Dosage timing

[HypoGuy96]

How do you time your dosage of NDT. Currently on 120mg/2 grains NDT a day.

i tried taking 1 grain before bed, but woke up with a puffy face!

[Schilddruse]

1 grain when I wake up well before breakfast (at least 1 hour) and 1 grain around 2-3pm.

[SmPea]

I take NDT exactly the same as childdruse. I leave an hour after lunch before taking 1 grain and an hour after before I eat again or drink something other than water. I set my phone alarm for the afternoon dose. The morning dose is easy to remember making a habit first thing you do on waking.

[FoggyThinker]

I take my first dose around 3:30am as I wake up then anyway - I'm guessing that's low cortisol and/or low blood sugar but who knows??? - and then another dose around 3:30 pm. 3:30am is intended to help raise my cortisol as it's been a bit low, if this wasn't the case I'd take it first thing and leave a good hour before breakfast. I've found too close to bedtime tends to stop me sleeping well... like others I try to take it well away from food. Good luck with finding your routine

[pennyannie]

Hello HypoGuy :

There is nothing on your profile - can you please complete :

What are you diagnosed with and when and what were you taking before switching to NDT ?

Do you have bench mark readings of your TSH Free T3 and Free T4 from just before switching too NDT :

Do you have any current readings for ferritin, folate, B12 and vitamin D as no thyroid hormone replacement works well until these are up and maintained at optimal levels ?

How did you get to 2 grains NDT ?

When switching to NDT whatever you were taking previously will take time to leave your body - Levothyroxine takes around 6-8 weeks to fully leave the body and in that time i is suggested that you slowly increase your NDT by 1/4 grain weekly or fortnightly :

Monitoring physical symptoms on blood pressure, pule and temperature both AM and PM :

If and when you reach 2 grains NDT you then hold this dose for 6-8 weeks - letting it bed into the body - and then run a blood test to see how it compares to the bench mark readings.

I only managed to get to 1 + 3/4 gains and started to feel uncomfortable in my skin and not as good as the previous week - so dropped back down to 1 + 1/2 grains - stayed on that dose 6-8 weeks and then ran a blood test.

My T3 and T4 had literally swopped places with regard to % through the range, I felt well and throughout the process my blood pressure and pulse had remained table and I tracked my temperature rise from 35.4 to 36.6 where it seems to be ok for me and now some 5 years on.

I started off taking my full dose at around 2/3 in the morning - which dovetails in with the circadian rhyme of the body and also, now, a toilet break.

It's suggested for maximum absorption any thyroid hormone replacement should be taken on an empty stomach and you should leave an hour before eating or drinking anything other than water.

I dose just once a day - but we are all different and need to find a time or times that makes sense for us -

I' m with Graves Disease - post RAI thyroid ablation 2004 becoming increasingly more unwell in around 2014/16 on T4 monotherapy and when refused both T3 and NDT by the NHS in 2018 decided to come out of the system and self medicate and am much improved.

[HypoGuy96 in reply to pennyannie]

Hi,

Thx for a great reply.

long story short:

Diagnosis: Hashimotos (inhereted).

Medicin: Levothyroxine for 10 years, before switching to NDT, 6 months ago.

About me. Highly fit 27 yo with a BW of 220lbs. I plan on studying Medicin next year, so i’m very nerdy regarding health overall, vitamins, foods etc.

Worst symptoms: Heart ectopics. Never had them before starting treatment when I was 17.

A little back story:

My blood work on Levo (200mcg) have always come out to be “in range”, but I still had periods (out of nowhere) where I dealt with terrible heart ectopics. That was my reasoning for switching to NDT. My T3 has never been above 4.

After 3 days on 60mg of NDT, 30mg am and pm, my ectopics started to disappear, hmmm.. I was symptom free for almost 6 months before suddenly getting the ectopics again. Here I made the big mistake of lowering my dosage to only 1/2 grain a day. This proved to be very stupid as I’ve last month got my blood checked with terrible results. Screenshot is being attached.

Now I’m trying to get my numbers up again and have reached a dose of 120mg NDT, maybe a bit too fast of a dose increase but here I am. Today I’ve taken 90mg of NDT first thing in the morning and planning on taking my other dose this afternoon. My pulls is definitely a bit irregular and still have those ectopics as I’m writing this. Tomorrow I will try to take the full dose in the morning. I see now evidence to suggest that u have to spread the dosage out throughout the day.

Could these ectopics be caused by a too low free T3? I’m planning on measuring my cortisol lvl’s next week in regards of adrenal fatigue. Talking to my doctor today to order blood work and get some advice.

How long would u suggest me being on these 2 grains of NDT before I should reacces things? Can’t be running around with these bad ectopics as it affects my overall life.

Kind regards from a frustrated 27yo ♥️

Thyroid blood work

[pennyannie in reply to HypoGuy96]

Ok then - so can you please complete your profile page with your diagnosis etc - so we have some reference to look back on quickly when reply to future questions from you.

I don't know what this screen shot represents - and I'm not too knowledgeable as to the heart condition but as I understand things the brain and heart take the ' lion's share ' of T3 -

and since these symptoms resolved but then started again on a reduced dose of NDT it looks to follow my thinking and maybe cause and effect -

You must go slowly in 1/4 grain increments NDT as it's very easy to miss your ideal dose and then fail and have to start all over again.

Too little or too much thyroid hormone replacement can cause fatigue and there are several symptoms which ' sit ' in both ' hyper ' and ' hypo ' camps - so it can get confusing and why it's best to go slow increasing or decreasing your NDT.

Do you monitor yourself on the more obvious physical symptoms of blood pressure, pulse and temperature as 100 years ago when NDT was the only treatment option and way before we had the science of blood tests and presumed ranges - we were monitored on these physical symptoms and believed as to how we felt :

[pennyannie in reply to pennyannie]

Having Hashimoto's does throw a spanner in the works as you are liable to erratic own thyroid hormone production as this AI disease progresses and attacks your thyroid, causing ' swings ' in symptoms - from hypo to hyper.

These swing are short lived - and when they swing back your thyroid will be further damaged and your symptoms of hypothyroidism likely further compromised.

I read that some people, sensing a swing coming on, stop/reduce their thyroid hormone replacement so to try and offset the severity of the AI attack.

You might like to read around the work and research of Dr Izabella Wentz who has Hashimoto's thyroid AI disease - thyroidpharmacist.com

[waveylines]

Hello HypoGuy I take my NDT dose of 3 3/4 grains first thing in the morning with water when I wake. Leave an hour before eating or drinking tea or coffee.

[Brightness14]

1.25 grains at 6/7am and another 1 about one hour after lunch. This worked for me for seven years.