NDT

[abyz321]

Dear all,

what is the best NDT brand? can those of you taking it share your experience? is it possible for all of NDT brands to be taken sublingual or to be chewed ? what does that add ?

Thanks in advance to all of you,

[gimel]

In trying to assess your thyroid status, an evaluation for symptoms that are frequently related to hypothyroidism is the most important indicator, even before blood test results.   The purpose of treatment with thyroid medication is to relieve  hypo symptoms.  So please tell us about all symptoms you have.  

Also, hypothyroidism is not just inadequate thyroid hormone, but instead it is "insufficient T3 effect in tissue throughout the body due to inadequate supply of, or response to, thyroid hormone."   So it is important to also test for Vitamin D, B12 and ferritin.  D should be at least 50 ng/ml, B12 in the upper part of its range, and ferritin should be at least 100.   If all these tests are optimal, then it is a good idea to also test for cortisol and Reverse T3 since they are antagonists of thyroid hormone.  Have you had any of these 5 tests?  

Also, your TSH make me suspect that your dosage and blood levels of FT4 and FT3 are not adequate since most people taking thyroid med adequate to relieve symptoms have suppressed TSH levels.   Note that there was a recent, very important study that quantified for the first time the effect of FT3 on hypothyroid symptoms.  The authors concluded that,  "Hypothyroid symptom relief was associated with both a T4 dose giving TSH-suppression below the lower reference limit and FT3 elevated further into the upper half of its reference range."    Would it be possible for you to get a copy of the lab report for the test results you mentioned, so that we can know the actual results and reference ranges shown on the report?

You might be interested to know that the average thyroid gland is reported to produces 94-110 mcg of T4 and 10-22 mcg of T3 daily.  Those amounts are more than your daily replacement amount.  Also, thyroid med is not absorbed 100%, so the med dosages need to be higher to account for absorption.     Of course everyone can be different in their need for thyroid, but this is an interesting comparison.  

[gimel]

I have used both Armour Thyroid and Naturethroid.  They both contain the same amount of T4 and T3 per grain.   I did not notice any difference between them.   You seem focused only on the med itself, but as I mentioned if you still had hypo symptoms, it would most likely be due to inadequate levels of Free T4 and Free T3, cue to insufficient dosage.     Other possible causes would be excessive cortisol or Reverse T3, or  low Vitamin D, B12 or ferritin.    I am not sure why you seem reluctant to talk about your dosage and FT4/FT3 levels and other important variables, but if you decide to do so, there are members with considerable knowledge and experience that will be happy to help with that.  

[abyz321]

I was on 100mcg synthroid + 10 mcg Cytomel, better than T4 only but not too much better.
My levels are TSH 1.14, and FT3 and FT4 mid range (don't have the exact numbers).

Tried other brand names of T4 also the improvement is not what one expect to.

[gimel]

Not sure what you mean by "optimal levels", but if you still had symptoms that caused you to switch to NDT, then I question whether your levels were truly optimal, especially if your TSH was still within range.  Most hypo patients find that when they are taking  only T4 med their body does not convert to T3 adequately and they continue to have hypo symptoms due to suboptimal T3 effect in tissues throughout the body.    Many of us have found that  we required Free T4 around the middle of its range, and Free T3 in the upper half of its range, and adjusted from there as needed to relieve symptoms.     In order to achieve these levels we required both T4 and T3 med.    NDT is a good choice for that.    The new Armour formulation does not work sublingually, it has to be either chewed, or just swallowed.   So it is not absorbed as well as previously.  That does not make it "not as good".   You just have to take a bit more to get the same effect.  

If you want our suggestions, we need to know what your current thyroid related test results and reference ranges are.   Also need to know what symptoms you have currently.    And what is your daily dose of NDT?

If you want to confirm anything I tell you, please click on my name and then scroll down to my Journal and read at least the one page Overview of a paper on Diagnosis and Treatment of Hypothyroidism: A Patient's Perspective.  

[abyz321]

Can anyone of you on it share your experience with this med ?!

Thanks

[gimel]

Inadequate effect may not necessarily have been from the type of medication, but the dosage.  Please post your thyroid related test results  and reference ranges shown on the lab report from when taking Synthroid and T3.  Also, what were the dosages for each?  And what symptoms were you having at that time?

What is your current med and daily dosage?  Please post your current thyroid related test results and reference ranges.   Also please tell us about any symptoms you currently have.

Also, if tested for  Vitamin D, B12 and ferritin please post those results as well.

[abyz321]

Lots of questions, I don't have all of the record, but I had optimal levels of T3/4 and TSH while on Synthroid alone and when my doctor added T3.

Is NDT a good choice? I read it is old and was used before T3/4!
Are there here people who feel optimal on it ??? I read that since the reformulation of the armour it is not as good as old formula ?!

Thanks

[flyingfool]

Chewing helps absorption. But most NDT I think tastes pretty bad.  So only a few people are willing to chew them.  With bad taste, waiting for them to dissolve might be unpalatable.

NDT or any drug with significant amount of T3 in it most often should be split and half taken in the morning and half taken in the afternoon.  As T3 is used up mostly within about 8 hours, peaking in the blood about 4 hours after taking it.  So by splitting the dose, you don't run out of the T3 in the afternoon and energy "crashing".  Taking half in morning and it will start winding down about the time you take the 2nd half around say 1-3PM, and then the 2nd dose is ramping up in the blood stream while the 1st half is winding down.

As Barb135 said.  Not sure there is much difference.  Some people tolerate the different fillers and binders better than others.  Some place to start is which one your health insurance will cover.  And see how it goes.

Is this your first prescription for thyroid?  If not, what have you tried before, at what doses?

[abyz321]

Hi,
Thanks for you response , I tried Synthroid and synthroid with T3 but I still suffer from symptoms!

[Barb135]

Hello... I don't think there, specifically, is a "best" brand.  As with the various synthetic thyroid hormones, each person may do best with  a different brand, since each has different fillers/binders, etc.  

I'm not on a desiccated hormone, so I'm not sure if they can all be chewed or taken sublingually or not.  Some of our members have discussed chewing the tablets, however, most simply swallow them.