NDT Dosage: I'm in the process of switching over... - Thyroid UK

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NDT Dosage

Sparklingsunshine profile image

I'm in the process of switching over to just NDT. I tried Levo/NDT and for the first time ever both my frees were at the top of the range, something I've never managed on Levo. As balancing 2 different meds is a challenge and I felt overmedicated I thought I'd try just NDT and see how I got on.

I'm taking it slowly as per the gudelines. I'm now taking half a grain twice a day for 3 weeks, then adding another half grain in and so on. So far so good. I'm using Thyroid S.

I'm just wondering what a usual final dose of NDT is. I know Levo often uses bodyweight as a dosage guide but what about NDT?

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Sparklingsunshine
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11 Replies
pennyannie profile image
pennyannie

Hello there ;

You need what you need - everybody's ability to convert the T4 content into T3 will be different and vary depending on various factors - levels of core strength vitamins and minerals, inflammation, antibody interaction, and physiological issues ( emotional or physical ) depression, dieting and ageing can all impact and down regulate conversion.

You may find inching up in 1/4 grains a better option.

Just go low and slow - there will be a week when you feel uncomfortable in your skin and must as good as the week before so drop back down to the previous dose - stay on that dose for 6- weeks and then run a blood test too track your result from your bench mark readings.

I found I continued to improve for a good 6 months once I'd settled on 1 + 1/2 grains - which I understand to be low compared to others but then I've Graves and had RAI thyroid ablation.

Sparklingsunshine profile image
Sparklingsunshine in reply to pennyannie

I started last week on a quarter grain twice daily. Then on day 8 (yesterday) I went upto half a grain. I dont really understand my difficulties on Levo as my vitamins are very good. I've never really felt good on Levo.

Jazzw profile image
Jazzw

I’m always careful to generalise this because pennyannie is right—you need what you need—but I’d say most people end up on a dose between 2 and 3 grains.

radd profile image
radd

Sparklingsunshine,

Usually anything between 1.5 to 3 grains but that is a generalisation and people will need what they need. I've has a couple of summers where I had to reduce to 1.25 because of excess inner heat but always need 1.5, even 1.75 in winter for extra warmth.

Raising slowly is good and remember symptoms may lag behind your individual biochemical levels, so don't just keep taking more & more but wait for the catch-up. Good luck 😊

jrbarnes profile image
jrbarnes

I just switched from Levo back over to NDT. I'd tried NDT before but the ratios of T4/T3 didn't quite work for me so this time around I'm on 1 1/2 grain plus 20 mcg T3, and still raising the T3. So it depends on what you need. Personally I can't tolerate a large amount of T4 with my T3.

serenfach profile image
serenfach

I just did a straight swop. The Consultant wanted me to try 500 T4, as he said I was underdosed. He also wanted me to drop the T3 as it was "dangerous". I was on 300 + 10 T3 as the GP did not want to go higher. I muttered "quack" thanked him, went home and ordered NDT.

I am supposed to be seeing him again in order to be able to test T3 - about an 8 month wait...

If I had followed his advice the first time, I dont think I would be alive. I will have to sew a zip into my mouth this time.

Sparklingsunshine profile image
Sparklingsunshine in reply to serenfach

Wow thats a huge dose. Like dosing a tiger level. I think that was my issue with Levo, I was on 150mcg and my frees are just scraping along the bottom of the range. I just had the prospect of trying ever higher doses, which just suppress my TSH, which then will have my GP having a panic attack, whilst doing nothing to help with the actual thyroid levels.

I'm not sure I can do anything else to help with improving my levels. I'm gluten free, eat very little dairy and all my nutrient levels are very good. Have you found much improvement on NDT?

serenfach profile image
serenfach

A huge improvement. When an Endo goes by TSH alone, you know it is time to run (or at least slither away if you are feeling like a salted slug).

Sparklingsunshine profile image
Sparklingsunshine in reply to serenfach

Lol I think my days of running away are behind me now. An animated amble is the best I've got 😄

serenfach profile image
serenfach

An shambolic shuffle here! In wellies.

Farrugia profile image
Farrugia

I've recently switched to NDT (Armour) from 100mcg levothyroxine. I started with a low dose like you and raised the dose gradually every couple of weeks. I was in the process of selling my house and moving when I started so I was very conscious of not adding to the effects of the stress. Each time I started a higher dose I felt as if I had drunk far too much caffeine and got a bit of a headache. The jangly feeling reduced as I got used to the new dose. I decided to reduce my caffeine intake and so I stopped drinking tea completely (I used to have two or more cups a day) and just have two little coffees per day. I think this helps. I'm now up to 3 pills per day and I'm waiting for my blood test results and a follow up consultation with the (private) doctor. I don't know yet if I'm on the optimal dose (I suspect I am) but I feel better than I have in years. On levothyroxine I basically wanted to lie down and sleep from midday and now I don't even think about having a siesta most days. I don't know if the dosage is related to weight - I weigh about 60kg and I think 2.5 to 3 pills per day feels about right for me but obviously don't have test results to confirm this yet. Good luck, I hope you find the right dose for you and I hope it helps with your symptoms.

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