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Has NDT gone bad?

NO, NDT hasn’t gone bad. That is the short answer. I take NDT myself, and it works just fine.

I see people claiming, NDT is no good anymore. That it is better to take synthetic T4/T3 now. I think this is very serious, that this incorrect, untrue info is being spread in the Facebook groups. It stems from STTM, Stop the Thyroid Madness, and its Facebook group, Adrenal Fatigue and Thyroid Care. STTM is a site that has contributed so much, and I am sad to see, there is such black and white thinking going on. This issue isn’t black and white.

I wrote to the woman behind STTM about this, Janie A. Bowthrope. I told her, we are lots of people who do great on NDT here in Scandinavia. She said, most of those who still “believe”  they are ok on NDT, only experiences adrenalin! I find that to be a strange claim. What does it mean? Adrenalin? We don’t have good thyroid levels? We just think we do? A female admin in the Facebook group, told me in a comment, we here in Scandinavia probably took our meds right before labs! None of us know how to do our labs? I am a member of thyroid groups  in many countries. The members in the Norwegian groups are among the better informed in the world, as far as I am concerned. I am aware that many thyroid patients don’t know how to do labs correctly. Norwegians on NDT are not among those.

It’s a little difficult to take this seriously. Yes, absolutly, there were some bad batches of Nature Troid in 18. It didn’t take long before there were good batches again. STTM claims, that NP Acella is bad now. We don’t have NP here in Scandinavia, I don’t know if they have it in other European countries. But I see lots of people saying it is fine for them in the US groups. We use a lot of Armour, Erfa and nature Throid over here. Just now, May 2020, I see people here in Scandinavia saying, there is something wrong with Erfa. With the smelly product Erfa themselves have made a statement about it. Erfa says, they contain the proper amount of hormone. But some experience it differently.  

Update: I wrote this last year. I have just checked back with people on NP now in August 2021. They are doing fine on it still. Despite STTM claiming, it does not work at all. So maybe it works for some, and not for others. Keep in mind as well, we fluctuate a lot in our levels. We use a lot of Armour, Erfa and Na

I am not saying, there are no issues. But to say, all NDT has gone bad, and to accuse the producers of being callous and indifferent to us patients and only out to make money, as Janie Bowthrope does here, https://stopthethyroidmadness.com/2019/09/23/the-sad-saga-of-where-we-are-today-as-hypothyroid-patients/  That is a sad saga.

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Synthetic T4 to NDT conversion

How do I convert my T4 dose to NDT?

This is a question one sees often in the thyroid Facebook groups. There is a lot of confusion and insecurity around this. Which is not so strange, as there is very little good info on the topic. Here are my recommendations

The conversion tables the NDT (thyroid) producers themselves provide are ridiculously low. They are wrong, wrong, wrong. I don’t understand how they think at all. If they do. Think. One would be seriously under dosed if adhering to those guidelines. And if one’s doctor reads them, one could get serious problems. I don’t know how many doctors read these instructions. I hope they don’t. Here is a table from Nature Troid as a (bad) example.  

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Conversion, deodinase

I have translated some of Thyroid Patients Canada’ articles on conversion into Norwegian. These articles are very interesting, esp this one, https://thyroidpatients.ca/2019/11/12/the-basics-of-thyroid-hormone-action-transport-and-conversion/      

Most of the hormone conversion, T4 to T3 happens outside the thyroid. though there are big individual differences how much.  There are 3 enzymes responsible for this conversion, D1, D2 and D3. They do a lot more than convert T4 to T3 though.

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FT3 ups and downs in T3 therapy

This is not really a post. I have translated Tania Sona Smith’s article, https://thyroidpatients.ca/2019/11/25/free-t3-peaks-and-valleys-in-t3-and-ndt-therapy/ , into Norwegian.  For every Norwegian page, I want there to be a corresponding English, and vice versa.  

This is just a presentation of Tania’s piece. She is looking into the reseach on how Ft3 behaves after dosing with T3 containing medicine.  Actually, there is not really any good studies on the subject . There is a study on FT3 after a single dose of T3. But that is not what most people take when dosing with T3. We do multidoses. There is no study on FT3 when multidosing, but there is one on T3, that is total T3. Where I live in Denmark, we cannot have FT3 tested. The endoes have forbidden it, they claim, FT3 fluctuates too much, it cannot be trusted. How do they know? With no studies? Anyway, FT3 and T3 follow each other in most instances . With a very important exception, when we take estrogen orally. Then both T4 and T3 becomes higher and FT4 and FT3 lower. So  VERY important to have the frees tested.

Anyway, there is a study on multidosing and T3, showing that T3 peaks app 2 hours after intake. So pretty unstable. Except of course, the peaking is very easy to predict. At least for us patients. I don’t know if the Danish endos,( and the English) have heard about the single dose experiment (Jonklaas et al, 2015) maybe, where one sees a huge peak after intake of 50 mcg T3 in one go. If that is the fluctuation that has scared the shit out of them. And then they never got around to reading  Busnardo et al’s study(1980) on total T3 and multidosing. Even though that study has been around for 40 years. 

Tania goes into all this and more.  We really need a good study on the FT3 level through the day and night. Preferably for all three T3 containing meds, Mono T3, synthethic T4/T3 and NDT.  And with differing dosingregimes. We are many today who also take a dose of T3 at bedtime, others set the alarm 2 hours before getting up, to provide T3 for the cortisolproduction that takes place in the early morning.  Considering how FT3 probably peaks 2 hours afterdose, that is maybe not the best time to take it. Anyway, such a study would be great.

Triac

This is just a short abstract of Thyroid Patients Canada’s article on Triac, https://thyroidpatients.ca/2020/01/02/when-dosing-t3-you-get-higher-levels-of-triac/ . I just want to draw your attention to this metabolite. The quistionmark on the image, is meant to signify my surprice when learning of Triac. I had never heard of this thyroidhormone metabolite until I read Tania’s post. It is quite strange, as it has been studied since the 1950ies. I don’t think many of our doctors have ever heard of it.

So what is it? It is a thyroidhormone metabolite like FT4 and FT3 are. It acts much as FT3, it’s abbreveration is TA3. It has a much shorter halflife than FT3, about 6 times faster.

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