Need Help - NDT Making Me Worse (Very Confused)

[Steve]

Help!

On No Medication:
TSH: 3.13
Free T3: 2.98 (76% vs top-of-range)
Free T4: 0.97 (81% vs top-of-range)

After 4 Months of NDT (Started ½ grain, went up to 2 ½ grains):
TSH: 0.67
Free T3: 2.4 (55% vs top-of-range)
Free T4: 0.91 (51% vs top-of-range)

As you can see the TSH is fine, but the Free T’s are significantly worse.
My temperature, pulse, & low energy have not changed a bit (all too low).

What on earth should I do at this point?
How can the NDT have absolutely no effect on my temp, pulse, energy, and how can it make my Free T’s worse?
_________________________________________________________________________
This all started with a hyperthyroid episode about 2 ½ years ago.
This was probably some kind of autoimmune issue as I had TSI antibodies.
After 6 months I went hypo where I remain. I still have the same amount of
TSI antibodies, but supposedly they can become blocking instead of stimulating, hence hypo.
Avoiding hypo is important as it should help the antibodies to die down.

 

[tca300]

Is your diet good? ( Protein/gelatin, Sugar, fat, calcium, magnesium, potassium, salt, vitamins A,K,E, B's, other minerals, enough calories, low PUFA, etc.. )

Is your vitamin D at a good level?
Is your life extra stressful?
Are you getting enough light?

 

[Steve]

I think diet is good. Vit D is 70.
Low stress. I'm outside for an hour each weekday, more on weekends, wish I had more.
I eat about 2,500 calories per day right now which keeps my weight stable.
I'm 6'1'', 194 lbs.

(Eggs, milk, oj, potatoes, rice, fruit, cheese, gelatin, raw carrot, cook with coconut oil, occasional gluten-free starch, 1 beer per day)

 

[tca300]

Are you sick? Infections can mess with thyroid and make it not work. Are you getting at least 120 grams of protein?

 

[docall18]

What is your dosing like?

You need to keep it at max 0.25- 0.5 grains per hour. Any more is unphysioligical and can bump up RT3 making your condition worse.

Try reducing your dose and start on 0.25 grains with every meal.

Also, drink coffee, to help your liver process it.

 

[Steve]

I tried taking it 3 times per day for a while, 1-grain, 1-grain, 1/2 -grain.
Then I tried 1 in the morning & 1 at night.
And a couple other variations.
I haven't tried just 1/2 grain per hour, so I guess I could try that, but at this point I don't have much confidence that it'll do anything.

I won't try this, but I seriously think I could eat the entire bottle of pills & feel nothing.

 

[Waynish]

What are your labs supposed to be at here? Your low TSH value seems to be the target for RPers. And RP says he doesn't trust free t3/t4 values.

 

[Steve]

Are you sick? Infections can mess with thyroid and make it not work. Are you getting at least 120 grams of protein?

No infections & no inflammation on my blood tests, just the pesky TSI antibodies.
I think my cortisol may be low along with DHEA-S & Testosterone.
I have low energy & always have a head thing going on (dizzy, inflamed, woozy).

 

[Steve]

What are your labs supposed to be at here? Your low TSH value seems to be the target for RPers. And RP says he doesn't trust free t3/t4 values.

Well my TSH was 1.5 before this all happened, so I think that's good for me.
Free T3 & Free T4 should be towards the upper part of the range.

My main concern is my temp & pulse will not budge no matter how much thyroid medicine I take.
Took my pulse a little bit ago & it's 58.
Never saw a pulse that low in my life until this thyroid stuff started.

 

[tca300]

I wish I could help. It seems you might have something not so common/typical going on. Hopefully someone with more knowledge can chime in. Take care!

 

[Steve]

At least temp & pulse usually rise throughout the day, especially around 2 pm after lunch.
Right now I'm at 98.2 & 70.
It was much lower before I ate, so eating has a definite affect.

By the time I get home this evening my temp will fall to 97.6.
When I wake in the morning my temp will be 97.1.

Not sure if this gives any other clues.

 

[tara]

Just a possibility, not a certainty, but I wonder if your system is defending you from a combination of thyroid supplementation and lowish calories?

I'm not sure how old you are, but I think the average grown man over 6' usually needs >3000 cals, and a young man still growing up till about 25yrs could be needing another 500 more. If you are eating significantly less than your body thinks it needs to maintain and run itself, it has various mechanisms it can use to bring the metabolism down - eg rT3.
Maybe consider eating more for a while and see if that makes a difference? No guarantees, though.

I also favour splitting your thyroid doses up to no more than 1/2 grain at a time.

NDT products can vary a lot in quality - some are a lot more potent than others. I'm no expert on which pbrands are most and least effective, but have you checked that the brand you are using does work for at least some people?

 

[Steve]

Just a possibility, not a certainty, but I wonder if your system is defending you from a combination of thyroid supplementation and lowish calories?

I'm not sure how old you are, but I think the average grown man over 6' usually needs >3000 cals, and a young man still growing up till about 25yrs could be needing another 500 more. If you are eating significantly less than your body thinks it needs to maintain and run itself, it has various mechanisms it can use to bring the metabolism down - eg rT3.
Maybe consider eating more for a while and see if that makes a difference? No guarantees, though.

I also favour splitting your thyroid doses up to no more than 1/2 grain at a time.

NDT products can vary a lot in quality - some are a lot more potent than others. I'm no expert on which pbrands are most and least effective, but have you checked that the brand you are using does work for at least some people?

I'm super incredibly very confused about how much to eat, especially after reading comments on this site.
If all of the calculators out there are correct I need about 2,800 to maintain weight which does seem about right for me normally.

The past couple weeks I've been trying to lose some of my beer gut so I've gone down to 2,200-2,500, and I have lost about 3 lbs (unless it just shows back up tomorrow).

I could easily eat 4,000 calories per day because I love to eat.
I'm pretty sure I would just get a bigger gut though.
I might try eating in the middle of the night tonight & see if that changes my waking temp.

 

[tara]

I'm super incredibly very confused about how much to eat, especially after reading comments on this site.

Not surprising. Various priorities and opinions abound. :)

If all of the calculators out there are correct I need about 2,800 to maintain weight which does seem about right for me normally.

AIUI, many public calculators are based off studies of what people say they eat, rather than what they actually eat, and therefore systematically underestimate calorie needs. And then there is the definition of 'needs' - maintaining current weight, or actually meeting all the bodies needs for maintenance and repair and whatever buffers it 'thinks' it needs.

There are also no doubt some individual variations in needs, and I can't predict with any confidence what will happen for you with various tactics - just ideas to consider and experiment with.

'Normally' for you is presumably at the base metabolic rate you are accustomed to. Adding thyroid supps is an attempt to increase the base metabolic rate, which if successful would be likely to increase your requirements for many nutrients, including calories.

The body has various mechanisms for maintaining energy balance, and seems to adapt to the life it has been exposed to.

One of the common responses to restricting calories for weight-loss is for the body to reduce base metabolism and/or to reduce lean mass, either of which mean that future metabolic fuel requirements will likely be lower. You may be using two tactics - calorie restriction and thyroid supps - that are working against each other.

Have you run your typical day's diet through cronometer or similar to see if there are any obvious micronutrient bottlenecks?

Some of us need a small midnight snack to keep us out of too much night-time stress and help us sleep enough, probably because our glycogen storage is not up to sustaining good blood sugar levels through the night. On the other hand, our digestive system is probably not optimally set up to handle a lot of food esp. protein at night.

 

[Nicole W.]

I think diet is good. Vit D is 70.
Low stress. I'm outside for an hour each weekday, more on weekends, wish I had more.
I eat about 2,500 calories per day right now which keeps my weight stable.
I'm 6'1'', 194 lbs.

(Eggs, milk, oj, potatoes, rice, fruit, cheese, gelatin, raw carrot, cook with coconut oil, occasional gluten-free starch, 1 beer per day)

I just finished an experimental course of NDT that lasted 4 months. By the end of this period I felt terrible, so fatigued I could barely function. I thought I had developed CFS.

My naturopath suggested testing adrenals with a DUTCH panel test. Interestingly, the results indicated that elevated thyroid levels caused my body to metabolize cortisol at a faster rate which did not leave enough for my body to use. Once I stopped the NDT and started supporting my adrenals I felt immensely better. If your adrenals aren't working optimally you'll have trouble finding success with NDT in my opinion.

 

[Waynish]

I just finished an experimental course of NDT that lasted 4 months. By the end of this period I felt terrible, so fatigued I could barely function. I thought I had developed CFS.

My naturopath suggested testing adrenals with a DUTCH panel test. Interestingly, the results indicated that elevated thyroid levels caused my body to metabolize cortisol at a faster rate which did not leave enough for my body to use. Once I stopped the NDT and started supporting my adrenals I felt immensely better. If your adrenals aren't working optimally you'll have trouble finding success with NDT in my opinion.

I'm starting to think exogenous thyroid hormones are only good for people with severely (and specifically) broken thyroids. In a system that is all working at a lower gear - including the thyroid - it doesn't seem to merely boost levels of that one thing...

 

[marsaday]

I just finished an experimental course of NDT that lasted 4 months. By the end of this period I felt terrible, so fatigued I could barely function. I thought I had developed CFS.

My naturopath suggested testing adrenals with a DUTCH panel test. Interestingly, the results indicated that elevated thyroid levels caused my body to metabolize cortisol at a faster rate which did not leave enough for my body to use. Once I stopped the NDT and started supporting my adrenals I felt immensely better. If your adrenals aren't working optimally you'll have trouble finding success with NDT in my opinion.

The final thyroid product is T3 and this works with cortisol to enter the cells. Too much T3 will deplete cortisol. Too much cortisol will leave a deficit of T3. Both examples will leave us feeling ill.

Balance is the key and so we must work with the thyroid and adrenals to slowly establish a good balance again. Too many people will take to much thyroid meds. The answer is to work slowly with the thyroid meds. T4 is the gentlest form of thyroid meds on our system. The body will take it and use it as it requires.

It all sounds easy, but many people struggle getting this balance working for them and it isn't easy for many people.

Lots of people say T3 is the best thing to use. It may be but i think you need to use it in very small doses = 1/8th tablet max (approx 3mcg).

When using NTH you don't have much control over the ratio of T4 and T3. i grain has 36mcg T4 and 9mcg T3 in it. So the hit of T3 is very high just from 1 grain. IF you use T4 and T3 you have greater control over what you put in the mix.

 

[Nicole W.]

I'm starting to think exogenous thyroid hormones are only good for people with severely (and specifically) broken thyroids. In a system that is all working at a lower gear - including the thyroid - it doesn't seem to merely boost levels of that one thing...

I totally agree. My thyroid function seemed fine "on paper" but because of ongoing fatigue and some evidence of myxedema my naturopath suggested a low dose of NDT. At first things were ok but after a month I started to tank so I thought the answer was to progressively raise the dose. That was pretty much a disaster. By the end I thought I was dying.
Have you ever heard of a product called Vital Adapt? I know that Ray is not a fan of supplements so suggesting it here might be sacrilege but that stuff is the number one thing that has turned my condition around. It's a tincture that is comprised of adaptogenic herbs and reishi mushroom, licorice... Their herbs support adrenal and thyroid. I'm super sensitive to everything, even b vitamins, but this I can take and it's very effective. I think the brand is Natura? Anyway, it comes in pill and tincture form. I don't believe my doctor would recommend it unless it was a superior product. I have used it off an on for about 3 years. I think you can still find it on Amazon and it gets high reviews. Personally, it's the only thing that worked for me. The NDT was a good experiment though, I'd would always wonder if I hadn't tried it.

 

[redlight]

Reverse t3, iron panel would be useful

 

[redlight]

The final thyroid product is T3 and this works with cortisol to enter the cells. Too much T3 will deplete cortisol. Too much cortisol will leave a deficit of T3. Both examples will leave us feeling ill.

Balance is the key and so we must work with the thyroid and adrenals to slowly establish a good balance again. Too many people will take to much thyroid meds. The answer is to work slowly with the thyroid meds. T4 is the gentlest form of thyroid meds on our system. The body will take it and use it as it requires.

It all sounds easy, but many people struggle getting this balance working for them and it isn't easy for many people.

Lots of people say T3 is the best thing to use. It may be but i think you need to use it in very small doses = 1/8th tablet max (approx 3mcg).

When using NTH you don't have much control over the ratio of T4 and T3. i grain has 36mcg T4 and 9mcg T3 in it. So the hit of T3 is very high just from 1 grain. IF you use T4 and T3 you have greater control over what you put in the mix.

^ Yup I do much better on separate t3/t4