Hi,
Can anyone send me a message on where to find a doctor in the U.K. to prescribe NDT ?
Thanks
Help: Hi, Can anyone send me a message on where... - Thyroid UK
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Denny39
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SlowDragonAdministrator
Welcome to the forum
There’s nothing on your profile
Before considering booking any consultation with thyroid specialist endocrinologist we ALWAYS recommend getting FULL thyroid and vitamin testing done
Presumably you are diagnosed as hypothyroid
Do you have autoimmune thyroid disease, also called Hashimoto’s usually diagnosed by high thyroid antibodies
What medication and vitamin supplements are you currently taking
Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors who will prescribe T3 or NDT if you have clinical need
tukadmin@thyroiduk.org
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine, or T3 or NDT
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Recommended on here that all thyroid blood tests early morning, ideally before 9am and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
List of private testing options and money off codes
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3
£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code
thyroiduk.org/getting-a-dia...
NHS easy postal kit vitamin D test £29 via
Link about thyroid blood tests
thyroiduk.org/getting-a-dia...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
Symptoms of hypothyroidism
thyroiduk.org/wp-content/up...
Thank you for all of the info.I have underactive thyroid from hashimotos.
Levo is not helping and I wanted to try NDT.
Can I self source this? Is this a good option? Or is it best to find someone who will prescribe? I was thinking about self source to see how my body responds to it and if I would be on it long term or not.
Thanks
First you must get full thyroid and vitamin testing done and important to test correctly…..early morning, ideally before 9am and last dose levothyroxine 24 hours before test
You may simply be under medicated and/or low vitamin levels
How much levothyroxine are you currently taking
How long on this dose
Do you always get same brand levothyroxine at each prescription
No thyroid hormones work if our vitamin levels are too low
How long since thyroid levels last tested
When were vitamin levels last tested
Assuming thyroid and vitamins not tested in last 6 months
Request GP test thyroid, vitamin D, folate, ferritin and B12
What vitamin supplements are you currently taking
If you’re not already on strictly gluten free diet, GP should also do coeliac blood test
Getting levothyroxine dose fine tuned, all four vitamins tested and at GOOD levels and trialing strictly gluten free diet are always the first steps
It’s all but impossible to get NDT prescribed on NHS. It would almost certainly need to be private prescription and is an expensive undertaking
Cheaper and more realistic option via NHS is to get T3 prescribed alongside levothyroxine
Either way……you need to get full thyroid and vitamin testing done first
Just recently has my bloods done this week. All vitamin levels ok, I am on the low side of vitamin D but taking 1000 tablet each day.
I’m only on 25-50mg levo and on this dose my TSH is around the low 4 mark but I only feel good when it’s around 2 or under. My T3 and T4 come back normal this week but I am not sure what the different is between normal and optimal for these. Can you help?
When I tried to increase levo dose further in the past I got muscle pain, hot flushes and anxiety which I think is possibly a side effect of the levo.
I am fatigued every day beyond belief.
Thank you for your help.
Well you’re extremely under medicated if TSH is over 2
Which brand of levothyroxine are you currently taking
Stay on same brand while increasing dose
Many people need to increase slowly….adding 12.5mcg…..wait 6-8 weeks……then either retest or increase again…..wait 6-8 weeks before retesting
Exactly what are your most recent vitamin results
Optimal vitamin levels are
Vitamin D at least around 80nmol
Folate and ferritin at least half way through range
Serum B12 over 500
Guidelines on dose levothyroxine likely to eventually need is approx 1.6mcg per kilo of your weight per day
Unless extremely petite likely to be at least 100mcg per day
Anxiety is common hypothyroid symptom
SlowDragonAdministrator
Examples of private testing results
Medichecks
healthunlocked.com/search/p...
Blue horizon results
healthunlocked.com/search/p...
Thriva results
healthunlocked.com/search/p...
If doing private testing, do this early Monday or Tuesday morning
Stop any supplements that contain biotin a week before all blood tests as biotin can falsely affect test results
Don’t send a test back in heatwave (risks blood being no good)
SlowDragonAdministrator
If been left on too low a dose levothyroxine a long time it can be slow process to increase dose up high enough
Frequently necessary to be on strictly gluten free diet and/or dairy free…
NICE guidelines on full replacement dosenice.org.uk/guidance/ng145/...
1.3.6
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Also here
cks.nice.org.uk/topics/hypo...
pathlabs.rlbuht.nhs.uk/tft_...
Guiding Treatment with Thyroxine:
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
SlowDragonAdministrator
TSH is around the low 4 mark but I only feel good when it’s around 2 or under. My T3 and T4 come back normal this week
Please add actual results and ranges
Was test done early morning, and last dose levothyroxine 24 hours before test
Hi, see attached. They didn’t take vit D level this time but it was low last time so they put me on 1,000 IU which I am still taking now. The test was done at 10.35am in the morning and I didn’t take my Levo that morning - I took it the morning morning and only took it after the blood test was carried out. Thank you
Photo
You need 25mcg dose increase in levothyroxine and bloods retested 6-8 weeks later
Dose levothyroxine is increased slowly upwards in 25mcg steps until TSH is ALWAYS below 2
Most people when adequately treated will have TSH around or below 1
Approx how much do you weigh in kilo
pathlabs.rlbuht.nhs.uk/tft_...
Guiding Treatment with Thyroxine:
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Unless extremely petite likely to need to be on at least 100mcg levothyroxine per day
I am 8 stone 12lb. Chat my help confirm what that would be for me? Can I ask what meds you take? Thanks
8st 12lb = 56.24 kg
Guidelines on dose levothyroxine eventually likely to need
56kg x 1.6mcg = 90mcg approx
90mcg x 7 days = 630mcg ……
87.5mcg x 5 days week and 100mcg twice week = 637.5mcg per week
You might need a little more…..or you might need a little less
But being left on 50mcg is never going to be high enough dose
You can read my profile on my thyroid journey
I take
Levothyroxine - 125mcg 6 days and 112.5mcg one day a week. Splitting dose, half at bedtime half 6am.
Plus (prescription on NHS) 20mcg T3 split as 3 smaller doses at roughly equal 8 hour intervals.
Always same brand levothyroxine and same brand T3 at each prescription
Confirmed severe gluten intolerance. Absolutely strictly gluten free. Significant vitamin supplements
I didn’t get on with NDT
I was on 50mcg but the last 2 days I changed to NDT armour only a 30mcg tablet in total over the course of the day. I got this from a private doctor through my insurance. I am sweating a lot after taking it and I am worried I have jumped in to something else so quickly. Im feeling lost what to do.
How long have you been on 50mcg
See/contact GP and request 25mcg dose increase in levothyroxine up to 75mcg
Meanwhile ESSENTIAL To test vitamin D, folate, ferritin and B12
To tolerate levothyroxine, T3 or NDT we need OPTIMAL vitamin levels
Do you have autoimmune thyroid disease aka Hashimoto’s
If yes, have you had coeliac blood test done ?
If not already on strictly gluten free diet
Yeah I have auto immune thyroid. I have had coeliac test and all ok but doctor did say try gluten free. I was low on vit d so been on 100 tablets for a while now and just recently received some b12 which the doctor said was on the low side. However since I just stopped the levo two days ago and went to NDT I am sweating really bad. Is this normal?
It would be a large increase in dose to go from 50mcg levothyroxine to one grain of NDT
If vitamins are low you may struggle to tolerate
When I tried NDT 25 years ago…..my vitamin D was severely deficient(12nmol)….no one bothered to tell me or prescribe. B12 and iron probably were deficient too
Ideally you would increase your levothyroxine and get all four vitamins OPTIMAL before considering NDT
And do at least 3-6 months minimum on strictly gluten free diet before adding NDT
Personally I didn’t add T3 until a year after going gluten free
Many people on NDT need to split the dose ….approx 10-12 hours apart
I am taking a quarter of a grain in a morning and a quarter of a grain in the afternoon so in total 30mcg armour NDT. Doctor has said it would increase my metabolism. I need to maybe change back to Levo 50mcg as I go on holiday on Wednesday and worried I am messing with my body. Do you think this will be safe?
Probably better to take the levothyroxine
How long are you away
U.K. or abroad?
Which brand of levothyroxine do you normally have
Do you have enough levothyroxine to increase dose to 62.5mcg (cutting a 50mcg in 1/4) while away
Increase to 75mcg (cutting 50mcg in half) when get home…..Then get new prescription from GP for 75mcg
I have 25mcg tablets and I have enough and I am going abroad. Will it be safe to change back to levo now after taking NDT for 2 days?
Sorry forgot to say the brand is north star. Is this a good brand?
Yes it should be fine stopping NDT after 2 days….you might notice a bit …..but probably better to be on levothyroxine on holiday
Never do a dramatic change in anything thyroid related before something important like a holiday
Brands of levothyroxine
Northstar is just the box
Northstar 25mcg is Teva brand
Northstar 50mcg and 100mcg are Accord brand
This catches many people out
Teva brand upsets many people.
Did you start on 25mcg dose
Ah I didn’t realise this, thank you. Yes I started on 25mcg and was on that for months feeling ok ish, then I started feeling very unwell and every time I have increased levo to 50mcg I felt terrible and like I was getting the flu (but I’m not) and also spaced out. I went up to 50mcg for a week (trying x2 25mcg tablets or x1 50mcg tablet) and didn’t feel the best. In the background I have been speaking to a private endo and decided to change to NDT as he said my levels between T3 and T4 were increasing so it didn’t appear my body was converting the best to T3 so that’s when we decided on either adding synthetic T3 or trying NDT. I’ve heard tons of people getting there life back on NDT so I have went down this route. What do you think? Thank you
Well generally…..unless you really can’t tolerate levothyroxine….you increase levothyroxine until on roughly correct dose
Working on getting all four vitamins are at GOOD levels….if conversion remains poor (high Ft4 and low Ft3) …..and trialing strictly gluten free diet
If ….once all these 🦆🦆🦆🦆 in a row …..then you might need to add small doses of T3 (possible, but difficult to get prescribed on NHS) …..or you might look at NDT…..virtually impossible to get on NHS, extremely expensive and lots of supply issues
Increasing from 25mcg to 50mcg ….perhaps you needed to
a) stay on Teva brand
b) try increasing to 37.5mcg initially
(cutting 25mcg tablet in half)
Many people find increasing by 25mcg too much, especially if vitamins are low
Generally recommended to NOT change more than one thing at a time ….so
Change the brand
Or
Increase the dose
Don’t do both
Otherwise you don’t know what is causing the problems
Thank you for the info - appreciated. Do you know the reason it is hard to get T3 on the NHS or the reason they do not like to prescribe NDT? Is NDT safe?
There’s approximately 2 million people in U.K. replacement thyroid hormones……almost exclusively levothyroxine.
Cost of levothyroxine per 28 tablets 90p - £1
Cost of T3 or NDT is vastly more expensive
Majority of thyroid patients do ok/well if on HIGH ENOUGH dose levothyroxine….optimal vitamin levels and often gluten free or dairy free
As you are only just starting on standard starter dose 50mcg levothyroxine……you won’t know yet if you will be fine on levothyroxine
Levothyroxine doesn’t “top up “ failing thyroid….it replaces it
Approx 10-20% of thyroid patients don’t do well on just levothyroxine…..but even then ….first step is to get levothyroxine dose increased slowly upwards and all vitamins optimal
Assuming…..Ft4 is at top, or over range …..Ft3 remains low ….this is poor conversion
Liothyronine (T3) use to be approx £6 per 28 tablets 20mcg
There was only one supplier….they recatorgorised T3 as generic…..no price regulation on generic medications….price went up to £268 per 28 tablets
Number of U.K. patients who go T3 on NHS plummeted from approx 15k to 6k
Now 4-6 suppliers…..price dropping …currently £50 per pack approx
£100m fine issued
news.sky.com/story/regulato...
So cost is a significant issue
Currently approx 58,000 prescriptions for T3 in England in last year (typically 6 prescriptions per person per year)
openprescribing.net/analyse...
Armour or Erfa NDT significantly more expensive and supply often interrupted.
2,000 prescriptions for Armour in England in last year
openprescribing.net/analyse...
Only 339 prescriptions for Erfa
openprescribing.net/analyse...
But also it’s not just the cost of T3 or NDT
It’s much more difficult to manage
…..taking almost any dose of T3 or NDT …..TSH will drop extremely low or suppressed…..many medics don’t understand/hate this
Endocrinologist has to be involved.
No T3 or NDT can be initially prescribed by GP …..it has to be via thyroid specialist endocrinologist
You have to get full thyroid test done privately as testing Ft3 is essential…..and Ft3 is very rarely tested on NHS
Also frequently necessary to multi dose …..2 or 3 smaller doses spread through the day
All requires much more dedication by patients…..and medics
Sorry for all of the questions I am new to all of this so just on a learning curve and feeling very gutted this happened to me.
NDT shot up in price since double whammy of swine flu ….mass culling of pigs right across Asia
And Covid of course
Hi Denny
Yes your TSH is way too high. Should be about 0.5 -1.
Do try increasing the dose to at least 100 mcg to see if that helps.
If not, then try NDT like many of us do.
I self source mine from Thailand.
I take 100 Levo and 1 NDT and it works for me.
All the best
Persevere99
Can you let me know where you buy it from Thailand? Thanks
Do you have any side effects from the NDT or levo mixed together?
No not really Denny
Hi, Do you feel 100% from the meds every day? Like how you were before you got this illness?
Hi Denny
My thyroid numbers are now all where they should be.
TSH 0.05 (0.5-4.2)
FT4 20 (12-22)
FT3 6.1 (3.6-6.2)
NSH don’t do antibodies.
What are your numbers?
So, yes, I think, I’ve cracked the hypo and I feel ok and my exercise is better now.
So, I’ll stick on here and try and help others.
All the best!
Persevere99
This is my numbers. What do you think of them? Doctor said I was subclinical hypothyroidism. My antibodies were 150 and now increased to 300. I’ve just changed from 50mcg levo to 30mcg NDT - 15mcg in a morning and 15mcg in the afternoon.
I’m a mess at the minute and not sure what I am doing it right or not. Thank you
Photo
Hi Denny
What are your hypo symptoms?
Your TSH does seem high normal.
I’ve read on here that TSH can be very low and you can still feel ok
FT4 and FT3 I’ve read should be in the top 25% of their range.
It also seems that you’re not taking enough Levo, try upping it
So, try all the above and see how you feel?
Agreed, numbers are not important, it’s how you feel.
So, once your numbers are where they should be, then it may be something else causing your symptoms.
All the best!
Persevere99
Can you just stop NDT after 4 days and go back to levo?
Feeling like I am sweating from the NDT. Doctor said it was because my metabolism has increased from taking the NDT. Do you feel like that anytime?
No Denny
Can you send me a message of where you buy it from in Thailand? Thank you
Hi Denny I have used <redacted source> in America for many years. They are excellent, cheaper and less time consuming than a private prescription. Check out their website. No prescription necessary.
Good luck.
Please don't post names of sources of medicines.
It is against our and HU's guidelines.
Thanks. Do you order 60mg (1 grain) ? Do you know what I would need for my weight? I am 8 stone 10lb ? Do you know if it’s the same if you were to get it on a prescription in the U.K.? Thanks
I have increased to 2 grain now as my TSH has risen.I was advised by my doctor to start on a low dose and judge it by how I felt. It is a Pharmacy and it is exactly what you would get here on a private prescription from them.
Hi jay, can you drink alcohol with NDT armour? Thanks
You have replied to the post - effectively to yourself.
You need to use the blue Reply button to reply to an existing response.
Many thyroid patients find they have become much less able to drink - sometimes to the point of not drinking any alcohol at all. However, within reason, there is no reason to completely avoid alcohol. Just go easy.
Blue reply button
Thanks, I am not a big drinker it was just for going on holiday and I wanted to make sure if I have a drink of alcohol it will not be dangerous with armour? Thanks
Theory is that, when getting adequate thyroid hormone, we should be like someone without any thyroid issue. While that is a very rose-tinted view, it doesn't stop you have a slightly rosé tinted view. 
Thanks. Have you ever had a strange after taste after taking NDT armour?
Thanks. Do you feel 100% every day and how you were before you took poorly with this?
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