How long on NDT before testing bloods.

[Jo-1212]

I’m switching back to Armour from Levothyroxin. How long once I’ve reached the dosage I was on before should I leave it before doing blood tests?

[Heatherv627]

I am going to do the same thing. What dose are you starting at? I am so nervous.

[Jo-1212 in reply to Heatherv627]

I’m starting at 1 grain but it was only 8 to 10 weeks ago that I came off it and I desperately need to get some T3 back into me. (See my long reply to Pennieannie below)

[jrbarnes]

6 weeks will give you the full picture.

[silverfox7 in reply to jrbarnes]

I was also going to suggest 6-8 weeks but I don’t think I’ve specifically known one so assumed it’s the same for all thyroid meds.

[ashquar]

I'm on NDT and I wait 6 weeks after any change

[pennyannie]

Hello Jo :

NDT was used successfully for over 100 years and prior to the blood tests and ranges which were introduced to be used alongside the launch of Levothyroxine as the new, better treatment for hypothyroidism in around the latter half of the last century.

Since you have been on NDT before I'm not wishing to teach you to suck eggs but my understanding is as follows :

First ensure you have optimal ferritin, folate, B12 and vitamin D levels as no thyroid hormone replacement works well if these core strength vitamins and minerals are not at good levels in the ranges:

Secondly take a blood test so to have a bench mark of your T3 and T4 :

Levothyroxine takes about 6-8 weeks to totally leave the body :

Switch completely from T4 to NDT starting with 1/4 grain and slowly start building up by 1/4 grain increases every 7/10 days - monitoring blood pressure and temperature daily :

If you reach 2 grains hold this dose for 6-8 weeks and then have a blood test to see where your T3 and T4 now are - they should have changed from your bench mark - with T3 being higher and T4 probably lower and your TSH dropping to low suppressed levels - which is all ok and to be expected :

If you feel well and still with symptoms of hypothyroidism continue slowly 1/4 grain increases.

If you take an increase and have uncomfortable, different symptoms, such as nervousness and irritability you may have gone past your ideal dose so drop back down that last 1/4 grain increase to your previous dose and that is your dose on NDT.

I have found my health improvements continued some months on from finding my " ideal ' dose :

Some people split their dose at around a 12 hour interval : others do not :

If you are self medicating you may find your T3 higher or running slightly over range within a 12 hour time frame :

If you are wanting a blood test for your doctor to approve you might prefer to leave a 24 hour gap between blood draw and last NDT dose.

It is all a little bit trial and error: -

NDT has a fixed ratio of around 1/4 T3 to T4 and this doesn't suit everybody and read of some adding in a little T3 or T4 when feeling close to their optimal dose on NDT :

Other people find their conversion of the T4 component of NDT compromised and need an alternative thyroid hormone replacement, moving over to T3 - Liothyronine only.

Why did you switch from NDT back to Levothyroxine ?

[Jo-1212 in reply to pennyannie]

Thanks so much for the all the details. It was a good refresher of knowledge that I was taught by Dr Skinner many years ago on increasing meds.

Why did I switch, - I had switched from Armour to NatureThroid years ago and all good. Until this year when I had to deal with a lot of stress and menopause. I started getting what I thought were menopause symptoms, at the same time as needing to order more NT which I didn’t realise wasn’t available due to a recall.

I approached my doctor for help to talk about menopause and she did blood tests which included Thyroid but only TSH and FT4 she then panicked when my TSH was suppressed at 0.15 sent my bloods over to a nhs endo and pretty much scared me with no other option onto Levothyroxin with the usual crap about heart, osteoporosis, NDT not being measurable rates etc. Even insisted I start on 50mcg of levo - managed to get them to increase to 75mcg. In 8 to 10 weeks of being on Levo I can barely function.

I run my own business which requires my brain working at optimum and was really struggling at times. So paid stupid money to get some Armour to function again until I can find a private doctor to work with on T4/T3 or NatureThroid comes back hopefully at a reasonable price.

Just been for blood test at doctors (that’s another issue with them not testing FT3, I asked the nurse this morning to request it as the doctor hadn’t even though she told me she had) so hopefully I have a current base to work on from 75mcg Levo. I was on 2.5g of NT

[pennyannie in reply to Jo-1212]

Hey there :

Well, I've read 1 grain of NDT is said to be about the equivalent of about 75/100 mcg Levothyroxine so if you were happy on 2.5 grains you could be looking at a dose of about at least double what you wee started on.

However I don't think it's worth comparing these medications, as they are so far from being similar.

Depending on the NDT brand 2.5 grains breaks down to about 22.5 T3 + 95.0 T4 :

You can purchase additional T4 yourself if your wait for replacement NDT becomes intolerable.

Would your doctor entertain a private script for T3 - no, this isn't a joke !!!!

Thyroid uk - the charity who support this forum hold a list of " sympathetic endos " - and I think you just need to contact Donna at Head Office and maybe consider joining if not already a member.

P.S. Thinking on your doctor could also write you a private prescription for NDT and you'll find the pharmacy information on the Thyroid uk website. Though of course, NDT is still meant to be available through the NHS on a " named patient only " prescription. No this is also not a joke !!!!

[Jo-1212 in reply to pennyannie]

Hi, Thanks, Yes I agree with you on all of the above and that is part of my longer term plan to see if I can get T3 prescribed somehow. My Armour arrives today and right now I just need to get functioning otherwise it makes it harder to even deal with the GP and their lack of knowledge and restraints.

I have just received the list from head office, unfortunately only one endo nearby, but I shall research him and others within a reasonable distance (I'm hoping some are now doing virtual consultations)

It makes me so upset to think that even with all the past knowledge I have on Thyroid and medication that the Doctor took advantage of my stressed state and made me worse rather than better, just because I didn't meet the standard textbook figurers. No wonder we have so many ill people around that never recover to their full potential.

[pennyannie in reply to Jo-1212]

You can always test your bloods privately, again info on the Thyroid uk website as the NHS don't seem to test T3, even for those taking T3 only, guess it's a bit like the 3 wise monkeys :

Glad your NDT is imminent and since you have been on it before guessing you can try starting slightly " up " the dosing procedure :

[Celestialbeing]

On desiccated, we can retest after 4 weeks. I would do so after each change in brand and/or dose. Endos at the international thyca conference stated 4 weeks for desiccated. For people that use synthetic, at least in the USA, the blood work assays have improved so that testing can occur at 5 weeks.