How long before I feel better after switching from T4 to NDT?

[Canu]

I've just started taking NDT after being on T4 for over a year and not feeling well despite my latest thyroid tests results being optimal (not just in range). Various tests for nutritional deficiencies were OK too. I have Hashimoto's hypothyroidism and I have fibromyalgia symptoms - numbness (hypoesthesia) in my whole body, stiff and swolen hands and feet, hair loss, a little fatigue and muscle pain. (I have had loads of tests ruling out other autoimmune conditions.) If switching to Armour works for me, when should I expect to start feeling better? Thank you!

[Lora7again]

It can take a long time I'm afraid and you will know once all your symptoms disappear. When I took Thyroid S it took me months to get to 1 1/2 grains by increasing by 1/4 grain every few weeks. Do you have some blood results to share with us?

[Canu in reply to Lora7again]

TSH 2.05 mlU/L (Range: 0.27 - 4.20)

Free T4 21.58 pmol/L (Range: 12.00 - 22.00)

Free T3 5.54 pmol/L (Range: 3.10 - 6.80)

This test was three weeks ago, while I was on 50mcg of levothyroxine.

I'm now switching to Armour half grain.

[Lora7again in reply to Canu]

50mcg is a starter dose and you should have increased that by 25mcg after 6 weeks and then retested. Usually you increase Levothyroxine by 25mcg until your TSH is 1 or lower and your T4 and T3 are in the upper third of the range. Also all your vitamins need to be optimal for both Levothyroxine to work and also NDT. Have you got your vitamin blood results? We need B12, Iron and Ferritin, Vitamin D and Folate. Why are you changing to NDT before you have given Levothyroxine a chance to work? I have taken both btw and Levothyroxine is free on prescription whereas I had to buy my NDT from abroad which is much more costly.

[Canu in reply to Lora7again]

"50mcg is a starter dose and you should have increased that by 25mcg after 6 weeks and then retested."

I did do that. I've had my dosage increased and decreased many times in the last 15 months. I'm very sensitive to thyroxine. I'm actually taking 50 mcg for 6 days and 74 mcg on the 7th day. Anything more than this and I start getting hyper symptoms (heart racing, etc.)

"Usually you increase Levothyroxine by 25mcg until your TSH is 1 or lower and your T4 and T3 are in the upper third of the range."

I understand that my TSH is too high, but my T4 is very high and my T3 at the borderline of upper third of the range.

"Also all your vitamins need to be optimal for both Levothyroxine to work and also NDT. Have you got your vitamin blood results? We need B12, Iron and Ferritin, Vitamin D and Folate."

Vitamin D3 (25-OH) 47.11 ng/mL (Range: 25 - 80) (I have increased my supplementation slightly since I did this test in March and I have been spending more time in the sun)

B12 (Cobalamin) 845.9 pg/mL (Range: 180 - 914)

I don't have any recent Iron or Ferritin tests, but here are the ones from last year:

Iron (Fe) 87.53 mcg/dL (Range: 35.00 - 160.00)

Total iron-binding capacity (TIBC) 310.6 ug/Dl (Range: 227.0 - 427.0)

Unbound iron-binding capacity (UIBC) 223.1 ug/Dl (Range: 155.0 - 355.0)

Ferritin 107.7 ng/mL (Range: 13.00 - 148.00)

I haven't tested Folate. I did many other tests too, other B vitamins, various minerals, protein levels... they were all OK.

[SlowDragon Administrator in reply to Canu]

50mcg levothyroxine is only a starter dose.

Were you left on that for a year!?

Please add vitamin results and ranges

What vitamin supplements are you currently taking?

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

As you have Hashimoto’s are you on strictly gluten free diet

[Canu in reply to SlowDragon]

"50mcg levothyroxine is only a starter dose.

Were you left on that for a year!?"

I've had my dosage increased and decreased many times in the last 15 months. I'm very sensitive to thyroxine. I'm actually taking 50 mcg for 6 days and 74 mcg on the 7th day. Anything more than this and I start getting hyper symptoms (heart racing, etc.)

I understand that my TSH is too high, but my T4 is very high and my T3 at the borderline of upper third of the range.

My vitamin tests:

Vitamin D3 (25-OH) 47.11 ng/mL (Range: 25 - 80) (I have increased my supplementation slightly since I did this test in March and I have been spending more time in the sun)

B12 (Cobalamin) 845.9 pg/mL (Range: 180 - 914)

I don't have any recent Iron or Ferritin tests, but here are the ones from last year:

Iron (Fe) 87.53 mcg/dL (Range: 35.00 - 160.00)

Total iron-binding capacity (TIBC) 310.6 ug/Dl (Range: 227.0 - 427.0)

Unbound iron-binding capacity (UIBC) 223.1 ug/Dl (Range: 155.0 - 355.0)

Ferritin 107.7 ng/mL (Range: 13.00 - 148.00)

I haven't tested Folate. I did many other tests too, other B vitamins, various minerals, protein levels... they were all OK.

"What vitamin supplements are you currently taking?"

B-complex, Vit. D, Zinc, Selenium, Vit. C, and also other things like Probiotics, NAC, etc.

"Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)"

I do, and also I did't eat anything for 2 hours after taking the levothyroxine (and now Armour).

"As you have Hashimoto’s are you on strictly gluten free diet"

Gluten, dairy, grain, sugar and anything processed free.

[Lalatoot]

No one can say. First you need to work up to a good dose for you testing bloods after 8 weeks of any increase. It is a slow process.

Next there is no saying that the ratio of t4 to t3 in ndt is what your body needs. Some folks find that they need to add some levo or some t3 to NDT to balance their ft4 and Ft3 levels.

There is no quick fix. If you are lucky it will be straightforward but no one can say.

[Canu in reply to Lalatoot]

Thank you Lalatoot.

[greygoose]

not feeling well despite my latest thyroid tests results being optimal (not just in range

If your not feeling well, then your results weren't optimal, were they. Optimal is when all the symptoms have gone and you feel well. Are you talking about the results you've given above? Who on earth told you they were optimal? Your TSH is too high, there, and your FT3 too low. Were you only on 50 mcg when that test was done? Were you on 50 mcg for the whole year? No wonder you didn't feel well!

Various tests for nutritional deficiencies were OK too.

OK is no good. We want optimal. And, with nutrients, unlike thyroid, you can see from the test results if they're optimal. Might be a good idea to give us those results, too. Because if you're taking NDT, it's essential that they are all optimal.

So, how much NDT are you taking? And, how long have you been taking it?

[Canu in reply to greygoose]

I've only just started taking Armour today.

I had my levothyroxine dosage increased and decreased many times in the previous 15 months. I'm very sensitive to thyroxine. I'm actually taking 50 mcg for 6 days and 75 mcg on the 7th day. Anything more than this and I start getting hyper symptoms (heart racing, etc.)

I understand that my TSH is too high, but my T4 is high and my T3 at the borderline of upper third of the range.

My vitamin tests:

Vitamin D3 (25-OH) 47.11 ng/mL (Range: 25 - 80) (I have increased my supplementation slightly since I did this test in March and I have been spending more time in the sun)

B12 (Cobalamin) 845.9 pg/mL (Range: 180 - 914)

I don't have any recent Iron or Ferritin tests, but here are the ones from last year:

Iron (Fe) 87.53 mcg/dL (Range: 35.00 - 160.00)

Total iron-binding capacity (TIBC) 310.6 ug/Dl (Range: 227.0 - 427.0)

Unbound iron-binding capacity (UIBC) 223.1 ug/Dl (Range: 155.0 - 355.0)

Ferritin 107.7 ng/mL (Range: 13.00 - 148.00)

I haven't tested Folate. I did many other tests too, other B vitamins, various minerals, protein levels... they were all around the middle of the range.

[greygoose in reply to Canu]

I understand that my TSH is too high, but my T4 is high and my T3 at the borderline of upper third of the range.

You don't convert very well. So, taking NDT is probably the best thing for you. How much have you started taking?

[Canu in reply to greygoose]

I've started taking Armour 1/2 grain (30mg), based on the conversion table guidelines here: getrealthyroid.com/conversi...

[greygoose in reply to Canu]

OK, well, 30 mg (1/2 grain) is only a small dose, so you will need to increase at some point, but take your time, and be guided by how you feel. If you do bloods, it is essential to test the FT3.

[Canu in reply to greygoose]

Thank you very much greygoose!

[greygoose in reply to Canu]

You're welcome.

[AnnaSo]

It takes time because you need to first get to your optimal dose by slowly increasing and then it will take time to settle. It took me around 6 months to feel better.

[Canu in reply to AnnaSo]

Thank you AnnaSo.

[AnnaSo in reply to Canu]

No problem. I know it’s a long time but it’s worth it!!! 🙂 I got my life back with NDT

[Canu in reply to AnnaSo]

You give me hope!

[Lora7again]

Sometimes you can feel worse before you feel better because your pituitary gland senses that there is levothyroxine in your body and stops stimulating your thyroid to produce thyroxine. When you start to feel worse it usually means you need to increase your Levothyroxine by 25mcg. This is a slow process and I am afraid it is not a quick fix. My Endocrinologist said to me when I was first diagnosed that if I had RAI I would be able to take Levothyroxine and everything would be ok ... this is not the case at all. The reason this site exists is because treating thyroid disease is not easy as some Endocrinologists tell us. I am just glad I researched what was wrong with me by joining sites like Elaine Moore's in the US and sites here in the UK. You can read my story on my profile page if you are interested.

[Canu in reply to Lora7again]

Hi Lora7again. I read your story. I'm so sorry you've been going through so much. Thank you for the tips. I found Elaine Moore's site and will be checking it out.