Blood results after changing to NDT

[MissSusan]

Can anyone help with the below results - I'm really not sure what the is norm when taking NDT.

I've been on Armour Thyroid since 29/10/20 starting on 1/2 grain twice a day and raising to 3/4 grain twice a day since 10/12/20. My weight has remained stable since starting NDT (before I was gaining weight pretty rapidly) However, I've not lost anything which is my goal as I am far too heavy. My hair is finally growing back (apart from my eyebrows). I went gluten and dairy free for just over 4 months and I really couldn't hack it any more. I felt like I was being punished...(a bit dramatic, I know).

My results before starting NDT (I was taking 100mcg Levo) were:

15/09/20

TSH 0.06 mIU/L (0.27 - 4.2)

Free T3 4.99 pmol/L (3.1 - 6.8)

Free Thyroxine 20.60 pmol/L (12 - 22)

My results from 12/02/21 are:

TSH 0.40 mIU/L (0.27 - 4.2)

Free T3 4.45 pmol/L (3.1 - 6.8)

Free Thyroxine 10.90 pmol/L (12 - 22)

CRP HS 0.61 mg/L (<5)

Ferritin 151.00 ug/L (13 - 150)

Folate - Serum 16.63 ug/L (>3.89)

Vitamin B12 - Active 164.000 pmol/L (>37.5)

Vitamin D 92.10 nmol/L

Thyroglobulin Antibodies 497.000 kIU/L (<115)

Thyroid Peroxidase Antibodies 598 kIU/L (<34)

I'm sure I'm undermedicated, I feel awful a lot of the time, very teary and fed up, although that could be to do with the current lock down.

Any help would be greatly received.

[SeasideSusie Remembering]

MissSusan

I'm sure I'm undermedicated,

Free Thyroxine 10.90 pmol/L (12 - 22)

This result tells us that you probably are.

Looking at your results from 15/9/20 on 100mcg Levo

TSH 0.06 mIU/L (0.27 - 4.2)

Free T3 4.99 pmol/L (3.1 - 6.8)

Free Thyroxine 20.60 pmol/L (12 - 22)

In theory these are good. Your FT4 is 86% through range and your FT3 is 51.08% through range. If anything I think members would have said add a bit of T3 to your Levo. Why did you change to NDT?

You've changed to NDT and now have the following levels

TSH 0.40 mIU/L (0.27 - 4.2)

Free T3 4.45 pmol/L (3.1 - 6.8)

Free Thyroxine 10.90 pmol/L (12 - 22)

Can we assume that you followed the advice always given here to take last dose of NDT 8-12 hours before the test, splitting dose and altering time the day before if necessary?

If so your results are much worse than before. Your FT4 is below range and your FT3 has fallen to 36.49% through range. But that is based on correct timing of both tests following last doses of thyroid meds (24 hours for Levo and, as mentioned, 8-12 hours for NDT).

NDT doesn't suit everyone. It has a fixed ratio of T4 to T3 which isn't necessarily right for us all, which is why some of us are better on a combination of Levo and T3.

Some of us are fine with a low FT4, some of us need it much higher up in the range, I personally need both FT4 and FT3 fairly well balanced around 60-70% through range (I'm on Levo plus T3).

Ferritin and B12 are both at a point where you should now find a maintenance dose as you don't want them getting any higher. Vit D could be improved a bit as the Vit D Society and Grassroots Health both recommend a level of 100-150nmol/L.

[MissSusan in reply to SeasideSusie]

Thanks for the reply.

My last dose of NDT was 17:00 and my test was done the following morning at approx 08:30 so 15.5 hours later - was that too long?

I really thought NDT was going to be the answer to my prayers - I read so many good things about it and was sure it was for me. I felt awful on levo, when my last bloods were done I was so fed up that I wanted to try anything.

I take desiccated liver capsules daily so will reduce from 4 to 3 or 2 a day. I also take Igennus Super B Complex x 2 a day so will reduce to 1 daily. I have the DLux 3000 vitamin D spray but am terrible at remembering to take it. Will keep it by the bed and take it at night.

[SeasideSusie Remembering in reply to MissSusan]

MissSusan

My last dose of NDT was 17:00 and my test was done the following morning at approx 08:30 so 15.5 hours later - was that too long?

Yes. Always advised is 8-12 hours to give normal circulating hormone levels. Taking NDT too close to test gives false high hormone levels, taking too far away gives false lows. However, as it's not massively too far away from the 12 hour limit, you can take it that your hormone levels are showing a bit lower than normal, mainly the FT3 level. As T4 has a much longer half life your FT4 level may not be far out, if at all. Which probably tells us that your FT4 is too low for you to be well.

As you are taking the D3 spray, are you also taking D3's important cofactors - Vit K2-MK7 and magnesium? Magnesium is necessary for the body to convert D3 into it's usable form. Vit K2 directs the extra uptake of calcium from food (when taking D3) to bones and teeth where it's needed and away from arteries and soft tissues where it can be deposited and cause problems.

[MissSusan in reply to SeasideSusie]

So will either be an increase in NDT or NDT with the addition of T3 - or maybe even back to Levo with T3.

No, I don't take K2 or magnesium. I've just seen the Dlux vitamin D with K2 spray so I'll get that. I also have Magnesium 375mg (magnesium oxide) tablets so will start taking those. Are there any supplements that shouldn't be taken close to each other?