# To NDT or not to NDT...



## my3gr8girls (Mar 18, 2016)

My doctor will not increase T3 any higher because of my low TSH (big surprise). He has me at 15 mcg daily, although over the last two weeks I increased myself to 25 mcg and I feel that this is my optimal dose because of symptom relief. So, my giant bottle of T3 will run out before it's supposed to and I asked him if he would try NDT instead of levo if he won't increase T3. He said he would rather switch me to NDT than increase T3. So he called me in an order of Naturethroid. I am afraid to try it! He wants me to start on 1.5 grains. Currently I take 88 mcg of levo and 25 mcg of cytomel (he thinks I take 15 of cytomel). I think I'd rather just take the dose of levo I'm currently on plus the T3 but I'll have to find a new doctor to keep this dose. Ugh. It is a little annoying to have to pop pills all day which is what taking cytomel requires. Anyone have any advice or information that will help me decide? It just seems like a big deal to switch meds which may mean going back down the hypo path to get the right dose. I'm tired of this struggle. I actually feel pretty darn good right now, and I don't want to go through it all again. Just because he won't give me more T3, I'm looking at figuring out a whole new dosage and routine.


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## Octavia (Aug 1, 2011)

Thoughts about having to take Cytomel multiple times a day may be misguided for some.

Information from rxlist.com says the following. (Don't confuse half-life of 2.5 days with absorption in 4 hours. It absorbs quickly, but lasts a lot longer than 4 hours in your system.)

Pharmacokinetics

Since liothyronine sodium (T3) is not firmly bound to serum protein, it is readily available to body tissues. The onset of activity of liothyronine sodium is rapid, occurring within a few hours. *Maximum pharmacologic response occurs within 2 or 3 days, providing early clinical response. The biological half-life is about 2-½ days.*

*T3 is almost totally absorbed, 95 percent in 4 hours.* The hormones contained in the natural preparations are absorbed in a manner similar to the synthetic hormones.

Liothyronine sodium has a rapid cutoff of activity which permits quick dosage adjustment and facilitates control of the effects of overdosage, should they occur.

The higher affinity of levothyroxine (T4) for both thyroid-binding globulin and thyroid-binding prealbumin as compared to triiodothyronine (T3) partially explains the higher serum levels and longer half-life of the former hormone. Both protein-bound hormones exist in reverse equilibrium with minute amounts of free hormone, the latter accounting for the metabolic activity.

_Last reviewed on RxList: 9/21/2016_


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## my3gr8girls (Mar 18, 2016)

That's interesting! I have read this before but so many people claim they have to take it frequently, some as often as every hour. I notice that I experience shakiness when it's time to take the T3 but maybe if I took enough in the morning that wouldn't happen. Or maybe it's just a symptom I will always have from time to time. Maybe I'll try it. I'm thinking about going ahead and trying the NDT. The pharmacy is apparently out of it so I'm waiting for the script to be filled.


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## my3gr8girls (Mar 18, 2016)

Deleted an accidental duplicate!


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## my3gr8girls (Mar 18, 2016)

Today I made the switch from levothyroxine/cytomel to Naturethroid. I'm hoping not to need the Cytomel but I will keep it handy. I'm trading 88 levo/25 cytomel for 2.25 grains of Naturethroid. I'm taking 1.5 grains (1 tablet) in the morning and 0.75 grains in the afternoon (half tablet). This should equal exactly the dose I'm taking of T4/T3 with the current regimen. I took my first dose this morning and I feel much better than normal! I was starting to get depressed over the last few weeks. I'd reached a limit with the T4/T3 and my symptoms were pretty well controlled although I still had aching shoulders. Still, something didn't feel right. So I took my endo up on his offer of NDT. I'm really hopeful that this will allow me to get back to living my life and not having to constantly worry about my hypothyroid symptoms!


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## Octavia (Aug 1, 2011)

Keep us posted - I hope you start feeling better with this change!


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## my3gr8girls (Mar 18, 2016)

It's been 7 days since I switched to Naturethroid from levothyroxine/cytomel. I definitely like it better. It was really tiresome popping T3 pills all day long and staying up 3 hours after eating dinner to take my T4. The Naturethroid is much easier. I take it twice a day and I feel better too.


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