Getting the NDT dosage right

[lutepavan]

Hello again friends,

I'm writing again in the hope that your collective expertise will come up with a solution for me. I switched from Levothyroxine to NDT (NP Thyroid) some time back, and I've been testing every 12 weeks and tweaking the dose trying to get it right. The latest results, which arrived yesterday, demonstrate that more tweaking is required--I still don't seem to have hit on the right dose. But despite this, I feel better on NDT than I did on Levothyroxine, even when my numbers were (on paper) more satisfactory on Levothyroxine.

In early February, after a period of taking 1.5 grains, TSH was 0.462 (0.27-4.2), T3 was 4.3 (3.1-6.8), and T4 was 11.3 (12-22).

So I increased the dose to 1.75 grains. Now my numbers are TSH 0.309 (ranges same as above), T3 4.0, T4 10.3. The puzzle is that increasing the dose resulted in LOWER T3 and T4! (And T4 has been below range for a long while. Can't be a good thing.) But I should add that I finished a bottle of NP Thyroid and started a new one near the beginning of this period, so perhaps the new batch is less effective? I think I read somewhere that NP can be a bit variable.

So now I'm considering my options:

1. increase the dose to 2 grains, either a) remaining on NP Thyroid, or b) switching to Armour, which is believed to be more reliable (?)

2. keep the current dose, but add 25 mcg of Levothyroxine to the daily mix.

3. something else I haven't thought of

Any ideas would be gratefully received.

Thank you.

[Edit: I should add that my antibodies remain sky high: Thyroglobulin Antibodies greater than 4000 (0-115), Thyroid Peroxidase Antibodies 321 (0-34). No data this time on ferritin, folate, etc.]

[Hidden]

How long did you leave between NDT and test?

[lutepavan in reply to Hidden]

Hello, thanks for your reply. I've been taking (and tweaking) NDT for 7 or 8 months now. And I always leave about 12 weeks between altering the dose and testing.

[Hidden in reply to lutepavan]

Sorry. I meant how long do you leave between taking the medication and the blood test? Sorry I wasn’t clearer

[lutepavan in reply to Hidden]

Oh, I see. About 26 hours.

[Hidden in reply to lutepavan]

In that case you’ve got a false low FT3. It’s important that interval isn’t more 8-12 hours. When taking NDT or T3 (NDT contains T3).

You’re probably looking at an FT3 of about 5.2 if you’d left the correct interval

FT4 level tends to drop when you’re taking NDT//T3. Some people take a small dose of Levo to keep their FT4 levels at a reasonable level. Looking at your results I think you may want to do this

[lutepavan in reply to Hidden]

Thank you, that's good to know. I was following the old protocol of not dosing for 24 hours before testing. I didn't realise that it needs to be different with NDT or T3. So given the options of increasing the dose to two grains versus keeping the dose at 1.75 grains but adding in 25 mcg Levothyroxine, you think the latter is a better choice? Thanks for your help!

[Hidden in reply to lutepavan]

That would be my choice .

[lutepavan in reply to Hidden]

Thank you. Greatly appreciated.

[Hidden in reply to lutepavan]

You’re welcome