STTM 12 waysA healthy thyroid makes five hormones, of which T3 is the most powerful. T4 is the storage hormone, meant to convert to the life giving T3.

But sadly, there are a variety of reasons why conversion of T4 to T3 my be inhibited, and which especially makes being on Synthroid or any other T4-only medication a risky choice in the treatment of hypothyroidism.

Even if you finally found the right treatment for you (which is adding direct T3 (the active hormone) to that T4 (a storage hormone)…or moving over to Natural Desiccated Thyroid…it’s important to learn the following reasons why you may not be converting that T4 to T3 in the most optimal way.

1) GETTING OLDER: Just as getting older can influence even the production of thyroid hormones, it can affect your ability to convert the storage hormone T4 to the active hormone T3! i.e. deiodination decreases.  www.hormones.gr/205/article/thyroid-hormones-and-aging.html

2) EXCESS GOITROGEN FOODS EATEN DAILY (broccolli, soy, etc) CAN GET YOU INTO TROUBLE!  www.stopthethyroidmadness.com/goitrogens


4) CERTAIN SUPPLEMENTS OR FOODS NEED TO BE TAKEN AWAY FROM YOUR THYROID MEDS Calcium, iron and estrogen are examples. Though this talks about levothyroxine (which patients are moving away from all over the world), the information is solid: www.peoplespharmacy.com/2010/08/26/taking-thyroid-medicine-properly/

5) NUTRIENTS ARE NEEDED TO HELP CONVERT T4 to T3!!  Are you low in Selenium? If so, it negatively affects the conversion of T4 to T3! So do low levels of zinc, B12, B6 and more. http://www.naturalthyroidchoices.com/ThyroidNutrients.html And why do we, as thyroid patients, find ourselves with low nutrient levels?? Besides having Celiac, here’s the most common reason for all: www.stopthethyroidmadness.com/stomach-acid 

6) CHEMOTHERAPY and RADIATION CAN NEGATIVELY AFFECT YOUR T3 LEVELS:   http://www.ncbi.nlm.nih.gov/pubmed/9204611


8) MORE THAN MODERATE EXERCISE CAN DECREASE CONVERSION OF T4 to T3!  www.ncbi.nlm.nih.gov/pubmed/18539729

9) LOW IRON IS A KNOWN INHIBITOR OF T4 to T3!  Just as low thyroid can cause low levels of iron due to low stomach acid, conversely, that low iron can inhibit conversion of T4 to T3!! www.stopthethyroidmadness.com/ferritin

10)  CHRONIC INFLAMMATION IS NOT YOUR FRIEND WHEN IT COMES TO CONVERSION OF T4 to the ACTIVE T3! Just as undiagnosed or undertreated hypothyroidism can cause inflammation, the latter in turn can negatively effect conversion! www.stopthethyroidmadness.com/inflammation

11) LIVER HEALTH IS KEY TO GOOD CONVERSION of T4 to T3! Since your liver is the main component in conversion, any kind of liver stress (fatty liver disease, hepatitis, heavy metals and more) will see reduced conversion to T3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC301912/

12) ESPECIALLY IN MEN, LOW TESTOSTERONE MAY INHIBIT CONVERSION! And like the two incidences about, undertreated or untreated hypothyroidism can lower testosterone, and low testosterone can further inhibit production of T4 to T3. http://www.allthingsmale.com/community/threads/interesting-testosterone-d1-increase-and-gh-increase-t4-to-t3-conversion.17213/

NOTE: you will sometimes see Diabetes listed as an inhibitor of T4 to T3, yet studies are not conclusive and some see higher T3 with diabetes, not lower.

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  1. Mary

    Janie, thanks for all the great info. I found the Mymedlabs for the first time. I am excited…. a question I have for you, is, what do you know about TSI test? I don’t see anything about it and it isn’t in the list of tests to pick from. I have had the test. It was the missing puzzle piece as why the other graves and Hashi tests came back negative for antibodies but yet I had severe hyperthyroidism and bulging eyes. The TSI is the one that relates directly to the attack on the eyes. I have currently gone the other way now and am quite hypo. Awaiting test results now for the TSI.

  2. Stephanie

    Wow thanks for the info! I am currently having a rt3 problem, I also just found out I have PCOS and menopausal levels of all my sex hormones. Could this be the cause of a bad rt3 ratio? Cortisol and iron seem fine.

  3. Sarah Bucknall

    I’m so confused, I was diagnosed with hypothyroidism in 2010, since then I’m up and down going over active then they change my meds then I’m getting hypo symptoms again, my hair is the main thing that suffers constantly falling out and thinning, I suffer from bad heads constantly, lack of concentration etc etc I just can’t bare to think I’m going to be like this for the rest of my life. I’m currently on levothyroxine!

  4. mina

    Hi, what do you recommend to increase ferritin? Want to change to nth, but have Problems of obstipation (hashimoto and pcos) and therefore dropped the Iron medicine. Thanks a Lot!

  5. Becky Buehrer

    I’ve been on Levothyroxine (150 mcg) for over 15 years when I was first diagnosed as hypo from a check up blood test. To my knowledge I had no symptoms and have never really had much in the way of symptoms other than heart paplitations (which led to a heart ablation about 8 yrs ago, anxiety issues, and what I now have heard is “brain fog”. I always called it lightheadedness, like I wasn’t “all there” or was on the outside looking in. The ablation took care of the palpitations and the anxiety/brain fog has been mostly gone (reoccurs every once in awhile). When I read the symptom list it seems I have some but not a lot….and not severe. No fatigue at all. I have always had a hard time losing weight unless I ate almost nothing, but after being on a low carb eating plan for the last 9 mos (at my drs suggestion) I’ve lost 30 lbs and now at 5’6″ weigh 134 and have never felt better. The only other symptom I may have is hair thinning starting a couple of yrs ago. I always had very thick hair and now at age 70 it is much thinner. When I read some of the stories women tell about how awful they feel and what they’ve gone through, I just know (and am grateful) that I’ve never had all that many issues. But after reading all that’s out there on the web and the STTM book about hypothyroidism and the evils of levothyroxine I’m wondering 1st, am I really hypo and 2nd, should I try to get on a different med? I have no other medical problems and except for the levothyroxine take no medicine. I wake up energetic every morning and walk over 4 miles every day at my local park. What do you think?

    • Janie Bowthorpe

      Becky, you listed this:

      1. heart palps
      2) anxiety issues
      3) brain fog
      4) lightheadedness
      5) hard time losing weight
      6) losing hair

      i.e. those are hypo symptoms due to an inferior treatment for so many hypo patients. Yes, you might want to explore this: http://www.stopthethyroidmadness.com/natural-thyroid-101

      • Becky Buehrer

        Thanks for your response. I haven’t had any heart palpitations since I had the ablation procedure about 10 yrs ago. The “lightheadedness” is what I called what others seem to call brain fog…not 2 separate issues for me . Yes, I’ve always had difficulty losing weight but nearly 4 years ago I started walking 4+ mi per day and eating a low carb high fat diet I did lose 50 lbs and now am maintaining at 134 lbs. And the thinning hair (never lots of hair noticeably falling out and not much in the shower drain) is something that just seemed to start a year or so ago despite being on levothyroxine for nearly 20 yrs. When I read the stories on here and in your book by women (especially you!) who obviously have felt so awfully bad, it makes me wonder because I feel great with no medical problems except the low thyroid! Those issues that I did have from time to time in years past haven’t bothered me in quite some time. I sure appreciate you taking the time to respond to my thoughts. What lab tests should I have to provide more information to let me know whether the levothyroxine is not doing its job?

        • Janie Bowthorpe

          Hi there Becky! Hon, it’s not just labs that tell the truth about Levo. It’s symptoms. And though some like me did awful on it from the get-go, others may not be as bad from the beginning, but like you, see more and more symptoms of a poor treatment the longer they stay on. 🙁 Unfortunately, too, a lot of T4 users are a bit in denial about those symptoms which creep up (not a criticism–we can all be in denial about things in our lifetime. lol) and/or don’t understand that those issues are, in fact, due to being forced to live for conversion alone!! What you can do is what so many do….give NDT a trial run. You’ll then find out as MANY have that it truly does give better results since it’s giving you all five thyroid hormones, not just one. But also understand that if you do, you HAVE to use it correctly. i.e. you have to raise and you have to not let a doctor dose the TSH. Study this: http://www.stopthethyroidmadness.com/natural-thyroid-101

          • Doreen

            I tried net for two months l was up to 4 1\2 grains was so sick and weak.had an ultra sound on thyroid showed thyroid totally burned out .the doctor said it was doing nothing for me so put me back on lethyroxine .Benn on it to r 3 days now feel bit better but eyes are still very blood shot an dry I want my life back!!! Heard so much good about natural thyroid so as Ted it to work.. guess I’m one of the unlucky people it doesn’t work for.i am 63 maybe it’s not good for the elders .sad

          • Janie Bowthorpe

            Doreen, it works. There is something else going on. And there are many FAR over 63 who are soaring on it….

    • neeters

      Well you stated you are 70 so of course your hair will have thinned due to aging and low sex hormone leves. This is normal. However mine did thicken up a bit when I took bio identical hormones, bi est , progesterone and testosterone and dhea. I don’t believe any doctor would prescribe those to you now at your age if you aren’t already on them. I keep my hair very short and wear funky hats, try that!

      • Janie Bowthorpe

        There have been a few women over 70 report here that they were able to switch to NDT.

        • neeters

          Janie I meant the sex hormones are very hard to get prescribed if you are not in the menopausal transition, like age 47 to 55. At least here in Canada it’s pretty much impossible.

  6. Jamie Kan

    Hi, I’ve been diagnosed with low thyroid in February 2014 in Vancouver, Canada. The doctor prescribed synthroid 75mcg, then few weeks later 100mcg. But I told the doctor my heart was beating fast, so he lowered my dose back to 75mcg. During this time I ha very dry skin and my hair was falling out a lot. (I thought the hair loss was due to having a baby august 2013). Anyhow, I moved to london, uk in June 2014. The doctor here in uk has prescribed me 75mcg levothyroxine. She said it’s the same as synthroid. But now I have low iron at 5, and low vitamin D at 14. I have found out from the pharmacist that I can purchase synthroid privately. But I am very confused as to which medication is better between levothyroxine and synthroid. I am also currently breastfeeding my 17 month old son. I want to be normal again, I want my life back. I am currently not losing any weight either. But when I was on synthroid I lost some weight and since on levothyroxine I’ve gained it all back and not losing anything. The doctor here in uk has prescribed me iron and vitamin d supplements. She has refused to refer me to see an endocrinologist. I also have two nodules on my thyroid, one is 0.7mm and the other is 0.5mm. I’ve also been told I have Hashimoto’s Disease. If you have any advice please help me. This is all new to me and very confusing. Thank you

    • neeters

      Avoid wheat and gluten at all costs if you have hashimotos. You might be low in progesterone this you can ask an obgyn for. Also if you are overweight of have blood sugar issues this will make you feel rotten as you describe.

      • Janie Bowthorpe

        Neeters, though the majority of Hashi’s patients do better without gluten, there is a small body who report still doing fine on it. Everyone has to find out what is best for them.

  7. Alison

    Hi Janie
    Can you tell me where you get your facts and figures from? It is hard to go to your GP with these but not know how they are backed up. The medical profession only really take notice if figures are researched properly.
    Many thanks


  8. Linnea

    I had to have my thyroid removed totally last July. .I am on the same dosage of synthroid since then. .I tried to get into dr for labs and was told I only need them once a year. .can you give me ideas for research on what I need to know about new meds..new diet..etc. I feel like my body goes into a “shut down” mode almost daily. .this is worse than before the surgery! Please help!

  9. Roxanne Hennig

    I had breast cancer 4 years ago. Barely stage 1, removed tumor, went through radiation. You mentioned it in list of things that can affect thyroid. I did not see anything above about it. I have been on thyroid meds for 10 years now. On levothyroxine 100mcg. I was size 6 before radiation, now size 10-12. My skin and hair are dry. Get tired more easily. I had a doctor that would not change my med levels. I was cold all the time. Said test show my level is okay. Changed doctors and she increased med level and not cold anymore. Just gaining to much weight. Any info on radiation and thyroid. Thanks so much.
    God Bless you for what you are doing. We need to know the truth on things. Thanks again.

  10. Kim Giammaria

    Hi Janie,
    I just found this web site….I found out hi had thread disease 20 some years ago…eventually was told I had hypo and hsimaoto and my thyroid was removed. The last few years my hair has gotten very thin, just found out my cholesterol is high, and sometimes blood pressure is high…Ive been on synthroid, zoloft water pill, blood pressure med. I have always exercised, eat good but now I have chronic pain but I do not want more meds…..can you direct me to where I can find info that might help me?

  11. Matt

    I was doing OK on Erfa for 3 years with a stable does of two grains. When I felt best on it, my FT3 was in the upper third of the range, but FT4 was only at the bottom of the range. Then I went hypo via labs this fall (high tsh, very low frees) but I FELT hyper with trembling hands, anxiety, fast heart beat all in the AM. PM- hard to get to sleep and would wake after four hours. I had to temporary counter act this with calming herbs like Valerian. This also happened to me when Armour reformulated in 09. Why do I seem to get hyper feeling of symptoms when I’m actually hypO per labs??? I changed to Acella NP, 3 weeks ago. It was hard to change. I felt even worse the first two weeks, now improving some, the AM anxiety is a little better now. My saliva test in the past showed a little over in the AM and lower after noon. Most of the adaptogens make me more hyper feeling. I never have luck treating my adrenals. Any thoughts?

    • Janie Bowthorpe

      Matt, your answer is probably here: http://www.stopthethyroidmadness.com/ndt-doesnt-work-for-me

      • matt

        I will get my Iron and saliva cortisol tested again. In the past I also had these hyper feelings when getting used to a new dessicated thyroid med, but I would feel better in two months.

        How do you treat cortisol that is slightly high in the AM and low in the PM (as compared to optimal)? I was both in the past. No Drs knew what to do. I have not read how to treat this.

        One last thing, even when I felt best my body temp was still 96 to 97.8 resting.

        thank you

        • Janie Bowthorpe

          Matt, cortisol is supposed to be at the tip top of the range, and bedtime cortisol is supposed to be at the very bottom of the range. I’d recommend joining the FTPO Adrenals group, which you’ll see under #2 here: http://www.stopthyroidmadness.com/talk-to-others

        • Karen Gardner

          Matt. A holistic doctor helped me. My cortisol was higher in the am and I would get headaches. He prescribed Dhea from a compounding pharmacy 10mg time released and it would clear my head. If I feel jittery magnesium helps and calcium with vit D. When I get foggy headed a little zinc helps. I m on Erfa thyroid now 2 grains l in am and then 1 at 5 pm. Head was so foggy today but when I took my 2nd Erfa took the zinc 10mg and my head cleared. Never had this problem with old Armour for 13 years but reform one bad last refill from Actavis didn t work. Now I m on ace inhibitor Enalapril for high blood pressure 20mg and low carb diet for blood sugar. Vit C helps cortisol too. Sea Salt in water. Those supplements for adrenal make me hyper too. Except Adrenal Complex that is mostly vitamins and adrenal and spleen glandular.

  12. Jamie Kan

    Hi Janie
    I will be seeing my gp tomorrow. If you have any advice or suggestions please let me know. Any help will be greatly appreciated.

  13. Sharon johnston

    My levels are all good. I take 2 grains of naturthroid. I need to lose 25 pounds. I have been on diets and have exercised, but my weight will not budge. Please help. Any suggestions would be appreciated

  14. Tammy

    Hi there!! I have hypo and hashimoto, I have been on synthroid or form of for about 20 years have never felt great since my body was attacked. I just started Nature throid today which I am very excited hoping it will help with all my symptoms.. I am alittle concerned after reading blogs, I was on 137 of synthroid and put on 130/2grains of nature throid right off the start wondering if this could be too high? If it could hurt me.
    thank you for any information you might have for me.

    • Janie Bowthorpe

      Hi Tammy. The reason we learned to start lower is two-fold: 1) The body is not used to direct T3 if you’ve been on the lousy T4-only meds. So we ease into it. T3 is powerful! 2) A lot of folks have either low cortisol or low iron because of being on the inadequate T4-only meds. That can cause folks to go hyper if they start over 1 to 1 1/2 grains due to the failure of T3 to get to the cells in the presence of low iron or cortisol.

  15. Dyan Puspito rini

    Dear jannie,
    I have been in hyperthyroid since 8 years ago
    Doctors give me PTU nothing seem work for me, I lost weight and I look awful look old and dry.
    Last year I move to canberra and the endocrin specialist give me carbimazol ( its taste sweet) for first months I feel better
    But then now I had puffy eyes swollen face and put on weight
    My hair thinning and change into frizzy hair and very dry, I can’t think normal and always tired, I’m now back to indonesia and plan to go to my doctor here next week to have blood test
    What should I do???please help
    My question for you what is natural thyroid medication?
    Should I said yes to doctor when they ask me to go for surgery and take out all my gland?
    What kind diet will work for me?
    Any vitamin I have to have?

    Thank youuu

    • Janie Bowthorpe

      Dyan, I would do an internet search for “Elaine Moore” with the word “Graves disease”. She’s the expert on Graves and also has a forum. They may help you decide if you need to have that thyroid taken out. You might also look into using Low Dose Naltrexone into calming that attack on your TSI…who knows, it might help you keep your thyroid. Read about NDT here: http://www.stopthethyroidmadness.com/natural-thyroid-101

  16. Kristin N.

    Can you help interpret my labs? My doc is worried and wants to send me to yet another specialist which I don’t have a lot of faith in anymore… yet I’m feeling much better than I have (maybe not perfect). I’ve been on Armour Thyroid for almost 3 years now. I take 90 mg/day (60 mg in the am and 30 mg in the afternoon). My labs came back Free T3 = 5.2 (very top of range), Free T4 = .64 (low), and Sensitive TSH = .057 (low). I had RAI 8 years ago after being hyper (but never received an official diagnosis of Graves or Hashimotos), played the synthroid game for awhile and even added cytomel to that but definitely feel better after switching to Armour. I did have my reverse T3 checked last year and it came back fine. Also, as a side note, I’ve also been gluten free for a year and feel better on that as well. Just curious what you think about these lab numbers? Thanks!

  17. Tina

    I’m taking 200 Mcg Synthroid and 10mg cytomel daily. Still feel like crap. So many symptoms. Lab results: Tsh-39.54
    Rt3- 12.8
    Why can’t I get regulated? I just want to be normal and feel good and find a Mississippi doctor who can help me get there. Help!!!!!

  18. Michael

    Hi Janie
    I wanna add that taking excessive Iodine supplement can actually suppress your thyroid. because nowaday our food is rich in iodine . and iodine deficiency is very rare today

    • Janie Bowthorpe

      Michael, no one is talking about taking excessive amounts of iodine, though. And to the contrary, patients are reporting that the iodine loading test is showing them to be deficient. And when they get on iodine, they will report either feeling much better, or seeing improvements in other areas. Women are reporting their fibrocystic breast disease disappears. So it doesn’t look rare.

  19. Pam

    Hello. I am taking 75 mcg compounded T3 q 12 hours. I have been on this dose for well over a year
    Labs RT3 <5
    FT3 6.6
    FT4 .07
    TSH .02
    I feel terrible, but the DO says I should stay on this dose. My body is falling apart. Could these levels contribute to the muscle wasting that I am experiencing?

  20. Shawn

    Hi Janie,
    Thanks for all the great information you provide. I have been diagnosed with Hashi’s for about 5 years. It began with panic attacks, insomnia and other pleasant symptoms. During that time period I was on Levothyroxine ranging from 50 to 175 mcg’s. During this time, I never felt anywhere near like myself regardless of the tsh results. (Actually I felt better when my tsh was .000(fill in the blank) Recently (around a month) I found an endo who gave me a script for Armour and he started me at one grain. My TSH had been around 4 at the time on 112 levo. After two weeks of 1 grain I have lost my focus and energy, along with other common issues. My tsh came back at 1.6, but I had only been off the levo for two weeks (I’m thinking the levo ovelapped with the NTH.) I bumped up the NTH this week to 2 grains this week, but wanted to ask if this is wise. I understand that no true equivalency exist between NTH and Levo, but I want to make sure I don’t throw myself into overdrive. I am positive that my endo is not experienced with NTH, and will only base my dosage on the tsh. I plan to purchase it elsewhere when my scripts are out. Not sure if it matters but I am 215 pounds. Thanks for your help.

    • Janie Bowthorpe

      Shawn, we generally only go up by 1/2 every two weeks, but I’m going to bet that as bad as you were getting on one grain (which is common since it’s only a starting dose and we found out it should be raised upon again…and again…), going up to 2 grains was fine. But do know that it may not be your optimal dose and you’ll end up raising again and again but by the smaller amount, if so. Read this carefully–it explains what you look for to find that optimal dose: http://www.stopthethyroidmadness.com/natural-thyroid-101

  21. Shawn

    Janie, I forgot to add that my free t-3’s always come back in the “normal” range. I also wanted to mention that I do get a boost a few hours after taking a grain. Thanks again

  22. Shawn

    Thanks Janie,
    I will hope for the best. Can’t rely on my endo for any support or knowledge for that matter. Over the years I’ve been told “stress caused my hashi’s”. “there is no difference between hashi’s and hypothyroidism”, as well as many times being denied Dessicated alternatives, and those are just the most common errors. It is truly embarrasing (as well as revealing) that medical professionals are beyond clueless in my experience. If I knew about the various places to purchase bovine and porcine alternatives, I would have did it years ago. My Doc’s always insisted that synthorid and levo where the only two meds that could be trusted.

  23. Judy

    Has anyone taken Armour along with Tirosint? I have heard that the two combined helps the numbers to line up and even have the excess weight leave!!!! Approaching doctor on March 5th, please respond if you have answers to this.
    Thank you so much!

    • Janie Bowthorpe

      Judy, most don’t need to combine the two! Armour and any NDT is 80% T4 anyway! That’s a lot. Adding T4 to NDT puts you are risk of making too much of the inactive hormone RT3, which will make you more hypo. We’ve seen this happen to a lot of patients who think they have to combine the two. If we raise NDT high enough to find our optimal dose, we get all the benefits. Read http://www.stopthethyroidmadness.com/natural-thyroid-101

  24. Cory

    In 2012 I had to have a thyroidectomy due to overactive graves disease that we just couldn’t get under control. For the last 2.5 years my doctors have been monitoring me in levatyroxin 175 per day. They lower it occasionally and up it back as blood work shifts around. My vitamin D and B levels are monitored however I’m always low on D it seems. Everyday I feel like garbage, literally its just hard to move. I was on cymbalta 125 per day but I took my self off after a year a few weeks ago because it just seems to make me worse and worse. I swear it was making me depressed and just like I didn’t care about anything period. My legs ache so bad everyday I’m on 10mg pain meds to get me to work everyday. The dr doesnt really understand why I hurt. And I’ve switched dr’ a few times because they just don’t want to help. They all focus on the pain meds and think that’s what its all about. The dr’s don’t seem to understand anything about the thyroid which is frustrating because finding an endocrinologist in Az is very hard. My last one took the thyroid out and then just handed care over to my primary like they should know. They know nothing except that according to blood work im hunky dory. Well that’s crap, no one has yhe hypo/hyper symptoms like I do daily (odd sleep patterns, pain, no energy,wieght changes, mood swings) and is ok but yeah sure just label it
    Fibromyalgia now and send me to a bone/spine dr. I know much more then them and I’m not even degreed. I will mention switching off the synthetic to natural and I bet my dr just ignores me. Please someone educate the Dr’s because we suffer and were over medicated because they don’t understand

  25. Courtney

    My reverse T3 is 37…my thyroxine free is 1.8 (range 0.8-1.8), my T3 Free is 3.8 (2.3-4.2), TSH 0.066 (0.55-4.78). Had my thyroid removed in 2007. I was on Levo 175, currently taking 150, been having hair pulling out. My Iron is 93 (26-154). What exactly do my labs indicate? Am I in good shape?

  26. Carrie

    Hi, THank you so much for all the wonderful information on your website and in your books. I just started Naturethroid about 4 weeks ago and am having a really hard time with it. I have Hashimoto’s and have been on Synthroid for 23 years. I was actually diagnosed 32 years ago at the age of 16 due to high antibodies but didn’t begin synthroid until 10 years later when TSH hit 82. My first 15 years on Synthroid were good except that I did experience unexplained infertility and always suspected my thyroid. (We have two wonderful adopted children as a result!) The hypo symptoms have been creeping in the past 10 years or so and I didn’t even realize they were thyroid related. At my rope’s end, I started research on my symptoms and realized the synthroid connection. I’m working with a holistic doctor who is fairly knowledgable. 6 weeks ago before the switch, my free T4 & T3 were both low and my reverse T3 was high at 29. I also have low iron (ferritin 14 and iron sat 17%) and suspect low cortisol. Dr did a blood test but not a saliva test. I’m about to order one on my own. When I switched, I stopped synthroid one day and started naturethroid the next, 1/2 grain twice a day. I felt great for the first two weeks, most of my hypo symptoms went away, and I was so relieved to have found an answer but then I started having major anxiety every time I took 1/2 grain and 3/4 of a grain was even worse. It’s a terribly anxious feeling without physical symptoms, heart rate and blood pressure perfectly normal. I am currently taking iron supplements but they make me SO tired and I’ve tried a bunch of different ones. I know that iron and adrenals need to be addressed but why did I feel so good the first 2 weeks?? If that is the problem, iron and cortisol were low then too. Since I still had synthroid left over in my system when I started & felt good, could I need a different ratio of T4 to T3? I now it’s the same powder but is there any reason, I should try armour instead of naturethroid? Would it possibly work differently? I know I need to work on iron and possibly cortisol, but I’m not sure I can remain on naturethroid (with this anxiety) while I do it and I don’t want to go back to synthroid! I also take B12 and need to take vitamin D as I was low in that too! Any advice would be greatly appreciated! Thanks!! Carrie

  27. Jacque

    This site is a God-send – I was diagnosed hypothyroid when I was 12, which was 17 years ago. I have been on the same dose of Synthroid since then, even with complaining for the past 5 years of hypo symptoms. I have gained 40 lbs in 4 years, exhausted all the time, hungry all the time, grumpy, sad – you name it. I FINALLY found this site and tried to talk my Dr. into testing T3 and/or switching me over to NDT, and got a long list of excuses on why she wouldn’t do it. In fact, she said that she wanted to test me for things like sleep apnea because “we shouldn’t just blame all your symptoms on your thyroid”.

    So I decided to take matters into my own hands – my body, my money, my decisions. I ordered Thiroyd online (after tons of research, this seemed to be a great choice), but I have no idea how long it will take to ship, so I started on Biomeds Porcine thyroid until I receive the Thiroyd. It has only been a couple of days, so I don’t feel any improvement yet. I may have to play with the dosage. I am also going to be taking my temp over the next few days to see how my adrenals are doing. I am sick of being a shell of my former self and I am ready to feel good again. This site has tons of great information, and the info from other hypo patients is just invaluable.

  28. Stefanie

    Hi Janie!

    Per recent labs, my doctor can’t seem to figure out what to do for me! Back in January, on 2 grains of WP Thyroid, my values were: TSH 0.02, Ft4 1.3 and ft3 3.9. I felt AMAZING!
    But then recently, around a month ago, my symptoms fluctuated between hyper and hypo, culminating in feeling very exhausted over the last week with 10lb weight gain, fluid retention and extreme bloating.
    Dr ran labs and as of April 3: TSH .38, Ft4 0.8, ft3 2.7
    my frees dropped substantially!!! Mind you, I was on 2 grains of WP Thyroid since August 2014 and felt amazing.
    what suddenly happened?? why did my free t4 drop to below the range and free t3 fall to midrange? Do we up the dose?
    He did pull a reverseT3…still waiting on result.

  29. Jamie

    You said that unstable pupil reflex is caused by low sodium and high potassium levels. Does this mean that I can have unstable pupil without adrenal problem (just low sodium and high potassium? Are there any other causes?

    • Janie Bowthorpe

      Jamie….usually, though not always, low sodium is doing to mean an aldosterone problem, and the latter all too often goes hand-in-hand with a cortisol problem, too. I’ve heard that taking too much zinc can tank sodium, but haven’t heard of real life experiences of that happening yet.

  30. Lisa

    Hi Janie:

    I used to take a compounded armour thyroid until my drug plan stopped paying for most of it. That encouraged me to take a cheaper drug. So after doing some online research, I took WP thyroid (RLC Labs), thinking it was ‘most pure’ starting in April, 2014. Not long after, I noticed that I would have very serious reactions to bug bites. That had never happened to me in my life before. My NP just advised me to use bug repellents when she saw the bites. I hate to use those, but I needed to. I got some HUGE welts last year that left scars. I continued through the next year on WP thyroid. This spring, I again noticed that I got terrible welts from any bug bite. In fact, they got so bad that I took myself to an urgent care center several weeks ago to request an antibiotic, as they looked like spider bites. The shocked looking doctor(after he viewed the welts), agreed that I take that drug to help them heal. I hadn’t taken an antibiotic for over 15 years so I figured it would help and it did. However, soon after, I got a couple more huge bites after being outside. So I decided to hunt for a better answer. In doing so, I noticed that WP thyroid uses inulin from chicory root as a filler. So I checked out chicory root side effects on Web MD and Andrew Weil, MD. Clear as a bell it says not to use chicory root if one has any allergy to pollen, ragweed, daisies, and a number of other flowers. And in checking severe allergies to chicory, I learned it may cause a severe reaction to bug and bee bites. This information is NOT mentioned in ANY of the RLC Labs literature. And how many people have seasonal allergies? Tons! Upon the advice of my pharmacist (who called my realization a ‘discovery’), I was advised to notify RLC Labs. I did that and got a very no care attitude. I was told that I should just talk with my doctor about my allergy and that there are too many allergies for them to list them all in their literature. I also learned on my own that some versions of Chobani yogurt, Kashi fiber bars, some ice creams, margarine, and other foods contain inulin and other chicory derivatives. I am being even more vigilant now in reading labels. Again, I contacted both Chobani and Kashi about my allergic reaction to chicory in their products. I was told the info would be ‘passed along’ but no one seemed even slightly concerned with my allergy. I am sure there are others who may be suffering with this same allergic reaction which is why I am reporting it here. As of a week ago, I started taking Nature-Throid. I immediately started itching on my scalp and neck. However, I read that sometimes chewing it up fully may help reduce the allergic reaction. So I started doing that two days ago and that definitely is helping some. I hope that side effect ends soon so I don’t have to switch yet again. Anyone have good luck and no side effects taking NP thyroid? That would be my last resort before going back to the pricey compounded stuff that’s barely covered under my drug plan. I won’t take synthetic drug versions. I appreciate any guidance here about NP thyroid. Also, where does one get a saliva test for adrenals? Thanks!

  31. Angela Cartwright Brown

    I am really thankful for your information, I have read your book. I was told I was a hypo I requested Armour then I switched doctors and have been taking dessicated for a couple of years now, I felt ok on 11/2 grains, I started getting sick every other week last February, experiencing fatiigue and weight gain. I expressed concern about RT3s and so I am trying T3 only but I am very tired and am having a hard time with my workouts because I feel weak and tired, I am not very motivated to get things done, have some depression and experiencing hot flushes that I have never had before but started with the T3. My Dr. had me read your book but I feel a little frustrated because at my last visit while we lowered the dosage I was told the reason might be that I am getting old…(I might as well call it quits now then, I am only 50) I am just starting to read Paul Robinson’s book Recovering with T3, I feel like napping all day, I read in your book that some people take a dose of T3 at night to sleep better, If I am taking too much could that make me so tired? I take vitamins, and other supplements you mentioned in your book. My blood test did reveal I have Hoshimotos but not bad. Feeling depressed

    • Janie Bowthorpe

      Angela, it sounds like you have been seriously underdosing yourself all this time, and thus, you may now have an adrenal or iron problem, or you simply need to raise! 1 1/2 grains is barely above a starting dose. Most people don’t even begin to be optimal until somewhere in the 2 grain area, and I, Janie, am optimal at 3 1/2 grains and some are higher than me! See what I mean? And with T3-only, you might also be underdosing yourself. Read this: http://www.stopthethyroidmadness.com/natural-thyroid-101

  32. Patty

    For the Love of your Thyroid, check Cholesterol medication WARNINGS, doctor gave me the highest dose of Livalo and Vacespa no tirating up just the highest dose. I weighed 105lbs maybe less at the time. Doctor knew I was Hypothyroid and not being treated. 1 week into these meds regular doctor says I am doing well on these meds. NOT. 3rd week in I go to regular Dr with multiple symtoms, she says its all in my head and go home. I was going into a coma from these meds. I figured this out on my own. NO thanks to the Pharmacist who didn’t know the medicine Warnings, REALLY, after what seemed hours on the website of Livalo and Vacespa I found the WARNINGS and for Livalo at 4mg a day, the Warning was:

    • Skeletal muscle effects (e.g., myopathy and rhabdomyolysis): Risks
    increase in a dose-dependent manner, with advanced age (≥65), renal
    impairment, and inadequately treated hypothyroidism. Advise patients to
    promptly report unexplained and/or persistent muscle pain, tenderness, or
    weakness, and discontinue LIVALO (5.1)
    • Liver enzyme abnormalities: Persistent elevations in hepatic
    transaminases can occur. Check liver enzyme tests before initiating therapy
    and as clinically indicated thereafter (5.2)
    Please lookup the definitions of Myopathy and especially rhabdomyolysis if you are taking Statins and for sure. But the real problem here was two doctors and the pharmacist didn’t apparently know and the Warnings are hidden in the Prescibers info not the patients info and obviously the Pharma Warning didn’t exist. I am just a normal Hypothyroid person that somehow figured this out on my own. The 1/2 life of this crap in my system took a minimum of 9 days to get out and it was not a FUN ride. Still not properly treated for Hypo and I don’t care if my cholesterol is 290 taking their BS poison I would be in a LOCKED in COMA, and they could care less. I also paid my copay to go back to this Cardio doc and tell him what he did. He knew and his attorney stood outside the door the entire time, I explained to him what he did and what the other doctor told me to go home its all in my head. And the pharmacy had no clue.


  33. Cindy

    ( I live in Quebec and my maternal language is french so I might make some grammar mistakes )

    I am 33 year old but I always feel like I’m in the final stage of my life. I just can’t take it anymore. Now that I found your site I permitted myself to feel a thread of hope, something I carefully avoid due to so many disappointments. I was diagnosed with hyperthyroidism in my late teens but a specialist made some kind of mistake in my treatment leading to unfit pill taking and side effects, referrals to other doctors, change in pills, dangerous reactions to pills, respiratory failures, tachycardia, major depression and more.. So much happened that I can’t recall in what order everything came. I had two RAI treatments but I can’t remember when, was it before it all started or a result of what happened ? I don’t know. A doctor filed a complaint against another for putting my life in serious danger because he misread my blood work results and aggravated my hyperthyroidism to the near point of cardiac arrest. At some point, I felt like the all the pills I was taking would kill me so I stopped them all. I was so fed up with doctors that I stopped seeing them. For the first time in two years I was pill free and feeling like myself. During my first pregnancy I had some blood work done and the doctor said it was like I never had thyroid problems. At age 24 my health started to decline and I decided to see a doctor. I was diagnosed with hypothiroidism and was put on synthroid. Later I was put on antidepressant because I had hypothyroidism symptoms but my blood work results were normal. I had my gallbladder removed after I got hospitalised for a pancreatitis due to gallstones. Then I was prescribed Effexor because I started to have panic attacks. I lost my job because I was too tired. Today I’m 33 year old and I am treated for :
    Hypothyroidism ( I take synthroid 0.2 mg)
    Major depression ( I take Bupropion 150 mg in morning and 100 mg in afternoon)
    Social phobia ( Effexor 150 mg)
    Chronic Fatigue Syndrom ( methylphenidate 80 mg twice a day otherwise I sleep most of the time )
    Pitting edema ( doctors can’t find the cause so I’m not treated )
    I’m waiting for a test to see if I have sleep apnea because I always snore and wake up with headaches and sleep does not relieve my fatigue.

    NOTHING makes me feel better.. I gained 125 pounds in the last 3 years, exercises are impossible because I am too weak and my heart rate is waaaay too fast. ( between 104 and 130 when inactive so imagine when I move ). I can’t stand hot temperatures and I feel hot all the time even in winter. I sweat a lot. I don’t feel cold even if my body temperature is always below 35.2 c, and when I feel feverish I almost reach 37 c. People think I’m exaggerating my symptoms, that a diet would resolve a lot of things even if I keep telling them that I can’t loose weight at all and they do see that I have no appetite most of the time !!! They tell me to force myself to exercise even if I tell them that I can’t do my daily chores because I become dizzy and my body hurts like hell. So they think I am lazy and that I make up excuses with false symptoms. I have no friends anymore because they tend to judge me and I have absolutely no energy to explain myself to people that won’t believe me because they give credit to my doctors explanations. Something is very wrong with me but IT IS NOT MY HEAD !! After finding your site, I took an appointment with my doctor and I will see him next thursday. I want adequate blood work and the adequate treatment. I hope to finally get better and be a proper mom to my two beautiful kids. I want to feel like a human again, be able to do normal family activities, have a clean house, relieve my boyfriend from all the things he has to do to compensate my lack of energy, hell I “want to want” to have sex ! Even if hope is a bitter sweet thing for me, right now it feels more sweet than bitter.

  34. Claire

    Hi. I am starting to feel a little better on WP Thyroid. I am trying to figure if I need to increase my dose. I have been taking a quarter in the morning and one eight before lunch. While being on WP my T4 has increased to mid-range but my T3 is just above the lowest level of the range used by this lab. Also, today I was back to college, lots of running around. It really felt like I need more of something as my heart was racing with palps. It felt like my heart needed more of something. I am thinking T3. Thyroid meds natural or not effect my sleep pattern especially as my T4 increases. Any ideas? Should I try taking a quarter before lunch and breakfast?

  35. Claire

    Janie, what do you think of these numbers?
    Iron 122 range 40-200
    Ferritin 125.5 range 15-150
    Free T4 1.2 range 0.8-1.8
    Free T3 2.7 range 2.0-4.4
    T3 Reverse 11 range 8-25

    I have been taking about 24 mcg daily of wp thyroid.

    Thanks for your input.


  36. Claire

    Should patients stop natural thyroid and only take T4 until they can figure out their adrenal issues? About 45 mins after taking my WP thyroid 16.25 my heart started to race. From my understanding this should not happen if you have healthy adrenals. Thanks.

    • Janie Bowthorpe

      Well, since it’s T4-only which pushes patients into having adrenal problems in the first place, we learned to do whatever we can to avoid returning to it. Instead, we just take whatever we can tolerate, which may be small amounts of T3-only for someone like yourself until you do saliva and treat the low cortisol.

  37. Claire

    The confusing thing for me is my salvia test did not show low cortisol. I guess I should have it taken again. How do you treat high cortisol.

    Also, should you always take meds before meals? At lunch today I tried taking mine after eating. I read somewhere that meals help with the voltility of T3. Thanks.

  38. Rebecca

    So I was switched over to WP thyroid from Nature Throid. I liked the idea of less fillers. However, WP thyroid is not working for me quite the same. My morning basal temps are not as good. My iron and cortisol were recently checked by my doc and no issue there. Anyone have experience with this? I still take some adrenal cortex now and then just for some support, I have always taken my nature throid and cortex together. Maybe I can’t do that with WP?? Thoughts???

    • Janie Bowthorpe

      Rebecca, doctors as a whole do NOT understand how to read lab results, thinking that if your iron levels, for example, fall anywhere in the so-called normal range, you are fine. Our observations prove repeatedly that it “ain’t so”. Compare your iron results to this page: http://www.stopthethyroidmadness.com/lab-values

      Second, you can’t go by blood cortisol, we’ve learned repeatedly. You’ve got to look at saliva testing. You can order your own here: http://www.stopthethyroidmadness.com/recommended-labwork And again, you compare your results to the above page.

      Finally, even if you find out via the “right” testing and the “right way” to evaluate your lab results that you do not have a problem, you just may need to raise that WP thyroid.

      • Rebecca

        Hi Janie, thanks for the reply. I should have been more specific. My values for saliva cortisol and iron testing are optimal according to the ranges on STTM. I have been fine tuning myself for four years. It is such a puzzle. I think you might be right, it might be time for an increase. Thanks again for your input!

  39. Diane Duke

    Hi, When i was first Diagnosed in 2012 with hypo my levels read 3.6 on TSH, I’ve been taking Levothyroxine (175 cut in half) .I’m 5’2 weight 135 age 39, i have my blood work done every 6 months but my Doc only checks my TSH, I’m having a few symptoms could you help with… I’m still tried all the time,, I get really cold after I eat its like my temperature drops really low, after that it’s like i can’t hold my eyes open anymore i fall asleep . I’m having memory problem, heart palpitations only when i first take it. Over all i just don’t feel like myself.. Any help to explain what’s going on, and any questions to ask the doc? Any help would be appreciated…

  40. Ann

    Hi Janie,
    I am just starting on this journey, although I have had “symptoms” for years. I will provide some of my results:
    T4 free- 1.0. Range- 0.8-1.8
    T3 total- 118. Range- 76-181
    T3 reverse-23.Range- 8-25
    Also my progesterone was at a 7.9 on day 21 of my cycle, I am 46 years old and female.

    I believe that my cortisol is high, as I have severe anxiety/panic, headaches, heart palps, I am unable to lose anything and I am 50lbs overweight. I have not been able to sleep in quite some time, I am fatigued and lightheaded/dizzy. My dr has prescribed WP Thyroid at 1/4 grain (16.25mg). I am very sensitive to pretty much anything I take so she started with the lowest dose. I have not taken it yet, because she also prescribed progesterone for: anxiety, sleep, palps, weight and elevated BP. I have not taken that yet either. I am nervous about all meds, as you can see. Can you tell from my labs which I would benefit from most, as the dr said I could not do the WP Thyroid and the progesterone at the same time.
    Thank you!

  41. Ann

    Thank you for getting back to me so quickly. I am so confused! So, I need to go back to my dr and ask for the free T3 test, and don’t take the WP Thyroid until I address the cortisol/iron issues? I am trying to use Vitamin C to help lower the cortisol naturally. I always thought that high cortisol caused the insomnia, heart palps, weight, etc.

    Ann 🙂

  42. Jamie

    Hi Janie-
    I have been on Nature-throid for approximately 2 years. I started seeing a homeopathic and was feeling really great. . .so good, I stopped taking my Naturethroid. I am having severe anxiety, heart palps, trouble sleeping, and depressed mood. My prescribing Dr. retired and I am having to wait two weeks (trying to find a doctor in Oklahoma City that is good with thyroid issues) I started back on 1 grain. My question is, could this anxiety event be due to stopping my meds?

  43. Karen Gardner

    I tried taking 30mg Erfa instead of 60mg in morning to see if it would stop the anxious feeling I get 2-3 hours later. Started to feel foggy so I took the Adrenal Complex and Dhea 10mg time release and then the other 30mg Erfa 3 hours later. Took a magnesium to help calm and also on 20mg Enalapril for high blood pressure. Took Enalapril 2 hours after first Erfa. The Adrenal Complex and Dhea help clear my head. Just feel like I can t think. Also take Ceylon Cinnamon to help with blood sugar. Found out the Cassia Cinnamon is bad for your liver. Anybody else have these problems

  44. stephen kattau

    69.99 USD for 1000 hits of thiroyd from thaimeds seemed a fair price. Took 10 days to get here via registered mail. Fair enough. Watched its progress online. I’ve been ramping up my intake from 1/12hrs to 3/12hrs. And have backed down to 2/day. Lest I get too much t4 conversion to rt3?
    Actually, I think I bought some bogus counterfeit crap that is providing no benefit to my hypothyroid condition.

  45. Heather

    I’m really struggling and can’t seem to find an answer :(…. I was diagnosed about 2 months ago and started NDT. I started with 30mg but recently went up to 60mg. (I know, slower than I should but my doctor was hesitant…) I have high rt3 so right now, I’m on 60mg of NDT and I’ve added in T3. I take a total of 50 mcg a day spread out over the day. In the afternoons, I finally have a clear head. For the first time in 12 years!!! It’s amazing! BUT, from the time I wake, to noon or a bit after, I have severe brain fog. Worse than every before….. I tried upping my morning dose of T3 but it didn’t help. Last night, I spaced out my doses so I could take 12.5mcg right before bed, and then I also got up and took 12.5mcg 2 hours before I get up in the morning to see if that would help, but unfortunately it did not. I’m not sure if maybe it just takes more time or if there is something else going on…. My iron levels are good, but I do have adrenal problems, but after a year of treatment, they haven’t gotten better. I still take all my supplements for my adrenals though as well as following all the lifestyle changes recommended. I can’t find any information on T3 being the CAUSE of the increased morning brain fog, and it does seem to be helping with my mental clarity in the afternoons, so I’m not sure what’s going on 🙁

  46. Margaret Langenberg

    I had hashimoto’s and thyroid was removed in 2013 when I underwent 4 hours of surgery for parathyroid adenoma. Was on Synthroid for first 18 months and did very well and then got switched to WP thyroid. From then on I have felt horrible, severely constipated (does not help to have 1000 feet of large intestine), sweating to point of numerous clothes changes, and TSH as high as 75.36 last summer and now up and down constantly. No lab is perfect. Now have severe bloating, belching, fluid build up and swollen genitalia, buttocks, legs and feet. Just very miserable and packing on weight like no tomorrow but do not eat much due to everything tasting like cardboard and no room to put the food, then have to drink 4 liters of water daily to prevent kidney stones. Am I a person that might be allergic to the T3/T4 naturals. I am allergic to bananas, latex, possibly coconut, and food and drug dyes. I have a different endo since last October and she swears by these drugs and when labs are not perfect figures I am skipping the meds. I am not. I have not been able to work and money has run out. Is this normal to feel this horrible on the T3/T4 combo, or is it the possibility that the drugs are not consistent in potency. All I know is I feel like my life the last year has gone down the toilet and no longer even care about life. Any ideas what is going on. I do have a hole in my heart between ventricles, a shunt (Dr. not sure if heart to lungs or lungs to heart) and a bad pulmonary valve (not surgery ready yet) most likely from birth and have had a neck fusion 18 years ago and thoracic outlet surgery so no longer have first ribs bilaterally and 3 of sympathetic nerves are severed. Is this part of the problem do you think.

    • Janie Bowthorpe

      Margaret, STTM is all about reported patient experiences and the wisdom we’ve gained from it all. And one thing we’ve learned repeatedly is that reactions to NDT are usually due to one of three reasons: 1) Not raising high enough to find one’s optimal dose 2) Having a cortisol issue 3) Having low iron. This page explains http://www.stopthethyroidmadness.com/ndt-doesnt-work-for-me This doesn’t mean you might not have other issues going on, too, but those three are common and worth exploring.

      Also…note that Armour changed in 2015, not only tripling in price but causing some people to see a return of their symptoms. So other brands are more and more being used by patients: http://www.stopthethyroidmadness.com/options-for-thyroid-treatment But even on other brands, the above link needs to be explored.

  47. Ellen Golden

    I have been scouring your site and the internet for some protocols to follow after being on too low dose of NDT for too long. (Another issue I have is erfa – Canadian Pharmacy I used did not put expiration date on bottle. I am switching to another pharmacy that does. I’m not questioning whether the thyroid is bad or not – yet until I try new prescription) I seemed to be doing well taking 60 mg. 30 in a.m. and 30 in afternoon for a long time and have to be careful – sometimes I forgot to take it and I also started taking iodine which not sure if too much could cause me to need less? The short of it is I’m pretty sure I’m in a negative feedback loop. I know what it feels like to be super hypo. and I’m not there just not feeling good, too high anxiety and have too low temps. I know correct way to get on NDT as I have read it here and done it before. History – I used to take 120 mg. but I started doing liver cleanses (dumping liver and gallbladder stones) and as I did those I lost weight, got heart palpitations which showed need to lower dose and lowered thyroid a bit and stabilized. That happened over 2 year process until I landed at 60mg. So given that I don’t have some other thing off like adrenals, cortisol – to correct negative feedback loop I suspect one goes off the low dose for a time and then starts over? – correctly. Which is 1 gr. for 1-2 weeks and then 1/2 gr. every few weeks. I doubt I will need any more than 2 gr. but I’m open to it. I just went to a useless MD who at least gave me a new prescription and need to spend $ – to go to better one. The one I’ve been looking at – a true artist/specialist would help me after a $550 initial fee. But strongly considering it. But first, I thought I’d just not take it for a few days. That seems to be what the body is saying and then start back on it – correctly. If that is a protocol – how long to stay off it before starting again? I suspect to let the body reset after negative feedback loop. I have gone off it before and found that I needed to be on it due to mild depression, chilled and low temp. OR is the a solution to just go up 1/2 gr. and that will take me out of the loop? I also give myself the possibility that I might not need to take it any more. Either way, I just want to feel good and have a normal temp.

    • Janie Bowthorpe

      Hi Ellen. It’s just very rare for anyone to be optimal on a starting dose, which 60 mg is, though you may have been in the rare area of people for awhile. But what we notice is exactly what happened to you…it backfires over time and the patient then finds themselves with all sorts of problems. Yes, we do go up by 1/2 grain, and most of us get up at least into the 2 grain area and then do labs to see. I’m optimal on 3 1/2, but optimal amount vary all over the place…i.e some a little lower, some higher. The reason for the labs is that we’ve seen repeatedly across the board that optimal puts the free T3 in the upper part of the range and the free T4 mid-range. This page explains: http://www.stopthethyroidmadness.com/natural-thyroid-101

  48. Ellen Golden

    Yes, the MD didn’t care about the Free T3, only the TSH but I asked for a copy of my lab results and looked later I saw my free T3 was still very low and alarmed me. Originally it was also pretty low when I first learned I was hypothyroid (after having been on antidepressants for 15 years and 80 lbs. overweight) Recent free T3 was 2.67 within a range of 2.00-4.40. I also read on your sight that heart palps happen when NDT too low as well as too high. And I had been experiencing this and thought I was too high as in past experience! So I’m very happy to hear your response and I know something important now from having experienced this! Learning! Up 1/2 gr. I go. Yes! Thank you!!!

  49. Jodi

    Hello I hope you can help. I am Hypo and my Doctor in another province in Canada put me on Cytomel. I was on 150 Cytomel for a few years now. I moved across Canada and Doctors out here do not like Cytomel. Last December they took me off Cytomel and put me on 137 Synthroid, within 4 days I gained 6 pounds, exhausted, red blotches on my face and more. Doctor immediately took me off and got me back on my regular dose of Cytomel. In April he tried again with Synthroid but on very low dose and dropped to 75mg cytomel 7 days later gained another 8 pounds and same symptoms plus more. Allergic to Sythroid. Back on cytomel but only 100. 3 months later to now, still feeling bad, can’t lose weight, but not gaining any longer. I am gluten free, watch my carbs, exercise 5 days a week and walk daily. Last Friday I started taking 30 DT along with cytomel. Felt amazing dropped 5 pounds my face was thinner lots of energy. Monday the doctor got me to drop my Cytomel and take 60 of DT. Tuesday (today) I feel and look like crap. I can barley get up off the chair. My hands are so cold they hurt, No energy. The doctor wants me on this dose for 3 months. Is this normal to feel like this? Or I think I am not taking enough and what to take more but afraid. I just want to know if this is normal? Thanks

    • Janie Bowthorpe

      One grain of NDT has approx. 9 mcg T3…but as far as “effect” because the T4 converts to more T3, is equal to 25 mcg T3. So….is it possible he is seriously underdosing you?

      • Jodi

        Thank You for getting back to me. That is what I was thinking but wasn’t 100% sure.

      • Jodi

        Hello Again.. I hope you don’t mind me asking you question about NTD. You seem to be so knowledgeable. I went and saw my doctor and he doubled what I was taking and then to add to it depending how I am feeling. I know my body and my doctor has trust in me that I do. How fast do I add? I am to give myself a couple days of feeling tired run down, cold etc or do I change it daily? I seem to crash around 2:00pm still. I just hate feeling this way, I am a wife and a mother of two teens. Should I stay at the 2 grain and add cytomel? or just stay off of that? I just don’t know much about this new med and need help from someone who knows more. I’m not really sure my Doctor knows a whole lot about NDT. Thanks..

  50. Kelly

    Im currently on Erfa 90 mg/day started 3 wks ago. Before i went on Erfa,i was losing tons of hair and had most of the symps. But I also have exp’d hair loss on my arms incl underarms and legs. The hair on my head stopped falling out and I am now looking fwd to seeing thicker fuller hair again. But the hair on my arms and legs are just not growing back. LOL i really don’t mind,but it’s is bothering me. Does anyone know what could be going on? My Dr doesnt seem to be bothered by it and thinks i am overreacting..


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