Natural Thyroid 101
(Important note: STTM is an information-only site based on what many patients have reported in their treatment. Please work with your doctor. This is not meant to replace that relationship or guidance, and you agree to that by reading this website. See the Disclaimer.)
What exactly is natural desiccated thyroid (NDT)?
Desiccated thyroid by prescription is real thyroid i.e. powdered thyroid from pigs (mixed from several pigs, not one) and it meets the stringent guidelines of the US Pharmacopeia, i.e it’s made according to certain quality standards, contrary to what some doctors say. To see ingredients of all, go here. To see all available options for desiccated thyroid, go here.
How long has Natural desiccated thyroid been around?
It’s been used successfully by patients for over 115 years, as reported in old medical journals and books and still with modern patients. For interesting information on its history & details on the product itself, see the revised STTM book, Chapter 2. Very worth it. There is also another chapter on NDT in the STTM II book by a doctor.
What’s the big deal about natural desiccated thyroid (NDT)?
Unlike synthetic T4-only meds which have been problematic for so many patients (Synthroid, levothyroxine, etc) …desiccated thyroid is natural and gives you exactly what your own thyroid would be giving you: T4, T3, T2, T1 and calcitonin. READ Chapter Two of the revised STTM book about details what each of these hormones are, and more..
A lot of patients who’ve tried T4-only, or even the two synthetics (T4 and T3) or even straight T3, have reported far better results with NDT. They have stated it’s a smoother treatment, removed their lingering symptoms, improved their immune system (which helped lower the antibodies of Hashimoto’s for some), allowed many to wean off anti-depressants, statins, BP meds and more, gave their lives back, stopped some from falling into low cortisol/sluggish HPA function (which SO many patients end up with because of the inadequacy of T4-only) and they feel it’s far better for your immune system if you’ve ever had thyroid cancer (because of the direct T3 within NDT which appears to improve immune function–that is big).
What are the brands of desiccated natural thyroid? Is one better than the other?
Everyone has their favorite. Yes, sometimes problems will creep up with a brand here or there, and STTM tries to report on that via the blog. You will also see internet over-the-counter brands which patients have reported good results with. NDT brands are all listed here. Ingredients here.
IMPORTANT NOTICE ABOUT ARMOUR: per many patient reports beginning in 2015 and continuing after Activas bought out Forest, the brand name of Armour seemed to cause a return of hypothyroid symptoms or strange new symptoms. It also tripled in price. It didn’t happen to everyone, but enough that you should know. You can read about it here and decide for yourself. There are other great brands people are moving to.
I’ve heard about problems with NDT in general. What are they talking about?
An important part of the process in using NDT, or even T3, is knowing what one’s iron or cortisol status is before raising NDT, patients have reported for years. Why? Because if either is not optimal, raising can cause hyper-like symptoms or problems! This page gives information about the importance of iron and cortisol before raising. It’s important to teach this to your doctor, too!
How do I move from taking T4-only to NDT?
- If on T4 like Synthroid or Levothyroxine, patients take it a final day…
- The next day, patients start on natural desiccated thyroid.
- A common starting dose is one grain.
- Patients then raise by 1/2 grain every two weeks or so, as long as their are no negative symptoms.
- Negative symptoms while raising usually point to inadequate iron or a cortisol problem
- Patients slow down somewhere in the two grain area to do labs, then tweak
- It’s common to end up in the 3-5 grain area when optimal, though some are slightly less, some slightly more
What do patients report as a good starting dose?
When first starting out, one grain (60/65 mg) has been a safe “starting dose” for most, patients have reported–but it’s individual. Nothing is black and white. Why just one grain? Because patients discovered that the body may need to adjust to getting direct T3 again, and there may be other issues which can reveal themselves as they raise, such as sluggish adrenals or low iron levels. So starting higher carries a risk of an overreaction if either of the latter two are present and not yet treated, patients have learned the hard way and reported back about. Not everyone has issues with either, but it seems important to mention it.
Do some doctors start patients lower than one grain? Yes. They may feel there is a good reason. But patients who want to start lower learned to keep going up, bit by bit, to counter the feedback loop suppression. i.e. those lower doses have made some patients feel even worse if they stay on them too long. But again, it’s individual. And again, no matter what patients start on, they have reported learning the hard way that they have to make sure their iron and cortisol levels are optimal.
How do patients raise NDT?
Those who start on natural desiccated thyroid (one grain is common apparently) report that they found it wise to raise by approximately 1/2 grain every two weeks or less to prevent hypothyroid symptoms from returning due to suppression of the internal feedback loop in the body, which can happen if we stay on a low dose too long before raising. They also want to introduce the direct T3 wisely so their bodies can adjust to it.
Most patients start to slow those raises down somewhere in the 2 grain area, or as they are approaching the 3-grain area (some are optimal in the 2 grain area). The slow-down is also because it gives the T4 time to build (which can take 4-6 weeks, literature seems to state) and show its conversion-to-T3 results…then inch their way up if they know they aren’t optimal, with their doctors assistance. Labs are usually needed around this time. Some patients end up in the 3-5 grain area when optimal, some on less, and some on more. It’s very individual. (Janie Bowthorpe is on 3 1/2 grains, for example; used to be on 4 when she was estrogen dominant).
REMEMBER: we have to have optimal levels of iron and cortisol to raise without problems, as reported by patients over the years.
Do I take Natural Desiccated Thyroid once a day?
To the contrary, 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 within NDT when it’s most needed. An example is taking 2/3 of your natural desiccated thyroid in the morning, and the other 1/3 in the early afternoon. 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, multi-dosing has always been our way to replicate that.
How do I know when I’m on enough NDT?
Patient see five outcomes when they are optimal:
- the near complete removal of hypothyroid symptoms
- a mid-afternoon temp of 98.6F or 37C
- a before-rising morning temperature of 97.8-98.2F (as learned from Dr. Broda Barnes)
- a good heartrate and blood pressure
- improved energy because our metabolism is better
- 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 can results in a very low TSH, our low TSH doesn’t seem to be the same.
Why do I not see the TSH mentioned above?
Because patients discovered it’s more about the free T4 and free T3, plus the elimination of symptoms. Granted, patients who feel wonderful again do note that the TSH goes quite low, and even below range for many without any hint of hyper symptoms. But the low TSH is not the goal; it’s simply the “result” when feeling wonderful again by the other measures as explained above. Doctors will sometimes overreact to a TSH that low, so read this page.
Note: if your free T3 is at the top of the range and you still feel horrible, or have hyper-like symptoms, time to test the four iron labs (by blood) and cortisol levels (via saliva, NOT blood). Problems with either will cause T3 to pool high in your blood and not get to your cells well. See this as to why you may not be soaring on NDT and have problems.
Can I go by those Synthroid-to-NDT equivalency charts?
Not unless you want to stay hypothyroid, patients have reported over the years. Granted, patients start lower than those so-called equivalency amounts as explained above. Why? They want to let their bodies and hearts get used to the direct T3, which can be stimulating at first. But they start raising in search of their optimal dose, which most of the time, is higher than those equivalent amounts. (If we react to NDT as we are raising, see the heading below titled Why did I feel lousy on NDT? Why do I feel “sick”? Why do I feel hyper? etc.)
Are there any non-prescription desiccated thyroid products?
Nutri Meds which is available in either porcine or bovine desiccated thyroid, and is far weaker, so patients report taking a lot. Plus there’s Dr. Lowe’s ThyroGold, a New Zealand bovine thyroid which seems to be stronger and workable. Neither Thyroid-S or Thiroyd from Thailand are by prescription, and patients report them working quite well, too. There can be others.
Do I swallow it, or chew it up, or do it sublingually?
Yes, some patients do swallow it and do great. But others like to do it sublingually, i.e under the tongue. In spite of what some literature says (that the molecules are too big to be done sublingually), patients report an even better result. Both Erfa and Acella can be done well sublingually, as can Thiroyd. You can also choose to chew it up, but it’s up to you.
It is false that you have to have an empty stomach when using NDT, patients have reported But when swallowing desiccated thyroid, it might be a good idea to avoid iron, estrogen and calcium supplements at the same time, plus possibly magnesium, since all are stated to bind the thyroid hormones to some degree. But note the “to some degree”. It’s only partial binding. Supposedly, we read that the tannins in coffee or tea can also bind thyroid hormones to some degree, but some patients report they take their NDT with coffee and are fine.
If the tablet is quite hard due to excess cellulose, chewing it up before swallowing can give better results, say some patients.
Why is the T3 in desiccated thyroid 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 does underscore the above: http://ajpendo.physiology.org/content/280/5/E761
How do I find a doctor who understands desiccated thyroid?
Patients regrettably find that many doctors are very ignorant about the efficacy and safety of natural desiccated thyroid. But many are finally coming around! If you click on the highlighted “doctors” above, you’ll find recommendations on how to find a good doc. And note that it is not uncommon to drive great distances to find an open-minded doctor–the latter which is a doctor’s most important quality. But be prepared that you may have to teach any doctor what you have learned from patient experiences! Read Chapter 2 in the revised STTM book. Become informed and be prepared to teach your doctor!
Why did I feel lousy on NDT? Why do I feel “sick”? Why do I feel hyper? etc.
There are three main reasons patients report they have problems when raising Natural Desiccated Thyroid:
- They didn’t raise it high enough, thus a return of hypothyroid symptoms and even too much adrenaline
- They have either too high or too low levels of cortisol. Saliva testing, not blood, is the way to find out accurately
- 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), rare genetic conversion issue with T4.
Why do some patients take T3-only instead of desiccated thyroid?
Chapter 12 in the STTM book is completely devoted to T3 and includes good information on RT3–the latter the reason why people might be on T3-only, or because they have Lyme disease.
Are there any beneficial supplements that I can take with desiccated thyroid?
Note: though this section states what patients have said they found beneficial, it’s not directing you to use the same. You have to decide about that between yourself and your doctor. Many patients take a Selenium tablet with their thyroid meds, which assists the T4 to T3 conversion. See the selenium page first for more information. L-Tyrosine helps some patients, too. Zinc and Vit. C may play a role in assisting your thyroid, say patients. Your need for B-vitamins will increase as you improve your energy levels, says some literature. Some patients benefit from iodine supplementation. Optimizing your Vit. D levels can be important along with Vit K2. Minerals can also be important. Chapter 15 in the revised STTM book has great information on supplements and good foods! This is totally your call based on your needs.
If I’m at retirement age or older, am I supposed to lower my NDT a great deal to have my free T3 and free T4 lower?
Patients who have moved up in age report not finding that to be necessary as far as a “great deal”. That idea comes from a study done with those on T4-only and who appeared to be overdosing themselves and had more bone fractures. But with NDT, 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 than one does at age 30.
Why does my doctor say NDT is “unstable”?
Because he or she doesn’t know what they are talking about. Synthroid has been recalled numerous times and that fact is common knowledge. Supposedly, prescription NDT meets the guidelines of the US Pharmacopeia for stability. And patient experiences with NDT do not find it to be unstable.
Any other tips?
Many patients are keen to having an emergency backup of desiccated natural thyroid 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 freezer or refrigerator door.
WANT EVEN MORE INFORMATION ON DESICCATED THYROID?
Definitely get the Revised STTM book, which is especially handy to take into your doctor’s office, or when you just don’t want to be on the computer. Work with your doctor.
- Read Things We Have Learned if you are new to this website, or need help understanding it all.
- To talk to others about desiccated thyroid, go to our Talk to Others page.
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 “falling in the normal range”.