Thread: My start on NDT

  1. #1

    My start on NDT

    Figured I'd start a new thread involving my journey to fix my thyroid issues to help others cause I know I'll be asking questions, so others can read and learn too. I left off with thyroid discussions on the last few post here to get up to speed here (other members had good info, worth reading) -> https://www.excelmale.com/showthread...r-on-TRT/page3

    I started taking NDT (30mg pills) June 1 from Defy. I take 1 pill in the morning. Within a couple days I became very tired by the early afternoon. I don't think it was in my head cause I figured it was going to do the opposite. So a little after a week, June 11 I spoke to Defy and was given the ok to raise it to 2 pills a day. Which I take 1 in the morning and the 2nd one around 2pm. After doing that within 2 days the sleepiness started to go away. After a weeks time I felt I had energy all day, nothing crazy but good enough to finally be able to stay up till 10-11pm without a problem if I wanted to, which is what I wanted. Was still able to fall asleep when I wanted to lay down and fall asleep though, which I also wanted. I remember reading you should wait 2 weeks before doing a small raise but as I said I was really tired. I was also monitoring my blood pressure, body temp and heart rate to keep a eye out for elevated numbers and I had none at all. So I figured it was a safe bet I could raise it.

    I had no anxiety during this time which I was worried about getting since I knew my iron was low and I never had a cortisol saliva test done. Two things I learned here that need to be good for your thyroid meds to work right. Now since May 7th I started to take 2 forms of a iron supplements with Vitamin C till my levels become good again. I also take 200mcg of Selenium with the iron pills and C at night on a empty stomach before bed. So I'm hoping my numbers came up some before I started the thyroid meds.

    Pros so far:
    I can stay awake all day into the evening. Before I'd want to sleep by 8-9pm.

    My abs are starting to show now. Wasn't overweight but definitely had a layer of fat. Haven't changed my exercise routine. I did start a reduction in diary and almost completely eliminated my milk consumption ( I used to drink a lot every day). So it could be that, probably more likely the reason. I'm doing it to see if it reduces my thyroid antibodies. Read how people have eliminated their hashimoto by diet changes.

    Cons so far:
    I started to experience anxiety again which really disappointed me. If others remember in other threads I've mentioned how glad I was to be on TRT since it also helped eliminate a lot of my anxiety issues. So to have it come back was a kick in my balls. I'd say it started three weeks (around June 25th) after starting to take the second pill. I've read t4 takes longer to build up so maybe I didn't get the full effect of taking only 1 pill a day or maybe I was finally getting the full effects of taking those two pills now. I will say I feel the anxiety is finally starting to go down a little this week. Or maybe I'm just getting better at handling it. I'm hoping maybe its just a case of needing a little more or maybe less thyroid meds. But I don't want to adjust the meds farther till I had labs done.

    July 2nd in the morning before taking my morning Test shot and fasting I went to get my labs done. I only took my NDT pill before giving blood. I also stopped taking my iron supplements 3 days ago, to get accurate iron lab numbers.

    I also added a couple extra labs

    1)SHBG to see if it has risen since starting NDT (raising my T3).
    2)Prolactin since I never got it tested
    3)Selenium since I want to know if I'm taking to much or too little (never tested it before starting Selenium)
    4)My thyroid Antibodies to see if they came down. Want to see if my reduction in dairy and taking selenium now is helping.
    5)My RBC, Hemoglobin and Hematocrit to see if I'm digging myself into a hole trying to raise my iron numbers by taking iron supplements.
    6)My TT and FT since if my SHBG did change I'd like to see the effect it had on those.
    7)Estradiol Sensitive to make sure I'm still in a good range

    I'll include my last labs so its easier to reference when I upload my new labs as soon as I get them. Hopefully next week, so I can load them here to learn more and to make my Defy follow up appointment.
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  3. #2
    Moderator Vince's Avatar
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    It sounds like it can be a struggle to get good thyroid levels. I know in my case it is. I'm taking a different approach then you with my thyroid meds.

    can cytomel by itself be used to treat hypothyroidism

    https://www.excelmale.com/showthread...hypothyroidism
    I am not a medical practitioner. Any suggestions I provide are not medical recommendations and are just my opinions. Please consult with your physician on any matters concerning your health.

  4. #3
    Quote Originally Posted by Vince View Post
    It sounds like it can be a struggle to get good thyroid levels. I know in my case it is. I'm taking a different approach then you with my thyroid meds.

    can cytomel by itself be used to treat hypothyroidism

    https://www.excelmale.com/showthread...hypothyroidism
    I've been following that thread since you started it. Hope you find what works for you Vince.

    I'm thinking my problem is I need to raise my dose again. I've read from the two other thyroid sites that are referenced here a lot that staying on a low dose to long can cause problems. In my case if I did stay on that 1/2 grain only for longer I probably would have given up. Me raising it definitely helped but again by the end of the second week taking 1 grain a day, improvements stopped and staying on that current protocol I feel I may have gone backwards a little after a little time, hence the anxiety showing up.

    Was honestly worried about raising it more (past 1 grain a day) due to not knowing how my iron levels were doing supplementing with iron and never testing my cortisol. Didn't want to have to deal with a pooling or going hyper problem. I'm hoping when I get my labs it shows I'm going in the right direction with everything and things are working like they should and I just need to raise that dose some more till I'm at a optimum level. On 1 grain a day I'm still not seeing elevated blood pressure, body temp or heart rate numbers. My temp is actually still on the low side by midday by mouth (82.0-82.4). Which I'm thinking is another sign I need to raise it. Hopefully I get labs soon so I can move forward.

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    Do you take any iodine?

  6. #5
    Moderator Vince's Avatar
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    Quote Originally Posted by Coopsdaddy View Post
    Do you take any iodine?
    I supplement with 325 mcg daily.
    I am not a medical practitioner. Any suggestions I provide are not medical recommendations and are just my opinions. Please consult with your physician on any matters concerning your health.

  7. #6
    Got my labs back

    Looking for opinions from the experts with a few questions.

    My reverse T3 went from 9.1 to 9.8 range (9.0-27) . Read healthy levels seem to always be in the bottom 2-3 numbers, So am I in the clear?

    In regards to my Iron, My ferritin went from being considered low of 26 to 85 range (30-400) . I'm glad about that but notice all my other iron numbers dropped. Did ferritin pull them or something? I'm assuming I should continue taking my iron supplements? Should I raise it or take more often? Right now I take before bed on empty stomach->

    1 Ferrett's iron supplement pill (106mg elemental from 325mg ferrous furnarate)
    1 vitron-c plus vitamin c pill (65mg elemental as carbonyl iron)
    1 vitamin c pill (1000mg)

    I original didn't want to take too much not knowing if I would get too much of a build up. I'm assuming seeing these results you guys can determine if I can safely raise it now or even if I should?

    My last big concern is the thyroid numbers...
    TSH dropped from 2.400 to 1.140 range (0.270-4.200) So my body isn't screaming as much for more, I guess lol? Which is good?

    My FT3 went up from 2.3 to 4.20 range (2.00-4.40) while my FT4 went up only a little 0.69 to 0.83 range (0.93-1.70) .

    Is this pooling since my FT3 is in the upper level while my FT4 is still low??? Read ( Having "pooling" aka a high Free T3 due to adrenal or iron problems. i.e. the high free T3 doesn’t cause rising RT3, but both can eventually happen in tandem for many ).


    This thyroid stuff is really complex, no where near as easy to understand as TRT. So what should I do guys and need to work on? I was thinking I needed to raise my NDT dose to 1 grain in the morning and take the half grain in the afternoon but seeing these labs now I'm not sure cause I don't fully understand the pooling thing and if I have it. But don't want to do something to raise it again. I also heard as I'm mentioned in a earlier post staying on too little NDT too long can cause problems too which I'm not sure if that's the problem here? I do feel better though and the anxiety has gone down again.



    One thing I think that helped with the anxiety is I lowered my AI dose recently. I never had symptoms of high E2 but took it to have a "good" number. I spoke to Defy last time about trying to take a little more or a little less to see the effects even though my sensitive E showed I was in range at 30.2 range (10.0-42.0). So week starting May 21st I took a extra pill and did a two week trial (Mon, Wed, Fri I took one .25mg AI pill). Felt no better with it raised. So went back to my regular protocol I've been on for a while of .25mg AI pill Mon and Thur for the month of June to fully reset back to that 30.2 range.

    These last two weeks since I have already been having anxiety I tried taking only one .25mg AI pill a week on Thursday. This was done after these labs I'm posting in this post. I felt better after a few days and notice my libido is better also. Thinking about discussing with Defy on my thyroid follow up call about giving me .125mg AI pills instead of the .25mg ones to take two times a week, which is what I've been doing these last two weeks but with only one pill a week. Figured spreading the dose would be better. Curious to see how I will continue to feel and was planning on getting my E2 tested to see the number. If it seems to not be enough I'm thinking I'll take the .125 AI pill one extra time a week, say Mon, Wed and Fri.

    I'm also wondering if I should lower my test shot of 50mg 3x's a week. I notice my Hematocrit went up a half point to 50.5 range (39-52) now. Could be from iron supplementing? I just know I don't feel like chasing my tail having to donate blood and dropping my iron levels which I'm now trying to raise cause I understand how important they are especially for someone on NDT. If i do lower it having those .125mg pill will probably be handy to have, so they wont be wasted. Thinking about 120mg total of Test a week instead of my current 150mg a week. What do you guys think?


    Got prolactin done for the first time also. Was 11.3 range (2.0-21.0) Didn't get a chance to look into that yet.

    BTW: I started taking the selenium pill (200mcg) in the morning with my first thyroid pill instead of taking it at night with my iron pills.

    Thanks for any info and sorry if this long post put you to sleep.
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  8. #7
    Looks like you have hachimotos. I see in your fist set of labs cortisol doesn't look good considering it's the morning cortisol. Have you considered 4 x saliva labs to verify your cortisol situation?

    Your iron still needs to rise some. Ferritin could go up some too. I'd suggest you keep it the same dosage for now and and get labs for it again in another 6 weeks if you can.

    Selenium will help bring down your antibodies.

    You are very low on T4 so I think you need to be taking some synthroid to increase that. It should be in the top 2/3rds of range.

    Once you take synthroid it'll probably increase your FT3 thru conversion and that'll mean you'll likely need to reduce your NDT dose.

  9. #8
    Quote Originally Posted by ratbag View Post
    Looks like you have hachimotos. I see in your fist set of labs cortisol doesn't look good considering it's the morning cortisol. Have you considered 4 x saliva labs to verify your cortisol situation?

    Yeah I was informed of that in the other post. That was my reasoning for trying to remove/lesson milk from my diet. Read people have cured their Hashi with diet, but I'm assuming you have to go all in then (gluten free no dairy ect) to see the improvement which I didn't. Those cortisol labs were done with blood and a few months before starting NDT. If it was easy to do the saliva test I would have. Unfortunately I live in ny long island and I'm surrounded by states that also won't send the test to there our my house. So I have to look into it more to see if the clinic I get my bloods done will do it or look into having it sent to someone in a friendly state then sent to me. Basically I need to look into doing it more and if I can even afford it. I agree the added information would help determine my problem.

    Your iron still needs to rise some. Ferritin could go up some too. I'd suggest you keep it the same dosage for now and and get labs for it again in another 6 weeks if you can.

    I agree


    Selenium will help bring down your antibodies.

    I was hoping to see my selenium level but the test didn't go threw. So I'm thinking to play it safe and not raise the dose without knowing my level?

    You are very low on T4 so I think you need to be taking some synthroid to increase that. It should be in the top 2/3rds of range.

    Once you take synthroid it'll probably increase your FT3 thru conversion and that'll mean you'll likely need to reduce your NDT dose.

    This is were I'm very confused what needs to be done. Did some re-reading last night to refresh my memory and I see things like this...

    Read this over at STTM:

    Notes: T4 is the thyroid storage hormone. Free in front of the T4 means you are measuring what is available and unbound. If you have low FT4 and a mid-range or slightly higher FT3, it usually means the T4 is converting like mad to give you the T3 you do have, which means remaining hypo. Or it can mean pooling. If pooling I read "some will see pooling first without having an excess of RT3. Later, if they continue to raise NDT, the RT3 dominance can occur".

    Is there a chance my problem is I've been on too low of a dose too long so my body is converting T4 like mad to give me the T3 I need? Or is this a pooling problem or iron (which the labs show I'm still low) or cortisol?

    and this...
    Can I raise my iron levels without being on iron?
    Possibly…if you aren’t severely anemic, and are just not totally optimal! One thyroid patient reports that just by getting on NDT and finding her optimal amount, she saw her iron levels go to an optimal level. Others focused on consuming high iron foods. You can see where optimal iron results should be, here.

    and this...
    Iron and cortisol–did you know these two are CRUCIAL to be “optimal”, not just “in range”, to do well on, or not overreact to, natural desiccated thyroid or T3??
    Or did you know that if you stay on a too low dose of NDT or T3, these two sidekicks can mess up?

    but then I read this...
    Symptoms that your cortisol is low while raising NDT or T3? Anxiety, shakiness, feeling wired, feeling worse, on and on. It’s individual to each person. But it’s STILL important to do saliva testing to see exactly what is going on when and how to treat it!

    I do feel I have all day energy now so I find unlikely I have a cortisol problem. Again I know getting tested with confirm for sure.


    Ferritin I just read on STTM...
    If your ferritin is low along with inadequate/lower levels of iron and % saturation, that usually points to simply low iron, which is common with those on T4-only meds, or undiagnosed, or under-treated. But we do NOT treat that low ferritin. We treat the inadequate iron and % saturation, and over time, the ferritin moves up by itself if it’s too low.

    So I"m assuming its safe to say I need to work on my iron and I should try to get the 24hr saliva test done if I can. To confirm if that's part of my problem? Should I leave my dose where it is though for now or am I on too low of a dose? Or am I pooling? This is were I'm really confused.




    Thank you for sharing your input!

  10. #9
    I think you are pooling some. I disagree on not treating low ferritin. What STTM doesn't know is that TRT can lower just ferritin. This is not your situation as you are low in iron serum too. And your RT3 is at the high end. I would not take anymore NDT until you get your Iron sorted out. If you have no signs of low cortisol then leave that and concentrate on iron. Iron will take time and then you do labs again and see how your iron/ferritin is and check your antibodies again. Dr. Crisler suggests taking 400mcg selenium daily if you have an antibodies problem. Also google taking baking soda. There is a new study claiming that drinking baking soda daily fixes autoimmune problems and that's what Hachi's is. Be patient. This will take some time.

  11. #10
    Quote Originally Posted by ratbag View Post
    I think you are pooling some. I disagree on not treating low ferritin. What STTM doesn't know is that TRT can lower just ferritin. This is not your situation as you are low in iron serum too. And your RT3 is at the high end. I would not take anymore NDT until you get your Iron sorted out. If you have no signs of low cortisol then leave that and concentrate on iron. Iron will take time and then you do labs again and see how your iron/ferritin is and check your antibodies again. Dr. Crisler suggests taking 400mcg selenium daily if you have an antibodies problem. Also google taking baking soda. There is a new study claiming that drinking baking soda daily fixes autoimmune problems and that's what Hachi's is. Be patient. This will take some time.
    How is my RT3 on the high end? My reverse T3 went from 9.1 to 9.8 range (9.0-27) . Read healthy levels seem to always be in the bottom 2-3 numbers?

    I feel to be on the safe side too, to continue at the same doses for iron supplementing.

    I decided to try the extra selenium pill, so I will be doing what you said Dr. Crisler suggest. One 200mcg with my morning thyroid pill and one with the afternoon one.

    I just made my follow up scheduled for the 25th. I will be staying on my Defy subscribed dose (1/2 grain twice a day) for now and see what he says. I'm still not 100% sure if I need more or not. I hear what your saying but I still don't fully understand all this. Was hoping to hear from Chris V. on what he thinks.

    Only reason I don't think I'm pooling is I "thought" my RT3 wasn't high and I'm low on FT4 but I'm close to perfect on FT3. "If you have low FT4 and a mid-range or slightly higher FT3, it usually means the T4 is converting like mad to give you the T3 you do have, which means remaining hypo."

  12. #11
    Sorry must of had my head in to another thread. So yeah low RT3 and low FT4... FT4 is something you should supp to get right. This really needs to be in top third of the range. I just went thru this last year. My FT4 was 50% of range and I had different hypo symptoms. So I knew from tiredthyroid.com and other studies that I needed to increase my dose of synthroid. So I got it to the top third of range and most of my hypothyroid symptoms disappeared. Your thyroid is definitely off with your FT4 being so low.

  13. #12
    Super Moderator Vettester Chris's Avatar
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    Wrench, One (1) grain split up twice per day isn't going to be anywhere close to effective with challenging your TPO enzyme autoimmune disorder being over the top. In fact, it more than likely will just aggravate it and fuel more autoimmune attacks.

    With elevated TPO, and One (1) grain of NDT, the T4 reserve tank is still empty. In your particular situation, I'd advise not to be fooled by the low RT3. Keep in mind, the TPO has declared war on your thyroid gland, and your FT4 values "were" and "still are" BELOW the reference range!

    The low yield of RT3 is going to be reflected by the lack of T4, meaning there just isn't enough T4 to convert at higher levels of RT3. Your FT4 went up just slightly, but your RT3 also followed suit and went up proportionately. When we talk about pooling, FT3 isn't reaching the cells for one reason or another (?), and the body shifts demand for T4 to convert at higher rates of RT3. Again, having sub-reference levels of T4 just won't convert all that much RT3.

    You've probably seen some guys on T3 cytomel only protocols, talking about how they do this to "flush out" their high RT3. What they're actually doing is inhibiting their T4 production, which in turn begins to lower RT3. Elevated FT3 will signal TSH to drop (look at yours for proof), and a reduction of TRH -> TSH will regulate further T4 production, or lack there-of.

    I think your iron & ferritin still need to come up a bit before this is really going to work. I find it concerning that one (1) grain of NDT increased your FT3 from 12.5% of Reference range up to 91.6% of reference range, but FT4 doesn't even show up on the reference range! I've seen guys on 3 grains that only get to 70% and 75% on the FT3 reference range, and FT4 mid 60's to 70% ref range, considering the actual T4 to T3 ratios of NDT are different than that of human thyroid levels; which is why many will implement some for of Levo T4-only to get the ratio closer to that of a normal, natural level for T4 & T3 ratios.

    If /when the variables are in place for FT3 to reach the cells, I would suggest getting a protocol put together that will be an adequate dosage to mitigate the autoimmune attacks. Also, with Anti TPO I would suggest at least 400mcg of selenium, and I would ramp up more vitamin C, at least 2,000mg. There are some other areas with nutrients as well, but for now give this some thought and do some research.
    Last edited by Vettester Chris; 07-15-2018 at 01:45 PM.
    Please, no PM's posting lab results ... Let's Keep them on the Open Forum for Everyone to Comment. Feel free to PM me a link to your thread if you would like me to comment. Thanks!!


    I am not a Doctor, I only play one on T.V. Please consult your physician, or a trained-licensed physician before proceeding with any comments or suggestions posted on this or any forum.


  14. #13
    Quote Originally Posted by Vettester Chris View Post
    Wrench, 1 grain split up twice per day isn't going to be anywhere close effective with your TPO enzyme autoimmune disorder being over the top. In fact, it more than likely will just aggravate it and fuel more autoimmune attacks.

    With elevated TPO, and 1 grain of NDT, the T4 reserve tank is still empty. In your particular situation, I'd advise not to be fooled by the low RT3. Keep in mind, the TPO has declared war on your thyroid gland, and your FT4 values "were" and "still are" BELOW the reference range!

    The low yield of RT3 is going to be reflected by the lack of T4, meaning there just isn't enough T4 to convert higher levels of RT3. Your FT4 went up just slightly, but your RT3 also followed suit and went up proportionately. When we talk about pooling, FT3 isn't reaching the cells for one reason or another (?), and the body shifts demand for T4 to convert at higher rates of RT3. Again, having sub-reference levels of T4 just won't convert all that much RT3.

    You've probably seen some guys on T3 cytomel only protocols, talking about how they do this to "flush out" their high RT3. What they're actually doing is inhibiting their T4 production, which in turn begins to lower RT3. Elevated FT3 will signal TSH to drop (look at yours for proof), and a reduction of TRH -> TSH will regulate further T4 production.

    I think your iron & ferritin still need to come up a bit before this is really going to work. I find it concerning that one (1) grain of NDT increased your FT3 from 12.5% of Reference range up to 91.6% of reference range, but FT4 doesn't even show up on the reference range! I've seen guys on 3 grains that only get to 70 and 75% on the FT3 reference range, and FT4 mid 60's to 70% ref range, considering the actual T4 to T3 ratios of NDT are different that human thyroid levels; which is why several will implement some Levo T4 to get the ratio closer to that of a normal level for T4 & T3 ratios.

    If /when the variables are in place for FT3 to reach the cells, I would suggest getting a protocol put together that will be an adequate dosage to mitigate the autoimmune attacks. Also, with Anti TPO I would suggest at least 400mcg of selenium, and I would ramp up more vitamin C, at least 2,000mg. There are some other areas with nutrients as well, but for now give this some thought and do some research.
    I think this may describe my own situation as well, very helpful, thanks.

  15. #14
    Super Moderator Vettester Chris's Avatar
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    Quote Originally Posted by Blackhawk View Post
    I think this may describe my own situation as well, very helpful, thanks.
    Yeah, the high activity of anti-TPO is a real game changer on how to view and treat the condition. Then there's the other factors that everyone is faced with, like iron & ferritin, low cortisol, electrolyte & iodine deficiencies, etc, that also have to be considered .. LOL, the party never ends at Camp Thyroid!
    Please, no PM's posting lab results ... Let's Keep them on the Open Forum for Everyone to Comment. Feel free to PM me a link to your thread if you would like me to comment. Thanks!!


    I am not a Doctor, I only play one on T.V. Please consult your physician, or a trained-licensed physician before proceeding with any comments or suggestions posted on this or any forum.


  16. #15
    Quote Originally Posted by Vettester Chris View Post
    Yeah, the high activity of anti-TPO is a real game changer on how to view and treat the condition. Then there's the other factors that everyone is faced with, like iron & ferritin, low cortisol, electrolyte & iodine deficiencies, etc, that also have to be considered .. LOL, the party never ends at Camp Thyroid!
    Well, my TPO is fine, but TG antibody not. I remain a bit confused over the difference in terms of function and treatment. (Note, don't want to derail WrenchHead's thread)

  17. #16
    Quote Originally Posted by Vettester Chris View Post
    Wrench, One (1) grain split up twice per day isn't going to be anywhere close to effective with challenging your TPO enzyme autoimmune disorder being over the top. In fact, it more than likely will just aggravate it and fuel more autoimmune attacks.

    With elevated TPO, and One (1) grain of NDT, the T4 reserve tank is still empty. In your particular situation, I'd advise not to be fooled by the low RT3. Keep in mind, the TPO has declared war on your thyroid gland, and your FT4 values "were" and "still are" BELOW the reference range!

    The low yield of RT3 is going to be reflected by the lack of T4, meaning there just isn't enough T4 to convert at higher levels of RT3. Your FT4 went up just slightly, but your RT3 also followed suit and went up proportionately. When we talk about pooling, FT3 isn't reaching the cells for one reason or another (?), and the body shifts demand for T4 to convert at higher rates of RT3. Again, having sub-reference levels of T4 just won't convert all that much RT3.

    You've probably seen some guys on T3 cytomel only protocols, talking about how they do this to "flush out" their high RT3. What they're actually doing is inhibiting their T4 production, which in turn begins to lower RT3. Elevated FT3 will signal TSH to drop (look at yours for proof), and a reduction of TRH -> TSH will regulate further T4 production, or lack there-of.

    I think your iron & ferritin still need to come up a bit before this is really going to work. I find it concerning that one (1) grain of NDT increased your FT3 from 12.5% of Reference range up to 91.6% of reference range, but FT4 doesn't even show up on the reference range! I've seen guys on 3 grains that only get to 70% and 75% on the FT3 reference range, and FT4 mid 60's to 70% ref range, considering the actual T4 to T3 ratios of NDT are different than that of human thyroid levels; which is why many will implement some for of Levo T4-only to get the ratio closer to that of a normal, natural level for T4 & T3 ratios.

    If /when the variables are in place for FT3 to reach the cells, I would suggest getting a protocol put together that will be an adequate dosage to mitigate the autoimmune attacks. Also, with Anti TPO I would suggest at least 400mcg of selenium, and I would ramp up more vitamin C, at least 2,000mg. There are some other areas with nutrients as well, but for now give this some thought and do some research.
    Thank you Chris for taking the time to write all this. Much appreciated. I did raise the selenium to 2x's a day (400mcg a day now). I will also raise the vitamin C to 2,000mg as you suggested. The iron supplements I will continue to take at current dose to see effects on next blood work. I understand my levels still being low aren't helping me here.

    To make sure I understand what your saying. For some reason my FT3 shot up fast and now my body is starting to say because of my FT3 getting up there, slow down with production (lower TSH now) , which will unfortunately slow down my T4 production too and keep it low? Hence why I need T4 added?

    Its NOT FT4 being used up faster because of demand to make FT3, from me staying on too low of a dose too long? Cause I felt better by the end of the first week starting till I felt I started to go backwards then raised it and felt even better but another week later started to feel like I was going backwards again but stayed on that dose for the last 3 weeks leading up to this blood test? From my reading, it sounded like a few people screw themselves up when taking NDT by not raising the dose as needed in a timely matter. I've read on a few forums I should have continued to raise it till I reached 2grains a day. I didn't push Defy to raise it past that since fearing low iron levels may mess me up worse with 2 grains then 1 grain.

    As for as NDT dosing goes, So I understand correctly stay on the current dose of NDT and add T4 or continue to raise NDT and also add T4 and retest 4-6 weeks later? Just to add I am a patient of Defy. So I am looking to see what they suggest. I'd like to have as much info as possible so I know the best choice is being made for me by them.

    Thanks again for taking the time in educating me and others.


    Quote Originally Posted by Blackhawk View Post
    Well, my TPO is fine, but TG antibody not. I remain a bit confused over the difference in terms of function and treatment. (Note, don't want to derail WrenchHead's thread)
    Fell free to answer the question here if you want. I'm curious to learn your take on it too.

  18. #17
    Quote Originally Posted by WrenchHead80 View Post
    Its NOT FT4 being used up faster because of demand to make FT3, from me staying on too low of a dose too long? Cause I felt better by the end of the first week starting till I felt I started to go backwards then raised it and felt even better but another week later started to feel like I was going backwards again but stayed on that dose for the last 3 weeks leading up to this blood test? From my reading, it sounded like a few people screw themselves up when taking NDT by not raising the dose as needed in a timely matter. I've read on a few forums I should have continued to raise it till I reached 2grains a day. I didn't push Defy to raise it past that since fearing low iron levels may mess me up worse with 2 grains then 1 grain.

    As for as NDT dosing goes, So I understand correctly stay on the current dose of NDT and add T4 or continue to raise NDT and also add T4 and retest 4-6 weeks later? Just to add I am a patient of Defy. So I am looking to see what they suggest. I'd like to have as much info as possible so I know the best choice is being made for me by them.
    I remember reading a study on that very issue some years back. It might have been part of Broda Barnes research. It stated that the minimum dose is usually 2 grains and that it's exceptionally rare for someone to need less than that. I read so often people Rx'd tiny doses like 1/2 a grain for 6 months and they wonder why it doesn't work. We have the same feedback loop as for testosterone that we need to overcome before we realise any benefit and that's one of the reasons we should increase the dose sooner rather than later. Obviously 6 months is too long to hold a tiny dose. Realistically I believe it should be a week or two max.

    You do need to add T4 to your protocol. You should be able to do that over a phone call to Defy without an appointment. I never had a T4 problem until I started taking T3. Once on T3 it drove my FT4 down to the point I had to start taking some. This is quite common for people on TRT. I take 250mcg Synthroid daily because I take T3. If I stop taking T3 I can also stop taking T4 and my FT4 normalizes. Weird huh. But then I end up with low FT3.

  19. #18
    Super Moderator Vettester Chris's Avatar
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    Quote Originally Posted by WrenchHead80 View Post
    To make sure I understand what your saying. For some reason my FT3 shot up fast and now my body is starting to say because of my FT3 getting up there, slow down with production (lower TSH now) , which will unfortunately slow down my T4 production too and keep it low? Hence why I need T4 added?

    Its NOT FT4 being used up faster because of demand to make FT3, from me staying on too low of a dose too long? Cause I felt better by the end of the first week starting till I felt I started to go backwards then raised it and felt even better but another week later started to feel like I was going backwards again but stayed on that dose for the last 3 weeks leading up to this blood test? From my reading, it sounded like a few people screw themselves up when taking NDT by not raising the dose as needed in a timely matter. I've read on a few forums I should have continued to raise it till I reached 2grains a day. I didn't push Defy to raise it past that since fearing low iron levels may mess me up worse with 2 grains then 1 grain.

    As for as NDT dosing goes, So I understand correctly stay on the current dose of NDT and add T4 or continue to raise NDT and also add T4 and retest 4-6 weeks later? .
    Wrench, I suspect you're pooling. One (1) grain went from 12.5% to 91.6% of reference range. As my post stated, "don't be fooled by the Low RT3". That marker is a reflection of increased conversion of T4 to RT3, but as noted your T4 is sub-reference, there's just not enough T4 to convert downstream.

    Again, based on your most recent labs, iron serum is definitely sub-par at 67, and ferritin is "close" at 85, but needing to increase some. I also think you need to have your cortisol tested, I thought something was mentioned on that in your other thread, I could be wrong?

    Talk it over with Dr. Saya, but just note it in the back pocket that IF you start adding Levo T4, and/or ramping up NDT, I suspect that T4 will start to climb and then start converting excessively to RT3. Again, 1 grain, you're at 91.6% of reference range on FT3. My theory, you were starting to feel better because some T3 was starting to reach the cells. Unfortunately, it's bottle-necked because of insufficient transport ability to the cells due to iron & ferritin, then it goes backwards like you said ... Like a traffic jam on the 405, and it's down to 1 lane .. Cars just start piling up. The RT3 marker isn't in play because of T4, or the lack thereof.

    To conclude, there's two (2) variables here with your situation ...
    1) You have Hashis/Autoimmune TPO disorder, so that is factored with a treatment program. If everything is GREEN light for treatment, you need adequate dosage to combat the TPO attacks.
    2) You have LOW Iron serum, and low (getting closer) ferritin. Hashis or no hashis, thyroid medication will be counterproductive if these levels are not adequate. That's not my rule or mantra, that's science and it's a fact. If I'm wrong, I would have expected your FT3 to be maybe 30% or 40% of reference with body just soaking up all the FT3 it can get. It's at 91.6% (lol, I know I sound like a broken record), which is telling me that your T3 is stuck on the freeway with only a little bit making it down the road.
    Please, no PM's posting lab results ... Let's Keep them on the Open Forum for Everyone to Comment. Feel free to PM me a link to your thread if you would like me to comment. Thanks!!


    I am not a Doctor, I only play one on T.V. Please consult your physician, or a trained-licensed physician before proceeding with any comments or suggestions posted on this or any forum.


  20. #19
    Quote Originally Posted by ratbag View Post
    I remember reading a study on that very issue some years back. It might have been part of Broda Barnes research. It stated that the minimum dose is usually 2 grains and that it's exceptionally rare for someone to need less than that. I read so often people Rx'd tiny doses like 1/2 a grain for 6 months and they wonder why it doesn't work. We have the same feedback loop as for testosterone that we need to overcome before we realise any benefit and that's one of the reasons we should increase the dose sooner rather than later. Obviously 6 months is too long to hold a tiny dose. Realistically I believe it should be a week or two max.

    You do need to add T4 to your protocol. You should be able to do that over a phone call to Defy without an appointment. I never had a T4 problem until I started taking T3. Once on T3 it drove my FT4 down to the point I had to start taking some. This is quite common for people on TRT. I take 250mcg Synthroid daily because I take T3. If I stop taking T3 I can also stop taking T4 and my FT4 normalizes. Weird huh. But then I end up with low FT3.
    Defy would have had me on 1/2 grain for the 6 weeks if I didn't email my PA at Defy after my first week asking if I could raise it cause I felt tired (worse then not being on it). I did feel better after the raise but didn't want to push it more fearing I could have pooling and not know it till I had labs done. So I figured Id wait till I get labs done to confirm it was ok.

    Thanks for the added info.



    Quote Originally Posted by Vettester Chris View Post
    Wrench, I suspect you're pooling. One (1) grain went from 12.5% to 91.6% of reference range. As my post stated, "don't be fooled by the Low RT3". That marker is a reflection of increased conversion of T4 to RT3, but as noted your T4 is sub-reference, there's just not enough T4 to convert downstream.

    Again, based on your most recent labs, iron serum is definitely sub-par at 67, and ferritin is "close" at 85, but needing to increase some. I also think you need to have your cortisol tested, I thought something was mentioned on that in your other thread, I could be wrong?

    Talk it over with Dr. Saya, but just note it in the back pocket that IF you start adding Levo T4, and/or ramping up NDT, I suspect that T4 will start to climb and then start converting excessively to RT3. Again, 1 grain, you're at 91.6% of reference range on FT3. My theory, you were starting to feel better because some T3 was starting to reach the cells. Unfortunately, it's bottle-necked because of insufficient transport ability to the cells due to iron & ferritin, then it goes backwards like you said ... Like a traffic jam on the 405, and it's down to 1 lane .. Cars just start piling up. The RT3 marker isn't in play because of T4, or the lack thereof.

    To conclude, there's two (2) variables here with your situation ...
    1) You have Hashis/Autoimmune TPO disorder, so that is factored with a treatment program. If everything is GREEN light for treatment, you need adequate dosage to combat the TPO attacks.
    2) You have LOW Iron serum, and low (getting closer) ferritin. Hashis or no hashis, thyroid medication will be counterproductive if these levels are not adequate. That's not my rule or mantra, that's science and it's a fact. If I'm wrong, I would have expected your FT3 to be maybe 30% or 40% of reference with body just soaking up all the FT3 it can get. It's at 91.6% (lol, I know I sound like a broken record), which is telling me that your T3 is stuck on the freeway with only a little bit making it down the road.
    I think I may actually understand this now lol. Sorry for making you repeat yourself, its just hard for me to understand whats going on here. So I know I understand this, in layman terms...

    Pooling can be shown threw having elevated FT3 or FT4 numbers above range OR in my case because its highly unlikely to have what "looks" like great FT3 #'s on the small dose I am on and the ratio to FT3 and FT4. So my FT3 is building up fast and floating around cause it doesn't have the iron or maybe cortisol (don't know since I haven't had it tested) to allow it to be used. My RT3 is low because that number usually only goes up if you have too much T4 building up, it spills over into RT3.

    I was thinking for some reason RT3 is the only indicator of pooling. Now I understand the importance of FT3 and FT4 #'s since they indicate pooling if above range and also how much a person has available to use when needed.

    Well personally I feel I'm wasting my time and money starting thyroid treatment right now. I'm basically not getting the usage out of the pills because of my iron and maybe because of my cortisol levels too. I feel maybe it would have been smarter to fix my iron levels first before starting the NDT. Wish I understood this better sooner. Just so you know I'm not talking to Dr. Saya, wait time was very long for him when I called and money is kind of tight right now. I was assuming the PA I am using runs things by him?

    I'm not sure I know what to do as for as dosing though still. I know 1 grain a day has me "better" and maybe for right now I should be happy with staying like this till I get my iron up more? Why would adding T4 help right now? Wouldn't it probably just build up and spill over to RT3? Same as raising the NDT right now? Or will I be hurting myself staying on too low of a NDT dose still, as I race to raise my iron levels?

    I feel I have to get this iron up and fast. Can I safely double my iron supplement intake at night? Or go even higher? I think you original said in my other thread I should take more then I am right now. I'll have to revisit that thread after this.

    This is my current dose->

    1 Ferrett's iron supplement pill (106mg elemental from 325mg ferrous furnarate)
    1 vitron-c plus vitamin c pill (65mg elemental as carbonyl iron)
    2 vitamin c pill (2000mg)

    Also do you mind explaining why the other three iron numbers went down and my ferritin went up a little since supplementing with iron? I figured they would have all gone up a little. My PA noted after I sent him my labs the my ferritin went up, but didn't mention the other iron numbers going down. I took it as it was good news having higher ferritin at least?

    EDIT TO ADD: I just read you shouldn't take your NDT before your blood work cause it will show elevated T3 numbers. But I heard on here you should take your NDT as normal before your labs in the morning? I took mine 1 to 2 hours before my lab test that morning. Is this ok? Every time I think I understand whats going on then I read something that makes me not sure again.

    Thank you again for taking the time in teaching me all this. Also you can never sound like a broken record to me lol. I seem to need to hear the same thing said differently at least two times to fully grasp it lol.
    Last edited by WrenchHead80; 07-16-2018 at 07:02 PM.

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