T4 is T4, whether it's synthetic or natural. It takes time to convert to T3. In fact, the T4 in NDT might take even longer than synthetic T4 because it isn't Free, it's bound to protein carriers.
But, what are you taking right now? T4 only? How much? What is your FT3 level? I suspect that nobody has attempted to reply to your post because you haven't given enough detail. If you've been on T4 only, and are basing your dose of NDT on that, adding in 22.5 mcg T3 all of a sudden is going to be a massive shock to your system! It may not be enough for a final dose, but it's far too much for a starter dose. We need more detail.
I have been taking NDT Thyroid s starting 6 months after my Thyroidectomy back in 2016.
I never had a thyroid problem before and never thought that I may well need an increase in Levo I was on 100 and started to feel unwell. Anyway I joined this site and started buying Thyroid s NDT which I had been on until Nov 2022. My results on it were optimal for years but suddenly FT3 fell from 6.06 (feeling well) to just 2.76 in just 44 days on a new batch after covid. I had been falling over and then knew why. Anyway I am try to cut short. I never had a thyroid problem until I was 68 years old, no Hashis, nothing. After filling up 4 diaries of A5 over the past 18months I can't seem to get better. I have a GP that never listens, nothing new there, just chants to me. I had been on Levo plus T3 but when he read my last result he cut my Levo from 100 to 75. Result FT4 21.6 which is good for me and FT3 4.64. He is OK with suppressed TSH knowing that I had cancer, and I have a letter from the surgeon.
I do realise now that I need my levels in a good place before starting NDT. I have just started back on Levo plus T3. I am prescribed 75mcg Levo and 12.5 T3 a day which is pretty useless.
I need about 56 T3 a day which I worked out when on Thyroid s. I have no gut problems and therefore appear to require less than most on the site each day. I can only take T3 in small amounts even after 18 months now on 8 x 6.25 a real pain in the As-. I now have a prescription for heart medication I have told the GP that my HR only increases when my T3 is running low. I cross it off the page and guess what I am still alive without it 12 months later. Any suggestions please write them on a postcard. Thank you for reading.
If currently taking T4 monotherapy this will take around 6-8 weeks to fully leave your body and in that time frame you slowly build up your NDT dose in 1/4 grain increments weekly or fortnightly so there is as smooth a transition as possible.
You were on NDT previously so know roughly what dose you felt ok on :
The T3 and T4 in NDT are attached to haemoglobin so more slowly broken down in the body and without a thyroid we just need that little bit of T3 to kick start our metabolism since we have lost our own natural T3 thyroid hormone production when we lost our thyroids.
I see NDT as a bit like self rising flour - and a ready made mix - ?
I see adding a little T3 to T4 manually - much like adding some baking powder to plain flour -to give it a lift and lighten the dough -
Thank you I have written more details to greygoose see below. Hopefully it will explain my situation. By the way as I live in France there is no Self Raising Flour so I know what you mean.
Having experienced both meds, I feel T4 in NDT is different than in Levo. I personally prefer it. But it is a bit slower ans gentler when you build it up, in comparison to synthetics.
I’m not sure I have the best answer for you as it has been a number of years since I stopped taking Levothyroxine due to the side effects. I was on either 100 or 120 mg from what I recall. I never had T3 separately.
Examples of side effects were joint pain, pain in my feet when walking, hoarseness and hair thinning/falling out. That said I’ll give you some input that you possibly can add to other suggestions members have made.
Unlike yourself, I still have my thyroid and after temporarily taking Thyroid S around 2016, as I was living out of the UK for several years, I returned to the UK and started taking Metavive both II and I.
This is Natural Dessicated Thyroid from pigs in the north east of England on non GMO farms. There’s a write up about it on the Natural Choice website.
My dosage has varied over time as I was testing my levels through Medichecks. I managed to get a comprehensive blood test on the NHS December/January so went through all the results to see how I could better optimise particularly my B12 and Folate which, whilst on the NHS ‘normal’ range, were in the lower half. I’m now taking a B Complex to bring the levels up more as was suggested on here.
I was taken to A&E in December after having abdominal pains and vomiting which turned out to be a UTI. My blood pressure rocketed at that time and is now much lower having recovered and I am currently on a low dosage (5mg) of Amlodipine.
My free T4 was 10.2 on the last test which was slightly lower than the ‘normal’ range but my TSH had gone down to 2.01 end December so there was an improvement and other results were better too.
I attribute this to my increase of Metavive I from 3 per day to 4 from end November after a test showed I was hypothyroid still.
I take two Metavive I in the morning an hour before breakfast and two in the afternoon. I take a magnesium capsule, B complex and vitamin D with my breakfast. 1 x Metavive II is equivalent to 2 x Metavive I.
I am no longer seeing the Integrative Health Practitioner at the practice I signed up with in 2017 mainly due to costs but I can order Metavive I myself directly from Natural Choice and in between standard NHS blood tests I’ll continue to use Medichecks.
My GP wasn’t familiar with this but my surgery now has it on record I’m taking it and by all accounts my thyroid blood results are looking better. I’m feeling better too. The weight loss helps though I have a way to go still.
I am pre diabetic though and have been for four years and have managed to keep things at bay but since being ill I’ve lost a stone and a half and now seriously looking at losing more weight with some professional help to enable me to reduce my blood pressure. I already have a healthy lifestyle but need to do some tweaking.
It’s difficult to know the exact ratio of T4 to T3 in Metavive but the regular blood tests help and I can adjust accordingly. It’s worth having a look at the breakdown in the Metavive composition to see if this would be helpful to you.
Unfortunately GPS don’t know much, if anything about NDT, so they’ll always want you on Levo and T3 got too expensive for the NHS, so my pharmacist pointed out.
I’m really hoping that the research into Thyroid conditions goes ahead. I feel so sorry for those who are having a tough time getting optimal.
I’m sorry I can’t offer you a solution but hope that adds to the mix. I wish you well. ❤️
I do not think you can equate the breakdown of T3/T4 in NDT to be the same as a potential dose you may think you need if switching to synthetic T3 and T4 - and vica versa :
I find my body reacts very differently to each treatment option -
You may have a ' ball park ' idea - but do not believe there is any direct comparison dose.
I agree there is not a direct comparison. I struggle on with levo plus T3 which usually starts working for me at around 16 days the T4 I mean. I am now taking the Levo PM because I cannot take the Levo and T3 together, I don't know why. The trouble is that the T4 takes time to work and without a thyroid it's a pain, I have 40 of the 25mcg T3 which I am using throughout the day. Trying to get both my levels back to where I feel well again.
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