Just upped my Nature Throid to 4 grains a day - ( expensive !!) & finding it hard to take the doses on empty stomach - with family meals -
I take 2 grains at 7.30 am ( that’s easy !)
But fitting in the remaining 3 doses of 1 grain is hard around meals l. ( I leave 2 hours after eating a meal - or take 1 hour before eating & away from caffeine )
I have been told it lasts in body approx 3 hours - and I have been getting very very heavy eyes once a day - often I think because I need that dose - & haven’t been able to fit it in ! 11am ish or in evening - otherwise feel
Much better on the extra grain ( which I added 1/4 at a time )
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I’m pretty sure I’m not the only person who has, in the past, taken their whole daily dose once a day. And I take 3 grains a day. Currently I split 1.5 in the morning (like you, around 7.30) and 1.5 in the evening, 2 hours after my evening meal (varies a bit—usually between 8.30 and 9.30pm). If I needed 4 grains I wouldn’t hesitate to take 2 grains in the morning and 2 grains in the evening.
It doesn’t seem to “wear off” at all and I’ve never heard of anyone needing to dose every few hours—I’d say that was unnecessary for a medication which has much more T4 than T3 in it.
Try it and see? I think you can “store” T3 better than is often mooted—I know the half life is shorter but I personally don’t notice a drop in levels unless I’ve accidentally missed a dose one day.
and go down to the section "Timing of Dosing" where she refers to Dr Blanchard's excellent book "The Functional Approach to Hypothyroidism".
Dr Blanchard says that surprisingly few of his patients found that they needed extra meds when taking with food. He has a theory that "thyroid hormone contacting the stomach wall has never occurred in the evolution of the human race until we started taking oral thyroid about a century ago".
I take half my NDT with breakfast and the rest with lunch. Much easier to remember. I take coffees and teas away from my main meals, so that keeps them away from my meds.
Wow ! Thanks for taking the time to reply Anthea - this is amazing! More reading for me ! Will read & digest ! It would change my life ! My dog has low thyroid & the vet said to give either with food or on empty stomach - but once decided which - to stick to same method & not change !
That's really interesting. Your vet could be right! He's allowing for a slight difference in dose needed. Your vet knows more than many doctors!
Getting dogs to take meds is always difficult. You've brought back memories of giving pills to our St Bernard. We found that the way to do it was to cut two pieces of brie (or something soft but not too soft), then wrap one piece round the pill - give the piece with the pill first and have the second one ready to follow it immediately, so that he saw it and the piece with the pill was gone before he noticed it. Asking in the shop for their cheapest brie and then saying that it was for the dog could be amusing.
Lol I have the perfect dog ! No Brie needed ! - a rescue - she’s an angel at taking her medication - we’ve finally got her thyroid working well ( she had lost her fur on back & tail ) she’s back to normal weight - she’s 14 years old -
I’ve never split my NDT dose. I didnt know you were meant to. Ive taken as much as 5 in the morning every morning an hour before breakfast. Now I take 3. Ive had blood taken the following morning and still got plenty of T3 in my system x
Wow ! All this is a revelation! I always thought NDT Had a short life ( just 3 hours I was told !) looking into this - always scary changing anything with
Thyroid disease isn’t it ? I was told by a prominent specialist to add a tiny 25 mg of levothyroxine (a while back ) & reduce my NDT by 1/2 a grain - I felt so ill thought I was dying !
NDT doesn't have any sort of half-life itself. It contains T4 and T3. T4 has a half-life of about 7 days. T3 has a half-life of about 23/24 hours in the blood, but what gets into the cells stays there for about three days.
So, your endo is talking rubbish! lol And, I would ask him if he even knows what a half-life is! Saying that T3 has a half-life of 24 hours means that if you take, say, 10 mcg this morning - let's call it Day 1 - by tomorrow morning - Day 2 - there will be 5 mcg left - but remember, we're talking about what's in the blood, and if some of that 10 mcg got into the cells, there will be less in the blood.
So, let's say, for sake of argument, you have 5 mcg of T3 left in your blood on the morning of Day 2, And, you then go and take your daily dose, so you have 15 mcg in the blood. Some will get into the cells etc. but by Day 3 you will have approx. 7.5 mcg in the blood. You take your daily dose and that takes it up to 17.5 mcg... And it continues like that all the time you're taking T3. T3 does not get used up. And, whilst it doesn't build up reserves like T4, if you take your dose every day, there is a kind of build up. These numbers are only approximations, but you get the drift. And, think about it, if T3 really did leave the body after 3 hours, there'd be no point in doing labs, would there? Because you'd always be running on empty! lol I sometimes wonder if these doctors ever listen to themselves talking such c**p. Orrrrrrrrr, I wonder? Could it be that is really what they do believe, and that is why they only want to test the TSH? Oh, it's like living in the Dark Ages! lol
yes that makes sense, however, my endo wont test my t3 as she says it has a short life span and its useless testing it! even though she has given me t3. she just goes on the tsh which is suppressed and she then tells me to reduce my levo even though my t4 is testing at 9 with a range of 11 - 22. she only did an initial t3 test which was on the low side and therefore agreed to treat me with combo t4/t3. its a long story and i actually am tired of talking to her. With the covid crisis i havent been getting appointments and so am just doing my own thing dependent on how i feel. however, i have ordered a medicheck test to test tsh, t4 and t3 and will see how i go
Sounds like the only useless thing is her! She has no idea what she's talking about. You cannot get well with an endo like that. She'll just keep you sick. Such ignorance! But, it's important that you know how it really works, so that you can advocate for yourself.
Yes I buy the Medichecks - & then send them to Endo - we have a zoom call after nowadays - I have no idea how to read blood tests - so I have to rely on him ! It’s like a foreign language to me ! Still learning
i know what you mean, i didnt have a clue about t this or t that but through reading, research and particularly this site, i can now more or less read my blood tests and if i am in doubt then i consult on here. i wouldnt tell my endo i did private blood tests as she is very arrogant and would never agree with that lol. i feel i have to pretend to listen to her so as she doesnt stop my combo
Well he’s pretty good in many other ways - he’s Recommended Selenium for example ( 1st time a doctor ever has -) & he’s saying that perhaps I do better on the higher side of levels etc - & he doesn’t panic that my THS is suppressed) so so far he’s the best I have !
Thanks for the insightful info - will digest & take notes
I was told by a prominent specialist to add a tiny 25 mg of levothyroxine (a while back ) & reduce my NDT by 1/2 a grain
There is no definitive equivalence between desiccated thyroid and levothyroxine. But there is no chance whatsoever of 25 micrograms of levothyroxine making up a half-grain reduction in desiccated thyroid.
We see discussions about this and, I suggest, one grain often comes out around 75 micrograms of levothyroxine. "Official" charts suggest more like 100 micrograms of levothyroxine.
I just translated that! I don't want to play the "microgram cop" role all the time!
helvella - The Microgram
The Greek letter μ (mu – pronounced just like the sound of a cat “mew”) – is the standard scientific way of writing “micro”. Micro means “one millionth”.
And yet even that slight change over 3 days made me so ill- I literally lay on the sofa & thought I was dying ! Yet couldn’t mobilise myself to call an ambulance! Horrid - and this was a highly recommended specialist in Kent ( private !) I went back to see him on NHS to let him know !
Teva is a curious make. While some find it absolutely fine, a remarkable number of us cannot tolerate it. (It is lactose-free and they use mannitol instead. It is hypothesised that might be why it affects so many, so differently.)
I did not like it at all despite it only being a small part of my dose - and stopped taking it after a few tablets.
This forum has a huge number of posts which report issues with Teva levothyroxine.
I suspect that could be a part, even the major part, of your feeling so bad when taking it.
Very interesting 🤨 the cure is worse than the disease !!! This is why I stick to NDT only & hope I improve - on the whole I’m so much better than the 25 years on Levothyroxine- can’t go back there - dark days
If you don’t know of the articles Dr Tania Smith writes in her blog they are well worth reading , they can be a challenge but are well worth the effort. There are a lot now. The home page lists them all. This one is the latest:thyroidpatients.ca/2020/12/...
This is the full title:Ingbar and Braverman’s historic study of LT4 monotherapyBY THYROIDPATIENTSCA on DECEMBER 21, 2020 • ( 8 )
If you put in Dr Tania Smith snd the first researchers name it should come up - all her stuff is excellent a real education it can be tough but I just keep rereading and picking up more each time
I have a few left atm - I buy from a UK pharmacy - but I will now have to spend more on Armour - as you’re correct they (RLC )have stopped - for now - I’m sure they will start again soon ? Anyone know ?
I have tried to contact them regarding this but all they say is they are working on it and will let us know. So 4 months so far and no news. I am about to start with NP Thyroid which is cheaper here than Armour, but I’ve tried it before and found it to be ineffective. That was a few years back. Let’s hope they have improved. Armour did work for me but it got so expensive. But I remember having a red itchy rash on my abdomen and I never realized it was that till I stopped it.Good luck
Ps it’s amazing you ever got a response from RCL LABs - my husband previously tried phoning them for me when he was in New York to see if he could obtain some Nature Throid & from where in NYC (with my UK prescription- ) he tried 3 times - “ bad line then “ no answer -
I believe he means that T3 has a short life of 3 hours once taken - that’s what he says anyway - and he’s the only one who’s ever improved my thyroid so far - long hard journey (25 years on levothyroxine) feeling awful - 3 years on NDT so far
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No carbs or sugar cravings since I upped my NDT dose, but protein cravings instead, How come?
NDT Efra dosing and timing advice 
NDT multiple, tiny doses
T3 on full or empty stomach? 
By how much should I reduce NDT dose?
