Moving from Levo only to NDT - Advice please - Thyroid UK

Thyroid UK

125,658 members147,248 posts

Moving from Levo only to NDT - Advice please

PixieElv profile image

Hello All

So my Endo wants me to move from Levo (175mcg) to NDT. My conversion rate has decreased and my symptoms returned, with energy crashes in the afternoon, eczema, disrupted sleep etc. In Sept 21 my T4 was 17 and T3 5.1 (same ranges as below). I tried T3 only but didn’t get on with that at all.

He recommended taking 2 grains in the morning and 2 grains before lunch. he said NDT - grains are T4 37mcg T3 9mcg, which sounds about right to replace 175mcg.

However, looking at other posts here people start on 1/2 grain or 1grain a day?

Ferritin last tested in July 21 90 (10-200) and Vit D 106 (50-200). I supplement.

I am also on 50mcg of DHEA as that’s very low and Holy Basil in the evening as cortisol is very high.

Any advice would be really useful.

Thank you so much

16 Replies

He recommended taking 2 grains in the morning and 2 grains before lunch. he said NDT - grains are T4 37mcg T3 9mcg, which sounds about right to replace 175mcg.

T3 is three to four times more potent than T4, so 36mcg T3 is roughly equivalent (although not like for like, obviously) to 100-140-ish μg levothyroxine.

You’d be raising your dosage from 175mcg to something roughly equivalent to 260-290mcg levothyroxine. That’s a big jump in one go.

You might eventually need it but I wouldn’t recommend you do a straight swap.

A grain of NDT is roughly equivalent to 75-100mcg levothyroxine. So it might make sense, if you do want to do a straight swap, to start out at 2 grains and see how things go. If it doesn’t seem enough, you could raise to 2 and a half grains after a few weeks, then to 3 grains a few weeks after that.

I definitely wouldn’t knock having a prescription for 4 grains—that could be a very handy thing to have (though likely very expensive) but taking the 4 grains daily from the off would probably not be a great idea.

PixieElv profile image
PixieElv in reply to Jazzw

Hi Jazzw, Very good points and very helpful advice. With that potency, 4 grains seems too much.

I might start on 2x 1 grain and raise slowly.

Thank you 😊

Brightness14 profile image
Brightness14 in reply to Jazzw

Hi, that sounds much too high 4 grains. I have no thyroid and take only 1 grain at 6am andanother 1.25 at around 2pm. Anyway I think that you should only increase gradually until you feel well again. Surely it can't be equivalent to 175 mg Levo.

I think you are right. Jazzw worked it out for me. 175mcg should be 2 grains

Hello PixieElv :

The T4 - Levothyroxine will take around 6-8 weeks to fully leave your body and in that time you slowly build up your NDT .

I have linked you into another post on here where there is a link to a very good article on how to dose Natural Desiccated Thyroid.

I switched from 125 mcg T4 one day to taking just 1/2 a grain of NDT the following day :

PixieElv profile image
PixieElv in reply to pennyannie

Hi PennyannieThank you. I can’t see the link? Would you mind sending that?

Best wishes

pennyannie profile image
pennyannie in reply to PixieElv

You should have received another message and directed to another post -

PixieElv profile image
PixieElv in reply to pennyannie

No sorry, I can’t see anything 😞

pennyannie profile image
pennyannie in reply to PixieElv

Have you seen your name on another post written by someone called HeartWoman?

PixieElv profile image
PixieElv in reply to pennyannie

YES, thank you. Just found it in the Alerts 😊

pennyannie profile image
pennyannie in reply to PixieElv

OK - so use the link there to the TPA website on how to dose NDT :

Posted by TSH110, a few posts above where my alerts have landed :

PixieElv profile image
PixieElv in reply to pennyannie

Really, really useful post. Thank you.

TSH110 profile image
TSH110 in reply to pennyannie

You beat me to it 🤣🤣🤣

I think that is rather a lot be taking straight off. I would tírate up gradually not start on 4 grains. I needed 1.25 grains for years and took 125mcg Levothyroxine before switching. I’d say 1.75 grains might be enough for you. But everyone is differen. Have a look at this guide to dosing NDT, I think you’ll find it helpful:

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

PixieElv profile image
PixieElv in reply to TSH110

Thank you TSH110 😊. I think I might start off with 1.5 or even 2 but no more.

TSH110 profile image
TSH110 in reply to PixieElv

Yeah that would be sensible then titrate up or down if you need to

You may also like...