NDT Users - do you take your NDT all in one go ... - Thyroid UK

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NDT Users - do you take your NDT all in one go or split dose?

FancyPants54 profile image
20 Replies

Which do you prefer to do and why? Have you tried the opposite way and what did you discover?

I'm just trying NDT and hate the idea of splitting it because I'm supposed to avoid food during the daytime then. My chaotic schedule does not allow for me to always eat at the same time so this is a big problem for me.

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FancyPants54 profile image
FancyPants54
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20 Replies

I take Levo, NDT, and T3.

I was splitting my dose twice a day, morning and night, when I was on just Levo and NDT.

Now T3 has been added I've gone back to just once a day at bedtime.

I think I felt better splitting my dose but I found it too faffy.

Staffsgirl profile image
Staffsgirl

It’s such a problem, isn’t it, having to avoid food and drink near meds? I haven’t entirely solved it for myself, but am learning to cut myself a bit of slack and maybe not always be so rigid with timings.

pennyannie profile image
pennyannie

I'm just once in the middle of the night, trying to dovetail in with the circadian rhythm of the body.

I seem to only need 1 + 1/2 grains - I do dip in the PM but taking more late morning/ early afternoon doesn't seem to do anything.

I'm 75 so a cat nap is doable and then I'm ok until around 10 pm when I go to bed and I wake around 6.00am

Delgor profile image
Delgor

Hi, I always take my NDT in one go in the morning - tried splitting it but didn't think it was so effective.

FancyPants54 profile image
FancyPants54 in reply toDelgor

That's interesting. How much do you take in your one dose a day?

Delgor profile image
Delgor in reply toFancyPants54

Well for almost 30 years I had been taking 3 grains - started with Armour; changed to Erfa when I couldn't access the former; and then Nature Thyroid because it was cheaper and which I preferred until they withdrew it from sale; and now back on Armour again but now only taking 1 1/2 grains as my body changed for some reason. Hope this helps.

FancyPants54 profile image
FancyPants54 in reply toDelgor

Thank you. Yes. It's good to see a range of experiences.

Imaaan profile image
Imaaan

I have to split due to palpitations/tachycardia. 8am, 12pm, 3pm, 5 pm and 10pm

FancyPants54 profile image
FancyPants54 in reply toImaaan

Good grief! That's a right pain for you. I take it you can't possibly keep to the not eating for 2hrs before and 1hr after taking a dose. You would have no time to eat at all if you did that.

Imaaan profile image
Imaaan in reply toFancyPants54

I would have preferred a one and done but it's not really that bad once I figured out a routine. For the 12 and 5pm, I have more leeway since I'm just looking to top up on the t3 and dont really concern myself with not absorbing the t4 in the ndt.

Delgor profile image
Delgor in reply toImaaan

Oh what a palava for you - I seem to get the above in the evening and hate it when I have to split the dose the day before a test

Imaaan profile image
Imaaan in reply toDelgor

Get palpitations? Sorry to hear. It no fun for sure.

Aurealis profile image
Aurealis

I take three doses per day of NDT and T3. I take the first dose 1/2 hour before breakfast and try to take the other doses 1/2 hour before food, if it works out. But I don’t worry about taking the dose with or after food if necessary, otherwise it would make my life a misery. I suppose my doses are adjusted for this lax way of taking it. I find it’s better to take it on time rather than risk forgetting it. Perfectly well and stable. For me, the advantages of taking it in 3 doses and not worrying about proximity to food outweigh the disadvantages. T3 is unaffected by food so that’s why it’s ok. However I was stricter when experimenting to find the right dose…

radd profile image
radd

FancyPants54,

I think it dependants how robust your adrenals glands are.

I've always taken half my dose upon waking and half around 3pm to avoid palps. Now I feel so much more stable on thyroid meds after medicating T3 for 6 years I was thinking of switching whole dose to the morning because having to buy Armour half grains doubles the cost and it's so flippin' expensive now.

FancyPants54 profile image
FancyPants54 in reply toradd

It is an expensive product, that is for sure. I bought some 1/4 grains so that I could experiment. They are almost as expensive as a full grain.

Brightness14 profile image
Brightness14

I have taken NDT for over seven years and always split it. 1.25 grains at 6am and another one grain at around 1.30 after lunch. This works best for me. I never find it a problem.

FancyPants54 profile image
FancyPants54 in reply toBrightness14

You obviously have a stable lunch time. I do not. At all! And I can't make that happen either.

witchcat43 profile image
witchcat43

I take 3 1/4 grains all at once every morning…don’t feel any difference from splitting the dose.

SilverAvocado profile image
SilverAvocado

I divide mine into four doses (one during the night). I started off with a single dose, and over the years have slowly split off into more. Each time I've split the dose further I've had an improvement in symptoms, so it's worth it for me. I'd like to split further, but I wouldn't be able to keep up having them as fasting doses, so I haven't gone there yet. The admin for four doses is quite high. But on the other hand I take tons of supplements all day, which is also a faff but probably less valuable to me.

I do fast for the full two hours before and one hour after each dose. (I know you weren't asking about T3, but some people in this thread have mentioned fasting isn't necessary for T3, which is an idea you sometimes hear. But my understanding is it's not based on any evidence or theoretical argument. There just hasn't been any empirical testing for taking T3 with food like there has for Levo/T4. But we kind of have to assume they will absorb similarly. Assuming otherwise is like the doctors who tell patients they can take their Levo with any food except coffee or milk. Just because the empirical testing they are aware of has only tried those specific foods).

I don't take my doses at the same time every day. I take them based on when I wake up and first start eating. I try to keep the margin within an hour or two, but sometimes it will be wildly different. When I only took two doses there was probably even more variation in my afternoon dose. I don't think it even occurred to me at that time to try and keep them stable, I'd just take it between lunch and evening meal, or after my evening meal depending on which gave the most even split.

One thyroid commentator, whose name I never caught, actually recommends taking thyroid hormone with food, arguing that it gives an absorption more similar to nature, and that pure hormone hitting the stomach lining is very harsh and unhealthy. So another possibility could be to take a second dose with your meal during the day. Especially if you're having a packed lunch at work and could eat roughly the same meal every day. I think that's always the most disruptive part of taking with food, that different meals might have different impacts on absorption.

With splitting doses, I always think it is more trial and error than any other part of thyroid dosing. If you're wondering whether splitting could improve your symptoms all you can do is try splitting for a few weeks and see if you feel an improvement on it. If your schedule is very chaotic then include the chaos in your testing and see if you can make it work. The worst thing that can happen is you end up feeling more unwell (likely the equivalent of being on a lower dose) and roll back the changes.

The only little tip I have is if you are on the underdosed end currently. If you want to split the dose, on the first day take your morning dose as usual and add the new dose as an extra one, rather than taking the smaller morning dose. In the past I've found my body really panics when getting that small morning dose and it prevented me from trying split doses for a while. If you're already on your ideal dose and feeling pretty well it's a bit of a trickier story, as you are risking feeling worse. But it's kind of a gamble in the hope of feeling even better once you've tried it.

FancyPants54 profile image
FancyPants54 in reply toSilverAvocado

That's a good way of looking at it all. 2 grains first thing made me feel tired and lethargic. 1 grain first thing yesterday made me feel even worse. Today 1 + 1/2 grain left me feeling normal until I got tired around 3:30. I then topped up with some T3 that has helped. Tomorrow I try 1 + 1/2 grain in the morning and 1/2 grain in the afternoon.

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