I've spent the last several years experimenting on myself with various combinations of doses, etc. after being under-medicated by docs for years on 125 mcg straight Synthroid. This led to cold intolerance, low oral body temps, low pulse, etc. For example, looking back at old medical records, for 5 years in a row during my annual physical exam, my oral temperature was never higher than about 97.6 F and was as low as 96.7 F on one visit (I'm in the U.S. - 98.6 F is normal).
Anyway, I took things into my own hands several years ago, learned everything I could about treating hypothyroidism and started buying my own meds overseas. I purchase my own blood tests and run blood work regularly to monitor my FT4, FT3, etc. and ensure mid-range or better numbers. I also monitor my oral temperatures, pulse, etc. on each dose.
I've tried everything from:
- 137 mcg Synthroid
- 150 mcg Synthroid
- 100 mcg Synthroid + 1 grain NDT
- 125 mcg Synthroid + 1/2 grain NDT
- 125 mcg Synthroid + 1/4 grain NDT
- 137 mcg Synthroid + 1/4 grain NDT
- others
So, here's the thing. I have always suffered with cold hands and feet (Raynaud's phenomenon). For some reason, it seems that the problem is worse when I'm on some of the NDT combinations vs. 100% Synthroid. I've even had times where it felt like ice water was running through the veins in my calves! This doesn't really seem to be an issue on 100% Synthroid however - at least from what I remember.
Has anyone else had a similar experience? Is there a medical explanation as to why this could be happening? Or perhaps I'm wrong and it's just coincidence?
In some respects I feel better on the NDT combinations, but not if I'm correct and my feet are consistently colder. Of course, it's tough to do an A/B experiment since it takes a couple of months for things to stabilize after changing doses. Plus, the issue is worse in the colder months of the year which are fairly short lived in my part of the world. So by the time I switch doses and things stabilize, the weather has changed.
Appreciate any thoughts or experiences you can share.
Thanks!
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jkozlow3
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Have you had iron levels checked? Also important nutrients Vit B12, folate (both work with iron) and Vit D? It is possible to have good thyroid labs but if correct cofactors aren't there, then hormones may not be working on a cellular levels meaning 'cellular hypothyroidism'.
These are common nutrient deficiencies in people with hypothyroidism and one drives the other. Old Dr P used to say constant coldness was a common reason for anemia as the making of RBC's is reliant upon normal temps.
Being cold is a classic hypo symptom and raising FT3 levels eventually helped me, but due to years of remaining undiagnosed it took several more to regain good thermogenic control. Also, if you have Hashi, controlling thyroid antibodies that may be inducing high levels of damaging inflammation.
If you post any results you have including ranges (numbers in brackets) members will comment.
I have Hashi, yes. So perhaps the NDT is aggravating my antibodies?
I do not test antibodies regularly (it's been years), nor have I tested vitamin D, B12 or folate for years. I have recently started supplementing with all 3 about 2 weeks ago. I historically have never had issues with my iron levels or ferritin.
I monitor my thyroid labs regularly and I always target 50% or greater FT4 and FT3 levels within the range. I've also found that my oral temperatures have increased to normal levels after taking my treatment into my own hands.
I guess what I'm wondering is, assuming my labs look similar between 2 doses (i.e. 125 mcg Synthroid + 1/4 grain NDT vs. 137 mcg Synthroid), is it possible that the NDT could be making my feet/extremities colder? If so, why?
Has anyone else had a similar experience or read about something like this?
Yes, it's possible because which meds & the dose most suited will be dependant upon how much thyroid gland you retain, other health conditions, and your conversion abilities.
Deiodinase enzymes (D1 ,D2, D3) determine cellular activity or deactivation of thyroid hormone in differing body tissues, with each changing in response to differing physiologic conditions and resulting in differing tissue levels of T4/T3.
A healthy thyroid produces a small amount of T3 but thyroid ablation or atrophy results in that loss. TSH stimulates D1 to encourage T4-T3 conversion in body tissues but any thyroid hormone replacement meds will have reduced TSH so lowering conversion & T3 levels, and if T3 (or NDT) has been medicated then TSH will be further lowered and even more conversion lost.
Throw in DIO1 & DIO2 common genetic impairments of various levels and there is more reduced T4 to T3 conversion, so it’s not surprising we become low in T3. Then Hashi inflammation can negatively alter how the deiodinases work and inadequate iron certainly does, as will deficiencies in the micro nutrients such as zinc, Co-Q10, etc.
Conversely the presence of T3 can up-regulate these enzymes and induce better conversion and so when we replace thyroid hormones it’s not just about sweet-spotting our levels but the correct individualised ratio for our body, and the raising of T3 levels may not be about taking more T3 meds but raising T4 that will encourage further conversion and sufficient T3 levels.
D1 & D2 enzymes that convert T4 -T3 can become down regulated by up-regulated D3 that converts excess amounts of T4 into RT3 and excess amounts of T3 into an inactive form of T2. D3 also up-regulates with stress, inflammation, dieting, depression, etc. Therefore, the activated amount of T3 in each cell is dependant upon D2 & D3 action which work in opposite ways.
Elevated thyroid antibodies can make us more susceptible to allergies/intolerances and there is thought that glandular proteins may be seen as an enemy, similar to the molecular mimicry scenario of gluten. Do you feel as if NDT induces a Hashi attack then?
I don’t think you need to keep testing antibodies as it’s not necessarily about the level of antibodies that causes the damage but the duration that changes those damaging immune cytokines into more intensified versions such as IL22.
Excessive unhealthy auto-inflammation very quickly generates further inflammation becoming a vicious circle and why people start accumulating more & more conditions. Therefore, its better to try reducing the whole immune response with a gluten free diet, fish oils, optimal Vit D, curcumin, etc. I take NDT but my own gland is atrophied.
Radd may I ask for the evidence that inflmmation causes a cycle inducing more autoimmune conditions to develop. I have a number of autoimmune conditions, my iflammation levels remain low so am intrigued. Thanks
Auto immune groups tend to be either organ-specific such as Hashi or multi-system such as Lupus. T- helper cells (TH) are a type of lymphocyte (WBC) that produce cytokines TH-1 & TH-2, which are immune messenger proteins. They are called 'non-specific' and 'specific immunity' and a balance of both are needed to fight invaders.
One or the other is generally dominant in Hashi (or other autoimmune conditions) and each has a distinct secretion of further cytokines known to be present in Hashi, RA, PA, MS, Sjogrens, Psoriasis, and numerous other autoimmune conditions. There are numerous cytokines but for ease the ones we lay people talk about are the interleukins (IL’s).
It used to be all about IL-6 but after TH-17 was discovered it is now more widely researched & known to produce IL-22 which is a super version of the previous cytokines so much more powerful and damaging and again makes it into that same cluster of autoimmune conditions. Also complicating the mix are many of these cytokines act both pro & anti-inflammatory.
The immune system is so huge & complicated it is difficult to know what to learn but Datis Kharrizian has good info in his books and Isabella Wentz is always referring to IL-17.
There are plentiful research papers available. Just input something like TH-17 + Hashimotos (for example) and this brings up many hits.
Here shows IL-22's connection to lupus, rheumatoid arthritis, multiple sclerosis, Sjögren’s and many more in both its dual pro & anti-inflammatory roles.
The other factor you dont mention is your vitamin levels. Vit D B12 folate and ferritin are all inportant in helping to utilise and make best use of thyroid hormones. I definately would not start supplementing without testing the levels. This is because you may not need to supplement but also because you can overdose on vit D, and iron. So test first to see if there is a problem before supplementing.
I had to move across to regular B12 injections. Once my b12 level was sorted and the effects of this on my body established I found I no longer needed to split my ndt dose. When I went gluten free due to gluten intolerance I noticed after a while that I was absorbing my ndt better so needed to reduce my dose a little.
As for your Raynards and the impact of different thyroid meds or combination on your condition......Id keep a careful log of what Im taking, vits minerals, temp first thing and pulse before first thing, date and in your case weather, temperature range outside. That way you maybe able to work out whether different med combinations impact on your Raynards or not.
I do know I need a tadge more when very cold and a tadge less when very hot. I dont have Raynards but am guessing extremes of temp will affect this condition far more?
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Has anyone had an adverse reaction to T3/Liothyronine?
Does DHEA balance your hormones? Have you used DHEA? Has anyone had a NHS test for DHEA levels?
freaking out! switching from T3, T4 combo to NDT anyone have experience? advice/thoughts needed..
Anyone supplementing NDT with T3?
