NDT Efra dosing and timing advice : Hello lovely... - Thyroid UK

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NDT Efra dosing and timing advice

PixieElv profile image
22 Replies

Hello lovely people

I’ve been taking NDT now for about 4 weeks and I’m getting on well with it (no side effects), but it’s hard to tell how well they work for my hypo symptoms, as I’ve had Covid.

As I’ve got bad energy crashes throughout the day, I am experimenting with taking 3 doses. I currently take 1 grain in the morning, one before lunch and 1/2 late afternoon. I think this works but it’s too early to tell. (No bloods yet)

Is anyone doing this and how does that work for you?

And how so I cut my pill into quarters? They just crumble ? I have 2 different pill cutters but they both deliver the same poor results

Thank you

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PixieElv profile image
PixieElv
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22 Replies
pennyannie profile image
pennyannie

Hello PixieElv :

I think it's recommended everywhere to start to take NDT in 1/4 grains and slowly weekly, or fortnightly, slowly build up this dose in 1/4 grain increments until you reach 2 grains where you stay on this dose for 6-8 weeks and then run a blood test to see what's going on.

If you were taking T4 previously this takes around 6-8 weeks to fully leave your body and in that time as the T4 level reduces, you slowly add little 1/4 grain segments of NDT.

Did you take bench numbers of your T3 and T4 levels before you started and are your ferritin, folate, B12 and vitamin D optimal as these are also essential to support your core strength and your body through the transition.

Are you monitoring on blood pressure, pulse and temperature twice daily ?

PixieElv profile image
PixieElv in reply topennyannie

HelloI was taking T4 before and was doing ok on it. Then i started to feel worse and my T4 shot up from 18 to 22.2 (10-22), whilst my T3 conversion dropped from 5.1 to 3.6 (3.4-6.8). Hence my Endo & I changed to NDT. I didn’t get on with T3 only previously.

So I’ve replaced my T4 with the same conversion dose of NDT (175mcg = 2h grain NDT) but feel undermedicated, hence I added 1/2 grain to that after 4 weeks.

Last time I checked my ferritin, folate, B12 and vitamin D, they were all really good.

And no, I don’t check blood pressure, pulse and temperature twice daily. When I do check they are all really good. Should I?

And why?

And ideas on how to cut pills?

And do you take NDT? All in one go or throughout the day?

Thank you

pennyannie profile image
pennyannie in reply toPixieElv

The most simplest way of knowing how fast your metabolism is running is by taking your pulse, blood pressure and temperature.

I took am and pm readings when i switched from 125mcg T4 monotherapy to NDT some 4 years ago :

My blood pressure and pulse remained constant but watched my temperature rise from 35.4 to 36.6 where is still is hovers today.

My tablets do not crumble and I'm quite successful at getting 1/4s and 1/2s and even if a little off, one way or another, over the course of the week my body seems to adjust the difference with no apparent issues.

I dose once a day at around 3.00am to coincide with the circadian rhythm of the body which now happens to also be toilet break anyway.

I had RAI thyroid ablation for Graves in 2005 and for all intents and purposes consider myself without a thyroid gland.

P.S. I've just looked back and seen we have spoken before about all this ?

PixieElv profile image
PixieElv in reply topennyannie

Yes we have 😊 but not the temperature & pulse. And I’m still new to this all, so any info is gladly received

pennyannie profile image
pennyannie in reply toPixieElv

Well I don't think I've anything else to add as I've replied on your previous post as well .

sandi profile image
sandi

The cutting pills is a problem with some batches of Erfa, no idea why. Thankfully my latest prescription cuts fine but the last two were so soft they crumbled and almost melted in my mouth when I took them. Was relieved to get back to being able to cut! I didn’t find any solution so wasted a fair amount of pills in the process.

I take twice a day and try to have the first one quite early which works better for me.

PixieElv profile image
PixieElv in reply tosandi

I seem to have a similar batch 😞

sandi profile image
sandi in reply toPixieElv

My sympathies. The batch numbers were totally different to one’s I’ve had before and since so I was wondering if they were produced at a different plant. I found that even trying to swallow the morning whole tablet it dissolved in my mouth before I’d taken a sip of water😡

PixieElv profile image
PixieElv in reply tosandi

It’s my first ever batch, so I wouldn’t even know

diogenes profile image
diogenesRemembering

There might be a reasonable solution rather than cutting tablets. The problem about cutting is the difficulty doing it on such small tablets. And dissolving in water is wasteful. So how about grinding up the tablet in a pestle, add a good lot of say baking soda powder (sodium bicarbonate) to this to bulk it up, mixing the whole lot comprehensively and thoroughly as a solid and then divide evenly into the 2,3 or 4 portions of equal size. This way you don't have cutter difficulty or wastage of product, because you don't dissolve the portions until needed. Just an experimental thought to ease matters. You will belch a good deal, but that cures any incipient heartburn. If you try and it works, by all means publicise.

helvella profile image
helvellaAdministrator in reply todiogenes

I have a milligram scale upstairs.

I'd probably first weigh the complete tablet. Then grind as you suggest. Then divide into two equal weight lots.

One tablet I weighed recently (Accord 100 microgram, I think) was very close to 80 milligrams.

(I know, most people don't have milligram scales.)

diogenes profile image
diogenesRemembering in reply tohelvella

That's why upping the scale by the addition makes it easier to separate by eye alone

sandi profile image
sandi in reply tohelvella

As I learnt from Jury Service drug dealers have such scales!😂

helvella profile image
helvellaAdministrator in reply tosandi

Indeed! And many adverts for them imply use by such dealers.

I just wanted to add tablet weights to my medicines document!

tattybogle profile image
tattybogle in reply tohelvella

yes , they do count as evidence for 'possession with intent to supply' so, it's probably best not to leave them in your kitchen covered in white powder residue ,next to a pile of tenner's ..... just in case the local PCSO pops round ......

"No gov, honest ... i'm just hypothyroid and really sensitive to the correct dose" ..... . "well, we'll have to discuss that down the station ... come along ."

helvella profile image
helvellaAdministrator in reply totattybogle

Many years ago, I had a big nasty knife - a Gurkha kukri which had been passed on to me for family/historical/sentimental reasons. And it was lying on a table.

Knock on door - police. Interviewed about a very nasty, violent case. I was incredibly aware that they could see this knife...

tattybogle profile image
tattybogle in reply tohelvella

:) lol, you definitely don't want to get visited with a pestle and mortar, baking powder , scales , white powder divided into 4 neat lines AND a big nasty knife.....

(and if you've got a collection of antique truncheons hanging by your front door like my dad did , then you should probably put those away too.....)

helvella profile image
helvellaAdministrator in reply totattybogle

Easter is, I think, a good time to be discussing apostles.

sandi profile image
sandi in reply tohelvella

Ok, a slightly more believable response than the one the defendant made which involved his wife and fairy cakes!

PixieElv profile image
PixieElv in reply todiogenes

That’sa great idea, thank you

shaws profile image
shawsAdministrator

I have found this pill cutter excellent and have had no problems with halves or quarters.

amazon.co.uk/s?k=pill+cutte...

PixieElv profile image
PixieElv in reply toshaws

Thank you. I’ll try it

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