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?
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Kcmc3
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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'.
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.
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)?
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.
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.
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
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
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
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.
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1st blood test result after starting Ndt 2 months ago 
NDT first blood test results 
Results help and starting NDT
Strange results after starting NDT - self medicating 
