Switching from T3 to NDT Question

[ronzo888]

Hi all,

My Endocrinologist wants me to switch from T3 only, which I have been taking for several years due to intolerance to Eltroxin, to Compounded Natural Dessicated Thyroid.

He said to start with 1/4 grain and work up, and to stop the T3 whilst doing so.

I'm just worried as I'm very sensitive to any changes in T4 medication (not so with T3), and want to make the switch as gentle as possible.

If I just totally stop the T3 and start 1/4 grain NDT, I'm worried that may be a shock to the system.

Would there be any benefit to continue taking a small amount of T3 whilst I start the 1/4 grain and decrease it when I up to 1/2 grain?

Has anyone done this transition, and how did it?

Any thoughts appreciated. Thanks!

[Butterfly801]

Why does he want you on off T3?

If you are sensitive to the hormone T4 (not just the brand Eltroxin), you may find NDT problematic too as it is mostly T4. Some people do need to be on T3 only permanently.

Also, the phasing-in of NDT is for people on levo who need to get used to direct T3. If your body is already used to T3, I don’t see the need to start on 1/4 grain. But since I have never taken T3 only, I am not sure how to make the switch while getting the T3 you need without too much T4 for your needs. But I am not sure the body needs to get used to T4 since it is inactive. Hopefully, others here will be able to advise you!

[ronzo888 in reply to Butterfly801]

Thanks a lot. I think the reason he wants me onthe NDT and off T3 is that the bloods are showing very low T4 levels - the thing is I think this is normal when on T3 only as your body is using the active form and getting enough of it, therefore the stored form isn't needed. I think that's how it works anyway! And I suppose with doctors a "low" level on a blood range is something they're uncomfortable with, even if the body is doing ok. So I'm not sure. I kind of agreed to try it for a while and see how I go. But I am worried I'll react the same way I reacted to regular Eltroxin (palpitations, etc. etc.)

[TSH110 in reply to ronzo888]

If you feel ok I’d be very reluctant to start chopping and changing if you’ve had a bad time with synthetic T4 . NDT is mostly T4.

This is an interesting article by Dr Tania Smith, you may find of relevance:

thyroidpatients.ca/2019/08/...

[ronzo888 in reply to TSH110]

:/ Yeah I'm of the same mindframe tbh, but unfortunately my doctor has reduced my T3 prescription and made up the difference with the T4 so I kind of... can't do anything about it, until, if after a month or two of doing badly on the T4 I go back to him and tell him and ask to be put back on T3 only. Real pain in the bum but if I respond VERY badly, I will try to get an appointment ASAP and relay the same to him.

And yeah, I feel ok! Like better than I've ever felt on any preparation of T4.

[FancyPants54 in reply to ronzo888]

As you said you feel well, you should stay as you are. I would not mess with NDT. Who cares if your FT4 is low other than this doctor? Nobody. Ring the office and say you have decided you don't want to change after all and would like your prescription reinstating.

NDT is not the golden ticket for everyone. I've been on it for about 2 years now. I wish I'd not switched. I can't find a reasonable level to help me. My T3 is too low. I've never felt well on any thyroid medication.

There is just 2.5mcg of T3 in a quarter grain of NDT.

[ronzo888 in reply to FancyPants54]

Yeah I think you're probably right. There's just one complicating factor - I have been trying to get disability as I have had some kind of chronic fatigue not related to the thyroid (possible Long-Covid) and the doctors won't help me with it as they just see the low T4 on bloods and say "See! There's your problem", even though I don't do well on T4, my T3 is fine, my TSH is fine and I feel better than I do by a lot than on T4.

SO my plan is, to my own detriment, to take the T4 for a few weeks if I can manage it, and if it doesn't agree with me it might be enough to put that idea out of the doctors' heads.

[TSH110 in reply to ronzo888]

So much for a partnership with your health care provider to attain good health, it’s a sham nothing more than an Endo dictatorship. Their brass neck knows no bounds with the cheek to happily make you ill for months despite a history of problems T4. When will these dummies wake up and listen? How much evidence do they need? They are not interested in evidence only torture.

[AKatieD]

I don't know how much you are currently taking and what your blood tests are like, but 1/4 grain is a small amount. Unless you are close to over replaced on T3 and you said T4 is low, I would consider adding the 1/4 before dropping the T3 and see what that does first. Then decide what to do next.

[ronzo888 in reply to AKatieD]

Thank you - So much T4 is very low - almost undetectable, my T3 is normal in range, and TSH low but apparently that's normal when well medicated.

I actually decided to do exactly what you recommend - instead of totally stopping the T3, and starting from 1/4 grain of NDT and gradually increasing, which is what my endo recommended (and seems like a bad idea?) I started on the 1/4 grain yesterday but only decreased my T3 slightly.

I was slightly over-replaced on T3, but had already reduced it a bit previously and T3 is perfectly normal atm.