New to NDT

[veritas44]

Hi, I finally joined the community after weeks of lurking and learning passively. I'm a 32 y/o cis-male and started taking NDT (Nature Throid) last week. My doctor suggested I'd start on a grain (65mg) per day. I had no reaction whatsoever the first day, but felt extremely spacey and overstimulated on the second day. No overheating/sweat, but my feet and hands were tingling a bit and my throat felt a bit swollen. On my third day, I tried to split the dose in two, one early in the am and one early in the afternoon – comes night time, I still get a pounding headache. I decided to lower the dose to half a grain, which has limited the side effects, but my throat is still swollen and have a hoarse voice. Energy levels are way lower than they were before I started taking the drug. I am not sure what to do, as I've read elsewhere that half a grain is too low of a starting dose – but I really couldn't take the suggested dose to begin with, it felt like too much too soon. Do the side effects eventually subside?

My doctor is away this week – so I thought I'd give this a shot. I am also debating getting a second opinion from a different doctor, to determine whether I need to be on NDT to begin with. I have chronic SIBO, hence my diet is somewhat limited. I take most of the minerals and vitamin supplements recommended for hypo.

For reference:

TSH 2.35 (0.45 - 4.5) uIU/mL

Free T4 0.92 (0.82 - 1.77) ng/dL

Free T3 1.7 (2.0 - 4.4) pg/mL

(TPO) Ab 15 (0 - 34 01) IU/mL

Thyroglobulin Antibody <1.0 (0.0 - 0.9) IU/mL

[greygoose]

Hi veritas44, welcome to the forum.

Were you taking anything before you started the NDT? Levo, or something? If not, then 1/2 grain is the normal starter dose. 1 grain is likely to be too high.

If I were you, I would go down to 1/2 grain and stay on it for at least two weeks.

I'm afraid those results aren't much of a reference because you don't tell us when they were done or what you were taking at the time. If they were done when your were taking nothing at all, before diagnosis, then they would rather suggest Central Hypo. But, before saying any more, I would prefer you give me the context to these labs.

[veritas44 in reply to greygoose]

Hi Greygoose! Thank you so much for your feedback. I wasn't taking anything, except for some Vitamin/Mineral supplements, at the time of those labs.

My doc ran a bunch of hormone labs on me because I had been feeling fatigued and tired for months. He suspected that was only partly due to the fat-free hypocaloric diet I have to be on (because of my SIBO and some other unidentified gut-related condition). After seeing those labs, he suspected that my slow motility could also be a symptom of hypothyroidism.

I have been on 1/2 grain for four days now, still have a swollen throat and feeling a bit off. Is it quite the norm that one gets worse for a few days/week before they get better?

[greygoose in reply to veritas44]

It often happens, yes.

OK, so you weren't on anything, and yet your TSH was low compared to your Free levels. Your FT4 was only 10.54% through the range, and FT3 12.58%, which rather suggests a sluggish pituitary. The TSH should have been higher with those levels. So, what would probably be a good idea is that your doctor investigate other pituitary hormones, like ATCH and HGH. They could also be low if the pituitary is compromised. Sounds as if you have a good doctor, so he should do that.

So, what vitamins and minerals are you taking? There are no supplements recommended on here. What we recommend is that you get your vit D, vit B12, folate and ferritin tested to get a base-line, and build up a supplement regime around the results. No point in taking stuff you don't need. Did you do that?

[veritas44 in reply to greygoose]

How did you get those %? It seems like my FT3 was much lower than the range.

We tested Estrone and Sex Horm Binding Glob, both of which were rather high, and a whole bunch of other hormones, which were all mid range, including IGF-1 and Prolactin (which were high in the previous panel we ran in May). ATCH and HGH were not part of the panel – I will mention it at my next appointment. Doc said try NDT and run more bloodwork in 4-6 weeks. Reverse T3 is in the plans for then.

As far as minerals/vitamins, I take them regularly to make up for my poor nutrition. I usually use Pure Prescriptions Nutrient 950 ( pureprescriptions.com/produ... ). I did get D/B12/Folate/Ferritin tested and all look good at this time.

I should also mention that I got a CT scan (I can't do MRIs) over the summer that showed a potential microadenoma pushing against my pituitary gland.

So your take, until the Doc is back at least – stay on 1/2 grain for a few weeks, despite the side effects, and hope they subside?

[veritas44 in reply to veritas44]

(I didn't mean to be ungrateful – THANK YOU, again!)