Adding NDT and dropping Cytomel

[Rosebud1955]

Hello everyone,

Hope you’re all hanging in and staying the course. I’m looking for advice again. I presently take Synthroid 100 + cytomel 10mcg. (6-7am) I’m still having symptoms ( daily headaches, weight gain, hair loss). Since my thyroidectomy almost three years ago, my levels have not been optimal. My Endo is now willing to try NDT, he was never a fan of cytomel. I feel that cytomel does not agree with me, although I felt better since adding it to T4. This is what he’s proposing : Synthroid 100 + 30mg NDT. Is equivalent to my present dose, or is it a decrease. He’s TSH obsessed, here are my recent labs: tsh: 0.02 (0.32-4.0), FT4: 12 (9-19), Ft3: 4.3 (2.6-5.8). I would really like to take less Synthroid and more NDT. I’m wondering if 50 Synthroid + 60 NDT would be close to what he’s recommending? I noted a post from SeasideSusie regarding starting doses. Since I’ve been on T3 already, do I still need to be starting on the small doses and gradually increasing? I really want to do it right and not be messing up. I’m scared to feel as unwell as I was 6-12 months ago.

I would really appreciate some guidance from members with experience. ( especially : SeasideSusie, Greygoose, Jim111 and many others. My goal is to eventually take NDT only. Would this be a bad idea?

Thanks in advance for your guidance.

[SeasideSusie Remembering]

Rosebud

Synthroid 100 + 30mg NDT. Is equivalent to my present dose, or is it a decrease

You currently take 100mcg T4 and 10mcg T3

NDT generally contains 38mcg T4 and 9mcg T3 per 1 grain (60mg)

What your endo is proposing with 100mcg Synthroid plus 30mg NDT is the equivalent of 119mcg T4 plus 4.5mcg T3.

50mcg Synthroid plus 60mg NDT would give you 88mcg T4 plus 9mcg T3.

I noted a post from SeasideSusie regarding starting doses. Since I’ve been on T3 already, do I still need to be starting on the small doses and gradually increasing?

That is the protocol for someone taking NDT only.

[Rosebud1955 in reply to SeasideSusie]

No, I take 100t4+10T3. Either you misread or it was a typo on my part. So, does that mean I can just substitute T3 for NDT?

Thanks for replying.

[SeasideSusie Remembering in reply to Rosebud1955]

OK. I have edited my reply to show that you take 100mcg T4 and 10mcg T3. The rest of my reply is still applicable and shows the amounts of T4 and T3 that you would get from what your endo is proposing and what you have suggested. Neither is the exact equivalent of what you currently take so you need to decide which you want to go with.

[Rosebud1955 in reply to SeasideSusie]

Thanks for the clarification. Still not sure what I need to do, I will discuss with the Endo.

[Batty1]

I would do 88mcg synthyroid and 30mcg Cytomel.....Not 100/30 Or just switch over to Armour Thyroid and no T4.

In my opinion If your Endo is TSH obsessed as (they all are) he's setting you up to fail so he can say I told you so and reduce your meds.

I had thyroidectomy 3yrs ago....horrible experience trying to feel normal again and horrible doctors that think numbers make us normal.

Your current labs look way better than mine... I'm currently on 100mcg synthyroid and 10mcg cytomel.

[Rosebud1955 in reply to Batty1]

Hi Batty1,

Thanks for your input. The dose the Endo offered is 100t4+30NDT. He wants to take me off cytomel. I wanted to try 50 T4 + 60 NDT, then I will eventually ask him to give me all ND. I think he wants to leave a little T4 on board as he thinks it’s easier to adjust in case my Ft4goes too high. He says it’s easier to juggle. My present dose is Synthroid 100mcg + 10 Cytomel. I’ve been on Cytomel for the past two years, I feel a lot better than when I was on T4 alone, but the head pressure is a problem, still cannot shed the pounds, just gaining weight and terrible headaches lately. He thinks the Cytomel might be too powerful for me since I’m turning 65years in a couple of months. He’s definitely tsh obsessed, even when my Ft3 was below range, he insisted that I was over medicated. What a novice!!!!!! I’m so frustrated with him.

So I see you had thyroidectomy around the same time I had mine. I have never been well since that fateful day. What a mess we’re in!!!

I wish you success in your journey. STAY WELL, BE SAFE!!!

[Batty1 in reply to Rosebud1955]

You should just switch to NDT instead of half of this half of that NDT contains both t4/t3. It seems that Endos only wants to deal with t4/t3 medication maybe they get kick back for prescribing the T4 meds from the big pharma. You age definitely will affect your script (so I'm told) your FT3 level is above range and this could be part of your problems.... My FT3 was pathetic and seems to be a lab no endo likes to order.

[Rosebud1955 in reply to Batty1]

Thanks! I agree 100%. My Ft3 is 4.3 (2.6-5.8) how could this be above range, unless I don’t understand how to interpret.

[Batty1 in reply to Rosebud1955]

Sorry I somehow miss read that result.

[vocalEK]

If your Cytomel dose was too powerful, you'd be losing weight like mad.

You said that your Ft3 is 4.3 (2.6-5.8). You can check how far through the range your Frees are by using this calculator.

Type your result into the first field, the lower number of the range into the second field, and the top number of the range in the third field. FT4 goes in the top line and FT3 in the second line. Then click the button (Oblicz). The results will be displayed below.

In this case, your FT3 is only 53.14% through the range.

[Liyaelize]

Some people gain weight on T3 as it may convert to Estrogen with some. Even though I am too slim T3 in higher dose causes water weight gain with me and make me feel awful. I'm 68 and only tolerate 2.5 mcg at a time