Hi thank you for your response. I will go with what had been prescribed and see how I feel. It’s just that I read a post saying the T4 takes time to leave your body and that 1 grain is equivalent to 80-100 mcg which I thought was maybe too much too soon as I’ve only been taking 50mcg. Although not been converting very well 🤔
I switched from 125 mcg T4 to another brand of NDT and self medicating.
The T4 will take around 6-8 weeks to fully leave your body and for a smooth transition from from one treatment option to another - one reason why it's recommended to go up on small, slow, dose increments when taking NDT.
I increased by 1/4 grain weekly - and I dosed just once a day at around 3.00 am in the morning at a natural toilet break so very sure I had an empty stomach and wouldn't be eating anything for over an hour ( as recommended for good absorption of the NDT )
I had no trouble going back to sleep until around 6.00 am-
My ran my blood pressure, pulse and body temperature Am and Pm daily and whilst the first 2 symptoms remained stable tracked my temperature slowly rise from 35.4 to 36.6 where it is today some 6 years later.
There came a week when I felt a bit edgey and just not comfortable in my skin - so I dropped back down to the previous weeks dose - stayed on that dose 8 weeks and then ran a blood test to see what was happening and I was feeling so much better.
My T3 and T4 had literally switched places as now my T4 was at 25% but my T3 at 110% through the ranges.
If you get to 2 grains - best to stay on that dose for 8 weeks and then run a blood test.
If your T3 hasn't moved much - and if still with symptoms - maybe NDT isn't the best treatment option for you - if you results look much better but you still have some symptoms slowly start upping the dose by a 1/4 grain weekly :
No thyroid hormone replacement works well until your ferritin, folate, B12 and vitaminD are up and maintained at optimal levels.
I find it strange that you have only ever been on 50 mcg T4 - as this a just a starter dose and needs titrating up as T4 doesn't ' top up ' thyroid support but replaces it - and this dose too low to have worked well for anybody.
Ok - so just looked back and see you have Hashimoto's Auto Immune thyroid disease and likely your low ferritin could have been part of your issue with poor conversion previously.
Many forum members find the research and suggestions of Dr Izabella Wentz useful as it does seem with this AI disease - stomach and gut health may need some attention - before you will see the full benefits of any treatment option.
and checking for certain food intolerances, especially those of gluten, wheat and dairy being common triggers for one's immune system -
Some Hashimoto's patients find that taking NDT ( pig thyroid ) actually increases their immune system response and need to stay on synthetic thyroid hormone replacement treatment options.
Thank you for all this information really appreciate it. I want to get as well as I can by trying other medication now as suggested by the Dr on Thyroid UK I feel it’s worth a try.
Yes - I understand but first off ensure that your core strength vitamins and minerals are all optimal - and get tested for celiac while still eating your chosen foods, if you haven't already had this checked out.
I know now I need to m my ferritin up at around 100 - folate around 20 - active B12 around 125 ( serum B12 500++ ) and vitamin D around 125 :
I am not aware there is any one doctor on Thyroid UK - there is a list of patient to patient recommended endos and thyroid specialists - NHS and private - which can be acquired by contacting admin @ thyroiduk.org - is that what you are referring to ?
You can’t know if you are a poor converter until on full replacement dose Levo
Dose Levo should have been increased slowly upwards in 25mcg steps until on full replacement dose. This is typically around 1.6mcg of levothyroxine per kilo of your weight per day
Unless extremely petite that’s likely to be at least 100mcg per day
What are your most recent thyroid and vitamin results
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
What vitamin supplements are you taking
Is your hypothyroidism autoimmune
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Testing options and includes money off codes for private testing
Thank you for all your help and information, it was on here that from my blood results suggested poor conversion although the Dr also said 50mcg is the starter dose. The GP has never altered it as TSH always within range. They don’t seem to understand it much
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
TSH should be under 2 as an absolute maximum when on levothyroxine
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
Im overweight for my height 5ft 3 weigh around 11st have trued hard to lose weight but find it impossible, yes it is expensive but getting desperate to try anything that may help
Heard about Armour and felt to give it a try as my ratio for conversion wasn’t good.
I'm an Armour user. It's not the magic bullet you might think it is. It works very well for some but others it's a battle to get the dose right. Given the cost and the difficulty using it, in your shoes I would be buying some Levo and increasing that to a sensible amount before I switched to Armour. You have never been given the opportunity to know if Levo works for you because your clueless GP has never given you enough of it.
Seriously, if you can get Levo to work it's so much easier and cheap as chips. First stage is to increase from 50mcg a day to 75mcg a day. You don't know how well you might convert if you have good levels of vitamins and minerals and a therapeutic dose of T4.
If I were you I would ask this private doctor for a prescription to increase your Levo first. And try optimising your dose. You can always switch to Armour at a later stage but I'd be afraid you were likely to throw away the baby with the bathwater switching straight from a long-term starter dose of Levo to Armour 1 grain.
I’ve not tried to increase the levothyroxine mercury this was mainly due to thinking I’m a poor converter and really had no idea how to go about improving that other than trying the Armour. I can see now there are alternatives such as adding T3 ?
The tinnitus does seem to amplify a while after I take the levothyroxine not sure why also the Vit D I started gave me leg pain that I didn’t have before I started taking it.
There is so much knowledge on here I need to read more and maybe even change GP
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)
Post discussing how biotin can affect test results
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