Is Natural Desiccated Thyroid (NDT) the Best Thyroid Medication?

Is Natural Desiccated Thyroid (NDT) the Best Thyroid Medication?

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Natural desiccated thyroid is a thyroid medication that comes from pigs!

This medication contains a more “complete” profile of thyroid hormones when compared to almost all synthetic thyroid medications out there. 

This has led many people to tout NDT as the “best” thyroid medication. 

In this article, we are going to explore this claim while also discussing the pros and cons of this medication. 

You’ll learn who should use this medication, who should avoid it, and the pitfalls of using it

Let’s dive in: 

What is NDT or Natural Desiccated Thyroid Hormone?

NDT or natural desiccated thyroid hormone is simply a type of thyroid hormone medication. 

It can be used to treat people who have low levels of thyroid hormone in their body from conditions like Hypothyroidism and Hashimoto’s thyroiditis. 

NDT is often claimed to be one of the “best” thyroid medications out there because it’s considered to be all-natural. 

So, with this in mind, let’s break apart what NDT actually is. 


Where does NDT come from?

NDT is porcine-derived which means that it comes from pigs. (1) 

To get NDT, people must take the thyroid gland of pigs and desiccate or dry it out. 

From there it is standardized to a specific dose and contains 38mcg of T4 (the inactive thyroid hormone) and 9mcg of T3 (the active thyroid hormone) in each grain. 

Grain is just a way to standardize the dose of NDT between different brands. 

Natural desiccated thyroid also contains other hormones and prohormones such as other types of thyroid hormone (T1 and T2).

These hormones are not nearly as active as T4 and T3 but they are thought to play an important physiologic role in the body otherwise, (2) why would your body produce them?

Each grain of NDT contains around 76% T4 and around 23% T3 which is a ratio close to the 80% T4 and 20% T3 that your thyroid produces naturally when it is healthy. 

For this reason, and because it contains prohormones, and because it comes from a natural source, (3) many people believe it is one of the most complete thyroid medications out there! 

While this may be true, it doesn’t mean that it works equally well for every single person. 

Let’s dig into the basics of NDT and talk about why it may not be the best medication. 


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Natural vs Synthetic Hormones

NDT is considered to be natural because it is sourced from a “natural” source, pigs. 

This sourcing of thyroid hormone is different from the approach used to create other formulations of medications such as Levothyroxine and Synthroid

Other medications are created in a laboratory from other basic compounds. (4) 

But you must always remember that ALL types of thyroid medications are considered to be bio-identical which is very important. 

Bio-identical means that the hormones you are taking by mouth are considered to be IDENTICAL to the hormones that your body produces naturally!

Where these medications differ is in the SOURCE. 

The source for NDT is from pigs while the source for Levo and Synthroid is other chemical structures. 

Some people believe that naturally sourcing thyroid hormone is superior to creating it chemically in a lab. 

From my perspective, there is no difference between thyroid hormone from a human or a pig when compared to thyroid hormone created in a lab

Both compounds look the exact same and function in a similar way in the body. 

Where they differ is in the other hormones and pro-hormones that come in NDT formulations. 

NDT Brands

Let’s take a second to discuss the various brands of natural desiccated thyroid hormones out there. 

There are several “well-known” brands and some less well-known brands. 

What you need to understand is that these medications do differ in the type of active and inactive ingredients in them but they all contain both T4 and T3 thyroid hormones. 

While it may not sound like the inactive ingredients make a big difference, they actually may be the reason that some people simply can’t tolerate certain types of NDT brands. 

For instance:

It’s not uncommon for someone to be on Armour thyroid but not feel well when switching to Nature-throid or WP thyroid even if their dose stays the same. 

These differences are likely the result of how your body interacts with the inactive ingredients and how difficult it is for your intestines to break down and absorb the hormones in the medication. 

What that means for you is that if you don’t tolerate one type of NDT brand it doesn’t mean you won’t tolerate all of them. 

Instead, you may want to switch to a couple of different brands to see if you can find one that works for you. 

With that in mind you can find a list of NDT brands below: 

Is NDT Superior to T4 Medication for Hypothyroidism?

It is largely felt by many online communities that natural desiccated thyroid is the single “best” thyroid medication out there. 

This logic has led people to believe that if you are taking NDT and it isn’t working for you that the problem must be with your dose and not with the medication itself. 

I’m not a fan of this approach and don’t believe that when it comes to your thyroid that there is a single “best” thyroid medication

A better approach is to always listen to your body while you look at other problems beyond your thyroid

Thyroid tunnel vision can lead you to believe that every problem you have is associated with your thyroid and that adjusting your dose is the solution to this problem. 

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This approach to management has led many patients to take higher than necessary doses of thyroid medication which can be dangerous! 

So, while NDT is a great medication, it’s certainly not the “best” or the only thyroid medication available. 

The type of thyroid medication that you use, and your dose, should be individualized to YOUR body. 

Natural Desiccated Thyroid for Weight Loss

One important note worth mentioning is that of weight loss and NDT. 

Some studies, like this one, have shown that switching to NDT does result in modest weight loss in certain patients. (5) 

This particular study took a look at 70 patients that were already taking T4 medication (Levothyroxine). 

This group of patients was taking this medication and despite having a normal TSH still had some symptoms of hypothyroidism. 

Thyroid lab tests in patients taking natural desiccated thyroid compared to T4

These patients were then randomized and given NDT (desiccated thyroid extract) for 16 weeks and then placed back on their old medication. 

During the period that these patients were taking NDT, they noticed around a 3-pound weight loss on average and roughly 50% of patients taking NDT wanted to stay on it. 

Not only did they lose weight but they also reported feeling much better on the medication in a subjective sense (based on their own opinion). 

3-4 pounds may not sound like a big deal to you, but when you realize that weight is incredibly difficult to lose when you have hypothyroidism this is actually a great feat. 

But does this mean that the weight loss is due to NDT itself or simply due to the T3 in the medication?

While we don’t have definitive studies, it’s logical to believe that the same results would have been achieved by simply adding T3 (in the form of Cytomel or Liothyronine) to existing doses of T4 in these patients. 

So, while NDT can certainly help you lose weight if you have hypothyroidism, don’t fall into the trap of believing that the weight loss is caused by the NDT itself. 

Instead, the weight loss is most likely the result of IMPROVING the total T3 and free T3 levels in your body! 

And this can be done with T3 medication of any type. (6) 

Common Problems and Symptoms when using NDT

Let’s talk about some of the problems associated with NDT use. 

The way that your body responds to NDT is going to be different from other people out there. 

This means that the type of NDT that you use, and the dose that you use, all may potentially lead to problems. 

What’s important is to focus on how YOU feel and how YOU tolerate the medication. 

By listening to your body, and by checking your thyroid lab tests, you can be certain that you are taking the right dose for your body. 

You can find a list of the most common problems that patients experience when they use NDT below: 

  • Some people take too much natural desiccated thyroid hormone – (7) Overdosing on NDT is a common problem because many people believe that higher doses will somehow improve their thyroid function. This leads to overdosing and symptoms of hyperthyroidism in some patients. This problem stems from “thyroid tunnel vision”.
  • Dosing is static which means you can’t tweak the T4 and T3 concentrations – NDT comes in a static dose of 38mcg:9mcg of T3. This means that you can’t individually adjust the amount of T3 in the medication without also adjusting the T4. You might do great on 38mcg of T4 but may need something like 5mcg of T3. If you fall into this category then you can’t adjust your medication. 
  • May lead to variations in free T3 & Free T4 levels – Some people experience very high free T3 levels and very low free T4 levels even when using low doses of NDT. This problem probably has to do with how each individual processes thyroid hormone in their body. 
  • Symptoms arise from the use of T3 which can be difficult to manage in some patients – (8) Some patients are exquisitely sensitive to even incredibly low doses of T3. These are patients that would probably do fine on certain types of T4 medication (such as Tirosint) but do poorly when they start even low doses of NDT. 
  • May be hard to break down for some patients in the intestines – This problem isn’t unique to NDT medications, but it’s worth considering if you have intestinal issues. Inactive dyes and fillers may cause reactions and may make the digestion of NDT difficult. 
  • May lead to immunogenic reaction (may not be ideal for patients with Hashimoto’s) (9) – There is a theoretical risk that taking a foreign pig-derived substance can “flare” up the immune system and worsen thyroid function in patients with Hashimoto’s thyroiditis. I don’t think this is a reason to completely avoid NDT if you have Hashimoto’s thyroiditis but you should be aware that it can happen.

Overdosing on NDT

Believe it or not but doctors have been using NDT since the 1950s!

Even back then it wasn’t uncommon for doctors to prescribe high doses of NDT (up to 3 to 8 grains per day) to patients. (10)

This was way before thyroid lab tests were created, so dosing was often based on the “Basal metabolic rate” which is a marker for metabolism. 

These doctors found that increasing the dose of NDT did result in modest weight loss by increasing the metabolism, but once the dose was lowered, the metabolism of the patient went back down to below-normal levels. 

This is as relevant today as it was back then. 

Currently, many people believe that by simply increasing their dose of NDT that they will finally feel better and relieve their symptoms. 

This happens frequently in patients who are suffering from weight gain. 

This leads to higher and higher doses of NDT which dramatically suppresses the TSH and temporarily helps with weight loss. 

But the unintended effect is that it may also cause long-term harm because of the high dose of NDT being used. 

Studies dating back to the 1950s showed that if you are responsive to NDT you only need a small dose (usually 1-2 grains) to improve your symptoms and improve your metabolism. (11) 

If you are still feeling symptomatic at that point then some of your symptoms are likely related to some other problem or some other hormone imbalance!

You can avoid these potential negative side effects by using only the appropriate dose and by monitoring your thyroid lab tests in the process. 

Who should use NDT

NDT is a great medication and many people out there stand to benefit from its use. 

I’ve compiled a list of just some of the patients that tend to do the “best” on this medication below: 

  • Those who have failed T4 medication – If you’ve been on T4 medication such as Levothyroxine or Synthroid and you just aren’t feeling well after 6-8 weeks then it may be time to consider a T4/T3 combo medication. 
  • Those with low free T3 levels (usually need a T3 medication) – Up to 15% of the population suffers from thyroid conversion issues which means they don’t convert T4 into T3 as well as other people. If you fall into this category you may have a “normal TSH” but your free T3 and total T3 levels may be lower than normal. If you fall into this category then adding T3 (from either NDT or Liothyronine) may help bring these levels up and help you feel better. 
  • Those who are post-thyroidectomy – Your thyroid (when functioning normally) produces around 80% T4 and around 20% T3. If you don’t have a thyroid, because it was removed or destroyed, then it makes sense to supplement with thyroid hormones close to this ratio. Most post-thyroidectomy patients take only T4 medications (so 100% T4) which do not contain T3. Some of these patients don’t feel well despite having a normal TSH. Taking NDT can provide your body with T3 in a ratio that is close to what your body produces naturally and may help those without a thyroid. (12)

This is not an all-inclusive list but it can help get you started! 


Natural desiccated thyroid is a thyroid medication that contains both T4 and T3. 

Because of this, it may be one of the better thyroid medications (but not the best!) out there. 

If you have thyroid issues and are struggling with low free T3 levels, weight gain, and/or other symptoms despite having a normal TSH, then this medication may help you

When using it be careful to watch for side effects such as anxiety, heart palpitations, or hot flashes which may indicate that your dose is too high. 

Now I want to hear from you:

Are you taking NDT? Is it working for you?

Are you not tolerating NDT?

Is it causing negative symptoms?

If so, leave your comments or questions below!

I’ll do my best to respond to each comment. 













NDT thyroid medication vs other thyroid medications

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About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 80,000+ people have used them over the last 7 years. You can read more about my own personal health journey and why I am so passionate about what I do.

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54 thoughts on “Is Natural Desiccated Thyroid (NDT) the Best Thyroid Medication?”

  1. Hi- been taking Armour 120 mg for a couple of years. It was very helpful compared to Levo. However low thyroid symptoms have been back for over a year.
    Currently, TSH has been .008 to now .012
    T4 has been .80 now 1.15
    T3 5.3 to now 4.2
    Endo just lowered to 90 mg. Been having symptoms of hypothyroid the whole time. Do you have any suggestions to help alleviate the symptoms? or doing/weaning schedules? Really would appreciate your input and direction. Thank you!

    • Hi Laurie,

      I’m not sure that weaning down further would help your symptoms any. Instead, you may want to focus on strategies to help what thyroid hormone you have in your body function. You can do this through diet and supplements to start with and ultimately you may need to adjust your medication further.

  2. Hi,
    Appreciate the informative article. I take 2 1/2 grains of NDT and feel good for the most part and my labs look great. My thyroid antibodies have gone down to 9 from several hundred as well. My main complaint still though, is lack of weightloss -despite not eating gluten, dairy, soy, artificial sugars, etc. faithfully for 5 years . I could stand to lose about 40lbs so it’s just so strange! Any thoughts??

  3. Earlier this year, I wasn’t converting my T4 to T3 and I was anemic. My anemia was corrected with an iron supplement and a good quality probiotic (after reading your studies). Thanks to you I avoided wasting time and money at a gastroenterologist. Just wondering why my endocrinologist never even considered giving me T3…that seems like a simpler solution. I’m 15-20 pounds heavier and struggling to lose the weight. My thyroid and synthroid are always causing my weight to swing. I can be a size 4 or size 12 in a matter of months. Ready to get off the roller coaster! I need you as my doctor! You get it!

    • Hi Genia,

      Most physicians won’t prescribe T3 usually because they aren’t familiar with how to dose it or what to do with some of the symptoms that may arise.

  4. Hey Dr. Westin,
    So I was diagnosed with hypothyroidism in February of this year after mainly having more hyperthyroid symptoms. I feel like I have lost part of who I am. I use to be able to do triathlons and feel like I could get so many things done in the day along with taking care of my two kids who are 3 and under. But after finding out I had hypo they put me on levo, and then kept increasing my dose all the time. I didn’t feel any better and my heart seemed so erratic along with feeling out of breath. So I asked my primary to switch me to Nature throid which he did at 1grain since the middle of April. Which seemed to help my mood, brain fog, and shakiness that I had experienced on Levo. I have been losing weight this whole time. I’m 5’3″ 116lbs which is what I weighed in high school and I’m 30. I still feel like I have so many issues. I did get my ferritin/iron checked and was not anemic but not optimal so I’m going to go in soon to see if the supplementation of iron is helping though I still feel fatigued and weak most days, especially after having my period. I’ve tried so many supplements and diet changes and feel neurotic and helpless.
    my symptoms now
    trouble sleeping
    aware of my left descending colon not painful just discomfort
    unintentional weight loss 123lbs in Feb 116lbs now
    obsessed with my health
    unable to handle exercise
    mood changes
    aware of my heart beat at different times of the day

    Any suggestions, or labs? wondering if I also might have blood sugar issues even though my A1C was normal. Ugh Sorry to throw all of this on you. But I’m guessing you might be used to this.
    Thank you for any suggestions.

    • Hi Chelsea,

      The first thing you should do is get a full hormone panel which includes both sex hormones and your thyroid. This information will really help you to determine where these symptoms are coming from but without this information you really won’t know where to start.

  5. Hi Dr.Westin Childs, just asking something quite confusing. Just got a bottle of Armour thyroid. The label stated 1/4 grain is (15 mg) and then under, stated that each tablet contains:

    levothyroxine (T4)…9.5 mcg

    And on the table guideline, 1/4 grain (15mg) contains levothyroxine T4-9.5 mcg and liothyronine T4 -2.25 mcg
    The question: what is right? Just about switching from synthetic Levo to Armour … Hoping for your reply…thank you.

    • Hi Roche,

      I’m not sure I understand your question, it looks like the numbers checkout to me based on the 1/4 tablet you mentioned.

  6. Morning,
    I have watched all of your videos more than once and have read all of your posts. My question is this:
    I was switched to Armour 90mg, from Synthroid 100 (but just before that the Synthroid was lowered to 88 as I was having hot flashes).
    Free T3 5.80
    Free T4 1.0
    Super cold hands and feet still. Morning temperature is 97.7

    I was on 60mg Armour with results of
    Free T3 4.1
    Free T4 0.8

    However, when I was on Synthroid only my Free T3 was extremely low and I felt achy all the time.

    I don’t know my Reverse T3 number. But my Ferritin is 215.
    I am lost as where to go next. Thanks.

  7. Hello Dr. Childs!
    Thank you for all your wealth of knowledge and all your great & helpful articles.

    I just got back my latest thyroid function results.
    TSH: 0.10 (past .32 & .21)
    T3: .900 (past .620 & 1.310)
    T4: L@4.17 (past 4.43 & 4.89)
    T3,free: 2.87 (past 2.40 & 4.14)
    FT4.N: L@0.72 (past 0.91 & 0.86)
    Anti-TPP AB: 1 (past 1 & 0)

    I was on NT 2 32.5 mg then bumped to 3 32.5 then after these results bumped back to 2. I started NT Aug 2017. The second number in past results is from that date and the 1st past number is from March 2018) then my current reading. I’m 56 and have been on this long health journey. I’m one to be wired at night and sleep till 1 pm daily :/
    I’ve also had an ongoing infection on my chin for past 2 years that won’t clear.., Staph folliculitis. I’m gluten dairy and mostly sugar-free as well. I’m thin as well.

    I’d love your opinion and suggestions would be greatly appreciated! Thank you so much.

    (More info: My NP said the medication is not working and there’s no alternative. She suggested going back to 2. I also came up with strong allergy to pork yet I don’t eat pork. Could it be from the NT? I’m below low in all my blood levels too. )

  8. Hi Dr Child’s,
    Thank you so much for taking questions. I have listened to all of your videos and learned a lot. I was on 125-150mg synthroid for 20 years and never felt right. I started Erfa NDT 3 months ago and am currently on 2.5 grains(150 mg) but still don’t feel right. I have a pressure behind my eyes kind of like a dizzy feeling(I have had numerous tests with no answers). I am wondering if this is caused by thyroid. I also feel weak and tired some days. Here are my current labs.
    Tsh-0.08. (0.32-4.00)
    Free t4-10. (9-19)
    Free t3-3.1. (3.1-6.2)
    Reverse t3 -8 (8-25)
    Thyroglobulin antibody-98. (Under 40)
    Tpo ant-570. (Under 35)
    Ferritin -74 (5-272)
    Vit D -112 (75-250)
    Iodine-13. (75-500)
    I have been gluten free for 6 months and am currently working with a naturapath. Any advice or insight you can offer would be greatly appreciated. I would like to raise my NDT because my t3 is so low.

      • Dr. Child’s,
        My main question is do you think it would be best (in your opinion)for me to raise my NDT or just add t3( cytomel) after seeing my labs and hearing my symptoms. Thank you.

  9. I had my thyroid removed 7 years ago and started Synthroid. I always took my pill when I first woke up and about a half hour later had coffee.
    A friend told me that wasn’t the correct way to take it. So in January I began taking it when I woke during the night (between 1:30 and 3:30). My TSH dropped to .006. My Dr. changed my 112 Synthroid to 100. I felt terrible — couldn’t fall asleep and when I finally did, I was awake almost every hour, constipated, no energy and continued to gain more weight. I actually couldn’t make it through the day without a nap. But my TSH improved. Couldn’t believe the way I took my medication could change my TSH so much. I am now on 2 pills of Nature-Throid for six weeks. I am sleeping so much better. I still wake up around 1:30- and 3:30 take my pills and fall right back to sleep. I’m not constipated and I am not gaining weight. I go back for more blood work in November and will see my Dr. To be continued.

  10. Is it possible that a person can’t tolerate any sort of thyroid replacement? Ndt, T3 etc? My dr has had me on both and said I can’t tolerate any sort of thyroid replacement. I don’t understand this I don’t want to go bald and be miserable the rest of my life! I’ve tried so many doctors and no luck anywhere, my labs aren’t bad just ft3 being 2.3 but everything else seems fine.

    • Hi Tmw,

      It’s certainly possible but I find it difficult to believe. There is probably a formulation out there that will work for you.

  11. I am 65 years old and have hashimotos. Take armour 180 for over 15 years. Just had a bone density and was diagnosed with osteoporosis. This doc blamed my armour. Said I am putting myself in hyperthyroid condition and wants me to go. On levothyroxine 112. TSH <.01. T4 free 1.3 T3 free 4.0. I don't want to change. Any advice? Doc said Fosomax.

  12. Hi, first time visiting your great channel.
    I had my thyroid removed Jan of 2018 due to Papillary Cancer and I am also BRAF positive too.
    I take a higher dose of Synthroid to suppressed my risk and recurrence of Papillary cancer. So I am in a interesting position of being in a state of Hyper not Hypo as I was before my surgery.
    I have gained about 27lbs too.
    I am avoiding all gluten foods, eating lots of veggies, drinking 60 oz of water. Unfortunately Not losing weight and very poor sleep and no energy.
    Tested negative for Cushing disease but Iam pre-diabetic.
    Any information or suggestions would be deeply appreciated.

    • Hi Debra,

      It’s important to understand that you can suppress the TSH and NOT be hyperthyroid. Hyperthyroidism is defined as a state of excess cellular activation from thyroid hormone and just taking an excess of levothyroxine often does not provide the body enough T3 to put you into hyperthyroidism even if your TSH is suppressed. After all, you would experience weight loss, diarrhea, and other symptoms of hyperthyroidism if you were truly hyperthyroid.

      Your best bet is to find a balance of both T4 and T3 thyroid medication which keeps your TSH suppressed while also providing more T3 for your cells. You can learn more here:

  13. Does any level of NDT, no matter how low, cause suppression of endogenous thyroid hormone production? My hormone optimization Dr suggested it but I’m weary of going on forever…like with TRT. I have fairly normal levels except for high reverse T3.

    • Hi John,

      The level of suppressed depends on the dose, so small doses will have a small suppressive effect and large doses will have a large suppressive effect.

  14. I am about to switch to a compounded t4 and t3 medicine from NDT.
    I would like to know will adding more t4 hormone to the compounded thyroid improve the status of my t4 levels without raising the t3 levels over the range? My t3 levels at the moment is not the top of the range but close. I have found that while on NDT my t3 always goes to the top range when I raise the medicine, and t4 is always below the range. I do feel that I am quite sensitive to t3 and although my other symptoms improve I feel nervous and have high pulse rate when my t3 is top of the range and t4 not even mid range. I do think that it does have to do with my t4 not being optimal. I have Hashimotos. Thank you so much for your help!!!

    • Hi Milica,

      It might, but I think it’s a flawed way of approaching thyroid lab tests and thyroid dosing. You can force your thyroid lab tests into optimal ranges while taking certain medications but that doesn’t mean you will necessarily feel better. In terms of importance, your total T3/free t3/reverse T3 are typically much more indicative of thyroid status in your body compared to free T4.

  15. Hello Dr. Childs,

    I could use some input. I had RAI treatment back in 2003 then started Synthroid back in 2004/2005 for borderline Graves disease. It’s been a roller coaster ever since. I am an active 40-year-old male

    I’ve done a panel of thyroid blood work all but Reverse T3 I thought the doctor ordered it but did not and was told there was a $30 charge for this test. I would’ve paid it but was not informed.

    My blood work came back for the thyroid tests and Testosterone tests along with other annual blood work within the “normal” range.

    Despite my blood work showing up as “within the normal range” I still haven’t felt right since I was put on Synthroid. I’ve also moved locations since then. My current family doctor feels that Synthroid is the “only/best” treatment out there based on my TSH results.

    After speaking with friends and family they’ve also felt that Synthroid isn’t the right choice for them either.

    I’ve had to increase and lower my Synthroid several times over the years, my weight can change going up or down by as much as 10-15lbs, I feel bloated often, stomach problems, some muscle spasms, some hair loss, acne at times, hives, etc..

    I work out like crazy 3-4 times a week and I’m not in as good shape as I feel I should be, I have trouble losing some weight, I feel tired often, and have never felt quite right since I was put on Synthroid.
    If I work out harder I feel run down and get sick, if I eat less I feel my cortisol levels going up. (I’m not diabetic). I eat well, live a healthy lifestyle avoid foods that cause me problems yet I still don’t always feel “well”

    A friend of mine recently switched to NDT called “Thyroid” which I understand is another version of Armour and has actually lost weight without changing anything else in her regimen. She has no negative side effects thus far and blood work is going well

    I’m debating requesting to change to this medication as well as I said I’ve never felt right on Synthroid.

    I’m currently taking 125MCG’s of Synthroid what would be the best starting dose of the NDT “Thyroid” medication?

  16. Hi Dr. Childs,

    I am I NP Thyroid 90 mg, my labs show:
    TSH .664
    Free T3 4.43
    Free T4 .943
    Thyroglobulin Ant 12
    Thyroid Perox Ant 53

    Like your opinion on what to do about extremely high antibodies. They have been high for at least 5 yrs. Dr doesn’t seem concerned and my autoimmune is attacking and difficult to manage. Any suggestions would be greatly appreciated!!

  17. Hi, Doing this on my own is new to me so forgive dumb questions. Please. I had been stable on 124 mcg levo for around 10 years. I am 72 BTW. Nov of 2018 my NP became obsessed with my thyroid issue even tho I was stable & doing very well. She didn’t like my tests even tho I told her, according to previous doctors that my tests were inaccurate. (See FDA on biotin warning). She immediately went on program to make my test normal by withholding my meds. (She nearly killed me!)Then she wanted to reduce them drastically but it did nothing for my test results. Finally I got a test while I was OFF the vitamin & my tests were back to ‘normal’ & I was doing ok when I was back on the 124mcg levo again.
    Now, even tho 112mcg levo is way too low-my temp dropped to 96, heart became irregular & slowed to 40, etc. Had ALL the hypo symptoms but the NP refused to reinstate the 124mcg. Now, because she refuses to even talk about it I have no choice but to try NTD to make up the difference between what she will give & what I need. How do I get from 112mcg levo to 124 with a combination with NTD? Hope this makes sense. I can’t change doctors. This is what I have to deal with in my area.Thanks

    • Hi Roxyann,

      It wouldn’t be a good idea to make up the difference between 112mcg and 124mcg of T4 with NDT. You could try to do it with 1/4 of a grain of NDT but I just don’t think it’s a good idea given that the conversion isn’t perfect and may cause issues.

  18. I left a comment but it didn’t post apparently. I was writing to ask an opinion about fluid retention that won’t budge despite champion type workouts intermittent fasting high quality clean eating. I have a raised tsh of 7.0. I don’t really have hair falling out or some other common symptoms. I know it’s fluid and not fat because I had a surgeon tell me when he went inside my body to collect fat for a injury I was trying to improve, that I had hardly any fat for the procedure. And yet I still looked like I did. So my question is about having fluid retention in upper and lower arms and upper and lower legs and my upper back. I do have lots of muscle but the massive amount of fluid retention hides it but I am very strong. Is this something you’re familiar with? There’s no day or time where the fluid retention lessens like some people where it’s relayed to female issues or something like that. It’s a constant for the last few years and I have been very patient with trying to help my body with it but it doesn’t change. Any insight is welcome. I am hoping a thyroid medicine can be used in the short term to help restart the thyroid but I don’t want to be on thyroid medicine for life which I’ve had a doctor tell me is possible dependent on each person, meaning some people don’t have to be on thyroid support for life. Is this something you’ve come across in your practice or are familiar with, with the fluid retention but not having dry skin, hair falling out, depression etc. all advice welcome thanks Dr!!

    • If you have a TSH of 7 and water retention I’d bet you have low T4 and T3 levels. I carry 5-8 lbs of water retention due to low T3 levels and I’m a very thin person naturally. High amounts of T3 added and my water retention melts off. Don’t put off finding the reason for your high TSH. Get your other thyroid hormones tested for the big picture. My symptoms were ignored and I lost half my thyroid due to a hurthle cell adenoma back in 2007 and now I’m stuck on medication for life. I’ll never know if it was something simple I could have corrected. Unintentional calorie restriction pushed my TSH numbers up.

      • Hey Janiece I really appreciate your response and insight on everything you mentioned about your experiences. I’m so sorry it happened for you that way. It’s interesting because I do not feel hungry sometimes which leads to unintentionally fasting or eating very little. I know there’s controversy about intermittent fasting with YouTube doctors like Eric berg etc. so every doctor says something different. I did get my thyroid panel and the t4 numbers are supposedly in range. Not that that means much in my opinion. Can I ask if you had fluid retention in your upper and lower arms and upper and lower legs like me? I’m also thin but the fluid definitely takes my definition away despite how strong I am physically. I have repetively asked for low dose of thyroid medicine like naturethroid but am rebuffed and shown my lab numbers. The most recent Tsh numbers (before corona time) was a little above 3.0 So again was told nothing will be done for me. I hope I found a way that works for u in your own situation. I still am up in the air, not helping my situation due to being told no by doctors. I also had high cholesterol and my doctor said let off the fried foods etc I don’t even eat fried food or junk period. So I see how little they understand and hear the patient which is pretty disheartening. Wishing you well!!

        • Sorry for the late reply. I don’t get notifications when someone replies to a message on the blogs.
          I’d say the fluid retention is all over and I can see it in my skin and face. I’ve lost strength and muscle from low T3. I also have very little to no appetite due to low T3 yet it makes me feel hypoglycemic all the time even though my fasting blood sugar levels are always optimal. A TSH of 3 is usually suspect of borderline hypo but I’d say it depends on what your Ft3 and Ft4 levels are and how you feel. If you’re hypo you’ll have constant fatigue.

          • Awe thanks again for responding it’s ok. I don’t know bc I haven’t gone to the doctors since corona but I know I have fluid retention in the places I said. My moons on my nails disappearing were one of the first initial signs I noticed with the weird fluid retention. I don’t know if I’m fatigued bc I have high anxiety so I heard that can interfere with feeling your exhaustion bc cortisol levels are high. I appreciate your insight and time. I don’t know maybe I’ll try to change doctors to try to get naturethroid or something since the fluid retention hasn’t budged. I did cross reference my lab numbers of t3 and t4 a while back with what natural doctors suggest and they were low t3 but my doctor brushed it off and the tsh has been higher than it should. But I just was interested in trying out naturethroid for like 6 months to a year or something to see if i feel different and if things change in my labs etc. I heard sometimes the only way to know if you have a real thyroid issue is to take the medicine for a few months and see. That was said by a natural doctor though. Who knows. I’m glad you found what works for you though dear.

      • Also can I ask how did You get t3 I couldn’t even get holistic doctors to give it to me. Or do u mean something like naturethroid when u r talking about high amounts of t3? I tried to get t3 only medication a couple years back when the fluid retention started but nobody would give it to me. Do you have any experience with thyroid glandular and the fluid retention being helped? Open to any advice all insight, thank you!!

        • I go to an obgyn that specializes in correcting hormones, weight and thyroid. I had my lab work over a four year period that showed decline in T3 levels and that’s how I got natural desiccated medications or T3. They won’t prescribe it if water retention is the only symptom. You have to show low levels of T3/T4 in your lab work. You don’t want to have to take this stuff unless it’s your last choice. I’d give anything to not have to take it.

    • Hi Anne. Just wanted to share something that might help. I have Hashimoto’s and have been on Armour 1/2 grain for 7 years. I feel well but noticed if I eat gluten or soy, my whole body immediately fills up with fluid. It takes a day or so to go away. Try avoiding those things and see if it helps.

  19. Ive been using NDT thyroid medication for half of my life (25 yrs). I am T3 deficient. I used Armour, solely, until there was a shortage, and I tried NP successfully. I now use NP, as my first option. I like both, but NP is far less costly. Years ago, NDT was back ordered, and my doctor called in Cytomel. It did NOT work for me, whatsoever! I crashed immediately. It started w no energy, and continued w other issues associated w no or low thyroid. I finally found a pharmacy who had WP in stock, and it saved the day. I did a bit of research on thyroid medications, and learned Cytomel was synthetic. I could do a blind test, and I promise, Id be able to tell the difference in most synthetic/chemical products vs natural (fabrics to meds to vitamins). My body responds best to natural. Mind you, it was here that I learned Cytomel is T3 only, so that might have been what caused it not to work well w my body. A couple of times I had to miss a day in taking my thyroid meds (pharmacy miscommunication, etc). Once I got my meds, (2-60’s 1x/dly), I took one sublingually, and one orally. I could tell a quick improvement in the way I felt. Ive not considered taking them sublingually on a regular basis, but Im considering this, and will speak w my doctor, should I move forward w this. I also want to look at options to supplement or replace the medications I take. Why? In the event there is another shortage, and continued back orders, which has happened to me more than once. Also, there may be better alternatives, and at some point, there may be a way to help the body function optimally. Ive not had a chance to look at the rest of your site, bc I wanted to read about types of meds/ absorption first. Im eager to continue and then move forward!

  20. HI DOC I am 67 yrs old and had my thyroid ablation about 8 yrs ago the reason was graves disease.when I started meds was first on levothyroxine had brain fog and didn’t feel right, after about half year switched to ndt and felt better I have been on it now for 7 years with minimal problems. When my DR does my blood work he only checks tsh for the last 6 or so months have been having heart palapitation. Had heart monitor for3 days and was told I have SRT.Ihad my naturalpath dr do blood work and found my t3 to be9.3 t4was13 and tsh is 3.2 how should my free t3 be lowered thanks RB

  21. Hello Dr Weston Childs- thank you for your interesting article on NDT and T3.

    There was no mention, however, that NDT, for example, won’t give a good result if iron or cortisol levels are low. This is really important and many people would have tried NDT and found it didn’t relieve their hypothyroid symptoms, and thought it not a good choice for them. That was so in my case, but I persevered, addressed cortisol and iron issues, and I am doing very well on 3 grain daily. However, my TSH is very low (as it would be from taking T3 and that’s makes sense), my free T3 is at the top of the normal range, and my T4 is mid to 3/4 range, and this is the optimal level for me. Doctors don’t like these results and keep lowering my dose, putting me into hypothyroidism hell, and it takes months to recover each time.

    Another consideration has to be diet – I find that goitrogenic vegetables, especially kale, has an impact on my thyroid function, even when taking NDT, and the day after a meal, I have hypothyroid symptoms that were present before treatment.

    Instead of these knee-jerk decisions by doctors, an educated, intelligent discussion and some research would be better, with the patient in mind, and not medical authorities. Everyone is different and no doubt genetics plays the biggest part in a treatment that works best.

    The standard lab test for thyroid function is likely created to test synthetic T4 effects in the body. Dosing according to symptoms works well and that’s the best way for me.

    If I sound like a grouchy hypothyroid person, well I am after years of fighting doctors just so I can live life with some quality. There are many of us out there who are indeed as grouchy as hell, because it’s a terrible battle to try to stay well.


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