levothyroxine/NDT?

[Lavender-Blue]

Hi All

Are the NDT conversation charts correct , am I understanding that: if taking 1.75 grain of NDT , would taking 175 mg of Levothyroxine be the the same?

I struggle to understand

Thank you in advance.

[helvella Administrator Thyroid UK]

The conversion charts are very much NOT accurate.

I suggest you have a look at this article:

thyroidpatients.ca/2020/05/...

In some people, one grain of desiccated thyroid is closer to 75 micrograms of levothyroxine. But, at the end of the line, we are all individuals. Charts are just approximations which, at best, might give an idea of what would work. But any one person might need more, or less, than reading from a chart would suggest.

[Lavender-Blue in reply to helvella]

Thank you for your reply , I will have a read.

Warmly.

[thyroidnodules in reply to helvella]

i currently take 2 grains of thiroyd which is coming to an end. my endo has agreed for me to go on eltroxin - 50mcg and T3 20mcg. Is this a realistic conversion. I, like lavender blue above, have no idea how to convert. i read the link you gave her but could not understand that at all. thank you in advance

[helvella Administrator Thyroid UK in reply to thyroidnodules]

Do bear in mind, I do not take desiccated thyroid so have no personal experience.

But, at a glance, it looks too low a dose.

Some sources claim Thiroyd contains 8.31 micrograms of T3 and 35 micrograms of T4. On a simplistic view, two grains would be 16.62 micrograms of T3 and 70 micrograms of T4. So the conversion you are being offered looks a bit low. Yes, T3 is slightly higher but T4 is lower.

But we all know that desiccated thyroid simply cannot be converted on that basis - it is just a starting point.

If you accept, make sure you have a plan of action if it proves too little or too much.

[thyroidnodules in reply to helvella]

thank you. when i realised my thiroyd was being discontinued, my endo agreed to put me on t4/t3 trial. the letter i received and the prescription received were not in harmony and i couldnt keep my appointment due to covid so i took 75 t4 nd 15 t3 and i was actually ok on that - then had a blood test, only t4 and tsh tested though. my t4 was 9 (range 11 - 22) but my tsh was 0.15. as they only go on the tsh she told me to reduce to 50mcg levo and 10mcg t3. i was so disgusted i decided to use the remaining thiroyd i had left but they are coming to an end and i am quite downhearted that i cannot continue with my thiroyd. its quite frustrating that an endo can put you on t3 treatment but not test the t3 as they do not consider it a viable test due to its fluctuations!! and only go on the tsh which, as we know, is always suppressed on homone treatment

[pennyannie]

Hello Lavender-Blue

I don't think there is any point looking at a conversion chart - these two thyroid hormone replacements are very different and you need to go low and slow when switching from Levothyroxine to NDT.

I took a bench mark blood test so I had a T3 and T4 blood test to work from.

I also ran my ferritin, folate, B12 and vitamin D and had optimal levels.

I stopped 125mcg T4 one day and started on 1/2 grain the follow day at my normal time of around 3 am in the morning to dovetail in with the circadian rhythm of the body.

I monitored my temperature and blood pressure twice daily and kept records.

My temperature rose slowly from 35.4 to 36.8. and my blood pressure remained constant:

After the first week I added another 1/4 of a grain to my dose.

Each week I increased by 1/4 grain and got to 1 + 3/4 and felt a bit edgey and uncomfortable in myself so I dropped back down to 1 + 1/2 grains and took this dose for 6 weeks allowing it to bed in. and then took a blood test.

My TSH was low suppressed my T4 had dropped down from 100% to 20 % through the range but my T3 had risen from 25% to 110 % through the range and I felt fine.

I was with no hyper symptoms and if anything still a little hypothyroid.

You dose NDT to the relief of symptoms not a blood test, range or guideline.

If you reach 2 grains stay on that dose for 6 weeks allowing it to bed in and then take a blood test:

If you feel no relief of symptoms and your T3 has barely moved this may not be the best treatment option for you.

If you are improved in your overall health and happy to continue you build up again at weekly 1/4 grain increments until your symptoms cease - there will be one week when you body tells you it's not " happy " - simply drop back down to the previous weeks dose, stay on that dose as that is your dose on NDT at that period in your life.

I hope that helps, reading someone's experience:

I'm now 2 years in and much improved and I find NDT a much bigger, more subtle treatment and am with Graves post RAI thyroid ablation in 2005. and now manage lingering Graves, thyroid eye disease and hypothyroidism.

[Lavender-Blue in reply to pennyannie]

Thank you for sharing your experiences.

I am thinking of going the other way agsin...ndt to levo.

Originally I felt good, but over the years I have tried to go back on levo with dire consequences.

I have been following the conversation chart and probably have ended up over medicating.

With the price of Armour too and having to order from the US, I am constantly worrying about obtaining it.

I had to order Armour due to Nature Throid being recalled.

I too find difficulty obtaining a satisfactory dose.

I thank all who have replied and hope that from here I can return to health.

It's scary when I don't feel well on ndt and historically not well on levo.

From my bodily wisdom and feelings, I am beginning to wonder if I was over medicated on levothyroxine prior to me having ndt in the first place.

Thank you.

LB

[pennyannie in reply to Lavender-Blue]

If you were overmedicated on T4 it would have become reverse T3 and overtime that would have declined and not an issue.

I do know I do need to keep supplementing ferritin, folate, B12 and vitamin D even though optimally medicated on NDT - as well as increasing stomach acid before food with apple cider vinegar, and supplementing adrenal glandular.

There's no easy fix - and currently buying NDT from anywhere is an issue, and get it :

maybe you need to consider replacing the T3 content of the NDT with Liothyronine ?

[Lavender-Blue in reply to pennyannie]

Yes I have thought of having some T3 but feel scared to take it as I do not know how it will behave in my body.

I do have some T3 on standby though. X

[pennyannie in reply to Lavender-Blue]

I believe it's the same procedure - low and slow.

Before I trialled NDT I trialled a T3/T4 combo ;

I dropped my T4 by 25 mcg from 125 mcg to 100 mcg and added 6.25 T3 instead :

I worked on a 1/4 ratio T4 to T3 which seems to be about right for most people :

It worked and I had immediate relief of the brain fog, and pressure building in my head and the feeling of walking around with the flu :

I think had I stayed on this longer I would have to have introduced a further dose of T3 in the pm and would probably have dropped down further my T4 ;

I did feel more turbo charged on T3 than when on NDT but I overdosed myself on T3 and lost confidence and decided I'd try NDT when I felt better. This was always my plan anyway, as I had already purchased both of these options so to give myself the best chance of resolving my health issues.

Maybe now I'm settled on 57 T4 and 13.50 T3 support from my NDT I can use this as a guideline should I ever find myself looking at alternatives - which I hope I never do, but you never know for sure in this precarious world and medical madness.

[helvella Administrator Thyroid UK in reply to Lavender-Blue]

The conversion charts from the manufacturers would tend to underdose when going from levothyroxine to desiccated thyroid. Hence would overdose when going from desiccated thyroid to levothyroxine.

However, the simple fact of desiccated thyroid having T3 makes a difference which cannot simply be compensated by checking on a table or chart. You have to consider yourself, your blood tests, etc.

[Lavender-Blue in reply to helvella]

Yes Helvella, it is personal and complex.

Thank you for your knowledge, the chart you sent to me helped...as instead of dithering over weeks to try to go back on levo, I did this morning!

Send me lots of healing energy please! X

[helvella Administrator Thyroid UK in reply to Lavender-Blue]

So very pleased to have been of, I hope!, help.

If healing energy comes over the internet ...

⚡⚡⚡⚡⚡⚡

[Lavender-Blue in reply to helvella]

I can feel it! X

[adin]

I was on 125mcg levo and 10T3 and now I take 1 grain of Thiroyd(Thai) and 88mcg levo, for me it match.

[Debon]

Everyone is different. I was on 140 mcg of T4 and 10 mcg of T3. I take 3 tablets of Thyroid-S and I had to take 4 of Thiroyd. I would go by how I felt and then my doctor would do the analysis. Good luck

[Lavender-Blue]

Thank you.