What exactly is natural desiccated thyroid (NDT)?

Desiccated thyroid by prescription is real live thyroid i.e. powdered thyroid from pigs (mixed from several pigs, not one) and it meets the stringent guidelines of the US Pharmacopeia, i.e it’s made according to certain quality standards, contrary to what some doctors say. To see ingredients of all, go here. To see all available options for desiccated thyroid, go here.

How long has Natural desiccated thyroid been around?

It’s been used successfully by patients for over 115 years, as reported in old medical journals and books and still with modern patients. For interesting information on its history & details on the product itself, see the revised STTM book, Chapter 2. Very worth it. There is also another chapter on NDT in the STTM II book by a doctor.

What’s the big deal about natural desiccated thyroid (NDT)?

Unlike synthetic T4-only meds which have been problematic for so many patients (Synthroid,  levothyroxine, Eltroxin, Oroxine, etc) …desiccated thyroid is natural and gives you exactly what your own thyroid would be giving you: T4, T3, T2, T1 and calcitonin.  Chapter One of the revised STTM book details what each of these hormones are.  A lot of patients who’ve tried T4-only, or even the two synthetics (T4 and T3) or even straight T3, have reported far better results with NDT. They have stated it’s a smoother treatment, removed their lingering symptoms, improved their immune system (which helped lower the antibodies of  Hashimoto’s for some), allowed many to wean off anti-depressants, statins, BP meds and more, gave their lives back, stopped some from falling into low cortisol/sluggish HPA function (which SO many patients end up with because of the inadequacy of T4-only) and they feel it’s far better for your immune system if you’ve ever had thyroid cancer (because of the direct T3 within NDT which appears to improve immune function–that is big).

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

They all work as reported by patients–it’s just individual which you want to use and which you feel works best for you! No, one brand is not necessarily better than another–everyone reports they just have their favorite. Yes, sometimes problems will creep up with a brand here or there, and STTM tries to report on that. You will also see internet over-the-counter brands which patients have reported good results with. They are all listed here. Ingredients here.

Update: for all too many beginning in 2015, the brand name of Armour seemed to cause a return of hypothyroid symptoms for many who reported so (though not all) plus tripled in price. You can read about it here and decide for yourself. There are other great brands. 

How do I move from taking T4-only to NDT?

The most common successful method reported by patients is taking their T4 a final day, then stopping it and starting on desiccated thyroid the next day with a safe beginning dose–the latter usually one grain, which is raised by 1/2 grain every two weeks, etc. Below (under the heading “How do patients raise NDT?”) explains how the majority of patients dose NDT.

Some doctors guide their patients to lower T4, such as by half, and start on desiccated thyroid. Ideally, though, if this method is used, we have found that the T4 should continue to be lowered until one is completely off of it in just a few weeks, with NDT having been raised as well. But the problem with this second method is that too many doctors keep their patients on T4 far too long with the NDT, raising the risk of the T4 converting to higher levels of RT3, the inactive hormone, as a way to clear out what will become too much T4. NDT is 80% T4 anyway!! We have found NDT to work fine all by itself, as explained in the first paragraph, and a safer in not causing excess RT3.

What do patients report as a good starting dose? 

When first starting out, thyroid patients and their doctors have found it wise to start on a smaller dose of desiccated thyroid than they will ultimately need, such as 1 grain (60/65 mg), which is considered a “starting dose” for most–it’s individual. Why just one grain? Because patients discovered that the body may need to adjust to getting direct T3 again, and there may be other issues which can reveal themselves, such as sluggish adrenals or low iron levels.

Do some doctors start patients lower than one grain? Yes. They may feel there is a good reason. But patients who want to start lower learned to keep going up, bit by bit, to counter the feedback loop suppression. i.e. those lower doses have made some patients feel even worse if they stay on them too long. But again, it’s individual.

How do patients raise NDT?

Those who start on natural desiccated thyroid (one grain is a common starting dose and seems to be safe for most) report that it is wise to RAISE by 1/2 grain every two weeks or less to prevent hypothyroid symptoms from returning due to suppression of the internal feedback loop in the body, which can happen if we stay on a low dose too long before raising. Most patients start to slow those raises down as they are approaching the 3-grain area or less, not necessary because it’s their optimal dose, but to give the T4 time to build (which can take 4-6 weeks) and show its conversion-to-T3 results…then inch their way up if needed with their doctors assistance.  Labs are usually needed around this time. Some patients end up in the 3-5 grain area when optimal, some on less, and some on more. It’s very individual. (Janie Bowthorpe is on 3 1/2 grains, for example; used to be on 4 when she was estrogen dominant). Work with your doctor on all the above.

How do I know when I’m on enough NDT?

Before labs were developed, doctors successfully treated hypothyroid patients by symptom elimination. Today, patients and many wise doctors still find symptom elimination an ideal way to treat…but in conjunction with other signs. As we are raising from the starting dose of one grain (60 or 65 mg) , we look for all of the following: the complete removal of our hypothyroid symptoms, an afternoon temp of 98.6F/37C, a morning before-rising temp of 97.8 – 98.2 (held under arm ten minutes with a liquid thermometer if you are imitating what Dr. Broda Barnes did), a good heart rate and blood pressure, plenty of energy and more positive signs, plus what is said right below about labs.

What does lab work look like when one is optimal on NDT?

We noticed that for most, when feeling wonderful and having no negative issues, the free T3 is in the upper quarter of the range (and some close to the top), the free T4 is mid-range, and the TSH is below zero. Doctors will sometimes overreact to a TSH that low, so read this page.

Note: if your free T3 is at the top of the range and you still feel horrible, or have hyper-like symptoms, time to test your iron (with blood) and cortisol levels (via saliva, NOT blood). Problems with either will cause T3 to pool high in your blood and not get to your cells well. See this as to why you may not be soaring on NDT and have problems. 

Can I go by those Synthroid-to-NDT equivalency charts?

Not unless you want to stay hypothyroid. Read right above.

Are there any non-prescription desiccated thyroid products?

Nutri Meds which is available in either porcine or bovine desiccated thyroid, and is far weaker, so patients report taking a lot. Plus there’s Dr. Lowe’s ThyroGold, a New Zealand bovine thyroid which seems to be stronger and workable.  Neither Thyroid-S or Thiroyd from Thailand are by prescription, and patients report them working quite well, as well.

Do I swallow it, or chew it up, or do it sublingually? 

Yes, some patients do swallow it and do great. But others like to do it sublingually, i.e under the tongue. In spite of what some literature says (that the molecules are too big to be done sublingually), patients report an even better result. Both Erfa and Acella can be done well sublingually, as can Thiroyd. You ca also choose to chew it up, but it’s not necessary.

It is false that you have to have an empty stomach when using NDT. But when swallowing desiccated thyroid,  it might be a good idea to avoid iron, estrogen and calcium supplements at the same time, plus possibly magnesium, since all bind the thyroid hormones to some degree. But note the “to some degree”. It’s only partial binding. Supposedly, we read that the tannins in coffee or tea can also bind thyroid hormones to some degree, but some patients report they take their NDT with coffee and are fine.

If the tablet is quite hard due to excess cellulose, chewing it up before swallowing can give better results, say some patients.

Do I take it once a day?

To the contrary, most patients have found it beneficial to divide their dose to at least twice a day in order to spread the energy-giving affect of T3 within NDT when it’s most needed.  An example is taking 2/3 or your natural desiccated thyroid in the morning, and the other 1/3 in the early afternoon. Your own thyroid, if healthy, would have given you what you need throughout the day instead of one dump; thus, multi-dosing has always been our way to replicate that.

Why is the T3 in desiccated thyroid so important?

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

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

How do I find a doctor who understands desiccated thyroid?

Patients regrettably find that many doctors are very ignorant about the efficacy and safety of natural desiccated thyroid. But many are finally coming around! If you click on the highlighted “doctors” above, you’ll find recommendations on how to find a good doc. And note that it is not uncommon to drive great distances to find an open-minded doctor–the latter which is a doctor’s most important quality. But be prepared that you may have to teach any doctor what you have learned from patient experiences! Read Chapter 2 in the revised STTM book. Become informed!

Why did I feel lousy on NDT? Why do I feel “sick”? Why do I feel hyper? etc.

It’s nearly always related to either

  • being held hostage to a dose too low (because of a TSH obsessed doctor or one who isn’t informed about NDT)
  • or due to having a cortisol issue
  • having inadequate levels of iron   i.e. if upon starting desiccated thyroid or raising it, you have very strange symptoms, including anxiety, insomnia, shakiness, rising BP, etc., we learned it was a strong sign that you may have either an adrenal problem or inadequate levels of iron, which are revealed with NDT. See this video.

Here’s a page that covers why NDT doesn’t seem to work for you. Or, if you felt great when you started NDT, only to see it go away and hypo symptoms return, you probably failed to understand that you needed to raise it! See mistakes patients make.

There are a minority of patients who might be allergic to the fillers on one brand, but not the other. Or there are some who are allergic to porcine–they might also note that when eating bacon or ham. Then there are a very small body who have a rare conversion issue with T4, and need T3-only. Also, some hashi’s patients will see their antibodies rise, but as they keep going up on NDT, they report the antibodies go down.

Why do some patients take T3-only instead of desiccated thyroid?

Chapter 12 in the STTM book is completely devoted to T3 and includes good information on RT3–the latter the reason why people might be on T3-only.

Are there any beneficial supplements that I can take with desiccated thyroid?

Many patients take a Selenium tablet with their thyroid meds, which assists the T4 to T3 conversion. L-Tyrosine helps some patients, too. Zinc and Vit. C may play a role in assisting your thyroid. Your need for B-vitamins will increase as you improve your energy levels, says some literature Some patients benefit from iodine supplementation. Optimizing your Vit. D levels can be important along with Vit. K2. Minerals can also be important. Chapter 15 in the revised STTM book has great information on supplements and good foods! This is totally your call based on your needs.

If I’m at retirement age or older, am I supposed to lower my NDT a great deal to have my free T3 and free T4 lower?

We haven’t found that to be necessary as far as a “great deal”. That idea comes from a study done with those on T4-only and who appeared to be overdosing themselves and had more bone fractures. But with NDT, the direct T3 has helped our bone strength, not make it worse. It’s possible if your activity level dropped, you might need slightly less NDT than one does in age 30.

Why does my doctor say NDT is “unstable”?

Because he or she doesn’t know what they are talking about. Synthroid has been recalled numerous times and that fact is common knowledge. NDT meets the guidelines of the US Pharmacopeia for stability.

Any other tips?

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


Definitely get the Revised STTM book, which is especially handy to take into your doctor’s office, or when you just don’t want to be on the computer.

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

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