturethroid, so I had to deal with this a couple of years ago when it was unavailable for a while, and then initially came back in only 1 grain tablets. I just put up with that at the time, it was more expansive than the 2 grain tablets I usually prefer, but as Naturethroid is relatively cheap it was still cheaper than the other US brands.
In my own case with T3, I have some kind of thyroid hormone resistance. The usual treatment for that is a high dose of T3-only, but I started on NDT before I realised I was resistant, and was still adjusting my dose and getting improvement. I got the the point where I was getting ambiguous overmedication symptoms, very disappointingly because I've been very impaired in what I can do and was still largely housebound. But on starting to reduce NDT I've had some big improvements. It stands to reason that having too much T4 around may be an issue (I was up to 8 grain at the maximum) and block T3, and for me that seems to have happened.
I've been following Dr. Westin Childs, he's a US doctor of osteopathy who treats thyroid disease and other endocrine disorders using NDT, T3, T4 (or any combination thereof) along with drugs to treat insulin resistance and other hormonal imbalances.
I know rT3 is a controversial subject, with some doctors (and patients) claiming the condition does not exist. However, I find Dr. Childs's theories interesting: he says that if you take more T4 than you need (from either NDT - which is still 80% T4 - or T4), your body will turn a disproportionate part of that into rT3 and that in turn will block the action of free T3 - basically leaving you hypothyroid even on high doses of T4/NDT. He describes case studies, one of which describes a patient on as much as 6 grains of NDT who improved and lost weight once on 3 grains of NDT + 25 mcg of T3 daily.
I don't expect to find many doctors like that in Europe, but the good thing is we can self-diagnose and self-treat to find our own personal sweet spot.
I am not sure what to believe, but I know some people have had success decreasing NDT (not necessarily going off it altogether) while adding pure T3.
That's very interesting to hear about Westin Childs. It sounds very similar to my experience. I wouldn't like to say my issue was rT3 specifically, but I also doubt all that extra T4 was doing me any good, as of course I was getting a huge amount of T3 as well.
I'm optimistic I may finally be approaching my ideal dose because I've had the biggest improvement I've ever had since I started reducing NDT. I plan to continue reducing for at least a little bit and see how I get on.
Yes, it's frustrating we don't have doctors to help us I'm sure I could have cut out the past year of experimenting and had these benefits in Summer 2018 if there had been anyone knowledgeable to advise me. It makes me feel angry about all the people with similar illnesses who aren't able to self medicate - or how I would have managed without this forum
I like to hear that you don't have to go off NDT/T4 completely which some claim is necessary in order to correct rT3 dominance; although I could probably benefit from reduced NDT and some added T3, I don't like the idea of going off NDT/T4 completely...
Thank you for the links, I'm having a read. It's a bit off-putting how he puts everything in terms of weight loss! But I guess that is a tough hypo symptom to crack.
I like to refer to NDT as DTE...desiccated thyroid extract. It seems that the word “natural” throws off clinicians, giving them an excuse that the word somehow has a connotation with “quackery”. Yes, DTE has been “grandfathered” in to the USA FDA. However, there are many products approved by the FDA that have caused health issues for people (not DTE).
My body does not properly convert T4 into T3. This includes synthetic T3. There are studies being conducted as to the reason for inadequate conversion/polymorphism. For me, use of Naturethroid has been consistent. It is easily obtained through MOPs. The cost is less than I would pay for synthetics. Naturethroid is less expensive than Armour.
Just an FYI: most recently, there have been issues with NP by Acella.
Sorry, I am not sure what you're saying: that your body is having issues with synthetic T3 as well, but you are fine on DTE...?
I think all prescription brands of DTE have been reported problematic: it started with Armour back in 2008/09, then Erfa a couple of years later, then Naturethroid, WP, NP...I got all this info from the STTM. I know that site is very biased towards DTE, but they have been keeping patients updated about the situation re DTE and have been recommending various brands depending on availability and patients reviews. It seems WP and NP were the last good brands (Naturethroid is said to have been reformulated much like Armour was, with cellulose added), and now they are also reported to work less well.
Yes, my body did not assimilate synthetic T3 Cytomel. It did not increase my FT3 as is was very low, it caused headaches, stomachaches, constant hunger, constipation. On DTE, I am fine. My BW has always been consistent.
I am aware of the issues with the DTE manufacturers. I moderate a few other online/in-person groups and try to help others that are having issues. IMO, the issue comes from the company that owns the raw material from which all the manufactures purchase the same raw material to make the DTE. Sadly for us, NP is having the same issues as NT and WP. Some of the issues could be that the fillers were changed in these TRHs. At least that is what others are writing and discussing in the other groups.
I just came back from the thyca conference in Denver, CO. There were many sessions and vendors. Surprisingly, there were clinicians-vendors representing the ATA. They are FINALLY researching further the use of DTE and patients that need it. Also, there was the a group from the American Head Neck Society. They are conducting a study regarding patient/doctor communication. For anyone that would like to participate, DM me and I can provide the link as I am not sure I am permitted to post it here.
I hope we can withstand these changes and be a collective voice, as it is much needed!
Interesting, thanks! I know a few brands have been reformulated - Armour and Naturethroid. I know there were rumours Erfa had been, too, but I remember the manufacturer denied it, at least initially (I have not really been following the news since). I am not sure what the problems with WP and NP are, only that many people who used to do well on them are now having issues. One of them is STTM mod Janie Bowthorpe who switched to Erfa after Armour was reformulated, and then to NP after Erfa stopped working as well. Now, she claims that NP is no longer working either.
I know there have been some rumours about raw material unavailability which could explain why some brands or strengths are suddenly on backorder, but am not sure why the raw material would affect the way the drugs work...but there have been too many complaints in order to dismiss them all as unfounded.
Have the manufacturers ever commented or acknowledged these problems?
Yes the companies have (finally, begrudgingly) made comments. If you go on RLC’s (manufacturer of NT, WP) website click on AVAILABILITY UPDATE. In the beginning, I was able to call and speak to company reps. Once the situation became enormously widespread and they began receiving too many calls, they stopped that and used the website online update system. They also had a FB account but that left a bit to be desired.
I know a few people called Acella (manufacturer of NP) and spoke to their president. If I remember correctly, NP is generic and made by the company that make Armour. If not, then there is some weird connection. They were told to report back to the pharmacies and the company the batch and lot numbers.
I still think all this has to do with whoever owns Armour and the raw materials. I think they are one and the same and there is some sort of monopoly going on. It’s always all about money.
Armour: [Treating Hypothyroidism. The medical use of desiccated* natural thyroid began in the late 1800s. The US rights to Armour® Thyroid were acquired by Forest Laboratories in 1990. Armour® Thyroid became an Allergan product with the merger of Forest Laboratories into Allergan in 2014-2015.]
NP/Acella: [Alora Pharmaceuticals, LLC, parent company of Avion Pharmaceuticals, LLC, and Acella Pharmaceuticals, LLC, announced the relocation of the corporate headquarters of its two companies to a new 58,000 sq. ft. facility at 1880 McFarland Parkway in Alpharetta, Georgia.May 29, 2018]
Allergan plc is an Irish pharmaceutical company that acquires, develops, and markets brand name drugs, and in 2017 generated 80% net sales from the U.S. healthcare system.[1][2] Allergan plc was formed in February 2015 when Irish–registered Actavis plc acquired U.S.–registered Allergan, Inc., and assumed the Allergan name.
I take a combination of T3 & NDT in different seasonal ratios. I didn’t have issues with the new Nature Throid, but swapped to Metavive as it’s easier to source. Thai NDT & Thyro Gold disagreed with me. I take a higher ratio of T3 in summer & found my pale skin doesn’t burn as easily if I take some NDT. In winter, I need a higher ratio of NDT to prevent skin issues I’d had for years as my lips crack if I don’t have enough. I also find I’m better able to produce body heat with NDT.
I took Thyroid S and it suited me but I only took it for about 6 months to support my thyroid. I have taken Levothyroxine which was prescribed by Dr Skinner and that suited me as well but we are all different and sometimes the fillers in the drugs can cause side effects.
I didn't know you could take thyroid hormone temporarily to support your thyroid, especially anything containing T3 like NDT as that tends to suppress our TSH so basically down regulate metabolism, leaving us even more hypothyroid than we were to begin with...so, pretty much what happens in people who are kept on a starting dose of thyroid hormone for too long.
I also had no idea you could support your thyroid to work better (which was presumably the purpose of taking Thyroid-S in the first place)?
If your thyroid is under attack like mine was and struggling, if you take either NDT or levothyroxine your thryoid stops trying to make thyroxine and it gives it a rest ,,,, someone told me this on a site in the USA and I think it is true but others might disagree.
It's just that I've never heard about this method before...this would assume that, after it has been put to rest, your thyroid is actually capable of kicking back into action.
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Benefits of switching from T3 + T4 to NDT...?
Evidence that T3 works - have any real world wide big guns written about this.
How the T4 and T3 bound on to thyroglobulin are released as free hormones
