low levels of T4 & T3 on 3 grains of NDT

[selenipap]

Dear all,

Again I need some help with my blood tests interpretation and further steps. I’m currently on 3 grains of thyroid-s and my results are as shown on the table below. Both FT3 & FT4 levels are not satisfactory.

Could this be because of the low levels of ferritin, D3 and B12? Or do I need to increase my dose or maybe take an extra 25 mg of T4 (as I was adviced before in this forum)? Is it possible that my levels are low cause of thyroid-s (compromised/low) quality (just a thought)?

TSH 0.02 0.27 - 4.2 uIU/mL

FT3 5.42 3.1 - 6.8 pmol/L

FT4 15.86 12 - 22 pmol/L

Ferritin 49 15 - 250 ng/mL

B12 (serum) 337 197 - 771 pg/ml

D3 (serum). 28.7 > 30 ng/mL Sufficiency

21 - 29 ng/mL Insufficiency

11 – 20 ng/mL Deficiency

Thank you!

[pennyannie]

Hello Selenipap:

No thyroid hormone replacement works well until your core strength vitamins and minerals are up and maintained at optimal levels :

I now aim for a ferritin at around 100 - folate around 20 - active B12 75++ say around 125 ( serum B12 500++ ) and vitamin D up at around 100:

Are you new to this treatment option - maybe I should have looked back ?

anyway - there have been a few issues with some people on certain batches - as happens when using a natural thyroid hormone product - but you have an obvious problem with low levels of core strength vitamins and minerals that need addressing first.

[selenipap in reply to pennyannie]

Thank you, pennyannie, for your advice.

No, I'm not new in NDT. It's been 3 years now that I've switched from Euthyrox to Thyroid-s. Actually, I used to take 2.5 grains and back then my T3 was very good but my T4 was low. As I'm desperately trying to lose some weight and also because my T4 needed a boost, I decided to increase the dose to 3 grains. As per your advice, I'll try to fix my vitamin levels first and repeat the blood test and then decide accordingly.

[pennyannie in reply to selenipap]

When taking NDT its quite normal to have a lower T4 then when on T4 monotherapy and you track on the T3 - and as long as your T3 is proportionately higher than when on T4 monotherapy you're going in the right direction.

By adding in T4 you are in effect eroding the unique ratio of 1/ 4.22 T3/T4 found in each grain of NDT and if anything might slightly reduce its effectiveness - just as adding little T3 would increase the T3/T4 ratio and possibly increase effectiveness.

Some people when very close to their ' sweet spot ' add in a little T3 or a little T4 to their dose of NDT but very many thousands of people find the existing T3/T4 ratio works very well for them as it has done for over 100 years prior to Big Pharma launching it's T3 and T4 synthetic thyroid hormone treatment options.

If you were doing ok on 2 + 1/2 grains - maybe a new batch could have needed adjusting up or down by a 1/4 grain -

There is a level of tolerance to the dose strength as printed and declared within which all medications need to fall - and since NDT is a natural product we need to be aware of the need for possible small adjustments when changing batches - though to be quite honest I hadn't any problems for 5 years and it's only this last year I've had experience of batches that I simply could not tolerate. - maybe the fillers used to make the tablet were changed - we simply do not know - but now again I seem ok :

I'm afraid the goal posts can also move - as apart from having to maintain optimal vitamins and minerals conversion can also be compromised by inflammation, antibodies and any physiological stress ( emotional or physical ) depression, dieting and ageing.

[selenipap in reply to pennyannie]

For me it is relatively difficult to tell if there is a problem with the batch I am using. So, as a first step, I will try to improve my vitamin and mineral levels. Either way, I'll need a new thyroid-s supply and hopefully things will change for the better.

Thank you any way for your good advice!