I wonder if any of you are successfully combining levo and NDT together and if you can even do it?
I am currently taking levo only, alternating 88-88-75, but my T3 could be a bit higher. It was at 4.1 and I would like to see it around 5. I have a lot of hair loss, some fatigue and also low motivation and drive and I have a business to run!
And yes, my TSH should be lower, it was 3.1 on the last test, however, I can't increase on levo and take a higher dose without side effects (elevates my pulse rate and blood pressure, makes me feel awful!) My T4 is 50% of the range. But I really can't increase levo any further.
(I supplement with iron, folate, B12, D, etc and monitor my levels, so it's not that side of things.)
So I was thinking: could I reduce levo to 50 mcg and add 25 mcg of NDT by taking 1/4 a grain?
Has a combo of more T4 and less NDT worked for anyone and can it help?
I've never taken NDT before and I didn't do well on adding synthetic T3 to my T4. Made me feel dreadful, panic attacks, heart pals - tried both slow and fast release. So I was thinking perhaps T4 + a bit of NDT could help?
I've already got NDT at home, so can try it, but wanted to get an input from all the amazing people on this forum. I honestly get more help here than from the private docs I've seen before!
Thank you!
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I experienced Armour and Metavive as very gentle on my system but that's just me. I did try adding synthetic T3 and it was much harsher. NDT did not do much for my T4 - it went down. I found this: One grain, about 60 mg, of desiccated pig thyroid extract contains about 38mcg of T4 and 9mcg of T3, so 1/4 grain would only be about 10 mcg of T4+2 mcg of T3.
Thank you, so perhaps 75 mcg of T4 + half a grain of NDT would work better? I was told that 1 grain is approx 100 mcg of levo, but not sure how accurate it is ... I have ERFA at home.
1 grain if Efra contains trace elements of T1, T2 and calcitonin plus a measure of T3 at 8 mcg plus a measure of T4 at 35 mcg.
Once your core strength vitamins and minerals, are up maintained at optimal levels it would be a good idea to run a blood test for at least a TSH, Free T3 and Free T4 before you switch to NDT so we have some bench mark readings to compare to after you try an alternative treatment option.
I simply switched from T4 x 125 mcg to NDT overnight - 5 + years ago.
There is a unique ratio of T3 and T4 in NDT that works very well for thousands of people and think your best option is first to try - just the Efra - why erode this unique ratio of T3/T4 by adding in more T4 than nature intended ?
Why would you never take Efra alone ? It was the original, first treatment option for hypothyroidism and used successfully for over 100 years until Big Pharma launched their treatment options on the back of NDT's success and then went about ganing market share through fair means or foul.
On NDT your blood tests will look different - the TSH will likely be suppressed, and your T4 lower BUT your T3 higher than when on T4 monotherapy.
I see little point in looking for a T3 of around 5 - just look for relief of symptoms and your T3 should be higher in the range and hopefully your health and well being improved.
You start with a 1/4 grain - and as your T4 levels diminish in your body - slowly increase weekly/fortnightly the Efra by 1/4 grain increments :
if you get t 2 grains stay on this dose for 6-8 weeks and then run a blood tests just to see you are going in the right direction and allow this dose to settle in - NDT is much softer on the body and the results much more subtle.
Some people split the dose AM and PM - I take mine just once at around 3.00 in the morning to dovetail in with my needing the toilet and the circadian rhythm of the body.
There comes a week when you feel you have gone a bit backwards and just uncomfortable in your body - drop back down to the previous dose - stay on this lower dose for 6-8 weeks and then run a blood test - and that is likely your best dose on NDT - at that point in time.
Some people do then add a little T3 or T4 to their dose if they feel it necessary.
Monitor yourself twice daily while doing this experiment with blood pressure, pulse and temperature - in my case the first 2 remained constant and my temperature rose from 35.4 to 36.6 where it generally hovers today.
On a blood test, taken around 10 hours after taking my NDT - my TSH is low suppressed and my T3 is around 90/110 % through the range and my T4 around 25/30% through the range - they literally swopped positions from when I was on T4 monotherapy.
No thyroid hormone works well until ferritin, folate, B12 and vitamin D are up and maintained at optimal levels and I aim for a ferritin at around 100 - folate 20 - active B12 75++ ( serum B12 500 ++ ) and vitamin D around 100.
Penny, this is so helpful, thank you so much for all this info! Absolutely amazing, I saved it. Based on your figures, I need to raise my folate, B12 and ferritin more, perhaps that will help me feel better on levo before switching to anything else. My concern with switching to NDT is that I had a bad reaction to synthetic T3 and I'm concerned about triggering the same symptoms again.
How often do you monitor your thyroid and nutrient levels?
I do just a yearly full thyroid function test to include the vitamins and minerals.
I became very unwell and with no answers from the NHS started researching low ferritin when I fell into this amazing forum and it took me around 18 months to get my vitamins and minerals optimal and in that time, I was basically housebound and started reading up.
i was refused both T3 and NDT through my doctor and hospital in early 2018 and had already ordered p both T3 and NDT as my Plan B as I couldn't accept how ill i was and how the NHS thought this acceptable.
I dropped 25mcg T4 and took 6.25mcg T3 - It felt like a light had been relit in my brain and I felt much better with my brain engaged - though I felt a little turbo charged and I couldn't get past this dose without making myself very uncomfortable - maybe I got it all wrong or misunderstood what I was meant to be doing - I don't know - but frightened myself -
I went back on T4 for a month and then I switched to NDT and I find NDT much softer, and smoother on the body, bit like wearing slippers rather than shoes two sizes too small.
I am with Graves post RAI thyroid ablation back in 2005 - full details on my Profile page:
T3 is very immediate when taking Liiothyronine. The T3 contained in NDT is very different. As long as you don't take too much at once when you start you probably will not have the same experiences with NDT that you got on synthetic.
I take 1 grain armour thyroid. Anything over that sends my t3 too high and leaves my t4 too low. I am pretty much in range now but need to tweak meds a bit more.
I am also not on standard levo. I source tirosint privately which is levo but without loads of fillers in. Only has water, gelatine and another filler I can’t remember the name of
yes it does work for me. I have tried being on tirisont and a comounded t3 but after a year of switching doses etc I just felt like I was going to die for a year. As soon as I went back on the armour I felt so much better
That's amazing! Did you add a grain right away, or started from 1/4, then 1/2, then kept increasing? Do you take levo and NDT at the same time? What was your T3 level before you added NDT?
I first started on NDT 1/4 grain and built up slowly to 1 grain, then added the tirsont 25mcg then upped to 75mcg. I was originally on levo but I felt so awful on the nhs stuff and kept reacting to it. So I switched straight over to NDT. I am not sure what my t3 was on levo as never got that far. But on 1 grain armour and 75mcg of tiro my t3 sits quite high at 6.8/7
Yes I take levo and Armour thyroid and have done for a long time as recommended by my consultant Dr Skinner, who was of the old school a long time before he sadly died.
I was stable until I experienced problems with Levo in the last few years when the levo brand I used was changed to another manufacturer. I am possibly just getting stable again now
I currently take 3 grains Armour and @ 37.5 Wockhardt Levothyroxine by splitting tablets 3 25mcg over 2 days
I understand how you feel when you are not feeling OK and need to work .. it sounded just like me 20 years ago so hope that you get it sorted with the help of the people in this forum who are very knowledgable.
I take NDT and thyroxine following seeing a consultant. T3 was always low end, tsh over suppressed - tsh never moved even when dropping levo which would resort in my t3 crashing to the bottom range.
So consultant reduced my thyroxine from 150mcg to 100mcg and 30mg ERFA whch improved my t3 and also felt a change cognitively. My tsh was still over suppressed so he’s changed my dose now to 50mg levo and 60mg ERFA.
It’s just a shame this can’t be prescribed on NHS as it’s a lot more expensive but I do feel it makes a difference.
I take thyroxine, just reducing from 100 mcg daily to 75 and 1 grain ERFA split between 6.45 am and noon. I tried just ERFA but couldn't get the balance of T4 and T3 right, T4 was bottom of range and T3 over range and I felt awful.
Yes I take NDT and Levo. I found my T4 levels were too low for me on NDT alone and went below range so I swapped out a small part of my NDT dose for 25mg of Levo which has worked well.
I have felt much better, but it did take a bit of time to hit on the right combination of dosing that worked for me. Others on the site have a lot more experience than me, but my understanding is patience is key when making any dose adjustments. Needs to be small changes and left for a number of weeks before another change is made. I certainly found I needed to do that to give my body time to adjust (with the exception of one increase in dose I made where it became clear quite quickly it was too much for me and I adjusted down on a couple of days which helped).
Everyone is so different, it is finding what works for you. For me pure Levo or pure NDT didn’t seem to work but I have managed to find a combination of the two that seems to be working and I feel well on it.
Good luck as you figure out what your options are.
I contacted a representative of ERFA and asked about the hormones in pigs that provide the NDT hormone. They could not guarantee that it is hormone free (meant are artificial hormones given to cattle, pigs). Is that of concern when patients use eg. ERFA or ARMOUR?
Im on NDT and Im finding it a concern- I do everything in my power to reduce toxins- eat only organic, don't use endocrine disrupting chemicals in my skin/personal products, home etc..... the last thing I want to do is be eating hormone riddled pig thyroid. Its scary as I can only see it getting worse.
I think this is the sort of thing that requires us to be pragmatic. The level of amounts of actual pig thyroid taken is pretty small, so the amounts of 'other' hormones are very much smaller again.
Balanced against restoration of health.
Balanced against the cancer risk of handling supermarket receipts.
Yes you can combine NDT and Levo but its hard working out whats going on, unless you could get a blood test every week. I would just convert to NDT. Starting low - like 30mg per day and slowly slowly over a few months optimist up, using how you feel as your guide and not worrying about bloods . You would increase to 60mg pretty quickly like 1-2 weeks but then really slow it down and be really careful with further increases. Watch for side effects like normal temperature, pulse rate and blood pressure, feeling awful, anxiety etc. You can pull a 60mg NDT cap apart and break it into 4 parts pretty easily, this is how I can increase by 15mg increments as I come closer to optimal dosage. Regarding heart feelings - I get a heart flutter when I am low thyroid and then crashing palpitations when I am super high. Don't confuse the two , although you pretty much described to a T being overdosed. Once you are optimal amazingly you will also make good blood tests. I make sure my TSH is not zero for blood tests or my GP has an aneurysm. Just stop NDT 24 hours prior to bloods.
Interesting you say about stopping the NDT 24 hours before bloods. I do the same thing and for the same reason to avoid the argument with a panicked GP.
Slightly nervous as my endo has asked GP to do bloods. Have seen letter and he talks about TSH in it (basically reassuring GP my TSH can be down to 0.1 and they don’t need to panic). Text from GP (presumably after letter was uploaded by admin) asking me to come for a TSH test 🙄
Not sure if best approach:
Ignore - but next prescription may get refused
Phone for appointment and ask if all 3 tests will be done - if say no decline and say will book my own and let them know results
Book appointment, ask before blood test, if only TSH advised refuse on the day and state will book own test. They might then override and ask for all 3 in panic.
I have the same problem with T3. By the way, there was an American endocrinologist and scientist named Dr Kenneth Blanchard who advocated for combining T4 (Levo) with very small amounts of NDT. You might want search for his books online.
Thank you so much for the reply! I have bought his book as per your recommendation. Basically, what I noticed so far is this: when I switched to NDT from levo alone, I felt great to start with. I thought that as I would up my NDT to build to a dose to replace levo, I would feel even better. However, this is actually not the case. Before reading your message, I thought to myself: what is the fact that I still had T4 in me and combined with small amounts of NDT it worked better? I will read the book and go from there! Thank you, this forum is beyong amazing.
But, if you want a more complete answer, I suggest you make a brand new post to ask your question rather than adding to an existing and rather old thread.
I tried, but it didn't work for me at all. Elevated my pulse and BP and I felt spaced. I've done just NDT, NDT + Levo and am back on Levo only now. I've found Ozone therapy and it's been life changing, I recommend it to everyone (Ozone IVs and rectal insufflations).
But some people do well on NDT + levo. It's all very personal.
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