I have been on Nature Throid for 3 months now, I take 1 1/2 grains a day which is equal to 150mcg's of Levo. My lab work is way off, TSH is 51, FT4 is 0.61, FT3 is 1.7 I am starting to feel tired and confused. I was taking 150-200mcg's of Levo before and my labs were fine. My doctor says most patients take 1 1/2 grains and do fine and a few need 2 grains.
I know I have to up my dose but I am not sure where to go with this. Any idea why NT isn't doing as well as the Levo at the same dose?
Yet another doctor that really doesn't understand. The conversion factor for desiccated type of meds from T4 types varies from one source to another. One says that one grain of NDT is equivalent to 100 mcg of T4. Others say that one grain is equiv. to only 75 mcg. It all depends on the assumption of the equivalent effect of T3. Some assume it is 4 to one. Others assume it is closer to 7 to one. For the first assumption, your dosage would of 150 - 200 would be 1 1/2 to 2 grains. For the latter case, your 150 - 200 mcg would be 2 - 2 2/3 grains.
Your doctor is wrong to say that few need two grains. I think that is clear from your recent lab tests. Your FT4 is too low in the range and your Free T3 is way too low. No wonder you have symptoms. I currently take 3 grains daily, and I am not the only Forum member to do so, by a long shot. Dosage is irrelevant. Clinical response is all important.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation. The letter is then sent to the participating doctor of the patient to help guide treatment. In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."
To clarify, I reversed the info if the first paragraph. It should say that, " Some assume it is 7 to one. Others assume it is 4 to one. For the first assumption, your dosage would of 150 - 200 would be 1 1/2 to 2 grains. For the latter case, your 150 - 200 mcg would be 2 - 2 2/3 grains."
Again, synthetics like your Levo is made in mcg, dessicated like your NT is made in mg sizes. Not the same. And remember 1 grain = 60mg.
The best way to increase / adjust natural thyroid is 15mg every two weeks - that is on the Armour website PDF. If the T3 in it does not make you edgy when increasing, then you could increase in less time.
One grain of 60mg can be split with a pill splitter in to quarters to get approximately 15mg. Its trial and error until you get close to feeling well.
All mass manufactured natural dessicated thyroid meds come in grains, one grain being 60mg. However one grain of a certain brand might be a little stronger or weaker than one grain of another brand, the difference being the fillers used that effect absorbing. So if you ever switch brands, its best to start a little on the low side as opposed to going hyper.
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