Are you adding t3 to NDT? Why and does it work for you?

[Incoguto]

Hi All,

I have come across a blog from Dr Childs, he seems to be using t3 with NDT with most of his patients.

Armour doesn't work for me on its own, I have been adding T4 to it, but so far haven't felt better, it feels worse to an extent, when I add it.

I would love to hear from people, who are adding t3 to their NDT.

My current results on 2.5 grains of Armour are:

Ft4 = 28%

Ft3 = 48%

I have added about 2 mcg of T3 and it felt like someone switched on the light...but I have zero hopes at this stage.

Thanks!

[Hidden]

I felt the same when I added T3! I have sustained it but I definitely felt my recovery took a lurch forward with T3.

[Incoguto in reply to Hidden]

You did? How are you faring at the moment?

[Hidden in reply to Incoguto]

Better than I was but am in perimenopause so I think a lot of my remaining symptoms are to do with that! There's a lot of crossover; it's hard to figure out which is what!

[Incoguto in reply to Hidden]

Oh dear...sorry to hear it. Are you sure it is peri or could the thyroid be making you perimenopausal? When I dropped Armour recently just by little my estrogen fell and lost my libido. So I know that this can happen😔

[Hidden in reply to Incoguto]

I wondered the same thing but my thyroid meds aren't too far from optimal now and blood tests showed below range estrogen and well above range FSH so it's safe to assume it's peri and not thyroid! 😂

[Incoguto in reply to Hidden]

Ah okay, if FSH is above range then that makes sense🤗hope you're okay!I have lowish estrogen, but fsh and lh midrange, so I assume it's thyroid.

Second day of taking a tiny bit of t3, feeling strange.

May I ask what are your ft3 ft4 tsh are looking like?

[Hidden in reply to Incoguto]

I'm still processing the idea of being perimenopausal at 37 but I'm grateful that this isn't 'it' for me, that some progress can still be made.

Most recent labs showed TSH at 3.5ish which is much too high but with hindsight I was very stressed and near burnout so not a good marker.

These were the results from before that where I had felt I was 'slowing down' (But again, that could've been stress)

TSH: 1.1 (0.27 - 4.2)

FT4: 12.3 (12 - 22)

FT3: 5.8 (3.1 - 6.8)

Results (ranges as above) when I felt best were:

TSH: 0.39

FT4: 11.3

FT3: 5.6

[Incoguto in reply to Hidden]

Progress can absolutely be made at all times, thus is what I'm telling myself every single day!

That is quite high!

So it seems you felt better with lowish ft4 and over midrange ft3, right? Are you testing after 24 hours or earlier?

[Hidden in reply to Incoguto]

Yes; I felt best with a below range FT4 but FT3 at 70%ish. BUT since I've been declining and my TSH rising my FT4 has been increasing so I wonder if I need FT4 higher in range to sustain feeling good.

Perhaps I feel worse because my FT4 is increasing... at this point, it's anyone's guess.

I test as I always have done; all meds at bedtime (9:30pm ish) and testing first thing (7:30am ish) so I don't test as recommended here but all my tests are comparable so I've preferred to stick to doing it this way!

[Incoguto in reply to Hidden]

It seems we are having the same dilemma, I have no clue if I feel better with higher or lower FT4...I'm testing 24 hours after NDT so potentially my ft3 is a bit higher earlier for sure and so is my ft4. Last week my ft4 was 44% with ft3 53%, I even went out at night! A week later my ft4 dropped to 28%, ft3 to 47% and I started to feel awful. I added some t3 yesterday and today, but I'm jittery 🫠

[greygoose]

Why? Because there's not enough T3 in NDT for some people - just as there's not enough T4 for others. Our needs are all different, there's no one-size-fits-all. You have to find what you need by trial and error.

But, don't be defeatist about it. You say it's helping you at the moment. If you feel it stops helping it will probably be because the FT3 level still isn't high enough for you as an individual - and remember, quite a few people need their FT3 right at the top of the range, or even slightly over.

[Incoguto in reply to greygoose]

This makes sense! And I wonder if I'm the "not enough t3" in NDT or "not enough t4" in it.I increase NDT and feel worse, I add t4 and that gives me another set of problems.

The only "worry" is that maybe my ft4 needs to be lower when adding liothyronine, but I guess I'll find out in time

[greygoose in reply to Incoguto]

By the sound of it, you are in the 'not enough T3' group. It was the same for me.

Why do you think your FT4 would need to be lower when adding T3?

[Incoguto in reply to greygoose]

Were you? Anytime I increase Armour it feels like it is better and then I feel worse and worse. Then I lower Armour, it gets better, then hypo issues start. This is why I am trying to figure out if it's the lower ft4 causing it or not enough ft3. My endo always says that t4 interferes with t3 and prefers to prescribe t3 only to bypass the varied and problematic conversion.

When I added T3 in today, 3 hours later it felt good, but also a bit jittery.

[greygoose in reply to Incoguto]

My endo always says that t4 interferes with t3

That's intriguing? Have you asked him in what way T4 interferes with T3? It sounds counterintuitives given that T4 converts to T3 - to a greater or lesser extent.

But, some of us do need T3 only, like me! Have you tried that?

Anytime I increase Armour it feels like it is better and then I feel worse and worse.

It is a fact that when increasing doses, you feel well for a certain time, and then hypo symptoms start to reappear. Usually, that just means that you're not on your optimal dose yes, and need another increase.

When I added T3 in today, 3 hours later it felt good, but also a bit jittery.

How much T3 did you add?

Are your nutrients all optimal?

How about cortisol?

[Incoguto in reply to greygoose]

I'm not sure what he meant by it, but he really doesn't like t4 as most of his patients don't convert and end up on t3 only.I haven't tried t3 only yet, no! I was thinking that maybe it's worth trying now lower NDT some t3 and progress in the "more t3" direction

I only feel well for a few days on more Armour and then increasingly worse and both ft4 and ft3 go up🤷‍♀️after 6 weeks I need to change the dose and unable to increase.

I added 2 t3 more less. I definitely felt it's effect 3 hours later.

All nutrients optimal, apart from ferritin still under midrange, but taking supplements for years.

Blood cortisol in range, over midrange, saliva within range, but according to regenerus a bit low in range.

[greygoose in reply to Incoguto]

Very rare to find an endo that doesn't like T4. Most of them think levo is the best thing since sliced bread!

I probably is worth trying to phase out T4 to try T3 only, because you won't know if it suits you until you've tried it. If it doesn't suit, you can always go back to NDT + T3.

I added 2 t3 more less.

2 mcg? That's a very low dose.

[Incoguto in reply to greygoose]

I know, almost all other endos I have met told me that t3 was not physiological...what?? It's what the body runs on, lol.

I know...2 mcg is low, but I am already taking 22.5🤷‍♀️but I generally feel more jittery when adding anything with t3 the first few days. Also I do better when taking everything first thing. Today, out of desperation, I added t3 at 1 pm and it probably peaked during my slower NDT peak lol not a good idea.

[greygoose in reply to Incoguto]

Well, that only takes you up to 24.5 mcg. Not a massive dose. I take 75 mcg. And, I take it all in one go, too. Sometimes that's best when we need to flood the receptors to get enough into the cells.

[Incoguto in reply to greygoose]

True that, I know that some of the 95 mcg of t4 is converting to something to, but will never find out what that is lolYou do take it all in one go? And feeling better this way?

Tomorrow I will take it all together.

What's your take on rt3? One of my doctors told me that maybe rt3 is my issue since it's high midday (not sure the right time to test).

[greygoose in reply to Incoguto]

rT3 is not an issue for anyone. It is the result of a problem, not the cause.

And, a blood test will tell you if you have high rT3 but not why - and there are many, many reasons, only one of which has anything to do with thyroid. Many people must have high rT3 without knowing it because it can be caused by:

* Chronic fatigue

* Acute illness and injury

* Chronic disease

* Increased cortisol (stress)

* Low cortisol (adrenal fatigue)

* Low iron

* Lyme disease

* Chronic inflammation

* Selenium deficiency

* Excess physical, mental and environmental stresses

* Beta-blocker long-term use such as propranolol, metoprolol, etc.

* Physical injury is a common cause of increased RT3

* Viruses, such as flu

* Starvation/severe calorie restriction

* Mistreated diabetes

* Cirrhosis of the liver

* Fatty liver disease

* Renal Failure.

* Fever of unknown cause

* Detoxing high heavy metals levels

* Etc. etc. etc.

As for rT3 being high at midday... I've never heard that before. Wonder where he got that from.

rT3 is inert - so doesn't cause symptoms - and only stays in the body for about 2 hours before it is converted into T2.

[Incoguto in reply to greygoose]

I have SIBO and I'm sure some other stuff from this list, which would explain why my rt3 is high.Okay, cool, I won't focus on rt3.

I hope taking that t3 tomorrow morning with ndt will switch that light on for me.

Out of curiosity, are you feeling much better taking all t3 in one go (at what time if I may ask?) as opposed to splitting?

[greygoose in reply to Incoguto]

Yes, I am feeling better that way. I think I have some degree of thyroid hormone resistance and I need to flood those receptors.

[Incoguto in reply to greygoose]

Thank you greygoose 😊 fingers crossed for me 🤞

[greygoose in reply to Incoguto]

Fingers crossed!

[SeasideSusie Remembering]

Incoguto

Ft4 = 28%

Ft3 = 48%

Why didn't you increase your NDT rather than add T3?

When on combination thyroid hormone replacement - NDT or Levo plus T3 - we are all different as to where we need the individual hormone levels. Some are fine with a low FT4 as long as FT3 is in the upper part of range, some need both to be fairly well balanced.

Some people add T4 to NDT to give a higher FT4. Some people add T3 to NDT to give a higher FT3. Some people do well with the ratio of T4 to T3 in NDT and it suits them. We're all individual and have to find what levels we need to achieve our sweet spot.

I take Levo and T3 at a slightly higher ratio than NDT gives (and I've also had a much higher ratio), and have a balance of FT4 and FT3 that suits me, but in the 8 years I've been taking T3 I have never felt like a light has been switched on, I'm almost envious of people who say this, I'd like to experience it to see if I'm missing anything!

[Incoguto in reply to SeasideSusie]

Thanks! When I increase NDT I get worse. The first few days is fine and then I nosedive after 4-6 weeks, both ft4 ft3 go up, but feel bad. I increase more, I overdose.On 2.5 grains I can't function at all.

Makes me thinks that the ratio is off.

I still have several hypo symptoms and high cholesterol etc.

May I ask what ratio have you found suitable for you?

This is the first time ever that it felt the light has been switched on. And I have been on meds since 2012!

[SeasideSusie Remembering in reply to Incoguto]

May I ask what ratio have you found suitable for you?

It has varied actually, it's taken a very long time of tweaking to find what's right then the Covid booster in November 2021 completely messed up my levels (there were a few of us whose levels were affected), so since then I've had to try various ratios and I'm still not sure I'm quite there as I've recently had a serious illness that may or may not have had an effect. I changed my dose in March and am currently on T4:T3 at a ratio of 4.5 : 1 and will be retesting in a few weeks' time to see if I'm yet back to where I should be. I'm currently taking more T3 than I have done for 5 years, prior to the Covid booster messing with my levels my T4:T3 ratio was 6:1

[pennyannie in reply to Incoguto]

Hey there again :

I self medicate NDT and increased my dose by 1/4 grains every week -

Maybe you need to look at increasing your dose more often, waiting weeks isn't recommended and why you likely keep feeling better and then dropping back.

Your results simply look like a work in progress as there is still room to build up your dose.

I need my T3 up at around 90% and my T4 then comes in at around 25% :

Some people do add a little T3 or a little T4 to their final dose of NDT if the unique ratio in NDT ( roughly 1/4 - T3/T4 ) is not just right for them - but you have a way to go before you get there.

No thyroid hormone works well until ferritin, folate, B2 and vitamin D are up and maintained at optimal.

[Incoguto in reply to pennyannie]

Thank you! So I have been at 3, 2.88, 2.75, 2.625, 2.56 and 2.5 now 😊

I feel like I run into trouble increase both ft3 ft4 for some reason.

Maybe I'm one of those people that need to add a bit of something else to Armour🤷‍♀️

[pennyannie in reply to Incoguto]

Maybe you are but currently you look to be undermedicated on and need more NDT.

Are these the grains you have been on ?

You're very handy chopping up smaller than a 1/4 - my quarters are a bit suspect !!

[Incoguto in reply to pennyannie]

Yeah I have been on all different grain sizes the last 2.5 years, something improves when I increase and something gets way worse. I know it's either t4 or t3 that is too high for my system. The fact that you are okay on ft4 25%, make me think it could be that my ft4 is just too high for me at 40-50% when I increase NDT...but of course, I could be wrong.

[pennyannie]

It would depend on where your T3 sits not you T4 :

On NDT you track on the T3 - the T4 is not as important and generally lower in % terms in range to that of the T3 when reading results.

[Incoguto in reply to pennyannie]

Unfortunately my ft4 increases to midrange and more when I increase NDT, then with ft3 at 60-80% I start to feel awful.This is why I wanted to potentially try lower Armour and a bit of t3 or the second option - lower Armour and a bit of liquid t4.

[pennyannie in reply to Incoguto]

Are you core strength vitamins and minerals all up and maintained at optimal ?

The adrenals and thyroid work together with the adrenals picking up the slack when the thyroid fails -

have you considered also taking an adrenal glandular supplement to support these vital glands ?

[Incoguto in reply to pennyannie]

They all are apart from ferritin, that one doesn't want to increase to midrange yet, but I've been supplementing the last few years.

I am getting strange results on cortisol. Blood cortisol is high in range in the morning, lowers a bit (to over midrange) when I up NDT, but my salivary cortisol is within range according to Regenerus, but not optimal. When my dose was higher in 2020, salivary cortisol was optimal.

Would it be correct to say that salivary cortisol, which is free, not bound to CBG, albumin etc, increases when the dose is adequate and higher? My blood serum cortisol lowers when the dose is higher, but gets over range, when the dose is lower and I'm hypo.

I actually have Thornes adrenal cortex at home.

[pennyannie in reply to Incoguto]

Well - when I started researching it was because my ferritin was down at 22 and told i was fine but given some iron tablets ( that I couldn't take due to side effects ) to get rid of me.

I read that ferritin needs to be over 70 for any thyroid hormone replacement to work well and now from experience I find my conversion of T4 into T3 is improved when my ferritin is up at around 100.

I don't know too much about cortisol but do know that supplement adrenals eased my achey achey lower back and have continued with this protocol for some 7 years now and started NDT around 5 years ago.

Having had RAI thyroid ablation in 2005 for Graves Disease and becoming very unwell with the consequences of same some 8 years later I read that this toxic substance is also taken up by other glands and organs in the body including the adrenals and so why I decided to start my repairs there - while I tried to get further help through the NHS with regards to symptoms, and trialling T3 and NDT..

[Incoguto in reply to pennyannie]

Thank you🤗my ferritin is 45, so possibly some impairment with conversion due to it, but was hoping that t3 in Armour would solve that problem

Oh interesting, may I ask what adrenal support you use and the amount?

Oh dear this sounds tough...RAI seems very toxic. It makes sense that you wanted to look after all those glands

[pennyannie in reply to Incoguto]

There are several brands available and at different strengths, some just cortex others the full adrenal gland - I take the latter as instructed on the bottle :

[Incoguto in reply to pennyannie]

Thank you so much appreciate it