How should I increase my NDT now?: Hi everyone... - Thyroid UK

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How should I increase my NDT now?

16 Replies

Hi everyone. Happy Sunday. I started on NDT (NP Thyroid) a few months ago, starting at 1 grain and increasing 1/4 grain until I reached 2 1/4 grains. I’ve now been on 2 grains for 6 weeks and will do a LetsGetChecked blood test on Tuesday morning.

I normally take 1 grain at 8am and 1 grain at 1:30pm, am I right in thinking I should delay my last grain until 8-10 hours before my test?

I still have all my hypo symptoms (fatigue, brain fog, aching joints) although they have improved a lot since I started on 1 grain. I know I need to keep increasing my dose, but my question is how do I do this? I was thinking I’d try 1/4 grain at a time, every week or two weeks.

Anyone had any experience with this and have some ideas?

Thank you all so much. 😊

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16 Replies
SeasideSusie profile image
SeasideSusieRemembering

TiredPanda

I normally take 1 grain at 8am and 1 grain at 1:30pm, am I right in thinking I should delay my last grain until 8-10 hours before my test?

That's more or less correct, the time gap for NDT is 8-12 hours.

I know I need to keep increasing my dose, but my question is how do I do this? I was thinking I’d try 1/4 grain at a time, every week or two weeks.

I don't use NDT but this is in the NDT protocol that I have made a note of:

Week 8-9: increase by another half grain and take one grain in the morning and one grain in the afternoon and stay on this for another 3 weeks (total 2 grains daily).

This may or may not be enough. If you are still symptomatic, increase by 1/4 grain (15mg) every 3 weeks. If you feel overmedicated then drop back to the previous dose.

in reply to SeasideSusie

Thank you SeasideSusie- that’s good advice. I’ll increase every three weeks. Hope you’re having a lovely weekend.

pennyannie profile image
pennyannie

Hey there :

Yes, that's my understandig of How To Dose with NDT " - going up by 1/4 grains weekly and monitoring symptoms + blood pressure, pulse and temperature at least once a day.

I only managed to get to 1 + 3/4 grains when I felt I'd gone too far so dropped back down to 1 + 1/2 grains waited 6-8 weeks and took a blood test for my reference.

My TSH was at 0.01 - no surprise there and my T3 and T4 had swopped positions in that now my T3 was at 110% and my T4 at just 25% through the range.

My temperature had risen from 35.4 to 36.6 - blood pressure and pulse constant and I was feeling much improved from when on just T4 thyroid hormone replacement.

At 2 grains let this dose settle in and then 6-8 weeks later just take a blood test to compare with your bench mark numbers : if your T3 hasn't moved much and you are still with the majority of symptoms NDT may not be the best option for you.

If you feel ok at 2 grains and happy with your progress and your T3 is moving up the range repeat the process all over again, building up from 2 grains in 1/4 increments.

There will come a week where you feel a little uncomfortable in your body, nervous, edgey, and not like' you ' - simply drop back down to the previous dose where you felt marginally better and that is your dose on NDT at that point in time - wait the 6-8 weeks letting this dose bed in and then take a blood test, if you wish, just for your reference and interest.

NDT is slow build and I found I continued to improve months after I'd settled on my dose.

I still need to maintain my vitmins and minerals at optimal level to assist me in converting the T4 content on the NDT into T3.

The ranges and guidelines were introduced to be used alongside synthetic T3 and T4 thyroid hormone replacement by Big Pharma to compete with NDT which up until the middle of the last century had been used successfully to treat hypothyroidism or over 100 hundred years.

NDT was successfully used prior to the science of blood tests, and you simply dosed to the relief of symptoms, no ranges, no guidelines and you listened to your body's reaction as you dosed up low and slowly on various slithers of pig thyroid.

in reply to pennyannie

Thank you Pennyannie- you always give good advice. I know Susie mentioned going up in three week increments- I’ll see how I feel after the first week and then assess whether to increase. Thank you for all your support. 😊

pennyannie profile image
pennyannie in reply to

Yes it's very much a " listen to your body " time - which is a total turnaround from having to fit into boxes and ranges, classed as well and feel like rubbish !!!

Thank you for the kind words - hopefully your T3 will have moved as this will give you the encouragement and confidence to trust yourself in your decisions.

Nothing is cast in stone and you have the power to adjust as you see fit - what's the worst thing that can happen ?

I read some people split their dose whilst others don't. some need more NDT in the winter months, whilst others do not, it becomes personal to you.

I only take 1 +1/2 grains and still with some lingering hypo symptoms but then I also seem to have lingering Graves symptoms despite having had RAI thyroid ablation !!!

But overall I'm much improved and much more able than I ever was before.

We all come at this with our own thyroid health issues and what works for one, may not another, but a 1/4 grain increase is minimal and you just drop back if it doesn't suit you.

in reply to pennyannie

I’ve found increasing based on symptoms (without doctors approval) is so freeing. It definitely makes me more self-aware.

I’m hoping my T3 has moved. Last time it was 5.3 (3.1-6.8) but still having lots of symptoms so hoping getting it higher like yours will help.

I’m so pleased to hear you’re feeling better- long may it last.

Thanks again, Pennyannie x

pennyannie profile image
pennyannie

Hey there :

Just another thought :

If you have experienced these " hyper swings " I read about for people who have Hashimoto's obviously this can cause confusion. as to your optimum dose of NDT.

I read of people who sense an imminent AI attack " leaving off " their thyroid hormone replacement for a day or two so to try and offset the severity of the symptoms suffered.

Hopefully you'll be able to build up slowly without any Hashimoto's spanners being thrown at you.

in reply to pennyannie

Thanks for this too. I’ve never had raised antibodies, but did have a recent ultrasound, which left me unsure of whether or not I even have Hashis.

Here’s the post if you’re interested-

healthunlocked.com/thyroidu...

Thanks for the advice though. I’ll certainly keep it in mind.

pennyannie profile image
pennyannie in reply to

Yes, i looked back and read this post which prompted me to add the little message.

in reply to pennyannie

Thanks Pennyannie

Peanut31 profile image
Peanut31

Hi

I self medicate with NDT & Levo. My advice would be to increase very SLOWLY and takes notes on how you feel.

I could only get to 2 grains then had awful symptoms. A blood test showed my T3 was over range hence my symptoms. I just couldn’t find my sweet spot on NDT.

I have now settled on 2 grains of NDT and also add some levo in the mix daily (only a small amount) That way my T3 didn’t go over range and I feel better.

I take my levo in the morning with my NDT, and my other NDT dosage at 2pm.

Hope that helps.

Best wishes

Peanut31

in reply to Peanut31

Thanks for your reply- what kind of symptoms did you have on 2 grains? It’s a shame you couldn’t find your sweet spot but it sounds like you’ve got a good thing going now.

I agree with the importance of taking notes- I’ve been doing that since I started NDT and a nice way to remind myself of how far I have come (always easier to think about what’s still not right!)

Thanks again Peanut.

Peanut31 profile image
Peanut31 in reply to

Hi

I’m ok on 2 grains with levo, but, if I went over 2 grains I felt jittery, anxious and couldn’t think straight.

Best wishes

Peanut31

in reply to Peanut31

Thanks Peanut. I’ll keep an eye out for those symptoms.

jjf255 profile image
jjf255

This may not be your issue but...when my husband was taking NP thyroid, even with the increases by his Dr., he never could get good thyroid numbers. His Dr. switched him to Armour thyroid at my request and finally his TSH has gone down and his T3 has increased. There have been issues over the past couple years with NP. Some doses were recalled, others not. Unfortunately Armour is more expensive. You may want to think about switching to Armour on a trial basis to see if anything changes for you.

in reply to jjf255

Thanks jjf255. Good to know your husband got on well with Armour.

I’ll definitely keep your advice in mind if I can’t find my sweet spot with NP Thyroid.

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