# Combing synthetics with NDT to improve free t4?



## BatMan (Oct 2, 2013)

Im trying to get my free t4 above 30% of range. My t3 looks good at about 75% of range and my TSH is supressed (0.001).

I was considering going back to half my original synthetic t4, then titrating up again with NDT.

I think the problem is the ratio of whole thyroid/NDT is not human ratio. Perhaps its also ranges are so different even within one country they can be different.

Any experiences or thoughts. My blood results in the labs forum if you really interested.


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## joplin1975 (Jul 21, 2011)

Do not add in t4. See my other response - this is expected when using NDT and should not be a concern. Only focus on free t3. You will very likely be over medicated with the addition of any more meds.


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## BatMan (Oct 2, 2013)

My understanding is you want both in the upper reference range, or is that just whispers?

i dont think I need more t3, at 210MG Im getting a LOT of instant t3.

Perhaps I should try dividing my dose for 6 weeks in half, see if that helps and takes away t3 spikes.


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## joplin1975 (Jul 21, 2011)

On t4 only meds, yes, that is correct.

On desiccated meds? Nope, it won't happen. Any time you add in t3, your free t4 will drop as will your TSH...which is why free t3 is so critical when dosing.


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## cujet (Feb 6, 2015)

Over the last 25 years, I've experimented with T4 only, added synthetic T3, Tried Armour only, then moved to a T4 + Erfa (Armour) combo.

None accurately replicate how I used to feel, prior to thyroid failure. But the combo of T4+Erfa (Armour) comes closest. Low blood sugar is a key indicator for me, which was never a problem before failure.

On T4 alone, even with a dose somewhat too high, I had constant low blood sugar issues.

With the addition of Cytomel (synthetic T3) I felt better, but for some reason, I was unable to function by the end of the day.

I then tried Armour without any T4 added, and it was about the same as the syn T4 + T3 combo. I crashed by the end of the day, Constant low blood sugar issues.

The best solution for me was 75mgc synthroid and 90Mg Erfa (Armour eqiv) . However, I do vary the Erfa from 90 down to 60 depending on feel.

I understand everyone is different, and what works for me, may not be ideal for someone else.

My labs have all numbers in the normal range, except TSH is at 1 or below (generally below)


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