People on NDT and Levo combo - has this raised ... - Thyroid UK

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People on NDT and Levo combo - has this raised your ft4 and made you feel better?

Incoguto profile image
30 Replies

Hey everyone,

I have been tweaking my doses the last while, arrived again at Armour only at 2.88 grains with results (tested after 6 weeks+):

Tsh = 0.04

Ft4 = 15.8 (12-22) 38%

Ft3 = 6.5 (3.1-6.8) 92%

Tests done after 24 hours as I'm unable to split, feeling unwell when dividing the dose.

My previous dose I was on for 5 months+, was 2.75 grains of Armour and 6.25 Levo, results not much different:

Tsh <0.01

Ft4 = 40%

Ft3= 88%

I have a few questions.

How high your ft3 needs to be to feel well and before you feel overmedicated? Is it high in range or over range?

What is the additional Levo helping you with?

I have some overdose symptoms (feeling very warm, hungry, shaky sometimes, greasy face and hair, left eye twitching etc. ) and possibly hypo (fatigue, cold late afternoon, dizzy, brain fog, still retaining water).

Thank you! 🤗

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Incoguto
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adin profile image
adin

Why don't you split your doses, 3 grain +some levo. . For exmpl. 2gr +25mcg levo and another grain at 2pm.?

in reply to adin

OP addressed that in their post.

Tests done after 24 hours as I'm unable to split, feeling unwell when dividing the dose.

adin profile image
adin in reply to

Yes I know. I felt the same if I dividend ndt it into equal doses. The idea is to have as much t4 as possible in the first part of the day without having symptoms of hyper. (for exmpl, if you need 125 mcg of levo /day, ideally, the first dose should be about 100 mcg and the rest, at noon).

Incoguto profile image
Incoguto in reply to adin

Thanks adin, I absolutely can't split the dose, did it for couple of years, 3 grains = 1 grain x times a day, then 2 grains AM and 1 grains PM, it was the worst thing I have ever done, felt so uneven.

adin profile image
adin in reply to Incoguto

Ok, I understand. Ok then, maybe you can take T3 at noon. I think its to much t3 that you take in the morning (aprox. 3 grain), as you say you have symptoms of overdose. T3(in ndt or synthetic ) has a short half-life (6, 8 hours) that's why you feel hipo in the second part of the day.If you add t4, ft3 will decrease, i supose.

For example, I can't sleep if I take more than 2 grains in the morning and my blood pressure rise. How is your blood pressure after taking 3 grains in the morning?

Incoguto profile image
Incoguto in reply to adin

I really can't take any other hormones in the PM, only morning I'm afraid. The other day I did it to try and it was awful.

Because t3 and t4 in NDT are bound to thyroglobulin I think this is why they get released slowly throughout the day.

When I add t4, as in Levo, my ft3 goes up, I still have some conversion, but don't feel well on synthetics, especially if it's just synthetics I'm taking.

I don't check my blood pressure, don't have a machine at home, I monitor my pulse, temps, respiration rate etc. I take 2.88 grains, but I think that is proven to be a bit too much.

OP, I'm on combo. On 75mcg levo and 2g Erfa my results were:

TSH: 0.05

T4: 57%

T3: 119%

I had no symptoms of overmedication though. Still felt undermedicated, in fact.

I think I need a higher t4, or more balanced perhaps. I definitely felt worse as my t4 dropped despite t3 being high in range.

I've just started taking 50mcg levo and 1.75g erfa so we'll see where that takes me!

adin profile image
adin in reply to

Still felt undermedicated, in fact.

Why are you lowering the dose then?

in reply to adin

Because my T3 was 20% over range.

Once that comes back into range we can focus on getting my frees more balanced.

adin profile image
adin in reply to

But you freeT3 how it is?

in reply to adin

Ft3: 120% over range.

adin profile image
adin in reply to

So, T3 was 20% over the range and Ft3: 120% over range.

in reply to adin

My FT3 was 120% through range. So 20% over range.

I've never had tt3 tested, only ever ft3.

adin profile image
adin in reply to

Ok i understand now, you wrote above t3(T or TT is the same) that's why I was misled.

Incoguto profile image
Incoguto in reply to

Thank you so much for your reply! This is very helpful. Have you ever been on NDT only?

My biggest issue is insomnia, I still retain 9-10 kg of water, get fatigued etc.

I know sometimes we can get symptoms of overmedication that look like under. Maybe you need a higher ft4 that 59%? Some people on here need 70% or even more!

in reply to Incoguto

I was NDT only for 2 weeks and I struggled enormously. I dropped the levo once I saw My ft3 was much too high, and in theory I should have been fine but I hated it.

My consultant has been trying to get me to NDT only and I've been slowly lowering levo. I absolutely feel my worst when my ft4 is too low.

I don't know what my consultant is aiming for but I'm aiming for roughly 75% through range for both! :)

It's been 2 years since my diagnosis... I definitely didn't anticipate it taking so long to find the sweet spot! 😂

Incoguto profile image
Incoguto in reply to

I know what you mean re: low ft4, makes me feel pretty bad too. When I changed from NDT + Levo to NDT only the first 2 weeks were the worst and then better, but now since my ft3 has been climbing I am feeling just not great. Especially the last few nights feeling so hot, kind of dry heat, hot skin, waking up at different times at night, weirdly rested in the morning. However, my skin has gotten oily the last few days and my hair too, which is normally a bad sign for me pointing to too much ft3.I sympathise, I have been diagnosed in 2012, was feeling fine up until 2017, suddenly same meds were causing a lot of issues for me.

in reply to Incoguto

I'm on my new dose for 8 weeks and then get back in tough with my consultant. He's floated the idea of adding in t3 as well so I'd be on a levo/t3/ndt combo. 😂 His preference is NDT and tweaking levels accordingly.

Incoguto profile image
Incoguto in reply to

Where are you now within those 8 weeks?That is a big combo lol I have considered it, but I don't do well with synthetic t3, trialled it for couple of years in different combinations. I hope it all works out for you soon!

Yeswithasmile profile image
Yeswithasmile

Hi.

I take a combo but not NDT.

However I thought my experience might be relevant due to levels.

On my journey I have discovered the I need ft4 at above 17 but below 18 even with a low t3 or I become very symptomatic.

I am re introducing t3 now. I’m only just on 10mcg after a few weeks. However last year I got up to 25mcg and this gave me racing heart, shakes and terrible heat all the time. I dropped t3 completely in the end, raised levo and whilst I still have night sweats at the mo I don’t have the daytime heat, racing heart or shakes. My ft3 never went over range.

My thinking now is I’ll raise my levo again once my ft3 is higher as I think it’s more about balance for me and feel that a higher ft4 would be beneficial but time will tell.

I hope this helps as you do sound similar to me. I felt dreadful with a lower ft4 and higher ft3.

Good luck.

Incoguto profile image
Incoguto in reply to Yeswithasmile

Thank you so much for your reply! That does make sense, my ft4 also cannot be too high like yours, otherwise I get horrible symptoms.

May I ask you, if you don't mind, the heat you had in the past on t3, was it kind of a dry type, dry heat with parts of your body very warm to touch?

I am keeping my fingers crossed for you🤞🤞

Yeswithasmile profile image
Yeswithasmile in reply to Incoguto

You are welcome.

It was like a perimenopausal hot flush that came on suddenly and then I’d just stay hot for hours and I would sweat. In the end I was rarely not hot. To touch my body was hot. I have had this at night for nearly 20 years previously and i did start to think it could be peri symptoms but then I started with other over medication symptoms. Dropped the t3 for about 6 months. With 2 weeks it went. Night sweats remain and now I’ve started again slowly up to 10mcg t3 they seem to be dropping off a bit. The last few nights I have actually slept until 5am 👏🏻👏🏻👏🏻

I think 6.5 would be too high for me. It may be the ratio of ft4 and ft3 and I have yet to get that right but the heat came on when my level was late 5’s so over 6 was bad too.

We are all different and it’s so difficult to know what suits 🤷‍♀️ So we just endure. I hope you work it out very soon x.

Incoguto profile image
Incoguto in reply to Yeswithasmile

Thank you!

Are you saying that increasing t3 is removing night sweats? My friend is hypo and she has night sweats, I have no sweats, but this hot feeling starting in the evening and sometimes throughout the day too, but it's more like dry heat I think. However, the last few days my face and hair started to get quite oily. I think I am overdosed.

Similarly like you, the feeling hot came in at around ft3 5.8-5.9 (3.1-6.8).

We endure so much, we need to keep going. I really hope you feel much better soon too x

Yeswithasmile profile image
Yeswithasmile

Yes. Increasing t3 this ti e does seem to be helping. They have been awful and I do think it’s helping. But I have done it much more slowly than the first time and I also split 3 times at the mo.

When I first got these night sweats I just used to feel hot but never sweaty. The sweatiness is something that has developed over the last few years.

It’s just finding that balance. Im sure we will get there 🤞🏻🤞🏻🤞🏻

Incoguto profile image
Incoguto in reply to Yeswithasmile

Makes sense, night sweats would be from lack of t3 and hot burning skin would be more from too much t3, this is why it might have changed over years. All the symptoms are so similar!Good going doing it slowly, I also go slow, maybe even too slow, not sure! Small amounts over long periods of time

Incoguto profile image
Incoguto in reply to Yeswithasmile

May I ask you just one more question if you don't mind? What is your ft4 exactly right now and ft3? Just curious as to what level you better on. Thank you!

Yeswithasmile profile image
Yeswithasmile

Hey 👋🏼

I’m afraid I don’t know. I’m waiting to do my tests. I think it’s a given that my ft4 will have dropped a bit but by how much I am unsure. I don’t feel like I did last year though so I’m am assuming it’s not too bad. I have another few weeks to go until I test. x.

Incoguto profile image
Incoguto in reply to Yeswithasmile

Thank you! Fingers crossed for you xI am dropping my Armour dose slightly today, have definite overdose, will see how it goes!

Yeswithasmile profile image
Yeswithasmile in reply to Incoguto

I wish you all the best too. I think in our desperation to feel better we always think more must be better 🤷‍♀️ Doesn’t matter how much we ask the experienced knowledgeable folks what we should do 🙄. In my case I had to learn the hard way. Determined not to this time.

I really hope you find what works for you soon x.

Incoguto profile image
Incoguto in reply to Yeswithasmile

100% agreeing with you! More doesn't mean better at all! I actually need to keep going until Thursday, my last blood test will be done then before I move on, fingers crossed, one more day! X take care, I will keep an eye on your posts to see how you're doing x

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