Anyone adding t4 to NDT? My FT4 plummeted (T3 is high), feeling like death

Hi everyone,

I have been on Armour since September this year. Started with 3 grains, but that was too much (ft3 was 130% of range, ft4 80%). Lowered to 2.75, ft3 still too high (tremors, headaches, anxious, fast pulse). Lowered to 2.6 grains (100 t4 and 23.75 t3).

Here are my bloods at 8 weeks in Dec:

Ft3 = 6.1 (3.1-6.8)

Ft4 = 14.4 (12-22)

My previous bloods at 6 weeks in Nov:

Ft3 = 6.2 (3.1-6.8)

Ft4 = 17.2 (12-22)

Noticed that when ft3 goes over 83% I get hand tremors and nervousness, sweating, faster pulse 3-5 hrs after taking my dose.

I was great at the beginning of this regime, walking 10 km walks, no pain, feeling lighter, moods were good, sleep was not as good as on higher t4 in results.

Now, my ft3 is still the same, but ft4 is the only variant that changed and it fell by 60% downwards. I feel very hypo, freezing cold, tired, bags under eyes, can't walk far without breathlessness, apathy, demotivating, headaches, things annoy me all the time, emerging PMS. All female hormones are good, no perimenopause. Vit D 135. Vitamins all in orders, have been supplementing for years, over midrange active b12, ferritin near half range, folate being supplemented.

I have high ft3 for me (I test after 24hr of last dose, I don't split doses as this makes me more hypo, tried for 2 years+ disaster).

Initially I have not reduced, added only 6.25 mcg t4 and it was too much, was shaky and anxious. So then I dropped Armour from 2.6 grains to 2.5 grains (100 t4, 23.75 t3 to 95 t4, 22.5 t3) nd added 12.5 t4. Mistake, pulse over 100, arrhythmia, nausea, shaking. Ok, so again added too much. So with lowered Armour to 2.5 grains added 6.25 mcg t4 and my pulse is better than when added 12.5 t4, no shakes, no anxiety, sweats. But very tired, hypo. I am very sensitive to mes changes.

I am definitely one of those people that need good ft4 higher in range and ft3 at a good level too.

How much do I reduce that Armour in order to add Levo?

Any advice is very welcome, I need to somehow increase my ft4 to feel better, without increasing ft3 because I get overdose symptoms from it.

Thank you!

NWA6 SlowDragon hey guys, it's Cuppa here I am back, I have seen you had some trouble with low ft4 too and had to raise it, would love your take on it x

Cuppa

[adin]

Hi, yes I take levo+ndt due to lack on the market, I thought I'd save some ndt. When I was just on synthetic I took 125levo and 15T3. Then I swap on 3,5 gr thai ndt. Now I take 1gr +88mcg levo + 10 mcg SR T3(in the afternoon). Weird combination but for me it's satisfying until I find a permanent source of good ndt. My values it's ok, I feel fine.

[Hidden in reply to adin]

Hey Adin, thank you so much, this is helpful. Could you tell me what your dose is on NDT + levo, when NDT is available. Did you feel okay on synthetics? I was not great myself.

[adin in reply to Hidden]

I don't feel good just on ndt, my ft4 is below the limit so I need to add some levo. Usually, I add 25mcg . No, I don't feel very good on synthetics full of anxiety and pain, brain fog, weight gain, etc.

[Hidden in reply to adin]

Yeah similar to me then. Hopefully I will get there too! Thank you for sharing you experience Adin

[adin in reply to Hidden]

May I ask you where do you get ndt? (pm me pls)

[Hashihouseman]

Too much t3 or t4 destabilises your thyroid system feedbacks and the balance of the the two is critical. While a big dose of replacement t3 sometimes feels better than chronic hypothyroidism unless you have specific clinical need for it you could probably do better if you aimed at replacement in precisely normal healthy amounts and proportions. The healthy thyroid probably delivers you around 100mcg t4 and 5-8mcg t3 so allowing for less than perfect absorption of levothyroxine a starting point in theory would be 125 mcg levothyroxine and 7.5 mcg of liothyronine (t3). If you are using desiccated thyroid replacement you can work out how much of that based on the t3 component so that you don’t overdose the t3 then add whatever levothyroxine gives the appropriate t4. Try this for 6-weeks with a before and after that period blood test for t3 t4 and tsh. Oh and another thing, split the levothyroxine as well as the desiccated into 3 on sleeping waking and then midday so that you don’t take more than 2.5 mcg t3 or 50 mcg t4 in any single dose, with all doses combined to emulate physiological thyroid output proportions of t4:t3. The natural thyroid metabolism doesn’t like big doses and it doesn’t happen in the healthy thyroid system and that’s what we should be emulating. If these dose levels don’t ameliorate symptoms after a minimum of 6 weeks, make gradual changes wait and test and observe again, it’s a long slow process but start with what’s more normal and natural and go from there.

[Hidden in reply to Hashihouseman]

Thank you Hashihouseman! Unfortunately smaller replacement like 7. 5 or 10 mcg t3 is not possible for me, my tsh is suppressed at 0 even if I'm taking no thyroid meds and my ft3 ft4 plummet. Therefore need extra t3 that my thyroid would produce and more from disrupted conversion (like someone after TT). A person without this problem can take such amount of t3. Armour is a bit different to synthetics, hormones are attached to protein - thyroglobulin, they are not available immediately. When I split it, I feel very, very sick. Have been experimenting for the past 3.5 years with these doses (splitting different times, amounts, 2x daily, 3x daily). Now I'm fine tuning since my labs plummeted. But I totally agree, there is a balance and I am hoping that I am getting closer