NDT

[foxglove]

I have been taking 1.75 thyroid-s (too high a dose), FT3 rose to 8.00 plus and I have been feeling most unwell. Would it be safe to reduce thyroid-s to 1.00 or do I have to reduce more slowly? Thanks

[Hidden]

It´s usually recommended to reduce (or raise) NDT by 1/4 grain (15 mg) at a time so that you don´t miss your sweet spot. A little can go a long way when it comes to reducing hyper symptoms. If you go straight to 1 grain daily, you risk ending up hypo.

[foxglove in reply to Hidden]

Thanks will try to be patient....not in my nature and ((maybe I'm wrong) but if I end up hypo perhaps doc. would give me in increase in levo!

[Hidden in reply to foxglove]

Is your TSH suppressed on NDT? In that case, I doubt your doctor would agree to an increase in levo since a suppressed TSH means overmedicated to most doctors.

If you do go off NDT and back on levo, you would need to wait for your TSH to rise and for your FT4 levels to stabilise (FT4 can be quite low on NDT). That would take approximately 6-8 weeks. Only then will you know how well you convert the T4 in levo to T3 (provided you take no T3).

Unfortunately, most doctors will only look at your TSH and, once it´s in range, will declare you optimally treated. They tend to overlook lingering hypo symptoms as they think an in range TSH is all you need. So unless your doctor is very knowledgeable about the treatment of thyroid disease, s/he´s not likely to raise your levo if your TSH is in range, even if you continue to have hypo symptoms.

In my +20 years as hypothyroid, I have never come across a doctor willing to disregard the TSH and pay more attention to the free Ts, especially FT3.

[foxglove in reply to Hidden]

Hear what you're saying, my next thyroid test at docs. isn't till October (that's if things are happening in time so perhaps TSH will suit ! I have carelessly los copy of thyroid results from Monitor my health but I know TSH was very low!

[pennyannie in reply to foxglove]

Your TSH will be low because you are taking thyroid hormone replacement that contain T3 - that is a fact and the nature of the medication.

[Hidden in reply to foxglove]

Yes, that´s very common on NDT/T3. Not a problem as long as your FT3 remains in range, although most doctors freak out at the sight of a suppressed TSH. Mine has been <0 for 15 or so years, and still doctors tell me I will die any day of a heart attack or end up crippled from osteoporosis...still waiting for that to happen...!

But, if you do plan on going back on levo only, I´d advise you to do so at least 6-8 weeks before you are scheduled to go to the lab. As far as I know, there is no need to taper off NDT, but you can just stop taking it and go back to the dose of levo you were previously on.

Your hyper symptoms will most likely go away within 48 hours if too much T3 on NDT was the problem. You would then need to let your FT4 levels build up. After 6-8 weeks, it should be possible to tell how well you are converting T4 to T3 (you´d need to have both FT4 and FT3 tested).

This only applies if you plan on going off NDT altogether and back on levo only. If you intend to stay on Thyroid-S, I´d advise you to reduce it by 1/4 grain at a time and wait for another two weeks before decreasing it further.

[foxglove in reply to Hidden]

Thanks again for advice (and knowledge) I was sort of panicking! I think the sensible thing to do is do give thyroid-s another chance and reduce slowly, seems a shame to waste the "stash".

[Hidden in reply to foxglove]

Or at least wait a good week as someone suggested in reply to your other post, as you need time to adapt to the lower FT3 levels. If you still have hyper symptoms on the lower dose, decrease by another 15 mg.

Good luck!

[foxglove in reply to Hidden]

Thanks for good luck wishes, I'm feeling a bit more confident now, I'm by nature anxious and the extra T3 probably added. I have also just weaned off (more or less) another drug, pregabalin so I'm adjusting to that

[SeasideSusie Remembering in reply to foxglove]

foxglove

I have carelessly los copy of thyroid results from Monitor my health

Log into your account, you will be able to see your past test results.

[foxglove in reply to SeasideSusie]

Thanks had reply from the test people telling me to log in . Easy when you know how

[silverfox7]

Sounds like my ‘expert’. I had a telephone appointment and we ended up shouting at each other! She is a consultant and thinks it’s wrong that my TSH is suppressed and keeps telling my GP we must get it higher! I would have thought that a consultant should know if anyone is taking NDT then TSH is going to be suppressed! The only other scenario I can think of is that she doesn’t realise what is in NDT!