I am here again looking for some guidance. Doing well then started to feel anxious.
I am currently taking 2 grains of NDT and 25mcg of T3.
Decided to do a blood test and my results are below…I have been taking the exact amount for some time .. but my results are different and why? What shall I increase of decrease to bring my T4 up. I have graves and my thyroid was treated with RAI therapy over 10 yrs ago. Any suggestions please
the last ready should I included t4 at 11 the range being 12-24. Many thanks for any replies
Hello Sophia :
I too have Graves and am post RAI thyroid ablation and now managing lingering Graves, thyroid eye disease caused by the RAI and hypothyroidism and self medicating with NDT :
Is this result after 24 hours from 2 grains NDT or do you split your doses of both NDT / T3 ?
It might make sense to check in on your ferritin, folate, B12 and vitamin D as these do need to be up and maintained at optimal levels for optimal health and thyroid hormone conversion.
I wonder if the operation you had could have impacted anything ?
I found myself ' anxious and somewhat turbo charged on T3 ' -
though likely never gave it long enough to find the right dose -
I think I saw that a few years ago you felt settled and were on half this dose of T3 ?
Would it make sense to drop some T3 but add in some NDT if it is this under range T4 concerns you ?
I only take NDT and just 1 + 1/2 grains at around 3.00 am in the night and after 10 / 12 hours from blood draw my T4 is around 25% through the range whereas my T3 is around 100% but I feel ok for me and if anything am running myself slightly hypothyroid.
thank you so much for the reply. I split my dose. So around 3am I take 1 ndt and 1 T3. Then at 7am I take 1 NDT.
I have not checked my ferritin. D3 or B12. I don’t supplement to be fair. I did not take my meds the night before bloods were drawn.
So you think I should half my dose of T3 and add half grain NDT. So morning 3am meds will look like 1plus half grain of NDT plus 12.5mcg T3 and 7am 1 NDT? Let me know what you think.
I know I am feeling anxious and hair falling…
Many many thanks for your advice
So your last dose was over 24 hours before the blood test and at 7.00 am the previously day and that was the 1 grain NDT ?
If correct in my thinking it's difficult to draw any conclusion from these bloods :
T3 has a much shorter life span than NDT and guess you are running with a high T3 which could well be causing the anxiety - from my limited experience.
RAI is known to trash vitamins and minerals ( amongst other things ) and despite how long ago you had this treatment it is a slow burn and there are long term consequences so strongly advise you to check your core strength vitamins and minerals as again, the hair loss could be low iron stores and everywhere I researched when my ferritin came back at 22 and considered ' in range ' suggested ferritin needs to be at least over 70 for any thyroid hormone replacement to work well.
Just for reference :-
All things Grave's Disease - elaine-moore.com
ncbi.nlm.nih.gov/pubmed/306...
pubmed.ncbi.nlm.nih.gov/338...
brilliant thank you… will look into the articles .. yes last does was the day before at 7am and took 1 NDT.
I think you are right I may be over replaced with T3… although NDT does contain some NDT.
I shall look into the vitamins. You have been brilliant ! Thank you
Sophie
Just for reference - if taking Armour/Thyroid S you are looking at 1 grain containing trace elements of T1. T2 and calcitonin + a measure of T3 at 9mcg + a measure of T4 at 38 mcg - if on Efra - the T3 is 8 mcg and the T4 is 35 mcg - i think :
I now find that I feel at my best with a ferritin at around 100 : folate at around 20 : active B12 at around 75 ++ and vitamin D at around 100 :
I also supplement an adrenal glandular as RAI is known to be taken up ( to a lesser extent ) by other glands and organs in the body including the adrenals which try to pick up the ' slack ' when the thyroid is not optimally medicated.
Your Thyroid and How To Keep It Healthy written by a doctor Barry Durrant-Peatfield - is a very useful additional book simply explaining human body physiology and he wrote the book to help educate and empower patients to self advocate as he was well aware of how mainstream medical can fail thyroid patients.
Amazing!
everywhere I researched when my ferritin came back at 22 and considered ' in range ' suggested ferritin needs to be at least over 70 for any thyroid hormone replacement to work well.
I've read this lots of times in many places too. What annoys me about it is that they never tie this result of 70 to a specific reference range.
So I could have a result of 70 with a range of 13 - 150 (41.61% through range)
and then my next test could return 70 with a range of 30 - 400 (10.81% through range)
and these sources would have us believe that results 41% and 10% through range are equivalent. I think this must happen because doctors (and apparently medical researchers too) think any result in range is fine, whether it is bottom, middle , or top.
I hate to think how someone of my age (60s) feels with a ferritin result of 70 with a reference range of 30 - 650 (6.45% through the range), the new range being used by some of the medical testing companies for people like me now.
I know it's totally ridiculous as there is no uniformity in ranges and one needs to read around and experiment to find a balance that works best for the individual and why I sometimes offer up my own targets found by my own trial and error.
Yes, I go by percentages rather than fixed numbers, personally.
Erfa is standardized same as other NDTs - 38 mcg T4 and 9 mcg T3.
I take 2 grains (60 mg x 2) NP-Thyroid (NDT) and add T3 (5 mcg tabs) as I feel the need. But I've found in the fall into winter, my levels tend to drop so I may add a 3rd grain at bedtime. So my "daily" T3 intake may vary from 18 to 37 mcg in response to not having any symptoms (18 to 27 mcg from NDT and 5 to 10 mcg from additional T3).
In your position I would not change the NDT but slowly back down the extra T3 to the point where you are feeling well, adding back in small increments if you feel the need. Because of the shorter half life, T3 is quite adjustable. It has an immediate effect - peaks in 2-4 hours and tapers off in 4-6 hours which we can use to help guide dosing throughout the day, and a more prolonged effect of approximately 72 hours which guides a 3-4 day interval for changing (decreasing or increasing) dosages.
I have also learned from this and other forums the importance of maintaining good nutrient levels (D, B, iron, etc.) - when I get sloppy with my supplements or diet I need more thyroid meds to function well.
Patti in AZ
I'm sorry but all the information we have here in the UK suggests Efra is - 8mcg T3 and 35 mcg T4 ?
I've never understood why, but everywhere I look, the precise levels do vary.
In addition to numerous other sources, even this formal research paper says so!
I so wish I could find the numbers on Erfa's own site.
Published online 2018 Jan 17. doi: 10.1186/s13044-018-0045-x
PMCID: PMC5772692
PMID: 29375671
Management of hypothyroidism with combination thyroxine (T4) and triiodothyronine (T3) hormone replacement in clinical practice: a review of suggested guidance
Colin Dayan and Vijay Panicker
ncbi.nlm.nih.gov/pmc/articl...
pennyannie
Are you a magician or did you pick up that I had tried and then deleted to reference across to your post on Litatmon's post ?
My reference came through so far away from your chart that I felt it wouldn't achieve my wish but you have - and just before Christmas !!
Thank you for that :
@ helvella and pennyannie - You're right. I beat my brains out trying to find a reference which might explain the difference. The only thing I can think of is that in CA they've gone with the lower apothecary weight conversion literally while the rest of the world rounded up to 65 mg (even where they call it 60).
In any case, I don't think the 1 mcg difference is significant as (at least in the US) existing guidelines already allow for a +/- 10% deviation in potency.
Patti in AZ
LOL
Coughing and Swallowing ( I not all is Thyroid related :) Just wondering )
Will I Be OK For A Week?
Just thought I’d do a new post for understand I managed to get a copy of my results
Just thought I’d update
Am i ok to take Zapain? 
