NDT or T3 doesn’t work for me!
(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.)
Have you ever felt or stated any of the following when you tried Natural Desiccated Thyroid or T3??
(It doesn’t have to be all of them–just one or more.)
It does nothing for me.
I feel worse on it!
It makes me anxious, shaky, or nervous.
My heartrate or blood pressure goes too high.
I get heart palps on it.
My hair falls out since on it!
I’ve had panic attacks!
I’ve gotten nauseated.
I have a headache now.
My T3 is high but I still feel bad.
I have a high level of reverse T3 (RT3)!
I’m having insomnia and trouble sleeping now.
There’s very explainable and correctible reasons why NDT or T3 doesn’t seem to work, as reported by patients over the years.
1) Staying on too low a dose
When for whatever reason, you stay on a non-optimal dose too long, or simply a low dose, it will always result in worsening symptoms…sooner or later. A starting dose is usually one grain (60-65 mg, depending on the brand), and from there we have to raise every two weeks or less by 1/2 grain, slowing down a bit somewhere in the 2-3 grain area…or as you near 3 grains, to start fine tuning with lab work to find our optimal dose. If this is you, study this page.
NOTE: If this is the case, you will start feeling better as you raise, and will NOT see pooling of that T3, or rising RT3, or worsening symptoms. If you do NOT feel better upon raising, or have the pooling of T3 or high RT3, see #2 below. The highest percentage of thyroid patients aren’t optimal until they are in 2 grain area and/or HIGHER. Some end up in the 3-5 grain area before optimal. There is a much smaller percentage who are optimal below 2 grains, but it’s a very small percentage. You need to read the section on how patients have reported finding their optimal dose on the Natural Thyroid 101 page.
2) Having either inadequate levels of iron or too low/too high cortisol
If upon raising NDT or T3, we have symptoms of either anxiety, shakiness, fearfulness, racing mind, heart palps, high heart rate, insomnia, nausea, a high FT3, a low FT4, increased hair loss, and or any strange problems…or we see a very high FT3 or a high RT3, patients have reported that it usually means one or both of the iron or cortisol levels are off, which NDT or T3 “reveals”.
In other words, it’s not a case of “everyone is different” or the need to return to T4-only, patients report discovering. i.e. NDT isn’t “causing” our problem; it’s “revealing” our problem!!
And by the way, if your response is “But my cortisol or iron labs were normal!”, note that labs have nothing to do with simply “being in range”.
Summary: patients note repeatedly that iron has a high risk of going low with undiagnosed hypo, or being poorly treated with Synthroid or Levo, or kept on too low dose of NDT. The reason? Low stomach acid. T3 tends to pool high in the blood when iron is low. Low iron can decrease the deiodinase activity i.e. conversion of T4 to T3, favoring reverse T3 (RT3) the inactive hormone.
What do I test to see if my iron is causing my issues on NDT or T3??
We have found it’s NOT just about ferritin. Testing for iron is with FOUR labs: ferritin, serum iron, % saturation, TIBC. Then results can be compared to where healthy people fall here…which again has NOTHING to do with just being “normal”. If iron is definitely not optimal, here’s how patients treat it, plus more in the Odds and Ends Chapter of the revised STTM book. Please share all this info with your doctor!
Summary: Being undiagnosed, or treated with T4-only like Synthroid or Levothyroxine, or undertreated with NDT, stresses the adrenals, resulting in too high cortisol, low cortisol, or mixed–all which cause problems when working to raise NDT or T3 to find our optimal dose. Problems include pooling (T3 going too high in the blood & not making it to the cells, or rising RT3 the inactive hormone. Symptoms of a cortisol issue include, but are not limited to, insomnia, waking up often, feeling unrefreshed when getting up in the morning, anxiety, fearfulness, paranoia, shakiness, etc.
Two important truths about cortisol testing
- We can’t go by blood. Blood results are measuring a combination of bound and unbound cortisol, and gives no clue what’s in our cells, looking high when it’s not (or even low when it’s not, as reported by some patients).
- We have to do the 24 hour adrenal saliva test as explained right here. You can order your own saliva testing here. And again, these results have nothing to do with “falling in the normal range”. They have to do with WHERE they fall, as explained here.
But I worked on both iron and cortisol and still didn’t do well on NDT!
Note that “improved” doesn’t equal “optimal”, we found out over the years. And just “being in the normal range” also doesn’t equal “optimal” we especially saw in ourselves! As far as iron, we have learned precisely how to raise iron and where it needs to be, which you can learn about here or at the beginning of the Odds and Ends Chapter in the revised STTM book for additional details (pages 181 – 187 in the English version).
As far as cortisol, a person can fail to correctly treat their cortisol issues as follows:
- thinking that taking only adaptogens can do the job (they frequently aren’t enough if you have low cortisol).
- not understanding how to use cortisol (many take too little, or dose it wrong, or fail to do Daily Average Temps to find the right amount, or fail to stress dose once they do find the right amount…plus more details (Chapter 6 of the revised STTM book has the best details anywhere on how to use cortisol-containing products)
- thinking that avoiding stress can do the job (helpful, but often not enough)
- thinking that a change in your diet can do the job (it’s not enough)
- failing to understand where your saliva cortisol results need to fall as explained here (for those who aren’t on anything yet)
- not understanding the correct way to do the T3CM or that it’s mostly just for low morning levels
- and more….
Should I stay on T4-only while correcting my low iron/low cortisol?
We haven’t found that necessary, or even desirable!! Many who tried it tended to convert to too much RT3 while on T4-only. We learned instead to either be on a small amount of NDT (such as 1 1/2 grains or less) or T3-only in small amounts, or a combo of both. We are looking for the amount that isn’t causing either pooling or high RT3 symptoms.
What if I still can’t tolerate NDT?
For a few rare individuals, they may have inherited a faulty deodinase enzyme (meaning you can’t convert T4 ever)…the best solution for these individuals appears to be T3-only, multi-dosed about 3 times a day, with a fourth smaller dose at bedtime, for example.
There are others who could be allergic to pig, which would also show up when eating bacon or ham! An alternative, in that case, is using a over-the-counter bovine NDT like ThyroGold, or using the two synthetics.
Finally there are could some who have a reaction to the fillers in the brand they are using. Switching to a different brand has solved that for them.
What about Lyme disease and tolerating NDT?
There are some with Lyme who report doing well on NDT. But there are many others who find the Lyme and related co-infections are driving their T4 to excess RT3, possibly due to the high or low cortisol response. This may need lowering of NDT and adding in straight T3….or being on T3-only. Another smaller group with Lyme are finding it makes them quite sensitive to red meat…but haven’t yet gotten evidence that they would react to NDT. We’ll see.
A side comment about heart palps
Some of us with Mitral Valve Prolapse (MVP) could notice heart palps when starting on NDT or when raising, not due to an iron or cortisol problem, but due to MVP sensitivity. Janie Bowthorpe has MVP and heart palps due to it when starting and raising NDT, but the palps went away after a few days on each raise.
BOTTOM LINE: For the vast majority of reports, NDT has always been shown to give the best results–just like a healthy thyroid would do! Even adding synthetic T3 to one’s synthetic T4 has made reported positive differences.
You just have to learn what the NDT or T3 is telling you when it doesn’t work well, and treat those issues correctly. Because unlike T4 with its history of problems, you may not want to miss out what NDT can do for you…or even adding T3 to your T4.
*** Need a good doctor to work this information with? Go here. Expect to teach even the better doctors. It’s workable!