Need advise please

[Natalie55]

Endocrinologist to which I see regularly would like me to change from NDT to levo plus t3. Iam taking 2.5 grains per day. He suggested to swap to 125 of levo and 20mg T3. Does it sound right ? Just feel that it's too much , or am I wrong? Any advise would be very appreciated . Thank you.

[SeasideSusie Remembering]

Natalie55

Do you feel OK on NDT? If so why is your endo suggesting you change?

1 grain NDT is approx 38mcg T4 and 9mcg T3.

2.5 grains, therefore, is approx 95mcg T4 and 22.5mcg T3.

[Natalie55 in reply to SeasideSusie]

Thank you SeasideSusie for your replay .

I don't feel too good on the NDT , my T4 is always below the range and t3 is near the top . He wanted to see if it will be easier to correct my numbers by using levo and t3 . My other question is , do I just change from one day to another or should I do it in stages ? Thank you

[pennyannie in reply to Natalie55]

Apologies, just jumping in here but when on NDT blood tests do not present as when on synthetic thyroid hormones .

On NDT your THS will likely be low suppressed, your T4 lower in range than when on T4 but your T3 should be higher in range :

These ranges and guidelines were introduced to be used with synthetic T3 and T4 and with NDT you simply dose to the relief of symptoms and not a blood test.

NDT was used successfully for over 100 yers to treat hypothyroidism prior to the science of blood tests and guidelines and ranges and dose was increased slowly with little nuggats of pig thyroid until symptoms disappeared.

Has your T3 improved since taking NDT ?

[SeasideSusie Remembering in reply to Natalie55]

Natalie55

Then probably the balance of T4 to T3 in NDT at approximately 4:1 isn't right for you. With synthetic T4 and T3 you have the freedom to tweak each hormone individually to find the exact balance you need.

As for changing from one day to the next, as you are used to T3 being in NDT it should be possible, but maybe err on the side of caution and take a bit less than the equivalent, you can always increase later. It might be sensible to start on 75mcg Levo and 20mcg T3 and see how that goes.

It might be worth pointing out that the only brand that does a 75mcg tablet is Teva and that brand contains mannitol instead of the usual lactose, many members here have reacted badly to it. They also make a 25mcg dose tablet under their own brand Teva and also under the brand name Northstar.

If you want to avoid Teva I would maybe ask endo to to prescribe at his suggested dose but just don't take as much as he says, then you will have some extra Levo to play with further down the line. Maybe ask for Wockhard for the 25mcg (they don't make a higher dose tablet) or mention that it's advised to stick to the same brand so you could have a 100mcg and a 50mcg tablet and cut the 50mcg into two.

[pennyannie]

Hello Natalie

If you feel well on the NDT what is the reason for changing your medication ?

I'm not sure you can compare NDT to synthetic thyroid hormones :

In theory 2+1/2 grains, depending on brand, equates to around 95 mcg T4 + 22.50 mcg T3 :

I also read 1 grain is said to hae the same effect as 100 mcg T4 :

It's all theoritcal as so much depends on your body's abilty to convert the thyroid hormone well.

Do you have any results you'lj like to share ?

I'm self medicating NDT and personally find this suits me better than synthetics as I feel less turbo charged and the medication " softer " on my body.

I'm with Graves post RAI thyroid ablation 2005 and managing lingering Graves, thyroid eye diseae and hypothyroidism.