Hi, I have only joined this Group today. I was on Nature thyroid for 2-3 years (before that Levo)which seemed to work until last year. Now its withdrawn do to sub-potency. I switched to Armour but doesn’t seem to be working as I keep gaining weight, feel low in energy, dark scalp and skin. I was searching to see if there is something new people are using. Then I found some posts on adrenavive and metavive. I was on 75gm Levo. I can see Metavive I, II and III.Similarly, Adrenavive I, II and III. Can someone advice what combination should I try with? I also read a lot about Dr P? Does someone has his details. HAs these new medicines worked for anyone. Will continue to read posts on this Group but if someone has any guidance it will be greatly appreciated. Thanks
Thinking of trying metavive and adrenavive - Thyroid UK
Thinking of trying metavive and adrenavive
75mcg levothyroxine is only one step up from starter dose so, unless extremely petite were likely under medicated
How much Armour are you currently taking
Obviously essential to get FULL thyroid and vitamin testing 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
Do you have Hashimoto’s
If yes, are you on strictly gluten free diet?
What vitamin supplements are you currently taking
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?
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
Please add most recent results and ranges or come back with new post once you get full results
Dr P has retired some years ago
Hi, I had a blood test through my Gp which said my thyroid is satisfactory n 75mg Levo quantity was fine. Then I also had private blood tests by blue horizon which showed my tsh,t4 etc was low but vitamin d, b12 etc all seems normal. This was back when I was taking nature throid and only started armour. Nature thorid seemed to be working for 2-3 years until recently when it has been recalled. I have lot of vitamins, multivitamins, good diet .
How do you know you have Hasitimos. I was told that my antibodies are attacking my thyroid. Does that mean I have this? Or is there special blood tests I have to do. My gp thinks nothing wrong with my thyroid so they r unlikely to do anything.
So these results are from when on Nature Throid
Typical results for someone on NDT ....very low Ft4.
OK Ft3
Did you split your dose day before test...taking third of daily dose approx 12 hours before test?
B12 and folate too low and vitamin D too low
When we are hypothyroid we have low stomach acid, this leads to poor nutrient absorption and low vitamins as direct result .......However good your diet is
Antibodies are negative now....but if antibodies were high at any point in the past, you still have Hashimoto’s even when antibodies are now in range
Vitamin D
Are you currently taking any vitamin D?
GP will often only prescribe to bring vitamin D levels to 50nmol.
Some CCG areas will prescribe to bring levels to 75nmol or even 80nmol
leedsformulary.nhs.uk/docs/...
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
But improving to around 80nmol or 100nmol by self supplementing may be better
pubmed.ncbi.nlm.nih.gov/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 NHS
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
I did not split daily dose. Yes my vitamin d although in range was on lower side. I did start with vitamin d dose, b12 and magnesium and selenium. I also started armour but it doesn’t seem to be working. Will you recommend taking metavive and which one should I try, I, ii or III. Many thanks for your help
Personally I didn’t get on with any NDT.
Like many, I find levothyroxine (always same brand) .....and VERY IMPORTANT levothyroxine at high enough dose, all four vitamins optimal by regular testing and supplementing, strictly gluten free diet and soya free diet
Plus 3 small doses T3 prescribed alongside levothyroxine (on NHS) via endocrinologist
Thanks
My tablets are put in daily doses, we never get boxes. So far I have had no problem, I take 125 mg per day.Levo. Never ever seen a blood test result. I do not think if I did it would make any difference. My doctor said as I am on the correct dose I would be able to lose weight. I did, lost 2st but maintaining is hard.
Why is very low Ft4 a "Typical results for someone on NDT ..... ". After being on a low probably insufficient dose for a long time and then nothing for a month I had reasonable FT3 and lowish FT4 and hight TSH (if you can believe labs!). It seems these levels are just so random and so many other things are also factors that I wonder what the point of them is.
I recently read that the reason FT4 levels are low on NDT/T3 is that the body protects itself from excessive T4 levels by converting more t4 to reverse T3 (rt3). The human thyroid when healthy produces tiny amounts of T3 and mainly T4 which is converted to T3 as needed. NDT contains T3 and T4 in a ratio that is not natural to humans. When you take more T3 than the body normally produces, the body responds by increasing T4 to rT3 conversion. This means less t4 is converted to free T3, making you more dependent on T3 from NDT/T3. It also makes sense that when you are taking drugs containing T3, your body needs less T4 readily available for conversion so needs to get rid of it...hence the lowish FT4 levels.
Reverse T3 is inactive. It’s a way for the body to get rid of T4 you do not need. If you feel good on NDT, no need to worry about lowish FT4. When on NDT, your FT3 levels are more important.
Thank you. So I wonder if... when you test for FT3 does that exclude reverseT3 and can rT3 be tested for? I will try to look this up.
Some labs offer rT3 testing. You may have to pay for it yourself though. I´ve heard it´s pretty expensive and not very useful. High rT3 can be a sign you are taking too much T4 for your needs. The more T3 you take, the less T4 is needed for conversion so the body gets rid of it by converting it to rT3.
Some sites like the Stop the thyroid madness advocate having FT4 levels at least 50% through range when on NDT or T3. But that may not always be possible. If you take NDT, have good FT3 levels and feel fine, I would not worry about low FT4. The latter is more of a problem if you are on levothyroxine only.
Low folate and low B12
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.This can help keep all B vitamins in balance and will help improve B12 levels too
Difference between folate and folic acid
chriskresser.com/folate-vs-...
Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.
thyroidpharmacist.com/artic...
B vitamins best taken after breakfast
Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)
Or Thorne Basic B is another option that contain folate, but is large capsule
IMPORTANT If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
Low B12 symptoms
b12deficiency.info/signs-an...
With B12 result below 500, recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
B12 sublingual lozenges
amazon.co.uk/Jarrow-Methylc...
cytoplan.co.uk/shop-by-prod...
healthunlocked.com/thyroidu...
Thanks is there a good supplement for folate
MGid
Why are you considering Adrenavive? It's an adrenal glandular. Have you done a 24 hour saliva cortisol/DHEA test and know that you need it?
As for Metavive, there is l, ll, lll and lV.
Metavive l and ll are porcine, with Metavive ll being double the dose of Metavive l. Metavive lll and lV are bovine with Metavive lV bei g double the dose of Metavive lll.
Metavive works for some members but not all.
Hi I read some posts and thought people are taking a combo of the metavive and adrenaline. I want to try new medicine to see if they work as with Armour I put so much weight, I gave no energy, feel low which clearly suggests the medicine is not working plus to export from USA it’s expensive. I was taking 1gram oh nature throid and armour . So want to understand the equivalent matavive to try. Also what is adrenal glandular. No I haven’t done the saliva test and only blood test but happy to try other tests if required.
MGid
An adrenal glandular is a supplement made from bovine adrenal glands and is basically used when people have low cortisol levels, but not when it's Addisons Disease (Adrenal Insufficiency) as that is serious and needs prescription medication. Addisons Disease would be suspected when your cortisol level is extremely low. Your cortisol level seems to be OK but, of course, it depends on the time you did the test.
The members who mention they are taking Adrenavive would very likely have done the 24 hour saliva test, it would be very foolish to take it if you didn't test.
It's not possible to give an equivalent Metavive to Armour or any other NDT. This is because Metavive is a thyroid glandular with no declared hormone content whereas NDT has specificed levels of T4 and T3. So those who use Metavive have to experiment to find a dose that might suit them.
What were you taking when that Blue Horizon test was done? Levo or NDT? Your results would suggest that you were taking NDT.
From the vitamin results in that test we can see:
Ferritin - this would be better a little higher. Ferritin is recommended to be half way through range so that would be 82 with that range. You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
apjcn.nhri.org.tw/server/in...
Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.
Vit D - this is way too low at 54nmol/L. The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L.
To reach the recommended level from your current level, you could supplement with 3,500-4,000iu D3 daily.
Retest after 3 months.
Once you've reached the recommended level then you'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
I like Doctor's Best D3 softgels and for Vit K2-ML7 I like Vitabay or Vegavero.
Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.
naturalnews.com/046401_magn...
drjockers.com/best-magnesiu...
B12 - this is way too low at 296. Many people with B12 level in the 300s have been found to have B12 deficiency. Do you have any signs of B12 deficiency – check here:
b12deficiency.info/signs-an...
b12d.org/submit/document?id=46
If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.
If you don't then you could supplement with a sublingual B12 - methylcobalamin or a combination of methylcobalamin and adenosylcobalamin (both are active forms of B12, Cytoplan do this combination cytoplan.co.uk/vitamin-b12-... ).
When taking B12 we also need a good quality, biovailable B Complex to balance all the B vitamins such as Thorne Basic B or Igennus Super B.
I would use one pot of B12 (along with B Complex) which should raise your level quite well then just carry on with the B Complex.
When taking B Complex we should leave this off when having any blood tests (including thyroid) because it contains Biotin and when Biotin is used in the testing procedure (which most labs do) then it causes false results.
Folate - your level isn't too bad but it's recommended to be at least half way through range (35+ with that range) and the B Complex will help there.
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
Great advice thanks a lot.
guidelines on dose levothyroxine by weight
Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
NICE guidelines on full replacement dose
nice.org.uk/guidance/ng145/...
1.3.6
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Also here
cks.nice.org.uk/topics/hypo...
gp-update.co.uk/Latest-Upda...
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
BMJ also clear on dose required
bestpractice.bmj.com/topics...
Wow thanks for all the tips and guidance. You do seem to know a lot. Yes those tests were done when I was on nature thyroid. I stopped taking Levi few years ago as I was gaining weight and it wasn’t helping. They were also done at start of winter when your vitamin d level drops drastically. Since then I have started taking vitamin d etc. The be thing I was also told by a call by my GP was that my cholesterol had gone to a very high level. My cholesterol is normally high maybe due to genetic reasons but n January/Feb it had gone in vet 6 where my GP was to go on steroids. I refused but I think it could be linked to when I stopped nature thyroid which seemed to have helped a lot in past but could also be linked to the fact that we are all in lockdown so eating more and gyms are shut. The worse is these days I feel so low in energy, very sluggish, brain fog etc n keep on faint weight. Going on NDT has certainly helped me so I think I will try this new medicine as importing them from USA is expensive and not sure Armour is working well for me. Thanks for all your help here - really appreciated n will certainly consider some of the things you have mentioned. I think along with medications, it’s important to maintain a certain lifestyle when you have under active thyroid. 👍
High cholesterol is strongly linked to being under medicated and still hypothyroid
nhs.uk/conditions/statins/c...
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
Approx how much do you weigh in kilo
75mcg levothyroxine is only enough for someone weighing around 47kilo (approx 7stone 6lbs )
I am about 62kg to 64kg for 5.6 height. I used to be about 56- 58last year with nature throid I felt the weight was under control but since I stopped and switched medicine it has been difficult plus low energetic, dry scalp, low moods etc. That’s the reason I am thinking to change medicine as nature throid has been stopped. You mention Erfa but I don’t think you can buy without prescription and it’s difficult to convinced doctors here to prescribe you NDT.
62-64kilo x 1.6 = 100mcg levothyroxine as likely daily dose required
As you are new to the site, you may find it helpful to use the search box - on my screen it's top right with 'Search HealthUnlocked' in it. Put in 'Metavive' and it will bring up posts related to Metavive. This is one of them which you may find helpful healthunlocked.com/thyroidu...
Another NDT you could try is Erfa. Quite a lot of people are using this, especially with the current shortage of NDTs. It's a lot cheaper than Armour.
You asked about Dr P - that's Dr Barry Durrant Peatfield who has written a very helpful book about the thyroid 'Your Thyroid and How to Keep it Healthy'. He's retired and we miss him.
Thanks will certainly have a look!
Please can I also stress how important it is the get your vitamins and minerals at their best. That may include supplements, diet and food intolerances.
When I had menopause problems some 25 or 30 years ago HRT disagreed with me and I was feeling pretty awful. No google then, but I found a nutritional doctor who advised vitamin and mineral supplements and diet changes. These took time, but sorted out my problems and I got through without HRT. My health improved so much so that my periods returned for some time, delaying my menopause!
One of the things I remember the nutritional doctor saying was that if you improve your nutrition it may clear up your problem and if not it makes any medical problem present more clearly so making diagnosis better.
My underactive thyroid wasn't diagnosed until about 10 years ago.
You will get plenty of good advice on here. We've been through it too.
Further thought you "put on so much weight, have no energy, feel low which clearly suggests the medicine is not working". I'll just point out that weight gain, no energy, feeling low are symptoms of an underactive thyroid, so it's not that the "medicine is not working", but that you probably aren't taking enough.
What time of day did you do the blood test? I ask as your cortisol level of 284nmol/Ls is low if it was done between 8-9am, plus with a T4 level which is very low suggests that you may have a problem with your HPA axis (hypothalamus, pituitary,adrenal glands) So before you commit to taking any adrenal supplement I would ask your GP to refer you to an Endocrinologist who is conversant with pituitary/adrenal issues to see if there is an issue. Cortisol first thing in the morning should be between 350-550nmol/Ls.
Hi, it was done in the afternoon I think from memory it was around 2-3pm or even slightly later.. Is that right cortisol for the time of the day, it’s hard to get the GP to recommend you to any specialist as far as they are concerned my blood tests were satisfactory (the Gp blood tests came normal) but the private one were the ones which showed the low thyroid etc.
In that case your cortisol result is perfectly normal for that time of day.
Thanks .. I will try to do my next blood test early morning
I order NDT online through a reputable pharmacy. I take Armour but they do provide other brands of NDT at around £100 for 3 months supply. PM me if you want to know the pharmacy.
Newly diagnosed thinking of trying metavive.
Bit of advice please!
Help I've stopped my Levo 50mcg and started Metavive I I feel awful tired and nauseous! Does anyone take these supplements ? 
Adrenavive alternatives? 
How to swap Hydrocortisone for adrenavive II/III?
