I have been on Levothyroxine since 2020. Gradually felt worse and worse. Aches and pains, poor digestion, constipation, pins and needles. Managed to find a specialist who prescribed a trial of Armour about 2 months ago. I’ve increased dose to 2.5 grains during that time but overall I feel crap. Aches are worse so much so that Xmas shopping feels like I’ve run a marathon. My mood is low. The constipation is worse. My hair was falling out although it’s improving. I’m so tired but can’t sleep. The only plus sides are indigestion better, eyelashes and eyebrows are great and I’ve lost 4 lb. I’m due to have bloods in early Jan and see Dr on 15th. I’m not sure I want to continue feeling like this for another month???
My questions are:
Is it normal to feel worse before it gets better
How long does it take
Should I give up and just revert to T4
Any advice?
my pulse has increased slightly to 70. My temperature is perfect. No racing heart at all. Vitamin levels are in good range apart from D and folate. Currently supplementing.
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IvyBoo
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Suggest you start separate B12 and then look at changing folate for vitamin B complex a week or two later
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement
A week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need separate methyl folate couple times a week
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 5-7 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) and continue separate B12 until serum B12 over 500 or Active B12 over 70
Post discussing how biotin can affect test results
Sorry you're feeling as you are. I wonder what dose you started on? and how gently you moved to 2.5 grains? I'm now on NDT only. The brand I take is Erfa, and although NDT may not work for some people it suits me well. My endo started me off with .5 grain and lowered my levothyroxine to compensate. Following advice on here I started with .5 grain plus lowered levo, and gradually, over a few months increased the Erfa to 1 grain. I'm now taking 1.5 grains and no levothyroxine.
If you click on my name above it should take you to all of my Posts....the ones that may be of interest to you are from 2 years ago.
I halved my NDT dose when I started daily B12 injections. Not everyone might want to do that, though sublinguals sprays or lozenges are an alternative. Proved the importance of making sure our essential micronutrients are optimal.
IvyBoo might also find a different brand of NDT works better for you. The issue might be Armour’s excipients rather than the active hormone ingredients.
I couldn’t tolerate Thyrogold or the Thai brands. RLCs two formulas were great till they changed them. Now I buy Metavive & occasionally add a bit of T3.
That's quite fast moving to 2.5 grains in 2 months. It took me about a year- year and a half to move to that. Are you going to do bloods? Might be a good idea?
IvyBoo I've been on ndt for 17yrs. I remember my transition across from levo. Whilst you can move straight across yo am equivalent its not often the best way because your response is likely to be different. Therefore it a bit if a guess. I've looked but can't see what dose of levo you were on.
2 1/2grains is:-
38+38+19mcg of = 95mcg T4
9+9+4.4mcg= 22.5mcg. T3.
T3 is alleged to be 3xs strength of T4. Some say 4x.
So 3xs 22.5= equivalent T4 67.5mcg.
Total equivalent of T4 = 95+67.5= 162.5
4xs equivalent of T4= 95+ 90 = 185mcg
However we process different products in very different ways.....and ndt is different to synthetic and very different to levothyroxine only.
So most people don't move straight across but start much lower to see how they feel.
How much Levothyroxine were you taking?.
Lastly your b12 is low.......symptoms of b12 deficiency can overlap eg fatigue. Others are specific such as tingling. You can get hair loss with b12 deficiency. Do look at b12d.org symptom checker. I was very surprised at some of the symptoms as I hadn't linked them. With doung and printing put to show your doctors.
High strength b12 supplementation with a b complex. And getting your GP to check you for Intrinsic factor before doing so. As well as coeliacs. You may have some absorption issues.
Hello again - I should have looked back as it seems I 've written this all out to you before !!
The T4 thyroid hormone replacement you were already taking will take around 6-8 weeks to fully leave your body - and for a smooth transition - as this treatment reduces - week on week - within your body - you slowly build up - week on week - the NDT treatment option.
It reads as though you have gone too fast switching over -
Did you take bench marks readings of your T3 & T4 before switching so we have some numbers to compare to when you next have a blood tests -
and are your core strength vitamins and minerals - ferritin, folate , B12 and vitamin D up and already at optimal levels ?
When I switched I also monitored myself AM & PM on my blood pressure, pulse and body temperature and tracked these throughout and whilst my blood pressure and pulse remained stable my temperature slowly rose from 35.4 to 36.6 where it is today some 7 years later.
So having stopped the T4 - you now week on week increase the NDT by 1/4 grains - taken with water - on an empty stomach and a good hour away from eating or drinking anything other than water:
There comes a week where you feel you have gone too far - and just not ' as good ' as the week before so you drop down the previous weeks dose - stay on this lower dose for 6-8 weeks - letting this dose bed into your body and then take a blood test to see where your T3 and T4 now sit -
If you feel well, keep building up the dose and if, when, you get to 2 grains you stay on this dose for 6-8 weeks and then run a blood test to see where your T3 & T4 now sit -
We track NDT on the T3 reading - and generally see a higher T3 than T4 percentage reading through the range - and that's ok if you feel well - with the TSH likely low, suppressed.
If you T3 is moving, you feel encouraged but still with some symptoms of hypothyroidism - you start building up again, from 2 grains in 1/4 grain weekly increases - until you sense you've gone a bit too far and feeling anxious, edgey, in your body,
so just drop down that last dose and run a blood test at 6-8 weeks later - as blood tests tend to run a couple of weeks behind symptoms being tolerated.
I switched from 125mcg T4 - and only managed to get to 1 + 3/4 grains and started feeling uncomfortable in my skin -
I dropped down to 1 + 1/2 grains - stayed there for around 8 weeks - and my blood tests showed my T3 was 110% with a T4 at 25% through the ranges and the total opposite of my bench mark readings and I felt very well :
Some people suggest increasing 1/4 grains fortnightly -
Some people suggest splitting the NDT dose - AM & PM -
I'm with Graves and post RAI thyroid ablation 2005 and refused both T3 and NDT on the NHS in early 2018 so started self medicating and am much improved as to how the NHS would have me be.
I think the quarter if the grain increase at a time depends really what the thinking is as to where you may end up. I was on 190mcg of levothyroxine......so starting at a quarter was way too low for me. The advice from Dr P was to start with 2grains and increase quarter of a grain weekly till 3 grains and stick. Then increments quarter 6 weekly afterwards. I actually ended up on 4 1/2 grains.
B12 jabs allowed me to drop it to 4grains. GF then allowed me to drop to 3 3/4s. The latter two were over a number of years after my transition across. Which really showed up the absorption problems hence higher dose of Armour that I could then slowly reduce.
Which just goes to show that getting the cofactors in place and optimal is really important.
Totally agree. Exactly if started on a very low dose with no thyroid would become very ill. It's a judgement call. I did mine under guidance of a doctor....and had tried levo with lio before moving to ndt. Armour Thyroid ndt is very expensive. Shocking price. I had mine on the nhs until this year......still battling to get it back....well established 17yrs. . For that reason it's a good idea to try both synthectics before trying ndt. Sadly am intolerant of lio.
My body is used to ndt and have done well on it. So patients in my situation are in a difficult place financially. We are all clearly poor converters so never understood the arguement of too high ratio of T3 to T4 content.
' having lost one's thyroid ' through a medical intervention - and thereby ' lost ' ones natural T3 and T4 thyroid hormone production -
and with the ' ball park ' suggestion being that a fully functioning working thyroid gland would be supporting the body on a daily basis with trace elements of T1. T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg.
I see replacing both these vital hormones as a logical step - if T4 monotherapy does not restore health and well being :
I first tried a T3/T4 combo - and found myself over medicated and frightened - and went back of T4 only for a month orso to recover and rethink my next step -
and since NDT is the original treatment for hypothyroidism and successfully used for over 100 years by many thousands of people - it was my Plan B - which was not at all upsetting and which I knew from a couple of weeks into taking it - that it was going to be the best option for me - I listened to my body - and ended up on just 1+1/2 grains.
I read with NDT the T3 and T4 are attached to thyroglobulin and therefore more slowly broken down and absorbed in the body -
whereas Big Pharma's synthetic T3 and T4 - launched on the back of NDT - are faster acting and read Bi Pharma are now tryng to make a slower release T3 treatment option as this is now deemed as the way forward.
Yes that's true. It does break down more slowly hence being more even. The Professor I'm under argues the difference isn't that big. Not what I read from Diogenes. Whether its great or not the effect for me is eveness.....& that's what counts to me. Lol.... No offense intended by my poor converter label......but one could argue that you can't convert if you have no thyroid because you can't produce either. My thyroid hasn't been removed but it's very dead.... been no production going on there for a long time now. Same boat really.
We both need T4 & T3......and though most professionals don't like to mention it we also get T1 T2 & Calcitonin in ndt.....all of which is absent in synthetics. They used to counter argue that T1 & T2 was of no value.....but as we know nature does things for a reason which science is just beginning to find out!!
I'd love there to be far more focus on treatments that work for the variability that occurs with Hypothyroidism......that the political/professional point scoring of the one trick pony or heaven forbid no trick pony was given up. Sadly I see no end in sight as this professional caterwailing descends into ever decreasing and poor treatment for us patients.
I pray one day soon some bright spark reinvents the wonder of diversity.....because that's what we all are.....diverse.....and need diverse treatments to match.
hi what are your vit d levels? When mine were low dr said he wanted them at 70 plus.Also as someone else said vit b12 is on the low side maybe want that at 400 plus.
NDT is medieval treatment, ok in a pinch but it’s designed for the animal it came from not you. Replacement should be human led and highly individualised to your needs ie to get your blood levels to normal which isnt just somewhere in the lab ranges for fT3 fT4 and TSH; it is a very tight and specific balance between all three that is stable for you and which ameliorates most if not all your symptoms. This is a demand critical issue that has to be led initially by supply of replacement T4 & T3. However the demand (balanced and stable blood levels) can only be precisely met by fine tuning supply of T3 and T4 based on the response seen in your blood levels, NDT could possibly provide the total T3 if you can balance it with the total 4 including levothyroxine, but it is more difficult with a natural product and a synthetic product. In vitro balance is much much easier to achieve using the accuracy and precision possible with synthetic liothyronine and levothyroxine together in split doses over 24 hrs… The human body has a VERY specific demand for T4 and T3 in very particular ratios in very particular circumstances all of which is very challenging to anticipate and model as well as the healthy thyroid system does it. Let’s say your healthy normal balance is found to be TSH between 1&2 free T4 around 15 and free T3 around 4.6 you could potentially get to that balance with say 85mcg T4 and 6-9 mcg T3 which as you can see requires quite a bit of attention to detail in dosing and then monitoring blood levels and symptoms frequently to adjust the dose to give a stable balance. The actual dose, the Supply will depend on your actual blood levels that are a) stable and in a physiological ratio and b) ameliorate most if not all symptoms, the Demand. Having tried achieving this with NDT plus levothyroxine Vs Liothyronine plus Levothyroxine I can say it is much easier and cheaper and more effective and efficient to use liothyronine with levothyroxine not NDT. Anyway, that’s my experience and after 10 years of chaotic treatment finding that stable balance through precise dosing and monitoring blood levels every month (same day same time always) I would only go back to sheep or cow or pig thyroid if it was the end of civilisation as we know it and the only source was the actual animal in the wild! This post will cause uproar from some but it is my tried and tested personal opinion and I am not aware of any clinical or other peer reviewed trial data showing that NDT is ever better than levothyroxine plus liothyronine…. Its all a matter of opinion and personal trial and error! Good Luck
Hm. T4 with T3, despite trialing various dose sizes and schedules, the T3 always made me sweaty, racy and anxious. I’d reduce the dose and turn into a slug. Armour thyroid doesn’t make me feel that at all. I’m not on my correct dose, I’m struggling to find it and have added T4 to try to improve things. But T3 with T4 definitely felt worse.
maybe you needed to find the appropriate balance with minimal dose amounts of T3?…. it takes a long time and can be a bit of a roller coaster because there is a constant trade off going on internally as the proportions of T3 and T4 are adjusted. Both have to be right in relation to each other and we have to go through sub optimal or even adverse ratios to discover the correct ones, its like trying to fit the pieces of a jigsaw at the wrong angle until we find the correct place of each piece. Changing T3 or T4 will change fT3 and fT4 without changing the other i.e. Tiny changes in T3 have an affect on free T3 and fT4 and small changes in T4 (which take weeks to establish their effect) may also change fT3 as much as fT4. This can be confusing! I found that taking T3 at roughly 10% of the amount of T4 per divided dose works best and the doses are best split according to the bodies likely natural circadian rhythm, so for me, around 2am 6am and 2pm or something according to your personal circadian rythyms. This means I never take more than 3.5 mcg of t3 and never without about 1/3 the 24hr dose of T4. The total amount of T3 that endos have prescribed me is always always way too much because they cannot believe the effects of tiny changes that are difficult to dose - I have never met an endo who has the condition or ever felt the effects of the medications and treatments they pontificate about……they do not get that it’s the balance with T4 that enables a minimum non-disruptive dose. The other trick is that it is better to make small changes of T3 within a stable dose period of T4 rather than the other way around; then any adverse changes can be backtracked to a stable point within 24-48 hrs whereas changes to T4 take weeks to back-track . That said fiddling with T3 constantly will disrupt fT4 even if the T4 dose is stable. Consequently, Monitoring fT4 fT3 and TSH monthly is necessary for this fine tuning because otherwise we can get confused by symptoms and yet there is the ratio of fT3 to fT4 that can be like the North Star for navigation through this. All the mass population data indicates that a fT3:fT4 around 0.33 correlates with normal healthy thyroid balance so that seems to me to be the direction to aim for and then adjust from there if it doesn’t ameliorate our most adverse symptoms after a couple of months. If as you say you are not on the correct dose with armour and levothyroxine presumably you dont feel right and wish to improve…..If you didnt ever get your fT3 fT4 ratio to normal yet maybe aim for that and if you can achieve it with your preferred replacement sources all well and good but I only managed it as described above with clean and precisely measurable T3 & T4 that could be divided and dosed as accurately as possible. A final point is that our bodies will have variable needs for T3 according to changes in environment activity status etc. so it may well be physiologically appropriate to adjust T3 in either amount or timing of dose very slightly even after we have established a baseline dose of T4 & T3 that usually yields a stable and symptomless fT3 ft4 ratio
I think its incorrect to call ndt medieval! Its a highly sucessful treatment thats been around for a very long time and for some people IS the best treatment for them. I also think it's simplistic to state its just a question of balance using synthetics. Synthetics does not suit everyone. NDT equally does not suit everyone. The truth is we need diversity. NDT is miles better for me to any comparible synthetic T4/T3 dose or T4 only versions. We are all different and the sooner we allow variety in medicine the better it will be for all.
who said anything about disallowing it ?! But it is literally medieval and that isnt necessarily a pejorative, all kinds of clinically usefully herbs and spices are medieval. However, where are the clinical trials that directly compare the efficacy of getting a near normal healthy fT3 fT4 ratio with NDT vs T3 & T4 treatments and consequently where are the NHS prescriptions for NDT… everyone knows the answer and therefore go the synthetic route wherever possible because at least there’s a chance, the only chance on the NHS, to get the life changing medication without paying for unlicensed and expensive product… If NDT categorically cures someone or is the suited solution for them and they can afford it and get clinical support if necessary than hooray otherwise dont waste your time and money….
One could say the same for anything on that basis.
At the end of the day it is what works. And setbparemeyers such as blood trst results are only one dimension..
I didn't say disallow ndt. You wrote that..It's the nhs that is severely restricting its usage without proper proven scientific evidence to do so....well given one nhs Endo could not produce any single piece of evidence let alone a body of it but said "NDT is dangerous." ......so my apologies if you read that as directed at you. It wasn't. 😊😊
I could never get precise dosing of synthetic T3. Trying to cut those tablets into 8ths was hopeless, no matter the cutting method I tried. And I was up and down on it like a yo-yo.
I know I don't do well without T4. I've tried T3 only twice in the past. I just feel rotten. When I switched from Levo and T3 to NDT over a year ago now I felt calmer, more even for a time. But then my T4 levels dropped too far. I tried adding more NDT but felt even more unwell. So I've been working at bringing T4 back up. I take 2 grains of NDT. If I add in another 1/4 grain without any additional Levo, my T4 will drop again and make me feel unwell. I'm hoping that by adding in the T4 slowly, I can improve with out more T3, or without much more because my T3 level rises as my T4 rises, it just seems to need a kick start as I have Dio2 genetic defect from one parent.
I don't sweat excessively or increase my HR particularly with NDT. I suspect I now need to move up to 50mcg Levo a day every day (currently 3 days a week, the other 4 days being 37.5mcg). But I will probably do that one day at a time as when I tried 50mcg a day earlier in the year it made me uncomfortable.
What I have noticed on NDT during the last 6 months or so is a bit more energy and stamina. But not a lot of motivation to start things. However, this is more than I've had for years and I have done some jobs that are helping me to see progress.
Thank you for this. I’ve seen a private Dr for the NDT who also has a thyroid issue and takes NDT. I was perhaps hoping for too much. Whilst I know my vitamin levels aren’t perfect, they are no worse than when I was on Levo only and I felt significantly worse on the NDT after about 3 weeks in. I seriously thought about going back on Levo only but I’m going to persevere until I get my bloods done and see what the Dr says in early Jan. my gut tells me my T3 will have improved but not sure about T4. I think I’m too low on something, rather than over but I’ll just have to see.
Your experiences with NDT reminds me of mine! Good especially compared to levothyroxine and before I figured out how to dose levothyroxine (never ever all at once) but also bad in that there is either insufficient T4 or excess T3 from NDT. On its own NDT will never give a physiological normal result.
Your comments about dividing T3 (liothyronine) also strike a chord, the idiot endocrinologists prescribed me a 10mcg dose from half a 20mcg tablet, itself tiny!!!! Even halving that was bonkers and 10mcg in one dose drove me bonkers, literally. I raised hell with the GP and the pharmacy and now insist on 5mcg liothyronine and 25 mcg levothyroxine tabs so the levothyroxine only needs one split tab to give 85 a day and is easily split into three doses without any other division (in any case levothyroxine is more dose tolerant of the small inaccuracies when cutting pills in that it evens out day by day). Liothyronine is another matter the smallest variations can be problematic but a 5mcg tablet, while still small, can be relatively consistently divided - I use a jewellers scales that are accurate to milligram levels but also work for practical purposes down to microgram levels given the proportions of actual T3 in a tablet are bulked up with fillers etc..
Incidentally it is possible to accurately divide 20mcg lio tabs and indeed licensed to do so but using crushing and dilution in water - perfectly possible but OMG what a faf! In an ideal world a proper pharmacy would provide each of us with a bespoke prescription of say 3mcg liothyronine with no divisions other than maybe half a tablet every necessary. But we live in a world of mediocre treatment at best _ I even tried making my own capsules with bespoke doses in lots of 100 by crushing 20mcg tablets and using pharmacy techniques to get accurate doses into blank capsules - works ok but its nerve racking in case I get the proportions wrong! All in all 5mcg licensed liothyronine tablets are the way to go.
Accuracy precision and consistency to get normal physiological blood levels is paramount……
I have to buy my T3 so no chance of 5mcg tabs. I take my T4 all in one go in the morning with 1 grain of NDT and the other grain at 5pm. I can't cope with more splitting than that. I need to fit other meds and minerals in around it and I need to feel free to eat and drink when I want to or I get very angry and depressed with it all. All this leaving 2 hours before and 1 hour after nonsense really does a number on me so I have to minimise it.
I have experimented with taking my Levo at bedtime and then the 2 grains spaced through the day but that means I can't have milk for my supper, which I love and I noticed no difference in how I felt.
I never worry about taking levo near food or drink, it all evens out unless you habitually wash every dose of it down with an espresso . Taking total T4 dose all in one go does more harm than good. Split doses are without a doubt nearer to physiological, humans do not produce it in one dollop it’s a continual 24 hr pulsatile secretion, taking too much at once will likely cause negative feedback for T3 conversion plus other feed back and feed forward loop disruption…. split dosing also spreads any possible reduction in absorption so that’s swings and roundabouts. If you havent tried prolonged split T4 dosing how do you know that it doesn’t bring any benefits? It has to be done for at least 3 months with meticulous diary of monthly blood tests and symptoms to find your set point between TSH fT3 fT4. Manual Correction of hypothyroidism is up against the challenge of emulating one of the most critical and biologically complex self regulating systems and so trying to do this cheap and easy is possibly just rinse and repeat, this is not a condition that lends itself to popping one pill a day or taking something that serves animal tissue better than human with a categorically inhuman thyroid metabolite profile. If a super simple replacement regimen and or NDT works and quality of life and overall health is positive/unaffected then great but if not surely its worth finding the optimal regimen even if that is a bit complicated….. I make little sacrifices in other habits to optimise the doses I take but I dont sweat it and thyroid balance is more critical and important than almost anything else. I went from 10 years of continually sub-optimal treatment (and that’s being kind about it) to completely symptom free with perfect and rapidly adjustable blood levels on the regimen I described. And hey guess what perfect blood levels of TSH fT3 & fT4 absolutely correlate with being symptom free - so they are worth aiming for despite what every endo and GP and uncle tom cobblers and all have told me for 10 years….
I took 25mcg of Levo at bedtime for more than 3 months but didn't find any difference to taking it when I wake to my 8am alarm. I might easily ignore the advice to avoid foods (I don't drink much coffee and what I do drink is decaf) but I need to take iron and magnesium too and that's much harder as they require 4 hours either side.
I've never tested monthly. I would not know where to start. I read what you wrote a bit back but it didn't really sink in. How would you do a blood test when we are supposed to leave a gap of 24hs between Levo and blood draw? You seem to never have a 24hr gap. It's hard enough using NDT, just have to ignore it really.
If I didn't have to worry about other meds/minerals and food and drink I could try chopping up my NDT and Levo and take them on a regular spaced out timetable. But I can't see how to do it.
lol . maybe i should start a 'chopping up' service as a sideline ... i can reliably cut Tiromel 25's into sixths (ie 4mcg ~give or take) or even eight's at a push ( 3mcg ish) .... i quite enjoy doing it..... mind you the neighbours probably think i've got a coke habit when they seem me at it through the kitchen window........
I can get the 20mcg Thybonn Henning. I find them easy to quarter but very unreliable to cut into 8ths. They don't so much crumble as scoot around and sever unevenly. I have tried various pill cutters and a craft knife, which is the only possible way to go to 8ths. But still very uneven. Not helped by the optical illusions of the blade and light making it hard to see exactly what I'm doing.
for tablets that refuse to do 8ths , getting 6ths is much easier. i've got an upside down coaster with a cork base , carved out a little notch to hold the flat edge of the 'half' .against ... i've drawn extended lines on the mat ( with a protractor ! .. nerd ) so i can see better where to put my knife blade for cutting each half into 3rds. A decent angle-poise lamp helps a lot., but the main thing is having guidelines that are longer , it's then much easier to see that you've got the angle right first time.
Works great for now , but I'll no doubt have to get a passing child to do it when i get doddery /more blind.
Very well thought out! I have a mini cutting board but the cork would do a good job at holding the tablet steady and I love the protractor use! I do have one. And I know where it is.
But I'm not using T3 at the moment, just the T3 in NDT.
You already have some improvements - digestion, brows lashes and hair, temperature, pulse, weight loss. They're good signs that your body is making use of the NDT. Many of us find that as we get close to the right dose we seem to get worse for a while. My take on that is that as the thyroid hormones are getting replenished, the body starts using them up to get on with overdue repair work throughout your system. Can feel like 1 step forward, 2 steps back for a while. It's not fun! but you're on track. When I started on NDT many years ago I was on 2 - 2.5 grains. Nowadays I take 3 grains in summer but currently 3.25 grains as it's cold / winter. Some people need as much as 4 grains - different products, and personal metabolism affect dosage, so it has to be trial and error.
Maybe a tiny increase now (1/4 grain) then hold steady until you do bloods. Then keep further increases small, and notice every little improvement, so you don’t lose heart.
And as it's been pointed out here, your B12 needs increasing a.s.a.p., and that may help improve energy and mood quite quickly.
Think of this moment as a blip, or a bump in the road, just part of the journey to thyroid health. Good luck.
hi Ivy. I don’t know how you got to 2.5 grains Blood tests I guess. But the best approach with NDT is start low like 60mg or 1grain. And work up slowly (1year)using symptoms . It’s a goldlielocks hormone Not enough you feel like rubbish, too much you feel terrible . Some Symptoms for me, are how is my body temp Do I feel cold in bed or am I too hot and sticking my feet out from under the covers. Others - Anxiety, joint pains, back pain, mood, energy levels, background headache, blood pressure, etc. I’m 6 foot and 90kg and take 60mg to 90mg per day (depending on how I’m feeling and what I’m doing). I still have a thyroid gland. And some people take 4 grains per day too it all just depends on your body, etc. But that gives you some idea of dosages.
James, I am finally beginning to feel better. I am 5 foot 8 and about 82 kilos. I have no thyroid at all and started on 1.5 grains, and I worked up to 2.5 over about 10 weeks. I knew I needed more as my hair was falling out and I remember that from a lack of Levo. However I still have all the symptoms you descrobe. Low mood, anxiety, back ache and joint pains but they are decreasing somewhat. My major issues atm are muscle aches and tiredness. I’ll see what the blood tests say next week and adjust accordingly. I’m not sure if you can mix NDT and T4 but I think my t4 might be too low. I know my T3 is better.
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