Having moved from T4 to 1 grain of Armour NDT in July on advice my private Dr, I seem to have had mixed days. These last 2 weeks have been particularly bad and I don't know why.
Test results from last week:
Blood test 7am. Last dose of NDT 24hr before. Biotin supplements stopped 5 days before.
FT3 3.4 pmol/L (range 3.1 - 6.8 pmol/L)
FT4 10.8 pmol/L (range 12 - 22 pmol/L)
TSH 1.21 mu/L (range 0.27 - 4.2 mU/L)
Currently taking various supplements.
Vit D 3000iu (level 57.7 nmol/L as of 02/08/22).
Eating iron rich foods. Tests on 16/08/22 show
Iron 16umil/L (range 5.8 -- 34.5)
TIBC 48.5umol/L (range 45 - 81)
UIBC 32.5umol/L (range 24.2 - 70.1)
Transferrin Saturation 33%
Transferrin 85.3ug/L (range 14-150)
Also taking Folate and B12
Tested Feb 22
Serum Folate 13.9ug/L (range >3.89)
Active B12 150pmol/L (37.5 - 188)
I expected T4 to fall but surprised that T3 is still so low.
I felt great 2 weeks ago and was able to help out with DIY projects and going cycling.
Today I took my NDT as usual (1 hour before breakfast) and then waited 2 hours before my Vit D3. Since taking the NDT I feel awful. Dizzy. Nauseous. Legs like lead. Exhausted. I've had to lie down.
Anyone got any suggestions as to what is going on??
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Kit_Monster
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1 grain is a tiny dose. And, you are obviously very under-medicated. So, not surprising you feel bad. How much T4 were you taking before?
In the beginning you felt good because of the T3. But the fact that you went on to feel bad again is an indication that your body was asking for an increase in dose. You can increase NDT by 1/4 grain every two weeks.
Might be better to leave a gap of four hours before taking your vit D. That's what is always advised on here. Do you also take its cofactors: magnesium and vit K2-MK7?
Well, if you get to two grains, you might like to stop there and hold for six weeks, and retest. Just to see where you are. Whilst you don't want to increase too slowly, you don't want to go too fast, either.
I think that you should have tested twelve hours and not twenty four hours which may improve your readings. Your FT3 is low and you probably require an increase one grain is a tiny amount. During covid I had to change my NDT and found that Armour was weaker than my usual one. When I started on NDT I increased by 1/4 every 10 days or so,
Hi Brightness 14, I only take my NDT in the mornings, hence the 24hrs between taking my last dose and test. I've been reading that T3 has a much shorter half life than T4 so a split dose with one in the evenings might help.
I have no thyroid and take 2/25 grains split in two. 1.25 grains at 6am, and another one after lunch well away from food. It does take time to get the dose right, good luck.
With NDT you dose to the relief of symptoms and just think you should have continued building up your dose from 1 grain in 1/4 grain increments weekly/ fortnightly - and when and if you reach 2 grains - then stay on the 2 grains for 6-8 weeks letting this dose settle in your body and then run a blood test to compare to your bench mark readings.
Some people find they need to split the dose - I don't but it's all trial and error and what suits you best and currently you look under medicated.
When optimum your TSH will likely be low, suppressed, and your T4 may be less than when on T4 monotherapy but your T3 should look proportionately higher.
My most recent tests for Vit D, folate, B12 and ferritin are in my post above. Some go back to Feb this year. Still a bit of work to get them optimum, but getting there.
Checking back through my notes from my last appointment, I wasn't getting on with T4, with new symptoms appearing that I didn't have when not medicated and just low on thyroid hormones. Even a T4 brand change didn't help. So Dr suggested trying NDT.
I had the DIO test done which shows that I have some issues with alleles at DIO2 and therefore T4 to T3 conversion.
You've now got me wondering about the switch to NDT and whether that was the right thing to do. I have to admit I really surprised at how much trial and error is involved with medication and dosage levels. I just assumed that thyroid issues would be as well understood as diabetes and as good a system for monitoring and managing it in place.
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.
I started on Teva 50mcgs but had instant sickness and hammering headaches upon taking the tablets. I switched brands to Eltroxin. I felt groggy and spaced out from the start.
The nausea / sickess, dizziness and groggyness only started when taking thyroid medication.
As very petite, only likely to need around 75mcg levothyroxine per day ……possibly with addition of small dose of T3 prescribed alongside…..once stable on levothyroxine
Just an update - there may be a bug going round as I've spoken to several people today who have exactly the same symptoms and who don't have thyroid issues.
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