Hi everyone, I have been on NDT for 6 weeks and am feeling really good. My private thyroid doctor now wants a blood test. Could someone in the know tell me the correct testing protocol for when I should take my last dose of NDT before taking a fingerprick fasting blood test the next morning?
I am currently on two grains a day. One grain when I wake up and one grain mid afternoon. It is Armour. One grain is equivalent of 38mcg of T4 and 9mcg of
The doctor will use the blood results to decide whether the dosage of two grains is ok - so I want to make sure I get it right
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lauraleeds666
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Always advised here, when taking NDT or T3, is to adjust dose the day before if necessary - split into 2 or 3 (whichever is your norm or most convenient) and take the last portion 8-12 hours before your test. This will give a measure of the normal circulating amount of T3 (the most important hormone) and will avoid a false high or false low result.
fab! Thanks for replying to quickly. I plan to do the blood test at around 9.30am so I will take the dose of NDT I usually take mid afternoon around 11.30 or midnight.
What's the reason why the second dose has to be taken much later than normal do you know? Just curious...
The blood test and ranges were introduced to be used with Big Pharma's launch of T3 and T4 synthetic thyroid hormones in the middle of the last century and on the back of NDT which was then the successful treatment for hypothyroidism and has been for over 100 years.
NDT was dispensed long before the science of blood tests and ranges and the guidelines were physical in that pulse, blood pressure and temperature were measured alongside symptoms being experienced.
Little nuggets of pig thyroid were given to chew on and the size of the nugget adjusted at appointment until such time as the patient felt improved and symptoms alleviated.
Your previous medication of Levothyroxine will take around 6-8 weeks to fully leave your body and in that time frame one generally slowly builds up the dose of NDT in 1/4 grain increments and when and if you reach 2 grains, you take that dose for 6-8 weeks, letting it bed in, and then take a blood test and compare against your bench mark readings and symptoms relieved, and or, still a work in progress.
Your TSH will likely be low suppressed and that's OK :
Your T4 may well be lower than when on T4 Levothyroxine BUT your T3 should be proportionately higher and if not maybe NDT is not the best option for you at this point in time.
No thyroid hormone replacement works well until ferritin, folate, B12 and vitamin D are up and maintained at optimal levels and conversion can also be compromised by inflammation, antibodies, any physiological stress ( emotional or physical ) depression, dieting and ageing.
thanks so much for your reply. I'm already at two grains. I've been at two grains for 4 weeks. My doctor told me to increase by a quarter of a grain every other day dependent on how I felt. I got up to two grains easily but I understand other people have to take it a lot slower.
Yes, my doctor said my FT3 should be higher. She also said she isn't concerned by what my TSH reading is. This was a massive relief to me.
The doctor said my folate, ferritin and B12 was ok. My VitD is low but I am working on this with the mouth spray.
I am feeling so much better on NDT compared to levo. I was a poor convertor. My brain fog and day time sleepiness have disappeared, I am much more alert and able to concentrate and hold a conversation
That's very good to read as your previous post revolved around your TSH and I just wanted to reaffirm that the TSH is not the measuring stick when taking any form of thyroid hormone replacement.
I took 1/4 grain increments weekly, though some recommended increments should be fortnightly - however - next question - when to stop building up your dose ?
It's actually not a blood test and more about you reading your body and this is especially true as I see looking back that you have Hashimoto's AI disease.
With Hashimoto's you are liable to erratic own thyroid hormone production and you may find you need to adjust your own medication down at times to try and off set the severity of these ' swings in symptoms ' however once this swing is over and the swing swung back, your thyroid will likely be further disabled you will likely need more thyroid hormone support.
Many forum members recommend the research and findings of Dr Izabella Wentz thyroidpharmacist.com
There will come a time when your last 1/4 grain increment doesn't work well for you and you feel a little nervous, anxious and or just uncomfortable in yourself so that is when you drop back down to the previous dose and stay on that lower dose for 6-8 weeks and then run a blood test, and that is your dose of NDT at that point in time.
There is no way of knowing - you need what you need - and dependent of how well you are able to convert the T4 content of the NDT.
I believe that weight/dose suggestion is for T4 - Levothyroxine and as an initial guide to a starting dose when first diagnosed.
You need what you need and your conversion can be compromised by non optimal vitamins and minerals, inflammation, antibodies, any physiological stress ( emotional or physical ) depression, dieting and ageing - so you all you can do is find an optimal dose for you now and just be aware of the co-factors that can impact your thyroid health and well being.
Plus the fact that we do not know how much of your own thyroid hormone production you currently have left.
I've had RAI thyroid ablation and now with absolutely no thyroid function and have been on 1 + 1/2 grains NDT for the past 5 years and I run my own yearly blood test now, more to see where my vitamins and minerals sit than my T3 or T4 readings.
I’m on NDT (ERFA Thyroid) and follow the same protocol as you for taking my grains (half early morning, half mid afternoon). I take my NDT as normal the day before and then take my blood BEFORE my normal morning grains (usually at 0700). I take blood the same every time to get a ‘usual’ reading. It’s more problematic with a GP blood test as earliest I can get it 0900.
I hope that helps. I had lots of advice from this forum to support doing it like this. And it seems to work!
it’s a private prescription with regular private blood tests (when seeing private doctor), but every year I have to have GP blood tests - TSH and T4 only. GP refused to prescribe NDT despite it being prescribed in my Health authority.
They asked to receive reports on my thyroid treatment and progress from my private Dr and have a duty of care for my overall health (My thyroid (hashimotos) is only one condition I have and I can’t take Levo). PS It’s not a private package - I self pay for each part (consultations, prescriptions, bloods) as a consequence of not being able to take Levo and being unable to get ERFA (only replacement I can tolerate) on the NHS.
Sorry to read you have been left ' high and dry ' by the NHS with regards to your thyroid hormone replacement treatment.
Even more galling when you see others within your area prescribed -
I'd find it hard to look and trust my doctor ever again -
I'm fortunate as I've not needed to see a doctor since I switched to self medicating NDT. some 5 years ago as I was refused both NDT and T3 through my surgery and hospital - I'm with Graves and post RAI thyroid ablation 2005.
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