**Sadly, though this page was exclusively about NDT, it is now also focused on taking T4/T3, or even T3 or “natural thyroid supplements” when it pertains to being “optimal”. Why not just about NDT? Because every single prescription brand of NDT has changed over the post several years from the consistent and good treatment they used to be for years and years. The last one to change was NP Thyroid in 2019–i.e. patients seeing a return of their hypo symptoms. And we don’t know why these changes have occurred to all of them in one degree or another. Patients have also reported feeling like not one pharmaceutical seemed to care.  As of this writing, we hope that Acella Labs will figure out what went wrong with NP Thyroid and bring patients back what they used to have.

Natural Thyroid, also known as Natural Desiccated Thyroid (NDT), is a hypothyroid treatment that has been around a long time and turned lives around. It’s often by prescription and is real thyroid i.e. it’s made from dried and powdered thyroid from pigs (mixed from several pigs, not one). Pigs are close in compatibility to human cells, thus why it works so well, plus gives you what a healthy human thyroid would be giving as far as all the thyroid hormones. NDT powder used to make the tablets also meets the stringent guidelines of the US Pharmacopeia, i.e it’s made according to certain quality standards, contrary to what some doctors say.

There is more info on NDT, plus applies to taking T4/T3, in Chapter 2 of the world-renowned 2019 UPDATED REVISION of Stop the Thyroid Madness: A Patient Revolution Against Decades of Inferior Thyroid Treatment.

PLEASE NOTE: this page as a whole comes under the DMCA or Digital Millennium Copyright Act, meaning this page is protected under copyright law. That means you are not welcome to copy this entire page, or even sections, or graphics, without asking for permission from Stop the Thyroid Madness LLC. 

1) How long has natural desiccated thyroid been around?

It’s been used successfully by patients since the 1890’s as reported in old medical journals and books.  For very interesting information on its history & details on the product itself, see the updated revised STTM book, Chapter 2. Very worth it. There is also another chapter on NDT in the STTM II book by a doctor.

2) What’s always been the big deal about natural desiccated thyroid (NDT), especially before it was changed over the past few years?

Natural desiccated thyroid gives you exactly what your own thyroid would be giving you: T4, T3, T2, T1 and calcitonin.  Thus, you aren’t totally dependent on conversion as you would be on T4-only–you’re getting some direct T3 in NDT. When optimal, it has always removed depression, improved the immune system for Hashi’s patients, prevented us from falling into adrenal fatigue due to being a better treatment, lowers high cholesterol, improve bone and heart health, remove T4-only-caused pain, on and on. READ Chapter Two of the revised STTM book for excellent details about NDT, those five hormones, and more. Note that OPTIMAL puts the free T3 towards the top part of the range and the free T4 midrange. Both.   

***Even using the two synthetics for T4 and T3 has met success if one’s optimal dose is found, say a lot of patients.

3) What are the brands of desiccated natural thyroid? Is one better than the other?

NDT brands and fillers are all listed here. Everyone has had their favorite. Also read about the changes that occurred. You will also see different brands of T3 for those who take the T4/T3 route of treatment.

4) Can I take natural thyroid or T4/T3 if I have autoimmune Hashimotos’s disease??

Definitely! Now some will see their antibodies go up when first starting. But as we move up towards out OPTIMAL dose (free T3 towards the top of range; free T4 midrange), that stops, which we think is due to an improved immune system.

Get the patient-to-patient book Hashimoto’s: Taming the Beast to learn a great deal about Hashi’s, about triggers and what to do about them, about gut health, lots of research, and best of all, a great deal of patient experiences on how they put their Hashi’s into REMISSION!

5) If on T4-only, how have patients reported moving over to NDT or T4/T3?



  • If on T4 like Synthroid or Levothyroxine, a lot of patients have reported taking it a final day…
  • …then the next day, patients start on natural desiccated thyroid with a starting dose of one grain/60 mg.
  • Or if just adding T3 to the T4, patients lower the T4 a bit and add in approx 5 mcg T3 in 3 days or so. T3 is raised by the same amount until optimal. Doing labs is VERY important.
  • On prescription NDT, patients then raise by 1/2 grain every two weeks or so, as long as there are no negative symptoms. On OTC ndt, it’s a guessing game, so labs are VERY important.
  • Negative symptoms while raising towards an optimal dose usually point to inadequate iron or a cortisol problem

6) If not on any thyroid meds, what do patients report as a good starting dose of NDT? 

When first starting out, one grain (60/65 mg) has been a safe “starting dose” for most, patients have reported. Then what is in the above graphic. Note that one grain of most NDT’s is 38 mcg T4 and 9 mcg T3. That will give a good idea if also treating with T4 and T3.

7) What is one wants to move from T4-only, to treating with both Synthetic T4 and T3?

Generally, we have lowered the T4 a bit for a few days (allowing the conversion to T3 to slow down), then we add in direct T3. Starting doses of T3 vary, but 5 mcg is safe for most, and dosing that 5 mcg twice a day (5 and 5) . Then raising by that much for each dose, and retesting the free T3 once taking a total of 25 mcg T3. It’s also about tweaking based on the free T3 and free T4 lab test.

8) What is an optimal amount of NDT or T4/T3 and what are common doses to achieve optimal?

For either, optimal is reflected by a free T3 towards the top part of the range, and free T4 midrange. Thus why doing the free T3 and free T4 labs are important. What amount achieves optimal? It varies between individuals. If we stay lower than optimal, hypo symptoms return, sooner or later.

9) But I feel great on non-optimal doses of NDT or T4/T3! Am I an exception to the optimal amounts?

Many people will feel better on the lower doses…at first. But it eventually backfires due to the suppression of the natural feedback loop in your body. Thus, hypothyroidism will return. The individuality is when.

10) Are patients taking NDT or T3 once a day?

Most patients have reported finding it beneficial to divide their dose to at least twice a day in order to spread the energy-giving affect of T3 when it’s most needed.  An example is taking 2/3 of your natural desiccated thyroid or T4/T3 in the morning, and the other 1/3 in the early afternoon. Or if on T3, more in the morning than in the second dose. And the theory was the fact that one’s own thyroid, if healthy, would have given you what you need throughout the day instead of one dump; thus, we replicate that when T3 is in our treatment.

11) What do patients notice when optimal on NDT or T4/T3 (#6 below is especially important)?

STTM graphic When Optimal on NDT

GRAPHIC SUMMARY: Patients report seeing these outcomes when they are optimal (along with optimal iron and cortisol:

  1. the near complete removal of hypothyroid symptoms
  2. a mid-afternoon temp of 98.6F or 37C
  3. a before-rising morning temperature of 97.8-98.2F (as learned from Dr. Broda Barnes)
  4. a good heartrate and blood pressure
  5. improved energy because our metabolism is better
  6. a free T3 in towards the top part of the range and a free T4 around mid-range. The latter labwork has been noticed frequently over the years when optimal. Yes, optimal seems to push the TSH lab result below range without a hint of hyper! i.e. though Graves disease results in a very low TSH, our low TSH isn’t the same, thus dispelling the fear-mongering by doctors that we will get bone loss or heart problems.

12) Why do I not see the TSH mentioned above?

Because patients discovered it’s more about the free T4 and free T3, not the TSH, which is a pituitary hormone. The goal is always about the free’s, NOT the TSH. Also, when the optimal levels of the frees are reached, the TSH will fall below range. Doctors will sometimes overreact to a TSH that low, so read this page.

13) My free T3 is optimal and at the top of the range, yet I feel horrible and my free T4 is lower in the range. Why? 

That can mean you are pooling due to a cortisol problem. This is the test patients use to see what’s up .

14) Can patients go by those Synthroid-to-NDT equivalency charts?

Not unless you want to stay hypothyroid, patients have reported over the years. You can’t compare the two at ALL.

15) Are there any non-prescription desiccated thyroid products?

Yes. They are usually bovine and some are mentioned on this page. Even on the over-the-counter natural thyroid supplements, its KEY to get optimal by watching the free T4 and free T3. It’s NOT just about “how you feel”.

16) Do patients swallow, chew it up first, or do NDT or T3 sublingually? 

All work. But many have found that putting it under the tongue (sublingual method) seems to give a better punch, in spite of empty strong opinions that it can’t due to the molecules being too big. Even biting the tablet up into smaller chunks work. If you do swallow it, you’ll need to avoid taking iron, estrogen, calcium or high fiber as any of the latter can “partially” bind the thyroid hormones. If the tablet is quite hard due to excess cellulose, chewing it up can give better results, say some patients.

17) Why is the T3 in desiccated thyroid, or straight T3 with the T4, or T3 alone, so important?

From a defunct biology website, but still good information: In your cells, T3 is essential to reconverting ADP (the ‘flat battery’) into ATP (the ‘charged battery’). A shortage of T3 leads to a poor ratio between ATP and ADP. That would seem to explain why a long recovery period is needed after exertion; it takes a long time, at this deficient rate, to get back to a decent level of ATP so you’re ready for more activity.

And here is a study which underscores the above: http://ajpendo.physiology.org/content/280/5/E761

18) How do I find a doctor who understands desiccated thyroid or T4/ T3 or T3-only?

Many doctors are very ignorant about it all. Others will prescribe, but hold you hostage to the TSH, or are afraid to go high enough to get your levels optimal. So be prepared to teach any doctor what you have learned from this page and the revised STTM book. Learn!! Study!!

19) I’ve read bad reviews with NDT. What are they talking about?

a) Initial bad reviews were because those patients were underdosed and didn’t get the bad results from that, or the NDT was revealing an iron or cortisol problem that can be treated.
b) Now, all prescription NDT’s have changed over the past few years, away from the consistent results they used to give. Can someone new to NDT make them work? The answer is watching your frees and getting optimal.

One can also be UNDERDOSED on either NDT or T3, which results in bad reactions over time. Study this page.

The below graphic also applies to taking T4/T3, or just T3.

STTM graphic Reasons NDT fails UPDATE (1)

SUMMARY OF GRAPHIC: 3 main reasons for problems when raising Natural Desiccated Thyroid:

  1. They didn’t raise it high enough, thus a return of hypothyroid symptoms and even too much adrenaline
  2. They have either too high or too low levels of cortisol. Saliva testing, not blood, is the way to find out accurately
  3. They have inadequate levels of serum iron, and the latter can push RT3 too high

OTHER LESS COMMON REASONS: allergy to fillers, allergy to porcine (they might also note that when eating bacon or ham), genetic mutations causing a conversion issue with T4.

20) Do I have to treat my adrenals before getting on or using NDT or T3?

Most with a cortisol problem, as revealed by a saliva test, can tolerate very small amounts of NDT or T3. But you will still need to discover and treat the adrenal problem in order to raise and get optimal.

An adrenal issue is why you need to read the updated revision STTM book. Chapters 5 and 6 go over it all. And the updated revision has many updates in those chapters.

21)  Can I get on NDT or T4 if I already know I have a high Reverse T3 (RT3)

We learned the hard way that a very high RT3 is going to need mostly T3, plus to treat that high RT3. Read all about RT3 here. More in the updated revision STTM book.

22) Why do some patients take T3-only instead of desiccated thyroid or T4/T3?

a) If reverse T3 (RT3) is going up when raising NDT or having T4 with T3, patients lower NDT or T4 and add in T3 to help lower RT3 while treating the cause.
b) A minority may have a mutation in the DIO1 gene which can prevent conversion of T4 to T3. Doing genetic testing such as 23andme can help find that gene mutation.

23) If one is retirement age or older, are they supposed to lower NDT or T3 a great deal? Or not use it?

That idea of lowering comes from a study done with those on T4-only and who appeared to be overdosing themselves with T4 and had more bone fractures. But with NDT or T3, the direct T3 has helped our bone strength, not make it worse. It’s possible if your activity level dropped, you might need slightly less NDT or T3 than one does at age 30. There is also a ridiculous idea by insurance companies that NDT is harmful for older folks. That has not proven to be true. It’s all about being OPTIMAL, no matter one’s age, we have noticed as patients.

24) Why does my doctor say NDT is “unstable”?

Doctors used to say this because they don’t know what they are talking about. T4-only had been recalled MANY times due to this issue. Today, sadly, we have seen many changes to all NDT brands which aren’t resulting in the consistent product we used to know. So the “unstable” designation now fits due to unknown changes by the pharmaceutical production, but NOT due to the NDT itself. NDT itself has changed lives since the 1890’s.

25) What fillers, etc, are in Natural Desiccated Thyroid or T3?

To see ingredients of all, go here. To see all available options for desiccated thyroid, go here.

26) Any other tips?

Many patients are keen to having an emergency backup of desiccated natural thyroid or T3 just for that–emergencies! Desiccated thyroid has a long shelf life, but you can also wrap it securely to avoid damaging moisture and place it in the refrigerator door.

WANT TO COUNTER BAD INFORMATION OUT THERE? It’s extremely important to be informed. This is why I, Janie, wrote the updated revised STTM book. Read. Study!! Underline. Highlight. Bookmark. We have no choice to be informed to get well.

Want to order your own labwork?? STTM has created the right ones just for you to discuss with your doctor. Go here: https://sttm.mymedlab.com/

Need help interpreting your lab results? Go here: www.stopthethyroidmadness.com/lab-values/ Because patients have learned that lab results have nothing to do with just “falling in the normal range”. 

Important note: STTM is an information-only site based on what many patients worldwide have reported in their treatment and wisdom over the years. This is not to be taken as personal medical advice, nor to replace a relationship with your doctor. By reading this information-only website, you take full responsibility for what you choose to do with this website's information or outcomes. See the Disclaimer and Terms of Use.