Changing from NDT to T3 What dose of T3 should I take to equal the amount of T3 in the NDT?

[DizzyD]

Hello allFor the past 18 mths I have been combo dosing with levo and NDT. Levo: 75/50mcg on alternate days. Efra: 30mg once a day. Ordered some NDT from Europe 6 January still not received them. Hence, I have ran out of NDT over five days ago, feeling really rough now, so my only option is to dose with some T3 which I have in stock.

Question is: What dose of T3 should I take to equal the amount of T3 in the 30mg of Efra I was dosing with? Sadly, I have no idea how much t3 is in 30mg of efra. The T3 tablets I have is 25mcg.

Really would appreciate some feedback.

Thank you in advance

[Imaaan]

About 4 mcg of t3 and 18mcg of t4 in 30 mcg of Erfa.

[DizzyD in reply to Imaaan]

Thank you Iaaan. Have a rewarding day

[radd]

DizzyD

You will need to start with a daily quarter of your 25mcg T3 pill added to your Levo. Are you able to split it?

Some find NDT stronger so although 1/2 grain of Erfa contains roughly 4mcg T3 + 18mcg T4, you might end up needing a bit more synthetic T3, say half a tablet daily. If you raise T3, many prefer to split dose am & pm.

The extra T3 might offset the Erfas 18mcg T4 loss but I think you will likely need to increase an extra days Levo to 75mcg as well. If you become symptomatic you will need to test 6 weeks post adjustments to accurately gauge FT4 & FT3 levels.

[DizzyD in reply to radd]

Thank you most sincerely for your reply/suggestions radd which amazingly (getting past the brain fog) I can understand.Yes I am able to split the T3 (Tiromel) tablet quite easily. Took one 1/4 which equals 12mcg t3 yesterday afternoon and this morning. Eventually, I would like to take 1/4 am and pm as you suggested but not sure about increasing levo to 75 daily.

I hope you don't mind, taking a look at my last thyroid blood results radd.

Nov 2022

THS 0.23 0.27 - 4.2

FT3 5.4 3.1 - 6.8

T4 18 12. - 22

Please note blood results taking levo 75/50 levo alternate days am. 30mg EFRA (1/2 grain) pm.

Given these test results what do you think radd?

[Imaaan in reply to DizzyD]

In regards to increasing the t4, I was thinking similarly to Radd that you would need to bump up your t4. The only difference is that I was only thinking about 12.5 to 18.75 instead of the 25 mcg that was suggested. The increase in t4 will help cover the 18mcg of t4 loss from the Erfa.

So if you were to add in the 12.5 mcg of t4 it would would look like 75/62.5 t4 plus 6.25 t3( taken twice a day)

I did a year of tinkering around with different doses of Erfa and synthetic t4 and found to increase t4 by small increments to find the sweet spot. Plus my system is a bit sensitive. I've increased by 6.25 mcg, 12.5mcg and 18.75 mcg in the past.

[radd in reply to DizzyD]

DizzyD, 

No, one quarter Tiromel tablet equals roughly 6mcg T3 (not 12mcg). A half Tiromel tablet would equal roughly 12 mcg T3. 

Looking at your great FT3 levels obtained from only daily half a grain Erfa containing 4mcg T3 (giving a weekly total of 28mcg T3), if this were me I would hold the quarter Tiromel tablet for 6 weeks and then retest levels, as this will be giving you a weekly total of 43.75mcg T3, which is quite a substantial T3 increase. 

We usually don't change two hormones at once but because you are losing 18mcg T4 a day from the loss of Erfa (totalling 126mcg T4 a week), you will need to increase your Levo or FT4 levels will drop.

Taking an extra 25mcg T4 one day a week gives you a weekly total of 475mcg T4 which is still substantially less than the previous 576mcg T4 acquired from the Levo and Erfa combo, which should offset with the increased dose of T3. 

You may well need a further Levo dose raise but as NDT can behave differently to synthetic it would be wise to test after six weeks before making further adjustments unless you were to become hugely symptomatic beforehand. 

[DizzyD in reply to radd]

Got it radd... Eureka!!! Thanks to your expertise and patience. Additional 25mcg of levo once a week.

Quarter synthetic t3...6mcg daily.

Retest: 6 weeks

Pheww got there in the end, bet you are glad that's over!

Surprised to hear my test results are "great".

Really do appreciate your help and support. Who knows what could have happened, left to my own devices.

Sincere thanks

[DizzyD]

Great suggestion Imaan really appreciate you taking the time to explain and breakdown of numbers.

In all honesty, I don't mind loosing the 18mcg of t4 from the Efra. Was not doing all that well on the levo/ Efra anyway. Usual hypo symptoms. Was toying with the idea of increasing Efra dose when I received it specifically for the T3 content which I cannot do now due to delivery failure of NDT.

So now taking 1/4 of synthetic t3=6mcg am and pm, as opposed to 4mcg from Efra. Bit of a jump, I know, but like like yourself I am have been tinkering for quite some time. Unfortunately, I have never found the sweet spot. Fingers crossed blood test in 8 weeks might be ok.

[Imaaan in reply to DizzyD]

Hopefully you find a dosage that works for you