My start on NDT

#21
That's the same thing as pooling. If you read the chart, it says “Available “ T4 will begin to conver to RT3.

So what happens when you have below reference range T4? Simple, there's only a small amount of T4 available to convert to RT3. Read the first paragraph of my post in #18.
 
Thread starter #22
That's the same thing as pooling. If you read the chart, it says “Available “ T4 will begin to conver to RT3.

So what happens when you have below reference range T4? Simple, there's only a small amount of T4 available to convert to RT3. Read the first paragraph of my post in #18.
So the link I put up is actually whats going on with me. I just don't have the FT4 to raise my RT3? So RT3 can only go up if it has FT4 available to do it?

Ok, so if I added more T4 with how I am "currently" low iron, my RT3 would probably jumped up more? Since I would then have the available FT4 to covert to RT3? I asked this in post 19 but maybe you didn't see it or your tired of repeating yourself (sorry I'm not grasping this easier/faster). I appreciate your continued help.

Also when I wrote in post #19 "My RT3 is low because that number usually only goes up if you have too much T4 building up, it spills over into RT3." is wrong. RT3 can go up if either my FT3 or FT4 is high but it needs the FT4 to actually be able to raise my RT3 numbers high?


I did raise my Iron, Vit C and selenium intake, based on what you said to me on my original thread that I started to talk about my thyroid problems.
 
#23
So the link I put up is actually whats going on with me. I just don't have the FT4 to raise my RT3? So RT3 can only go up if it has FT4 available to do it?

Ok, so if I added more T4 with how I am "currently" low iron, my RT3 would probably jumped up more? Since I would then have the available FT4 to covert to RT3? I asked this in post 19 but maybe you didn't see it or your tired of repeating yourself (sorry I'm not grasping this easier/faster). I appreciate your continued help.

Also when I wrote in post #19 "My RT3 is low because that number usually only goes up if you have too much T4 building up, it spills over into RT3." is wrong. RT3 can go up if either my FT3 or FT4 is high but it needs the FT4 to actually be able to raise my RT3 numbers high?


I did raise my Iron, Vit C and selenium intake, based on what you said to me on my original thread that I started to talk about my thyroid problems.
Wrench, everything you are asking, I have thoroughly stated, answered, and repeated. 3rd and 4th paragraph in #12, 3rd paragraph in #18, etc. The chart you posted from Tired Thyroid even validates that "Available" T4 will convert to RT3 if FT3 is too high, or essentially if it's pooling and not getting to the cells.

Is this your exact situation? I don't know, only you, your physician, and time can answer that. However, again, adding Levo T4 (synthetic T4) to your protocol will IMO increase T4, only to convert more excessively to RT3, or at least this is a theory/possibility that should be factored.
 
#25
Just wanna say thanks to Chris and all the guys replying in this thread. It’s
not the first time i’ve read it but i’m learning more every time i browse through.
 
Thread starter #26
Had my follow up appointment with Defy.


He didn't feel I was pooling. I explained everything I read here though. He feels my FT3 was high because I took the NDT pill before getting my labs done. He also thinks my iron is ok because my Ferritin came up a little. So I should stay on my current dose (half in the morning and the other half in the afternoon) and in 3 months retest but don't take the NDT before the labs this time. He feels my FT4 and FT3 will level out by then. I'm thinking they will be level but low.

My main problem I'm dealing with right now is I feel warm all the time even though my temperature is never high, its still low.

I will only say for right now, I know I have a iron problem that needs to be worked on. So I'll deal with this dose for now and work hard to get my iron levels up. By next appointment I'm hoping my iron levels will look better so I can raise my dose if needed, which I'm assuming would be a wise choice.

Is Dr. Saya the only Dr at Defy you guys recommend I should consult with as for as the thyroid stuff goes?

On a different note I explained I want to do everything possible to avoid donating blood if possible to save my iron. So I suggested daily shots of 20mg for my Test C (which will also lower my weekly total from current 150 to 140mg). I'll also pin my HCG daily also at 150iu's. Will no longer take AI now, unless I have symptoms. I have a full bottle of .25mgs AI pills so if I do need to use them I'll do the vodka mix thing with them. I figured another good reason to try this is I've remained a low SHBG person, so this protocol may work out better for me.

I mentioned I was never offered DHEA and I notice my number was only mid range. So he was fine with my supplementing with it. Figured it will help with my cortisol which will help my thyroid too. I also mentioned I wanted to take a small dose of Pregnenolone since when I started HCG I felt a certain wellness feeling I liked. Thought this was another way to back fill it to ensure good levels.

I've been on the new protocol since July 23rd. No complaints.
 
#27
WrenchHead, just noticed the times you take iron and NDT and wanted to say a heads-up in case you're not aware.. you can't take any iron or calcium within 3-4 hours of taking thyroid meds, it severely compromises it's effectiveness.
 
Thread starter #28
WrenchHead, just noticed the times you take iron and NDT and wanted to say a heads-up in case you're not aware.. you can't take any iron or calcium within 3-4 hours of taking thyroid meds, it severely compromises it's effectiveness.
I don't, I may have written it wrong or was misunderstood where you saw it but I remember reading that here on many threads not to do that. I take my morning pill first thing in the morning on a empty stomach when I wake and have breakfast a hour or two later. The afternoon one I take around 2pm. Basically I make sure I take it two hours after my lunch and don't eat anything for a hour after. The taking of all my iron supplements happens in the evening before I go to sleep on a empty stomach.

I wanted to originally space out the iron pills threw the day but didn't like how they would be close to the time when I would take my NDT. So I take all the iron stuff in the evening with the Vitamin C. Luckily I dont get any negatives like upset stomach I read others have had. Would their be a benefit in finding time to space out the iron threw out the day?

Thank you Ratbag for watching out for me.
 
#29
No worries, I had seen in your first and last post that it appeared you were taking iron and NDT around the same times.

Right the only time you hear of the need to space out iron supping is because you are sensitive to it, which you are not, so once a day is just fine.
 
#30
To add to my last post (can't edit it now) does RT3 also go up if you have to much FT3 also? Was under the assumption it only goes up with high FT4 but then I read the following from here.

http://www.tiredthyroid.com/blog/2015/08/11/high-reverse-t3-rt3-can-be-a-sign-of-too-much-t3/
Edit to add: I tried messaging Dr. Saya to see what he thinks about my labs but I can't find a messaging button for him that I can find with other members.

I have my follow up with Defy this Wednesday, but its with a PA.

Wrenchhead it will be interesting to hear what Defy has to say. I'm in a little different boat in that my RT3 was 28.1 back in Feb, took T3 med Cytomel 15 mcg 2 x day and bought it down to 13.1 after 3 months. Blood test showed TSH and T4 were below range. Didn't take anything for 6 weeks then, RT3 shot back up to 24.5 so, back on Cytomel again which is lowering my TSH and T4. I do not take a T4 med. The thyroid is soooo different to treat...
 
Thread starter #31
Wrenchhead it will be interesting to hear what Defy has to say. I'm in a little different boat in that my RT3 was 28.1 back in Feb, took T3 med Cytomel 15 mcg 2 x day and bought it down to 13.1 after 3 months. Blood test showed TSH and T4 were below range. Didn't take anything for 6 weeks then, RT3 shot back up to 24.5 so, back on Cytomel again which is lowering my TSH and T4. I do not take a T4 med. The thyroid is soooo different to treat...
Read post #26 for what the PA at Defy said. I don't know what to think at this point as far as how my treatment is going. As you said the thyroid is a complicated thing.

I know I ruined my iron levels by my own fault. I figured my main mission right now is to work on building those iron levels back up in the mean time. I am upset that I didn't try harder to get a answer about if I should have taken my thyroid pill before the labs, which I did. I asked here before getting those labs done but no one answered the question. From my own searching I did read Defy wants you to take your NDT before labs, so I did. Yet recently I see a new thread with members that know the thyroid saying you SHOULDN'T take it. Defy says I'm not pooling and my FT3 was high because I took the pill. Next time don't take it. So I wasted time getting inaccurate labs done and paying to have a follow up and protocol based on them?

So does that mean if I didn't take the NDT my FT3 would have been more even with my FT4 and I could have had my NDT dose raised and be on a path of getting better sooner? Who knows. Now I have to wait 3 months on this dose to see what the labs show next time with me not taking it before hand. I'm not even sure if that's a good idea to stay on a low 1 grain a day dose protocol for that long. Everyone here and from my own reading tells me I would need a higher dose to fix my thyroid problems.

I'm trying to convince myself that a half grain pill couldn't have raised my FT3 that high and I actually really do have a high FT3 problem. But reading now how I shouldn't have taken it before labs and Defy saying my FT3 WAS high because I took, I don't know what to think.

I'm tempted to go back and get full labs done sooner to see what the difference will be with not taking it before hand, but the other part of me says I still need time to build up my iron to make whatever dose I take work the right way. Even though the PA doesn't think my iron is bad now.
 
Thread starter #33
I use Dr Calkins. He spotted my high RT3 back in March when a PA missed it in 4/2017. Appears to be very knowledgeable on thyroid as well as low T.
Is he with Defy? Is he very popular meaning its hard to get a appointment in a short time? Don't like the idea of "having to get your labs done and sent to them before you can make a appointment". DR Sayer was a 3 month wait to see when I asked. I don't want to be discussing old labs and I would be waiting a few months while I don't feel good either.

On a different note, I had some time to look into the taking not taking of NDT before labs.

You DO NOT want to take NDT before labs. Wish I knew this before I wasted my money on a follow up. I'm completely clueless as to why defy wants you to take your ndt before.

On a few websites I have read taking a T3 or NDT (which has T3 in it) pill before labs will show spikes on your FT3 and a lower TSH number. T3 has a very short half life compared to T4. Some people show huge FT3 spikes depending on timing of labs. I take mine at 6am had the test done at 9pm. Ideal timing to have the highest FT3 reading possible from my reading on different sites.

Taking only a T4 pill before labs you can. It will only slightly bump your T4 numbers up because it is released so much slower compared to T3. It's still recommend not too though.

Based on this info and me being tired of feeling tired and feeling hot, I'm not going to wait 3 months to fix this error. I felt better off this stuff then I do on it right now.

I'm going to make a appointment to get my thyroid labs done again some time this week. This time no NDT before and I'll schedule it for the same time as last. I'm hoping my hunch is correct and my results come back with the same numbers but a much lower FT3 which would show I need to raise my dose. Which I'll email to the PA at defy and explain I want to raise my dose.

Figured TSH FT3 FT4 and RT3 will be sufficient.

I also started taking my whole dose (1grain) first thing in the morning and not splitting it like I was. I started a few days ago to see if I would feel better. I did. It ended the ups and downs. Have more energy (still low though) during the day and become tired by early evening. Which I can live with for now. Instead of starting the day ok then slowly crashing by 2pm and coming back to life around 6-7pm to be fine to stay up all evening. I really dont care to be up past 10pm during the week.
 
#34
Just wanted to comment to say that i’m following along. I also have hashi’s and am starting NDT later this week (whenever the package from Defy gets here)
 
Thread starter #35
Finally got some results back. I don't have RT3 yet. Either they forgot or the results haven't come back yet.

As you can see there is a difference with not taking your NDT before labs. My FT3 is lower. As I have read it doesn't effect your FT4, which looks to be true. I'm "assuming" my FT3 may not be low enough to justify raising the dose as of now with a still low FT4 also?? Thoughts? I'm "assuming" my FT4 is still low because of the pooling issue. Normally FT4 would be higher given the ratio of FT4 and FT3 in NDT right?

On the plus side my iron levels are continuing to come up. I am surprised given the amount of iron supps I'm taking every night how long its taking to raise though. What are healthy iron levels in people? Mid or upper range on labs?

On another note I do feel better taking the whole NDT dose in the morning instead of splitting it. My temps are no longer really low and I can hit 98.6 by the afternoon. Maybe splitting a low dose NDT protocol, in my case 1 grain, wasn't a good idea.

I do notice I've been sweating more then usual though. Not sure if its thyroid related or me not taking my AI pills anymore since I went to daily test shots. I notice the back of my shirts are wet during the day. Just sitting in a chair getting a hair cut a few days ago, I noticed the back of my shirt was all wet afterwards. Any ideas what could be causing it???


Edit to add: Is this a posibliltiy?
"May lead to variations in free T3 & Free T4 levels - Some people experience very high free T3 levels and very low free T4 levels even when using low doses of NDT. This problem probably has to do with how each individual processes thyroid hormone in their body. "

AND

May lead to immunogenic reaction (may not be ideal for patients with Hashimoto’s) (9) - There is a theoretical risk that taking a foreign pig-derived substance can "flare" up the immune system and worsen thyroid function in patients with Hashimoto's thyroiditis. I don't think this is a reason to completely avoid NDT if you have Hashimoto's thyroiditis but you should be aware that it can happen.

The reason I ask is because I can get armour thyroid instead threw Defy threw my insurance. I've heard reports of Armour vary lately so I didn't want to do it just to save some money. But if the above is true, is their a chance Armour will give me better levels?
 

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#36
What sticks out is your very low FT4. It's way under and optimally you really want it at 66% of range or above as research concludes. So technically you are hypothyroid with a FT4 like that.
 
Thread starter #37
What sticks out is your very low FT4. It's way under and optimally you really want it at 66% of range or above as research concludes. So technically you are hypothyroid with a FT4 like that.
Why do you feel my FT4 is still low? Pooling? What would you do?

I'm still having a hard time understanding this thyroid stuff. Don't understand how Defy says I'm not pooling.

I agree with Chris in post #23 that if I did take T4 to raise it I would think it would raise my RT3. The only reason I don't have a high RT3 is because I have no T4 to make it, if I understand this right.

What I don't get is my iron is coming up, it may not be ideal yet but I am in range now at least. But it doesn't reflect better thyroid numbers.

Figured in the mean time at least my iron levels are continuing to come up. So I'm not totally stalling in place. I am concerned with the sweating of shirts lately. I notice my temperature in the afternoon goes pass 98.6 to 99 sometimes. Were as I have mentioned before it seemed hard just to get to 98.6 most of the time.

I haven't bothered emailing the PA because I'm not sure how to take these new results. Was hoping more people would respond.
 
#38
your FT4 is below range. What thyroids meds are you taking now? and what dosages. Have you ever had saliva labs for your cortisol? Sorry just don't wanna read the previous 100 posts to find out.
 
Thread starter #39
your FT4 is below range. What thyroids meds are you taking now? and what dosages. Have you ever had saliva labs for your cortisol? Sorry just don't wanna read the previous 100 posts to find out.
I understand,

I'm taking two 30mg NDT pills in the morning when I wake up on a empty stomach with 400mcg of selenium. I take all my iron supplements before bed.

I never did a cortisol saliva test. I live in ny so online sites will not ship here and I'm tight on money. I have recently found this on amazon

https://www.amazon.com/Diurnal-Cort...sr=8-2&keywords=24+hour+saliva+cortisol+test&

Saw no mention of ny being a problem. Was hoping to get it soon if I start a new job I applied for last week. Right now money is tight though.

Thanks for any help
 
#40
Your ferritin looks ok now but your iron serum and percent sat look lowish. ZRT is good. I used them back in the day and the price is nearly the same. Before you increase any thyroid meds I would get that 4 x diurnal saliva tests done if you can do it. If your cortisol is low it would explain a lot of your symptoms and your RT3 problem.
 
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