combination of NDT and t4?

[Ajva]

Just reaching out to see if anyone else is on a NDT with an added t4.

Unable to increase NDT due to t3 going over range. I ended up adding in t4 50mcg to 1 grain armour.

I then switched to 125mcg (gradually increased to this over the past 7 months) plus a 5mcg of t3 compounded.

well I feel dreadful on this combo, the extreme fatigue is unbearable I can hardly function. I have all my hypo symptoms (worse than before I started meds)

NDT helped a lot of my symptoms away but my t4 sat under range and caused cardiac problems (please note I already have pots so it increased these problems).

Due to feeling so unwell the past 7 months on this combo I think I would like to go back on NDT and added t4.

Any help or advice would be much appreciated! Bloods in Picts

these bloods were on 100mcg of t4 and 5mcg t3 (just had increase to 125mcg t4).

please note I am taking vit D, Iron and B 12 complex, probiotic.

[pennyannie]

Hello Ajva :

So you have Hashimoto's and liable to experience swings in symptoms and hyper type experiences and readings though understand after these swings you are liable to swing back the other way and likely experience further hypothyroid symptoms as your thyroid function becomes further disabled.

I take NDT and my question was simply to understand why you would want to reduce the unique ratio of T3 and T4 in each grain NDT since you said you felt better taking NDT ?

The blood test ranges and guidelines were all introduced when Bgi Pharma launched it's own T3 and T4 treatment options and do not apply to NDT - as NDT was used successfully for over 100 years and long before we even knew what a blood test was.

With NDT you dose to the relief of symptoms and generally speaking people will have a low suppressed TSH and likely a lower T4 than when on T4 monotherapy but you track on the T3 and this should be proportionately higher than when on T4 monotherapy.

NDT on it's own, works well for many thousands of people and a low T4 does not matter

I do read that some people need to finely tune with a little T3 or a little T4 to find their sweet spot at the very end of their trial and having let the NDT dose bed in properly over a period of a month or two.

[Ajva in reply to pennyannie]

to answer above. I was originally on 9.5mcg t3 and 100mcg of t4 when I first moved over to synthetics. BUT for some reason my body (heart mainly) couldn’t tolerate the synthetic t3. I do not seem to do well on it. I have kept over the course of 7/8 months tried to increase from 5mcg to 9.5mcg splitting doses through the day.

When I was on armour even increasing from 1 grain to 1 1/4 grain, again same issues heart racing blood pressure all over the place, high anxiety and kept seeing yellow spots in vision. So had to keep going down to 1 gain. Eventually the 1 grain was not helping and all hypo symptoms returned. So my only option was to add in t4 (which worked ok). My Dr then said I may as well go on t4 and t3 separate meds.

I have been having bloods done and adjusting every 6 weeks but I feel no better. All my symptoms are the same as how I felt not being on any meds. I feel stuck on either meds but overall I did feel better onNDT and t4. But my biggest issue was it increased my PoTs Symptoms.

[pennyannie in reply to Ajva]

That must be difficult as with Pots and Hashimoto's the symptoms experienced can get very confused.

No thyroid hormone works well until ferritin, folate, B12 and vitamin D are up and maintained at optimal and conversion can also be down regulated inflammation, antibodies, and any physiological problems ( physical or emotional ) depression, dieting and ageing.

So whilst we can't stop some of these it might help getting your vitamin and minerals check out.

Just another thought ?

The ratio of T3 and T4 in NDT is around 1/4 - T3/T4 -

so maybe your ideal ratio is around - 1/4.50 - 5.00 - T3/T4.