I switched in December last year to NDT as Levothyroxine wasn't helping me at all, then I tried T3 only but it didn't seem to agree with me at the time, so eventually tried NDT and got to 1 grain.
Did labs with Medichecks and got the below back:
TSH 1.04 Range 0.27-4.2
Free T3 5.45 Range 3.1-6.8
Free T4 10.4 Range 12-22
Do these labs look ok for adding more NDT? I feel really hypo still, but I think I just need a fresh eye over the labs to reassure me I am on the right path.
Thank you so much
Lou x
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ladylou_uk
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It is my understanding that with Natural Desiccated Thyroid you dose slow and low and the idea is simply to dose to the relief of symptoms.
Did you do bench mark T3 and T4 numbers before you started ?
Are your ferritin, folate, B12 and vitamin D optimal and not just in the range somewhere ?
Are you monitoring your blood pressure and temperature daily ?
OK - so I started on 1/2 grain and stayed on this dose for around 10 days : I had already trialled for myself a T3/T4 synthetic combo and suggest if new to anything other than T4 - start at 1/4 grain and wait around a week, and if feeling ok increase to 1/2 a grain and hold for another week.
I then weekly increased by 1/4 grain - monitoring daily blood pressure and temperature :
If you reach 2 grains I read it's suggested to hold that dose for 6 weeks and then take a blood test to see where you are, compared to before you started.
Your T3 should have risen and your T4 may have gone lower than before.
If there has been little or no movement in your T3 this may not be the best treatment option for you, assuming vitamins and minerals are optimal and other than hypothyroidism you are not taking any other medication that need to be taken into consideration.
If you are happy with these results and still have symptoms you continue up from 2 grains in the 1/4 grain weekly increments : there will probably be a week when you feel a little uncomfortable, edgy, anxious, and all you do is drop back down to the previous weeks dose and that is your dose on NDT at that point in time.
I have been on 1 + 1/2 grains for just over 2 years and my temperature risen from 35.4 - 36.6 and I much improved : I am with Graves post RAI thyroid ablation and now manage lingering Graves, thyroid eye disease and hypothyroidism.
The blood tests, ranges, and guidelines as we know them, were all introduced to be used when Big Pharma launched their own synthetic thyroid hormone replacement : T4 :
As you still have symptoms of hypothyroidism and your T3 well in range, I'd keep increasing - slow and low monitoring blood pressure and temperature and being aware of your symptoms
Thanks so much for taking the time to respond to me, I really do appreciate it!
I only had an NHS thyroid test before I started, I did make a note of the TSH and T4, but for the life of me cannot find it, I will keep searching my papers and update if I come across it.
Ferritin is slightly high and iron low, seems I am pushing iron into storage due to inflammation (working on this with LDN, just started yesterday). Vitamin D results came back yesterday and were not optimal (58) so have ordered a supplement to start on that. Haven't checked folate yet, will get that done asap.
I have been monitoring temp daily and I seem to be sitting around 36.3 around 3pm in the afternoon (if I should do it more times or at different time let me know ) Blood pressure no, but if that is helpful for monitoring I will get a monitor ordered.
I do feel pretty horrendous at the mo, but I realise my Iron issue and low vitamin D won't be helping that at all. Should I maybe wait until my iron and D levels are better before increasing? I do have some T3 left over, not sure if adding that to the NDT would help either.
Again, thank you so much, I have saved your description of how you increased so I can print it off for guidance.
Well obviously if vitamins and minerals are not optimal your ability to convert the T4 proportion of the NDT is limited :
Realistically if your conversion is compromised when taking NDT I'd expect your need for NDT will just be greater than that of someone who has good conversion.
If we accept that the average persons needs and uses about 50 mcg T3 daily just to function 6 grains at around 9 mcg T3 per grain content will just about do this for you.
But if that's the case it's probably cheaper to go T3 only :
What happened when you tried T3 - was that as a T3/T4 combo ?
Hey no it was just T3 on it's own though I am open to trying T3/T4 together. Previous bloods had shown I wasn't converting well on Thyroxine so that's why I chose T3 on it's own.
The T3 I felt like I just kept going up and up and feeling no different to when I was on Thyroxine and struggling. Maybe it might be worth retrying the T3 - now that you've said average person needs 50mcg T3, I wonder if I just never got high enough
Well, I wouldn't do that until you have a strong solid base of ferritin, folate, B12 and vitamin D to support you:
T3 only is the very last option to consider ;
A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1. T2, and calcitonin plus a measure of T3 at around 10 mcg and a measure of T4 at around 100 mcg.
If you found more support with Levothyroxine what's changed - maybe with optimum levels of the vitamins and minerals T4 will be ok for you, as it does work for very many people and most people on here just tend to be under medicated.
What's your thyroid history save me looking back and loosing this thread ?
Hashimoto's / post surgery / RAI thyroid ablation / ???
I was borderline for many years feeling sicker and sicker, eventually diagnosed hypothyroidism and given thyroxine. Was 50mcg, never felt well until late pregnancy. Post pregnancy needed dose up to 100mcg. Again, still felt rotten and labs at time put my T4 as good but T3 wasn't optimal.
Thanks so much for taking the time to help me, my brain feels very muddled with it all and it's really lovely to have someone help me make sense of this all
OK I got a wee bit confused with the last post but I think I've got my head round what you were saying, and if I did it right the number is 3.47 - but maths has always gone over my head!
I don't tend to shop places, I had posted it in the Facebook group then I remembered I had a log in for here, just poor memory and fatigue affecting my ability to think right at times. I had a very reflux, angry toddler and PND at that time so I was a bit of a forgetful mess!
No worries - yes, full marks there - it is T3 that gives you the debilitating symptoms - when too low a T3 you experience hypothyroid symptoms and when too high a T3 you can experience hyperthyroid symptoms and it's all about where you are in the range for your optimal health.
There is a lot more information on the Thyroid uk website who are the charity who support this mazing forum and when you have a bit more time, dip in, learn a bit more and feel confident in your knowledge and feel more able to ask questions of your doctor and try and get the level of medication you need.
Once your vitamins and minerals are optimal all thyroid hormone replacements options should work for you:
T4 - Levothyroxine is probably the easiest and definitely the cheapest option to use:
Many people start on T4 and then find for one reason or another that it seems to stop working for them, and move over to NDT and then T3 only:
i notice you have Dr P's book - snap - I do supplement adrenal glandular as well as NDT as I have Graves and am post RAI ablation and now self medicate and manage lingering Graves, thyroid eye disease and hypothyroidism. I read that the RAI gets taken up and burns out ( to a lesser extent ) other glands and organs within the body so am repairing these little all important glands too.
So IF you were on T4 - Levothyroxine ONLY when you had this Medicheck result :
Your conversion ratio is coming in at around 3.50 so with TSH at 1.72 and no apparent antibodies to muddy the water, I would think a dose increase of 25 mcg, and then another blood test after 6-8 weeks and see how you go : maybe even another T4 increase as providing your T3 stays in range, where you feel at your best becomes a very personal thing :
Yes the previous labs were T4 only. I had increased after that last post recommendation, I remember the link to body weight calculator. I went from 100mcg to 112.5mcg before deciding to try the T3. Again, thank you so much
Well, I believe the O/P did reply confirming this fact and this wasn't an assumption on my part :
As you say, best to leave things here as I'm getting more confused let alone the O/P keep getting " pinged " unnecessarily.
Not agreeing with a poster is one thing, but your posts just sound like you're needling pennyannie to provoke her.
What's the purpose? She's just giving support and advice to someone worried for their health. This is a patient to patient forum. What makes you think your knowledge is better than someone else's?
It wasn't my intention to suggest she wasn't capable of holding her own.
There are much nicer, much less abrasive ways to challenge someone.
Goodness, it seems you're just itching for a fight.
Just because someone can stand their own, doesn't mean it's unnecessary to show them support.
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