Stopping NDT..

[Weasel]

I was just wondering if I can just stop NDT? I've been taking 1.5gr every morning for close to a year now. I've saw no benefit from it that I can see, and feel like I have a foggier than normal mind although I cannot directly contribute that to NDT.

What are the consequences stopping NDT cold turkey?

Most recent labs on 1.5gr NDT. roughly 2 hrs after taking NDT

FT3 4.8H 2.3-4.2 pg/ml
T3 Total 145 76-181 ng/dl
RT3 13 8-25 ng/dl
FT4 1.04 0.85-2.32ng/dl
TSH 0.592 .465- 4.68 uIU/ml


Thoughts?

 

[Vince]

I wouldn't, I believe it's very beneficial for improving small LDL particles. You could take a lower dose.

 

[Weasel]

I wouldn't, I believe it's very beneficial for improving small LDL particles. You could take a lower dose.

Thanks Vince, I appreciate the feedback.

Does anyone know the half life of NDT? Is one does in the morning enough to hold me over until the following morning?

 

[Vince]

6 hour half life, 6.25 per cent left after 24 hours

 

[Weasel]

6 hour half life, 6.25 per cent left after 24 hours

Wow thats really short half life for 1x day dosing....

 

[HarryCat]

The different components will have different half lives. The half life Vince is referring to is for the T3 portion. NDT also contain T4 (and some other minor components), the half life of T4 is about 7 days.

So if you stop NDT cold turkey the T3 will clear out of your system quickly, but the T4 will take about a month to clear.

 

[Weasel]

The different components will have different half lives. The half life Vince is referring to is for the T3 portion. NDT also contain T4 (and some other minor components), the half life of T4 is about 7 days.

So if you stop NDT cold turkey the T3 will clear out of your system quickly, but the T4 will take about a month to clear.

Awesome, Thanks HC. just the info i was looking for. And during that 7 days, t4 should be converting to t3 at some rate, also while my thyroid begins ramping up its own production again. Seem reasonable?

 

[Vettester Chris]

Weasel, I hear your frustration, and something is amiss having Free T3 over the top at 1.5 grains. Here's the thing, if you're hypothyroid, stopping cold turkey isn't the solution. I get it, the RT3 marker looks fine in its ratio to FT3, but that (like TSH) isn't always the smoking barrel for proof.

Free T4 is only at 12% of reference range, and FT3 is > 100% (think about it), so your T4 is converting quickly (and even at 1.5 grains, I speculate there's not a huge excess of RT3 conversion, and the deiodination of RT3-to-T2, T1 can process quickly when/if serum levels are normal/stable). However, the FT3 portion is just building, all indications of pooling, which suggests the free active hormone is not getting to the cells. Again, 1.5 grains is moderate, semi-moderate dose, nothing that should be pushing any of your levels over the top (that's just my take, there could be other things I'm not seeing).

Since starting this process, have you seen a steady increase of feeling anxiety, change in BP, heart rate, sleep issues, any observation in body temp? I don't know if we've covered iron, ferritin & the 24 hour cortisol lab in our previous posts with you? As I stated at the top, I don't like the idea of quitting treatment "if" you are hypothyroid and need thyroid meds. At the same time, it's redundant taking NDTs or synthos if all it does is pool and stop short of reaching your cells, and ultimately causes adverse results.

Unlike testosterone treatment, thyroid treatment can be quite tricky, as there's a litany of variables that need to be checked in order for it to work. Testosterone (for the most) gets in, gets metabolized, and beyond protein factors that might effect the amount of free/bio active test, it does its deed. Thyroid hormone ... Well, not quite the same, and there's a whole host of factors that can roadblock it to the cells, not to mention enzyme and protein autoimmune disorders that can cause havoc!

I know this sounds like a parrot, but I think the first step is a good doctor. If you have one that knows the gamut (or is at least open minded and somewhat versed) primary & secondary supporting thyroid labs, nutrients, electrolytes, antibodies, deiodinase enzyme process (D1,D2,D3), etc., then I would hope he/she explores "WHY" the results are where they're at, and what steps are NEEDED (if any) to make your thyroid treatment successful. It would suck knowing you're only needing some elemental iron support to make this work, or adrenal balance, etc. In the meantime "possibly" taper back, maybe to at least get FT3 down a bit until you get other solutions.

 

[munch520]

I did the same thing, as mentioned above T3 is out of the system quickly, T4 takes a while. I quit cold turkey and had no issues, felt better with 10 days.

NDT (and higher dose T4 meds) were way too stimulating for me, you might find the same is true for you...

 

[Weasel]

Weasel, I hear your frustration, and something is amiss having Free T3 over the top at 1.5 grains. Here's the thing, if you're hypothyroid, stopping cold turkey isn't the solution. I get it, the RT3 marker looks fine in its ratio to FT3, but that (like TSH) isn't always the smoking barrel for proof.

Free T4 is only at 12% of reference range, and FT3 is > 100% (think about it), so your T4 is converting quickly (and even at 1.5 grains, I speculate there's not a huge excess of RT3 conversion, and the deiodination of RT3-to-T2, T1 can process quickly when/if serum levels are normal/stable). However, the FT3 portion is just building, all indications of pooling, which suggests the free active hormone is not getting to the cells. Again, 1.5 grains is moderate, semi-moderate dose, nothing that should be pushing any of your levels over the top (that's just my take, there could be other things I'm not seeing).

Since starting this process, have you seen a steady increase of feeling anxiety, change in BP, heart rate, sleep issues, any observation in body temp? I don't know if we've covered iron, ferritin & the 24 hour cortisol lab in our previous posts with you? As I stated at the top, I don't like the idea of quitting treatment "if" you are hypothyroid and need thyroid meds. At the same time, it's redundant taking NDTs or synthos if all it does is pool and stop short of reaching your cells, and ultimately causes adverse results.

Unlike testosterone treatment, thyroid treatment can be quite tricky, as there's a litany of variables that need to be checked in order for it to work. Testosterone (for the most) gets in, gets metabolized, and beyond protein factors that might effect the amount of free/bio active test, it does its deed. Thyroid hormone ... Well, not quite the same, and there's a whole host of factors that can roadblock it to the cells, not to mention enzyme and protein autoimmune disorders that can cause havoc!

I know this sounds like a parrot, but I think the first step is a good doctor. If you have one that knows the gamut (or is at least open minded and somewhat versed) primary & secondary supporting thyroid labs, nutrients, electrolytes, antibodies, deiodinase enzyme process (D1,D2,D3), etc., then I would hope he/she explores "WHY" the results are where they're at, and what steps are NEEDED (if any) to make your thyroid treatment successful. It would suck knowing you're only needing some elemental iron support to make this work, or adrenal balance, etc. In the meantime "possibly" taper back, maybe to at least get FT3 down a bit until you get other solutions.

Man you are a wealth of Knowledge Chris!!

I do have a excellent Doc, His name is Dr. Justin Saya You might have heard of him.

I didn't make the connection between Lowish T4 and High T3. Makes a lot of sense that I didn't feel a change at all and losing fat seems to be harder now than pre NDT.

I don't have those numbers You've asked for from the labs listed in my original post but here are all those numbers from my PRE NDT labs. As you can see from my PRE NDT, I probably would not be considered truly hypo. In Hindsight, I should have probably tried iodine and Selenium first.

TSH 1.43 (0.465-4.68)
T3, REVERSE 14 (8-25)
FREE T3 2.6 (2.3-4.2)
T3 TOTAL 84 (76-181)
FT4 1.19 (.85-2.37)
THYROID PEROXIDASE <1 (<=9)
THYROGLOBIN ANTIBODIES <1(<1)
THYROID PEROXIDASE ANTIBODIES<1 (<=9)

FERRITIN 17.1 (17.9-464)
TIBC, CALC 390.2 (261-462)
TRANSFERRIN 278.69 (206-381)
IRON 76 (49-181)
IRON SATURATION 19% (11-56)

Test Name Result Units Range
Cortisol (Saliva) 9.4 ng/mL 3.7-9.5 (morning)
Cortisol (Saliva) 2.5 ng/mL 1.2-3.0 (noon)
Cortisol (Saliva) 1.4 ng/mL 0.6-1.9 (evening)
Cortisol (Saliva) 0.7 ng/mL 0.4-1.0 (night


Thanks again for your help Chris

 

[Weasel]

I did the same thing, as mentioned above T3 is out of the system quickly, T4 takes a while. I quit cold turkey and had no issues, felt better with 10 days.

NDT (and higher dose T4 meds) were way too stimulating for me, you might find the same is true for you...

I do have some issues sleeping. Do you feel like you returned to your pre NDT state?

 

[munch520]

I do have some issues sleeping. Do you feel like you returned to your pre NDT state?

Oh yes, definitely. Within a few weeks I would wake up and be groggy/be able to go back to sleep. Even on lower dose (25mcg) synthroid I still went to sleep easily and was able to sleep in if I wanted to (I'm a chronic "snooze-pusher" haha)

Instead of how I was on NDT/higer synthroid dose...I would jolt awake hot and sweaty and couldn't go back to sleep (usually happened around 2-3am). Also felt anxious, jittery, had chronic temperature (low grade ~100), sweaty, dry mouth, etc.

 

[Weasel]

Oh yes, definitely. Within a few weeks I would wake up and be groggy/be able to go back to sleep. Even on lower dose (25mcg) synthroid I still went to sleep easily and was able to sleep in if I wanted to (I'm a chronic "snooze-pusher" haha)

Instead of how I was on NDT/higer synthroid dose...I would jolt awake hot and sweaty and couldn't go back to sleep (usually happened around 2-3am). Also felt anxious, jittery, had chronic temperature (low grade ~100), sweaty, dry mouth, etc.

intresting, MY fitbit never thinks i sleep between 1-3ish. I know im restless and not in a deep sleep for sure. Not sleeping but not awake either.

 

[munch520]

Do you have any excess sweating, nausea, diarrhea, fever, appetite loss, etc.?

 

[Weasel]

Do you have any excess sweating, nausea, diarrhea, fever, appetite loss, etc.?

now and then i wake up soaking wet from sweat. Goes in streaks. Same with diarrhea but havent had that in some time now i guess.

 

[munch520]

now and then i wake up soaking wet from sweat. Goes in streaks. Same with diarrhea but havent had that in some time now i guess.

I had all of it, thought it was cortisol (but I took 24 hour test during a bad bout of insomnia)...a recheck showed that was ok. But once I stopped meds and reintroduced them at lower dose I was fine. I do need to recheck cortisol now that I'm back on T4 though

 

[Vettester Chris]

Man you are a wealth of Knowledge Chris!!

I do have a excellent Doc, His name is Dr. Justin Saya You might have heard of him.
Yes, I think I've heard his name once or twice!
I didn't make the connection between Lowish T4 and High T3. Makes a lot of sense that I didn't feel a change at all and losing fat seems to be harder now than pre NDT. If T3 isn't making it to the cells, then it's still the same symptoms of hypothyroidism.

I don't have those numbers You've asked for from the labs listed in my original post but here are all those numbers from my PRE NDT labs. As you can see from my PRE NDT, I probably would not be considered truly hypo. In Hindsight, I should have probably tried iodine and Selenium first.

TSH 1.43 (0.465-4.68)
T3, REVERSE 14 (8-25)
FREE T3 2.6 (2.3-4.2)
T3 TOTAL 84 (76-181)
FT4 1.19 (.85-2.37)
THYROID PEROXIDASE <1 (<=9)
THYROGLOBIN ANTIBODIES <1(<1)
THYROID PEROXIDASE ANTIBODIES<1 (<=9)

FERRITIN 17.1 (17.9-464) ..... Red Flag ... Run it by the good doctor
TIBC, CALC 390.2 (261-462)
TRANSFERRIN 278.69 (206-381)
IRON 76 (49-181) ....... Red Flag ... 120 -to-140 would be ideal, but it's even more concerning when looking at your ferritin
IRON SATURATION 19% (11-56) ... 30% to 40% (IMO) is the "optimal" zone. Take your Iron Serum and divide it by TIBC ... Iron Sat = (Fe/TIBC) ... So, if you got your iron to 130, your Iron Sat would result at 33%.

Test Name Result Units Range
Cortisol (Saliva) 9.4 ng/mL 3.7-9.5 (morning)
Cortisol (Saliva) 2.5 ng/mL 1.2-3.0 (noon)
Cortisol (Saliva) 1.4 ng/mL 0.6-1.9 (evening)
Cortisol (Saliva) 0.7 ng/mL 0.4-1.0 (night
Can't arugue much with your circadian profile!! Looks GREAT!!!

Thanks again for your help Chris

I don't know how current any of the Iron related results are, but Iron/Ferritin is indeed a Primary marker on the thyroid! It's a DEAL KILLER for thyroid hormone making it to the cells!!!

Provided some notes above in RED

 

[Weasel]

I don't know how current any of the Iron related results are, but Iron/Ferritin is indeed a Primary marker on the thyroid! It's a DEAL KILLER for thyroid hormone making it to the cells!!!

Provided some notes above in RED

Thanks again Chris, Maybe the master himself will chime in here. He initially did not want to treat as he was afraid of driving up HGB and HCT. The iron labs posted are from 5/16 just before I started NDT.

 

[Will Brink]

I was just wondering if I can just stop NDT? I've been taking 1.5gr every morning for close to a year now. I've saw no benefit from it that I can see, and feel like I have a foggier than normal mind although I cannot directly contribute that to NDT.

What are the consequences stopping NDT cold turkey?

Most recent labs on 1.5gr NDT. roughly 2 hrs after taking NDT

FT3 4.8H 2.3-4.2 pg/ml
T3 Total 145 76-181 ng/dl
RT3 13 8-25 ng/dl
FT4 1.04 0.85-2.32ng/dl
TSH 0.592 .465- 4.68 uIU/ml


Thoughts?

That would depend on why you started it in the first place, but if it makes sense to stop (vs lower dose, change meds, etc) no reason not to titrate dose down vs just stopping per se. Without know the why you're on it, no way to answer that Q accurately.

 

[Dr Justin Saya MD]

Thanks again Chris, Maybe the master himself will chime in here. He initially did not want to treat as he was afraid of driving up HGB and HCT. The iron labs posted are from 5/16 just before I started NDT.

Indeed Weasel, balancing NOT increasing H/H while having adequate iron supplies to support thyroid (and other functions) is exactly that...a balancing act. Based on your response to the NDT, both subjective and objective, more iron is possibly the missing piece there, but at the possible trade-off of stimulating further erythropoiesis. Since your screenname isn't attached to your chart ;-) , please remind me what your hemoglobin/hematocrit levels as well as MCV have been. Thanks!