Can anybody message where I can buy NDT from? I'm struggling to find anything that looks reliable searching online. Thank you.
NDT links?: Can anybody message where I can buy... - Thyroid UK
NDT links?
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Frenchbird1
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SlowDragonAdministrator
Welcome to the forum
Please add a little about your thyroid journey so far on your profile
Before considering NDT you need full thyroid and vitamin testing
Have you had this done
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
If/when also on T3, or NDT make sure to take last third or quarter of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test
Is this how you do your tests?
Thank you for your reply. I have been on Levothyroxin for nearly 5 years. I had untreated hypothyroidism before that (always borderline results) but they made me go on meds when I was pregnant, threatening great danger to my child if I didn't. I had no symptoms, other than I was overweight (had always been). Recently I have put on more weight for no apparent reason (no lockdown has not affected my eating habits. I am type a 1 diabetic and have eaten low carb for 6 years).
I definitely think levothyroxine is affecting my mood. I get very angry very fast, whereas before I was quite laid back. I basically hate taking it and they have just upped my dose (I had a full blood count for another issue and therefore didn't really think about going in the morning as I normally would).
How much levothyroxine are you currently taking
As type one diabetic that’s autoimmune virtually guaranteed your hypothyroidism is also autoimmune
About 90% of primary hypothyroidism is autoimmune thyroid disease (Hashimoto’s)
Hashimoto’s frequently starts/gets worse after pregnancy
Extremely important to regularly test vitamin D, folate, ferritin and B12
Have these been tested
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels NOW
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
List of private testing options
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test
Thriva also offer just vitamin testing
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test
bluehorizonbloodtests.co.uk...
If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3
£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code
thyroiduk.org/getting-a-dia...
NHS easy postal kit vitamin D test £29 via
vitamindtest.org.uk
they have just upped my dose
From what dose and how much has it been increased
Bloods should be retested 6-8 weeks after any dose change or brand change in levothyroxine
Do you always get same brand levothyroxine
Many people find Levothyroxine brands are not interchangeable.
Many patients do NOT get on well with Teva brand of Levothyroxine. Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Are you currently taking Teva?
Teva, Aristo and Glenmark are the only lactose free tablets
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but beware 25mcg Northstar is Teva
List of different brands available in U.K.
thyroiduk.org/medications-f...
Teva poll
healthunlocked.com/thyroidu...
Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Watch out for brand change when dose is increased or at repeat prescription.
academic.oup.com/jcem/artic...
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
verywellhealth.com/best-tim...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
I'll try and answer your questions as well as I can and am once again very thankful that you are taking the time to help. The hospital/my GP are always very focused on my diabetes (very well controlled) and rarely seem to care about the hypothyroidism.
From what dose and how much has it been increased?
I was on 125micrograms, I am now on 150
Do you always get same brand levothyroxine?
No it tends to vary. Northstar this month, not sure about before but different package. I have tried to ask my local pharmacist before to be consistent with another medication I take but they said they couldn't. Should I change chemist's?
I did have a fairly comprehensive blood test with Medicheck last August but everything seemed in range (if on the low side sometimes, especially vit D but I have been taking supplements since).
Here are the results (you'll understand them better than me):
Ferritin 28.4
B12 79.1
Vitamin D 58.8
TSH 4.45
FT3 3.79
Free Thyroxine 21.2
Thyroglobuline antibodies 32.5
Thyroid peroxidase antibodies 10.1
Northstar 25mcg is Teva
Northstar 50mcg and 100mcg are Accord
Accord don’t make 25mcg tablets
Take your prescription to different pharmacies until you get brand you need.
Accord is also available as Almus via Boots
Small independent pharmacies are often more helpful
Ferritin 28.4
B12 79.1
Vitamin D 58.8
Unfortunately no folate (often difficult to get tested)
Vitamin D and ferritin are too low
Ferritin - aiming to improve to at least around 70
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
List of iron rich foods
Links about iron and ferritin
irondisorders.org/too-littl...
davidg170.sg-host.com/wp-co...
Great in-depth article on low ferritin
oatext.com/iron-deficiency-...
drhedberg.com/ferritin-hypo...
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
healthunlocked.com/thyroidu...
restartmed.com/hypothyroidi...
Post discussing just how long it can take to raise low ferritin
healthunlocked.com/thyroidu...
Never supplement iron without doing full iron panel test for anaemia first
Post discussing why important to do full iron panel test
healthunlocked.com/thyroidu...
Why low ferritin needs improving
healthunlocked.com/thyroidu...
Recommend reading many replies by humanbean on iron and ferritin
How much vitamin D are you currently taking
Important to test vitamin D twice year
Aiming to improve to at least around 80nmol and around 100nmol maybe better
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
NHS Guidelines on dose vitamin D required
ouh.nhs.uk/osteoporosis/use...
But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better
ncbi.nlm.nih.gov/pubmed/218...
vitamindsociety.org/pdf/Vit...
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
Test twice yearly via vitamindtest.org.uk
Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7
amazon.co.uk/BetterYou-Dlux...
It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average
Calculator for working out dose you may need to bring level to 40ng/ml = 100nmol
grassrootshealth.net/projec...
Government recommends everyone supplement October to April
gov.uk/government/news/phe-...
Taking too much vitamin D is not a good idea
chriskresser.com/vitamin-d-...
Web links about taking important cofactors - magnesium and Vit K2-MK7
Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine
betterbones.com/bone-nutrit...
medicalnewstoday.com/articl...
livescience.com/61866-magne...
sciencedaily.com/releases/2...
Vitamin K2 mk7
betterbones.com/bone-nutrit...
healthline.com/nutrition/vi...
2 good videos on magnesium
healthunlocked.com/thyroidu...
Vitamin D and Covid
Notice how much vitamin D many of these medics are taking
There is so much here for others, too. Thank you.
TSH 4.45
FT3 3.79
Free Thyroxine 21.2
Thyroglobuline antibodies 32.5
Thyroid peroxidase antibodies 10.1
Was this test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test?
Ft4 is high in range
But Ft3 is low in range
suggests you might have taken levothyroxine before test
If you took levothyroxine 24 hours before test, then shows very poor conversion of Ft4 to ft3
Antibodies are within range, but that doesn’t exclude autoimmune thyroid disease (Hashimoto’s )
Have you had ultrasound scan of thyroid
If not, request that it’s done
(Private ultrasound £150 if medics refuse)
20% of Hashimoto's patients never have raised antibodies
healthunlocked.com/thyroidu...
Paul Robson on atrophied thyroid - especially if no TPO antibodies
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