Endo switching me from T3 only to NDT.

[Sunsh]

Hadn't been feeling great so did blood test and my TSH seem to be superhigh again. results below.

I am on T3 only and have autoimmune thyroditis. Endo suggested trying NDT instead of increasing T3 again ( I am on 60mcg of T3 )

Has anyone done this and any advice will be greatly appreciated.

Endo suggested Springfield pharmacy for NDT but I am not sure on pricing.

If I do switch do I just stop T3 and start NDT? Endo had suggested 3 grains to start with.

My cholesterol had crept up again . I am on HRT as I have premature menopause too.

Looking forward to any advise and any wisdom on sourcing NDT and use.

My bloodworks

TSH 77.04 mIU/L ( 0.3 to 3.94 ) Auth

Free T4 1.0 pmol/L ( 12.3 to 20.2 ) Auth

Free T3 4.3 pmol/L ( 3.70 to 6.70 ) Auth

Thank you

[Hypopotamus]

That is a high TSH for somebody on your dose of T3.

NDT has been better for me than T3 alone. But 3 grains seems like a high starting dose to me. I would suggest stopping the T3 and starting on 2 grains of NDT and seeing how you get on with that.

[Sunsh in reply to Hypopotamus]

Thank you. I have been prescribed Erfa. Would you know if that’s a good NDT? I have also seen thyroid S NDT.

[Hypopotamus in reply to Sunsh]

ERFA worked well for me until they changed it in some way. I then moved to Thai NDT, and am currently on Thyroid-S. ERFA may well work for you though.

[Sunsh in reply to Hypopotamus]

Great . Thank you so much for your time.

[Hidden]

In terms of pricing, I get erfa from a pharmacy in Bristol.

For bottles of 100 tablets I pay:

£80 for 60mg and £60 for 30mg

I take 105mg a day so it works out at £1.40 a day.

[Sunsh in reply to Hidden]

Thank you, so what’s 105mcg in terms of grains? New to NDT so trying to work out how much it would be for 2-3 grains/day.

[helvella in reply to Sunsh]

Desiccated thyroid is measured in milligrams - not micrograms!

105 milligrams is 1.75 grains

(Some makes convert a grain as 60 milligrams; others use 65 milligrams.)

My Vade Mecum has a section on measurements.

helvella - Vade Mecum for Thyroid

The term vade mecum means:

1. A referential book such as a handbook or manual.

2. A useful object, constantly carried on one’s person.

Please don't get put off by the number of pages!

Nor by the fact it is targeted at people interested in thyroid issues. Much of its contents could be of use to many involved in health issues. Things like abbreviations, lists, general reference information.

In particular, it is not intended that you sit and read the document. Just that you download it and know you can look things up.

If there is anything you'd like me to add, let me know.

Not everything is in this one document - my major medicines document is still separate!

From Dropbox:

dropbox.com/s/vp5ct1cwc03bl...

From Google Drive:

drive.google.com/file/d/1P9...

[Sunsh in reply to helvella]

Thank you so much. 😀 lots to learn for me.

[Hidden in reply to Sunsh]

OK, so 60mg is 1 grain and 30mg is 1/2 grain.

So 2 grains would be 1.60 a day

3 grains would be £2.40.

I stick to mg thinking about NDT because I get muddled trying to talk in terms of grains. 🤣

[Sunsh in reply to Hidden]

This makes sense now… 😀 grains micro grams ,whole new world now got me. Thank you 😊

[radd]

Sunsh,

A TSH of 70 when medicating 60mcg T3 doesn't hold true.

If you are switching to NDT as an alternative because T3 alone is making you feel rough, then these results don't hold so much importance. However, if you switching because of that TSH, I would be inclined to retest using a different lab to reduce the risk of interference and ensure to avoid biotin for the week before.

T3 alone & NDT are different meds so equivalence can't be complete but would be roughly around 3 grains but as they work in different ways I would drop to 2 grains as an introductory dose, hold for six weeks and then retest. This will also give you opportunity to assess how you are feeling.

If you have iron or other co-factor deficiencies no thyroid hormone replacement is going to work to its best capacity.

I can't comment on UK prescription NDT sourcing as I self source from abroad but others have been helpful 😊.

[helvella in reply to radd]

A TSH of 70 when medicating 60mcg T3 doesn't hold true.

Certainly seems unlikely.

I wonder if the product/make being taken has changed?

[radd in reply to helvella]

helvella,

O/Ps TSH was a much more realistic 0.01 mU/L just two months ago which leads me to be more inclined towards some sort of test inference.

[helvella in reply to radd]

I agree - just didn't want to ignore the possibility of the medicine itself being a cause.