Hashi's person / 56 years old.
Quick question please: Does anyone experience headaches before their next NDT daily dose? I take one around 7am-8am & one around 7-9pm.
For example: I seem to have headaches an hour or so before my next dose & then the headache goes around 2.5-3.0 hours after my NDT tablet.
Possibly need to increase my morning or evening dose slightly ... (3 monthly bloods in 2 weeks time, so that will provide a good data point).
Hi Cola NDT T3 dilates your arteries slightly and toward the end of a dose you maybe slightly low T3. I split dose like you and also keep a 60mg in my pocket and have 10-20mg top up around 4pm every second day or two. I wouldn't worry about blood tests on NDT, much better using symptoms - like this one to drive it. I only do annual blood tests for the GP, and do what ever it takes so he gets a TSH1.5-2 and leaves me alone for 12 months.
Perfect James - very helpful. I will try this also & maybe a 1/4 tablet every other day around 3-4pm. Agree... going by symptoms is far better than on-the-day bloods & being swayed by a Doctor in another direction. Thanks again for helping. Very best, Martin.
jamesal0,
NDT must be taken in the same daily dose because contains T3.
TSH often takes weeks or months (and maybe never) to raise in response to a reduced med dose. Can you advise what is it you do you get your TSH to 1.5-2 for docs approval?
Hi Radd - Are you suggesting your body works exactly the same every day. When I'm cold in winter I eat heaps more, when I'm hot in summer I drink more. NDT is exactly the same, you adjust your dosage daily using your symptoms. Not by much 15mg maybe. For finer tunes (less than 15mg) you use food to mellow it down and also provide a delayed release effect.
While I probably shouldn't say this - I think everyone on NDT should experiment with going slightly hyper and slightly hypo a few times so they under stand the side effects and can use to drive and optimize their dosage.
To optimize a TSH=0 just go off NDT for a day or two prior to bloods. You have 5-7 days T4 stored in you, you might feel a little weird as your body has got lazy being handed T3 all the time but you won't die.
jamesal0
Yes, I agree we use continuously varying rates of energy but T3 doesn’t just supply energy but effects every cell & organ in the body in varying ways.
In health thyroid hormone production is regulated by a feedback loop incorporating TRH (hypothalamus) & TSH (thyroid stimulating hormone) which also acts upon other systems such as the HPA (adrenal) and HPG (gonads), etc.
When we supply our bodies with exogenous thyroid hormone we’re effectively losing a part of the compensatary mechanism that ensures everything keeps in balance. For instance T3 is mainly bound to a transporter protein called TBG that raises inline with T3 levels only leaving a tiny fraction free & available for active use within the cells (FT3).
However, offering your body inconsistent and varying T3 amounts may risk excess binding so leaving too little FT3 for well-being and when this happens we get in that yo-yo effect of having to add a little more each time to achieve the same effect.
Another example would be regarding SHBG that raises inline with T3 and dictates your bound testosterone. Fluctuating T3 levels risks raising SHBG that may result in too much bound, leaving a low' free' testosterone level.
If we can’t exercise efficiently without having to add extra T3 then perhaps we are slightly under-medicated or have low adrenal reserve or some other cofactor deficiency such as a zinc, Co-Q10, or glucose all vital in the production of ATP, that won’t be rectified with sporadic T3 dose raising & decreasing.
Don’t forget we can have enough glucose in the blood that isn’t duly available due to a little insulin/leptin resistance common in hypothyroidism. Also the foods we consume will be metabolised differently. I naturally don’t eat enough animal protein but always bump it up if I’m busy as have noticed my T3 meds work so much better in converting long lasting energy and stamina. And those foods metabolised at a cellular levels to make ATP also require oxygen as in glucose + oxygen -> carbon dioxide + water + energy = ATP.
Regularly altering your T3 dose by 15mcg (presume you mean mcg & not mg) as in several times a week sounds a lot to me when every paper & information I read advises to medicate the same daily T3 total, (which may be split dosed if necessary).
Regarding winter dosing I increase by about 15mcg NDT (1/4 grain) to offset the cold and then reduce again in spring but these are only two small changes a year of 2.25mcg T3 + 9.5mcg T4, not the numerous weekly of 15mcg T3 that you suggest. I love discussing exercise & T3 because it is so influential. Maybe it's your numerous T3 dose changes that have kept your TSH signalling so sensitive 😬 😁
Hi Rad. Thanks for that medical grade reply. Here's my personal experience. Lets say theoretically you take 120mg NDT everyday as this is what a GP recommends after reviewing an annual blood test taken at a single point in time. But your body actually needs 135mg on swim days, which you do 4-5 days a week. Over a month you will obviously go into deficit and then start exhibiting hypo symptoms. So you go back to the GP and have a whinge and they put you up to 150 and now you go hyper after a week.
But if you were to use the traditional method. ie Find a couple of side effects (for me tinglings on the tip of my tongue , my temp, energy levels, anxiety levels, head ache levels) And use these to steer the daily or weekly variations you can have a better than normal life. I say "better than normal" because being on optimal dosage NDT is almost a “cheat". As a 57 year old male. I’ll have 15mg NDT 30 min prior to hitting the pool or mountain bike track, and often hunt people down 10-20 years younger and who are struggling aerobically. Where as on Levo I was putting on weight like crazy and panting after two flights of stairs.
Anyway - I take as much NDT as can every day (120mg), and then a couple of times a week I drop 60mg as I feel myself going slightly hyper ( head ache and tongue tingles).
Footnotes - How can an annual blood test be used to accurately drive thyroid requirements. 1. our bodies use different amounts of thyroid each day. 2. TSH vary's throughout the day. 3. Winter Summer variations. So results will very depending on time of the day, time of the year and amount of exercise on the day bloods were drawn.
Levo and NDT comes in predefined pill sizes (30mg, 60mg etc) and GP's attempt to place you on some std size pill for simplicity, not an optimal dose. As an example, my cleaner at work, 63year old young lady struggles with remembering what day of the week it is (probably brain fog) let along managing to take 75mcg/100mcg on alternate days.
James
Cola4444,
Before Hashi diagnosis I used to get early morning headaches if I laid in bed after waking. I was told it was hormonal clearance issues as the headaches went if I got up, moved around and ate breakfast, etc.
After medicating NDT these early morning issues went but I still got headachy before my second NDT dose. I split doses into three a day for about a year mainly to support poor adrenal function but this also alleviated the headaches.
Now I have been split dosing twice a day for several years and the headache issues have never returned.
It is important to medicate NDT at the same daily dose as it contain T3. This is influential on many other hormones and must be kept at a steady daily rate.
Because i've had tge flu recently i think it's drawn upon more FT3. 2 NDT per day has been right for me for some time (FT3 50-70% thru range & TSH around 0.5). I believe in the symptoms approach & will try a 1/4 or 1/5th of a grain of NDT every other day for now. I also believe slighly more is needed if doing high intensity exercise. Fortunately, I don't have to convince a GP/DR and can self serve with NDT.
Thanks Radd for sharing. Our situation seems very similar. Very best, Martin
Timing of dose before testing
Latest thyroid results after splitting dose the day before - NDT
When to take the last T3 dose before a blood test.
