Hi, just wondered if I’ve been doing the right protocol for taking my meds and also timings for bloods drawn!
I split dose 2x day… no food 4 hours before and 1 hour after…could I leave smaller gap before with NDT… food wise please?? Finding it really hard as don’t have regular sleep patterns and just changed my last dose from midnight to 6/7 pm as starting HRT which take at night and needs 4 hour gap!
Also for blood tests (which I have quite a lot of trying to find right dose) I try and have them early morning no food/coffee etc and leave morning dose while after bloods…like I used to do when just on Levo… but on last appointment Endo said to have bloods 4 hours after morning dose and doesn’t matter about food… do now doubting myself, is it different on Armour NDT to levo?
Thanks guys
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Blanche1960
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I take my NDT all in one go in the morning on an empty stomach and 1 hour before food or cuppa. If I were to split it I would apply the same protocol later in the day. For consistency I do blood tests in the morning around 8-9.00 am having fasted and no meds until after test because this will give you your highest TSH. I saw a private endo last year who asked me to do exactly what you've been told to do and to eat and take meds and then blood test 4 hours later - when I asked the reason why I was told that it would show my highest levels of what thyroid hormones were in the blood. On checking on this forum everyone said that it was ridiculous because you don't go all day with that amount or hormone in your blood and they advised against as it would obviously lead to a decrease in the medication. I'm currently under the NHS endo and even when he booked me in for a blood test late morning I changed the appointment for the test and told him that I wanted to be consistent with my tests and he just accepted this. Nearly forgot to say that the day before being tested I do then split my NDT into two and take the second half 8-12 hours before test. Hope this helps!
Absolutely not! I've been on NDT for almost 30 years and have always bought it myself as it kept me well. I got referred to him by my GP just before the pandemic took off - saw him once but did get scanned as I have a multinodular goitre but refused to go on T4. He offered to trial me on combo but wanted me to come off all thyroid meds to see what was happening which scared me so I decided to keep buying it for myself and not be under his control.
Thank you that’s very useful info will bear all this in mind… Will do it his way, long story but not the nicest… scares me to death, stops me when talking and wraps appointment up very quick… but it’s NHS and I realise I’m lucky to get NDT free with having had thyroid cancer… know lots of areas cannot get it at all!
Blanche, timing of blood tests and doses depends on what you want to measure.The doctors want to measure the peak so they want to measure 2 to 4 hours after a dose. Our body doesn't run on the peak for the rest of the day so some of us ignore that request. We don't tell the Dr. that!
If you are not concerned about your tsh level then you can have your blood test any time of day. The no food very early blood test is only because tsh is higher that way.
If you want to measure the average level of thyroid hormones in your blood you half the amount of hours between your doses then do your test that many hours after a dose.
For example, I am not concerned about TSH levels and I dose first thing and bedtime, a 16 hour gap. So I always do my blood tests around 2pm which means I take my usual morning dose at 6am leaving 8hours before my bloods. I like this as it causes no disruption to dosing.
However you chose to do your tests it is important to do the same thing each time so that you are comparing like for like. It is also important to bear the timing gap in mind when interpreting your result is these levels are the peak, or these levels are the average etc
With NDT you dose to the relief of symptoms and blood test ranges and guidelines were all introduced to be used with Big Pharma's T3 and T4 preparations - not NDT .
NDT was successfully used for over 100 years and long before the science of blood tests, and and the terminology of TSH, T3 / T4 and the bells and whistles of when to take, what to do and what not to do.
You simply chewed on a nugget of pig thyroid and if that made you feel better - so be it - that was your measure - and if no better a larger or smaller nugget would be given by the doctor next time you saw him.
100 years on - and here we are trying to fit our blood test results into the ranges to ensure we get a repeat prescription from whom ever is the controller of our health, usually a doctor,.
We generally only get a TSH blood test and the majority of us are on T4 monotherapy and it's been found that the best way of getting a dose increase in T4 - Levothyroxine ( as historically we are generally undermedicated ) is with an early morning blood draw and by not taking the daily T4 before the blood test as this should result in the highest possible TSH and the lowest possible T4 reading - which are the 2 results looked at by the doctor.
just as we don't want our TSH reading being too low we don't want our T4 reading being too high as these 2 factors generally determine a dose reduction.
It sounds like all this is stressing you out and since you split your dose it can get confusing but consistency is what is important so you can compare like with like :
But anyway you are taking NDT and have a doctor looking at a TSH, Free T3 and Free T4 reading - and these 3 results will be looked at together and your dose should be adjusted on your Free T3 reading and not your TSH or T4 reading.
Maximum absorption of any thyroid hormone replacement is when the stomach is empty so 1 or 2 hours after or before food is sufficient.
Why not say to the doctor that you've got muddled up and do what he suggests as consistency in results is what s/he is looking for and tracking you on your Free T3 reading.
Some forum members are finding that introducing HRT is having an impact on their thyroid health, and needing to increase their thyroid hormone replacement ??
I self medicate NDT and take my dose all in 1 go at around 3.00am and my blood test is around 10/11 hours after - if I fast my T3 will be higher than if I ate breakfast - as it takes energy to metabolise food - and the more energy you expend the more T3 you use up that's what's for and how the body works.
Just a question on blood tests whilst on NDT, if the ranges were developed for those on Levo does that mean those on NDT should ignore them, and additionally if on a steady dose of NDT which suits, can blood tests be carried out less often.
I believe the ranges and guidelines were introduced to be used alongside Big Pharma's synthetic T3 and T4 treatment options in around the middle of the last century.
Up until that time, NDT was the grandfathered treatment option and has been used successfully used for over 100 years and people were treated on physical symptoms as the ' science ' of blood test was not known and we knew nothing about TSH, T3 or T4 or contents of the thyroid, but that NDT seemed to solve most peoples health issues.
Big Pharma launched it's treatment options and then went around gaining market share by discrediting NDT.
With NDT you dose to the relief of symptoms - I now run a yearly full thyroid panel more for my vitamins and minerals than my thyroid levels - my blood pressure and pulse are constant - I have no symptoms of over medication and my temperature runs at around 36.6.
MyT3 runs slightly over range after around 10 hours -
if I eat breakfast - it is in range - and my T4 hangs around 20 % through the range.
I dose just once a 3.00am - and my results are near enough the exact opposite of where they sat when on T4 monotherapy when my T3 would be at around 25% and my T4 at around 110% :
I'm not concerned as I have no symptoms of over medicating and since I'm self medicating I have no stress worrying about seeing the doctor.
So if a doctor saw my results I guess they would be the one getting stressed unless they understood how NDT presents in a blood test.
I'm not saying ignore guidelines but that they are just guidelines and designed for Big Pharma's synthetics and not NDT :
On NDT don't expect the same results or targets to achieve as suggested when on T4 monotherapy :
Pay attention to physical symptoms as no one wants the symptoms of overmedication just as they wouldn't choose the symptoms of hypothyroidism - it's a fine balance.
Hope that makes sense - I know I've gone on a bit as I'm aware some people are reading and learning without asking questions and I don't want to sound irresponsible as I 'm not and this is my health which I now take very seriously after being left so ill by the NHS treatment I received.
I hope to offer a considered and balanced opinion -
I am with Graves Disease and post RAI thyroid ablation in 2005and now manage lingering Graves, thyroid eye disease caused by the RAI and hypothyroidism.
P.S, If anything I'm running myself slightly hypo as I'm still with some symptoms that I can't resolve without adding in a solution for my low stomach acid, vitamins, minerals and adrenal glandular.
“Maximum absorption of any thyroid hormone replacement is when the stomach is empty so 1 or 2 hours after or before food is sufficient.”
Thankyou… Regarding your reply above I’ve been trying to leave 4 hours so stomach empty before taking meds but like you said yes it’s stressing me out as sleeping pattern all over place… and struggling to fit other meds/ it’s etc in… So you saying that a couple of hours with empty stomach would be ok instead of waiting for 4 hours before taking… sorry my brains mashed been so unwell!
So much has been happening my own stupid fault… not sure if I said but I took too much Armour (3) for 2wks in Dec been back on 2&1/4 for 4 wks now so can’t really go on recent blood results but long story…
because I was having palpations/sudden sleepiness/hot etc which have been getting better last couple days (but got digestive problems now, can’t sleep and Chronic headaches… sorry moaning again)! I asked if I was taking too much or maybe not enough…endo didn’t know said could be either… anyway can’t remember if I suggested it first or not but Endo reduced again down to 2 grains which I haven’t done yet as totally confused… TSH and T4 was below range (highlighted in red on screen) T3 lower than usual…. So if reduce again like we said they will go lower… is that right?? If so he will just increase next time!!
I said Id been trying to get t4 levels up anyway so reducing would make them lower? which endo said didn’t matter it was the TSH that mattered… he likes my TSH in range (if only just ) he’s happy with that! Know there’s lots things on here regarding that but can’t find the words or energy to argue it out!
Anyway I’ve stuck to 2&1/4 and then will try and get private blood test in 2wks (maybe should have postponed endo appt last wk till been back onproper dose for 6 wks) I messed it up with taking too much 4wks ago!
Thanks I will stick to his protocol like you said and have bloods done 4 hours after last dose!
Yep I have read on here I’m sure that taking Hrt will need higher dose… that’s one more reason why I’m reluctant to reduce at mo… not sure if to try and wait till find sweet spot with NDT (if ever) or maybe adding HRT will help as not sure what’s causing what!!
No worries - OK - as I've said before I think an endo dosing on a TSH is not good as he should be tracking on your FreeT3 readings - not a TSH and not a Free T4 :
Introducing HRT into the mix right now may not be the best thing to do but I'm not you and dealing with all these symptoms and anxious for some resolution.
I have been taking NDT for over seven years. 2.25 grains per day. Split in two doses the first at 6/7am 1.25 grains and the other 1 grain at around 1.30pm. The afternoon one is 1 hour after my lunch this works fine for me. Blood test first thing in the morning on an empty stomach. Leave 8/12 hours after taking NDT before the test.
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