Switching from NDT to T3 only - what dose?

[Whippets88]

Hi,

I have been on NDT since 2016, and surely had some relief when starting. Before NDT I really had no life. But as I still have a lot of symptoms (the worse being extreme fatigue), I decided to try to taper off to see if I was over medicated. So this spring I tapered from 2,75 grains to 1,25 grains (I did go lower but then felt even worse). I feel the same, I would say, at 1,25 as I did on 2,75 grains.

I have then come upon Dr. Lowe, and would like to try only T3 to see if that would make me feel better. But I am confused as to what dose of T3 I should switch.

1,25 grains of NDT should be 47,5 mcg T4 and 11,25 mcg T3.

Should I replace with 11,25 mcg T3?

Or should I somehow calculate the T4 to T3 and add that as well to my T3-only-dose?

I can see that I must only very slowly go up in dose with T3, like 5 mcg a week; I suspect that I need to get higher to feel better.

I am in Denmark, and doctors only go by TSH here. It is not possible to get a free T3 measurement either, so I will be self medicating from how I feel and temperature/ heart rate. My temperature is always low, and my resting heart rate is 58-60, even though I am very much out of shape due to the fatigue. I can see that Dr. Lowe does not consider blood testing anything to go by anyway.

I would be very happy with any input!

[Brightness14]

Just out of interest which NDT are you taking now.

[Whippets88 in reply to Brightness14]

I am taking Thiroyd (I have tried Armour and Thyroid S a few years back, but I feel better on Thiroyd).

[Morning_gl0ry in reply to Whippets88]

hi whippets88 what I would say is with hormones, it’s a slow and steady progression, you’ve got to give it time before you make further changes. So six weeks to settle into a new dose, and when you add a hormone it affects other hormone levels too so there’s a balancing taking place. I have been on t3 for about 8 months and it has worked for me, i was sceptical at first and scared but i have been much better. I’m also at menopause age so hrt has played a part, but I also think i could have started hrt 10 years ago and cut out alot of suffering over the years. Take it slow, I wish you well! Good luck x

[Whippets88 in reply to Morning_gl0ry]

Thank you! I will slowly increase and hope for the best I am perimenopausal, and it makes everything more difficult I think - it is not always easy to know if symptoms are due to hypo or changes in hormone levels. I am happy to hear that you have found what works for you

[pennyannie]

Hey there again ;

I read people on T3 only need around 50 mcg a day to function ;

Quite how you get there is the question :

Could you possibly have been over medicating and 1+1/2 grains is your best dose - would it make sense to stay on this dose for 6-8 weeks allowing your body time to adjust and see how you go ?

Do you have any current readings for ferritin, folate, B12 and vitamin D as these all need to be maintained at optimal levels for optimal health ?

Maybe check out Paul Robinson - Recovering with T3 : paulrobinsonthyroid.com

[Whippets88 in reply to pennyannie]

Thank you for taking the time to answer me - and also for the link to Paul Robinson!

I have been on 1,25 grains for 90 days, and I am fairly sure I am not over medicated - I have low pulse, low temperature, extreme fatigue, brain fog. I had the same symptoms on 2,75 grains, and also a few years back when I went to 3,25 grains to see if I was under medicated. This is why I would like to try only T3, as it seems NDT cannot get me all the way to feeling good.

Latest labs:

Vit D (2021): 56 nmol/l (lab range: 50-200)

Folate (2020): 13,1 nmol/l (lab range: >5,6)

Ferritin (2019): 70 µg/L (lab range: 12-300)

B12 (2021): 258 pmol/L (lab range: >200)

Thank you, really appreciate your time!

[pennyannie]

Is your Thiroid - the NDT from Thailand - it must be well out of date now - isn't it ?

I now aim to maintain my ferritin at around 100 : folate around 20 : active B12- 75++ ( serum B12 - 500++ )and vitamin D at around 100:

So I'm thinking you need to be supplementing all of the above for optimum health and the ability to convert T4 into T3 -

Even if you go T3 only you do need a strong core strength to support you which is basically the same vitamins and minerals as detailed above.

[Whippets88 in reply to pennyannie]

Thank you! I will try to supplement and see if that helps And yes, I am on my last bottle of Thiroyd, I stocked the freezer a few years back 😁 I am always terrified of running out. I have some Thyroid S now, but last time I tried it, a few years back, it didn't work for me at all.

[pennyannie in reply to Whippets88]

I'm a little confused with your B12 reading as to the range - presume 200 means the very minimum - in which case I wonder if you should get checked out for Pernicious Anemia :

[Whippets88 in reply to pennyannie]

Yes, 200 is the lower limit, and I had 258

[pennyannie in reply to Whippets88]

Do you have the top of the range as usually we need to good 50% ++ through a range for optimal :

Just had a quick look and getting a range of 200-900 -

so you need to be looking at 500++ :

Maybe this needs checking out with the doctor as to why it is so low - and maybe you have pernicious anemia as suggested earlier - and need B12 injections.

[Whippets88 in reply to pennyannie]

Thank you!! I will look into this.

[Whippets88 in reply to pennyannie]

Thank you for this; it seems that a lot of my symptoms match very well with low B12 (even though I don't think that my doctor will agree that I even haw low B12, as I am over the limit); I have a lot of neurological symptoms that matches as well. But - I can see that low B12 often gives a fast herat rate, and mine is very low at below 60 even though I am out of shape. I will try to supplement though, and see id it helps

[LucyYoga]

For guidance/ information on T3 only dosing read Paul Robinson’s book

[Whippets88]

Thanks - I have ordered it a week ago, hoping it will get here soon So far I started taking 10 mcg, and after 2 days changed to 5 mcg as I had headache and nausea. This change is enormous! After 15 years of fatigue, and the past 8 years on NDT feeling a little better, I have had 5 days with energy! A totally new feeling in my body, and no more pins and needles! Fingers crossed this will continue.

[LucyYoga]

👏👍

[Whippets88]

So I am back with an update - I have today decided to go back on 1,25 grains of NDT.

I definitely felt some improvement on T3 only. The pins and needles in my feet and hands almost disappeared, and I also felt more clear headed. But also, I felt more and more fatigue and depression sneaking up on me. The feeling of every cell in my body being so extremely tired. I suspect the T3 dose of 10 mcg was way to low, but increasing to maybe 50 or 80 or 100 mcg as slow as one has to, would take to long - I am worried about feeling this low. So I will go back to a NDT dose where I know I function - maybe not thriving, but functioning.

I still want to try to add T3 , but now I will stay on this NDT dose for at least 3 weeks, and then maybe try to add some T3 to that dose. Eventually I might try to taper a bit down with the NDT and add more T3. I wonder if I might need some T4 always as well, to keep the levels steady.

I have gotten Paul Robinson’s book (the blue one). The strange thing is that my heart beat is the same (58-60 BPM) all the way from taking nothing to taking 3,5 grains of NDT, and my body temperature the same, steady low. Nothing I do will raise them. I have only read a few chapters so far, hoping to learn more!

I am very grateful for this forum, thanks for all the kind feedback I have been receiving!