First test results since starting NDT - Thyroid UK

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First test results since starting NDT

Kcmc3
Kcmc3

I am taking 2 grains Thyroid S since starting on 1 grain on 15/10/19. I’ve been on the 2 grains since 6/11/19.

My results from Medichecks have just arrived:

TSH 0.068 (0.27-4.2)

FT3 5.62 (3.1-6.8)

FT4 13.6 (12-22)

Prior to starting NDT I was on 75mcg Levothyroxine and my last results (same ref ranges) immediately before switching were:

TSH 4.21

FT3 3.58

FT4 18.3

Obviously, the comments from Medichecks say that it looks like I’m over medicated due to very low TSH. But I still feel some fatigue and feel like I need a bit more NDT. And I’m confused why my FT4 has gone down...? is this normal with NDT?

18 Replies
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shaws
shawsAdministrator

Blood tests were introduced along with levothyroxine alone. Before that we were prescribed NDT and it was gradually increased until symptoms were relieved.

Levo is T4 alone and has to convert to T3 and the tests were introduced along with levo.

NDT contains T3, T4, T2, T1 and calcitonin

The following link may be helpful and this doctor would never prescribe levo. He only prescribed NDT or T3 for patients who were 'resistant to thyroid hormones'.

naturalthyroidsolutions.com...

Kcmc3
Kcmc3
in reply to shaws

That’s a very useful link! Thank you!

HiddenThis reply has been deleted
SeasideSusie
SeasideSusieAdministrator
in reply to Hidden

shaws I think you have put this reply on the wrong thread :)

Did you mean to put it here healthunlocked.com/thyroidu...

shaws
shawsAdministrator
in reply to SeasideSusie

Thanks - am obliged and I have removed it.

SeasideSusie
SeasideSusieAdministrator

And I’m confused why my FT4 has gone down...? is this normal with NDT?

Yes. Taking NDT tends to lower, even suppress TSH, and generally will lower FT4. This is due to the T3 that's in NDT.

Your FT3 shows that there is room for an increase but now you've reached 2 grains all increases should be 1/4 of a grain only so that you don't miss your sweet spot.

Ignore the comments from Medichecks, their doctors are NHS trained so will have the same idea about low TSH as any GP.

Kcmc3
Kcmc3
in reply to SeasideSusie

Thank you Susie! I’m going to increase by a quarter grain as I still don’t feel optimal. Do you think two weeks is long enough to wait before I increase again (if necessary)?

Kcmc3
Kcmc3
in reply to Kcmc3

Also, is it possible that a “mere” quarter grain can take me from still feeling very tired to feeling great?

fibrolinda
fibrolinda
in reply to Kcmc3

Absolutely😁 Trouble is you don't know which quarter ... But yes 1/4 CAN make a big difference that's why low and slow now, good luck.

Kcmc3
Kcmc3
in reply to fibrolinda

Aww that gives me some hope then! I’m better but not better enough so I really hope this little increase will make all the difference. Thank you!!

SeasideSusie
SeasideSusieAdministrator
in reply to Kcmc3

Kcmc3

Do you think two weeks is long enough to wait before I increase again (if necessary)?

Personally I would wait longer. Your FT3 is 68% through it's range at the moment so it's likely that's not far off your optimal level. The T4 in the NDT is going to take longer for the FT4 level to settle so if it was me I'd give it 6 weeks. Depending on how much natural conversion of T4 to T3 you have, the extra T4 in the NDT will not only affect your FT4 but it is likely to increase your FT3 as well, then there's the extra T3 in the NDT. So I'd leave things to settle and not rush it, it's so easy to miss your optimal dose.

Kcmc3
Kcmc3
in reply to SeasideSusie

Ok, that’s all really helpful, thank you!

SlowDragon
SlowDragonAdministrator

Next Medichecks test, recommend getting vitamin D, folate, ferritin and B12 levels tested too

Do you have Hashimoto's? High thyroid antibodies

Kcmc3
Kcmc3
in reply to SlowDragon

Yes I have Hashimoto’s. I’ll definitely check all those at the next test. I’m taking 3000IU vit D daily and I checked my iron before starting NDT (all four markers) and all seemed fine. The others need to be re-checked.

SlowDragon
SlowDragonAdministrator
in reply to Kcmc3

As you have Hashimoto's are you on strictly gluten free diet? Or tried it?

This frequently helps reduce symptoms too

approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Kcmc3
Kcmc3
in reply to SlowDragon

Thanks SlowDragon. I tried going strictly gluten free for 6 months some time ago and didn’t really detect much change. My antibodies fluctuate anyway and the very slight decrease when I tested didn’t seem significant after all that effort going gluten free. In fact, my last antibody test (when I was eating gluten) showed a markedly reduced ATG and Anti Thyroid Peroxidase below the threshold. This surprised me a bit but I have been doing a lot of other “alternative” things for my health so maybe that’s helped. I’ll be testing antibodies again soon. May try going off gluten again but I’m trying to balance ease/stress and I did find it quite stressful trying to avoid it.

SlowDragon
SlowDragonAdministrator
in reply to Kcmc3

good to hear you tried it .....always best to rule in ......or out

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