Overdosed or not with ndt

[adin]

Hi, I've been re-taking ndt for a while(Thyroid-S), 2 grain in the morning +1 grain in the afternoon and another one at bedtime, in total 4 grain.

I'm a little agitated, my knees hurt, chest pressure, my blood pressure and pulse are high in the morning, etc. Because I didn't feel very well, I did my tests today. They are coming back over the range. So, fT4 is 15,44 (12-22) and fT3 9,24(3,1-6,8). As you can see ft3 is over.

I would have two options; -to reduce ndt and add levo ( let's say 3 grain +25mcg levo) or - to return to the synthetic(levo+T3) but there I have other side effects. I can't find a balance, I take daily B12, D3, vit.C...

Wath do you think?

[SlowDragon Administrator]

Why not SLOWLY reduce NDT

How long have you been on 4 grains

Usual advice is reduce by 1/4 grain at a time

Reducing by 1/4 grain, wait 6-8 weeks….retest

Or reduce again by a further 1/4 grain …wait 6-8 weeks then retest

Etc

You could try ending up on 1 grain waking, 1 grain mid afternoon and 1 grain bedtime…..

What vitamin supplements are you currently taking

When were vitamin D, folate, ferritin and B12 last tested

[adin in reply to SlowDragon]

I was on 3 grains and I didn't feel well I had to increase the dose quickly, I couldn't stay without increasing the dose for more than a week because I felt very hypo. It seems that in 3 grains t4 is not enough for me. It seems that in 4 grains I find t4 as much as I need but also too much t3(due to pig ratio).I'm without thyroid and I go into a hypo quickly, I can't stay 6-8 weeks...

[Hidden in reply to adin]

You can split into halves or quarters

[adin in reply to Hidden]

I know, I was on 3,5 grain but it wasn't enough for me. I need more T4 and less T3.

[Hidden in reply to adin]

I need less T4 and more T3. Been wondering how to combine NDT with T3 to achieve that

[Hidden]

There is possibility when you reduce your NDT from 4 to 3.75 or 3 5 grains, that your ft4 will go up and ft3 will go down, as sometimes t3 suppresses t4 as it does with tsh. If it's the case that your ft4 is low in range after reduction, you can add levo, but start with 12.5 mcg or even less, I had to start with 6.25 mcg. I would look at your labs at 3.5 grains to make the decision if you need that additional t4

[TSH110]

You need to reduce your dose, both symptoms and blood test indicate you are on too high a dose. Start reducing now. Not sure if you should stick to 1/4 grain reductions or going higher might be advisable given how much over your FT3 is. It should be in top 1/3 of range, ideally. Others might suggest a suitable rate and amount of reduction to follow.

Have a read of this very good guide to dosing with helpful advice on how to hit the right dose:

tpauk.com/main/article/trea...

I take ThyroidS too but don’t need such a high dose (1,75 grains) I used to take 125 mcg Levothyroxine but felt rubbish on any dose to be honest but that was as neat as I could get between hyper and hypo. But everyone is different. I feel really well on ThyroidS. I used the guidance posted and was able to find the best dose successfully just slowly going up till I felt my old self again. The key is very small increases and leaving enough time for those to take effect.

I hope you get a more suitable and optimised dose very soon.

[pennyannie]

Hello Adin :

I think if you seriously believe you must maintain a T4 at around/over 50% through the range you might find it easier to work with synthetic T3 and T4 :

The other option would be maximising your NDT dose and then, if you felt you needed a little T4 just adding a little but not because your percentage blood test of T4 wasn't over 50% .

With NDT you dose to the relief of symptoms and not a blood test.

The blood tests and ranges were introduced to be used with synthetic T3 and T4:

On synthetics I think achieving a T4 at around 50% and then topping up with T3 through the day might be easier to " read, feel and manage ".

4 grains of Thyroid S is giving you - 36 mcg of T3 + 152 T4 :

I read we need to find/convert/ utilise around 50 mcg T3 daily, just to function.

I'm not sure it's helping you splitting Thyroid S more than twice.

There were some brands of NDT that could be chewed and more easily split into small pieces to take more often, but Thyroid S isn't one of them.

I too have had RAI thyroid ablation for Graves back in 2005.

I now take Thyroid S and find I 'm pretty much ok on just 1 + 1/2 grains at around 3 in the morning but I do dip a little in the afternoon - though having tried a second dose at around 12 hours apart from the first, it had no effect on me, other than make me ravenous at 10 pm.

I'm still a work in progress, and am thinking of maybe trying a little T3 in the PM ??

I found my symptoms continued to improve months after I settled on this dose of NDT and now at 74, maybe I'm more accepting of where I am in all this but do find NDT much softer on my body and a " fuller " support system than synthetic thyroid hormone replacement.

[adin]

That's exactly what I did today, I took it in the morning 2grain & 25levo +1,5 grain at 4pm and already it's much better. So the all is 3,5 ndt +25mcg levo. Thank you.