Experiences of NDT v Levo and Lio

[Piglet1956]

Hello again,

I have been trialling NDT (2 grains since mid March 2024. I was previously on 75mcg Levo and 10mcg Lio (from NHS Endo) but still had symptoms. Both T4 and T3 levels are better on NDT yet I’m not feeling improvement.

The private GP I saw increased my dose to 2.25 grains and I felt jittery, hand tremors, hot sweats at night and generally over medicated. However I also had been ill with a chest infection and had lost half a stone in a week because of this. I tried the increased dose for over 2 weeks but have reduced over the last 3 days back to 2 grains as the jittery feelings were not going away.

I also realise that a lot of my symptoms might be menopausal so maybe need to address that. Upshot is I think I may as well be back open the NHS Levo and Lio as my symptoms were less, I don’t need to pay and I got spooked by the tales of not being given unprescribed NDT if I end up in hospital unable to administer my own medication. I think this was also brought on by being so ill with the chest infection.

So my questions are -

1. Is it unusual to feel NDT (Armour) isn't making a difference?

2. If I decide to change back, how best to move from NDT 2 grains daily to my previous dose of Levo and Lio?

My most recent results are in the photo - February test is Levo and Lio and April is NDT. Percentage figures are the equivalent points in the ranges for T4 and T3 using Helvella’s calculator.

Thanks for reading.

[TiggerMe Ambassador]

Doesn't look like either gives you enough T4 to get your fT4 above 50%, I'd suggest if you are going back to try 100mcg Levo and 10mcg T3 and make small tweaks from there.... or

It sounds like NDT is a bit T3 heavy for you so you do have the option of first trialling adding a little T4 to your current 2 grains? Maybe 25mcg T4

[Piglet1956 in reply to TiggerMe]

Unfortunately 100 suppresses my TSH and Endo won't allow that. The reason I decided to try NDT. And thanks for the suggestion re adding 25mcg T4.

[SlowDragon Ambassador in reply to Piglet1956]

Unfortunately 100 suppresses my TSH and Endo won't allow that.

Then likely to need different endocrinologist

[SlowDragon Ambassador]

suggest if you are going back to try 100mcg Levo and 10mcg T3 and make small tweaks from there

I would agree with TiggerMe

Ft4 was ridiculously low on 75mcg Levo

Increase to 100mcg daily and retest in 8 weeks

Likely to need to make further adjustments after that

Which brand of levothyroxine and which brand of T3 were you on

How much levothyroxine were you on BEFORE T3 was added

Are all four vitamins at optimal levels

What vitamin supplements are you taking

[Piglet1956 in reply to SlowDragon]

The reason I tried NDT was that the Endo wouldn't allow me to have suppressed TSH which it was on 87.5 Levo and 10 Lio. so it was reduced to 75 and 10 and T3 fell through the floor from 83% to 33% through range. T4 has always been low when on T3.

[SlowDragon Ambassador]

suggest you get FULL iron panel test including ferritin if not done so

retest 3-4 times a year if self supplementing any iron

It’s possible to have low ferritin but high iron

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

Stop iron supplements 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Suggest you reread your previous post on iron levels from 9 months ago

healthunlocked.com/thyroidu...

[SlowDragon Ambassador]

Are you on gluten free or dairy free diet

[Piglet1956 in reply to SlowDragon]

Thanks for your replies SlowDragon. I will respond to your other questions in due course. I'm on a strictly gluten free diet.

[Gillybean1]

Hello Piglet1956,

We have some similarities. Do you split your NDT doses through the day and away from food, and 4 hours away from supplements?

On STTM site they discuss that some split two times, or 3 times or even 4 times through a day, to tolerate the much needed T3.

Every best wish , G

[Piglet1956]

Hello Gillybean1, I take NDT at 6am and at 3pm, both 4 hours from supplements.