June 26, 2012

"How to start taking Natural Dessicated Thyroid" AND "How NOT to Start Taking Natural Dessicated Thyroid"

How to Start Taking NDT

In her chapter on What Thyroid Patients Have Learned, Janie Bowthorpe explains the patient-based protocol for starting Natural Dessicated Thyroid (NDT):
  • 1 grain (60 mg) for one-to-two weeks
  • increasing by 1/2 grain every two weeks
  • and holding around 2-3 grains for four-to-six weeks to allow time for the T4 to build and convert to T3
This is the protocol whether you are switching from synthetic T4-only medication or starting thyroid medication for the first time.

How NOT to Start Taking NDT

Today I was reviewing my calendar and notes from when I first went on NDT.  I try not to think about the painful experiences surrounding that, but I thought I would share it here since others can learn from my mistakes.

At the time that I started on NDT, I thought that the protocol for starting on NDT is different for people who were switching from synthetic T4, as opposed to those who are going on it from nothing.  I mistakenly trusted my doctor who claims that it is perfectly suitable for people who are on synthetic T4-only medication to switch to a similar milligram dosage of NDT.

In my brain fog, I didn't realize that whether you're starting from nothing or on synthetic T4-only, you have to start low and gradually build the T4 in your NDT, to allow for the conversion to T3.  Otherwise, you'll get a huge dump of T3 into your system at once. 

And that is precisely what happened to me. 

Prior to NDT, I had been on 150 mcg Levothyroxine.  Here is how my doctor started me on NDT:
  • Started on 3 grain
  • One week later, increased to 4 grains
  • One week after that, increased to 4.5 grains.
  • A week after that, I backed myself down to 4 grains.
  • A couple of days later, (this was four and a half weeks after starting NDT) my doctor started me on 4 pellets of Isocort in the mornings. 
I immediately started having heart palpitations, tremors/shaking all over, nervousness, anxiety, panic attacks, chest pain, low back pain, and reflux.  I thought I was having a reaction to the Isoscort, but I am certain that it was flooding T3 from the T4-to-T3 conversion! 
  • After a few days of being on Isocort, I increased my NDT dose to 4.5
    • I was thinking that I must not have been on enough. After all, my doctor said to increase every few days until I had relief of my symptoms.  Heck, I was being cautious by increasing weekly! Or so I thought. 
      • I even tried a day of taking the extra 1/2 grain in the afternoons.

  • After one week of taking Isocort, a nurse at my doctor's office suggested decreasing to 2 pellets a day.  Maybe a was sensitive to it.  
  • A week later, I decreased my NDT to 4 grains.
  • A few days after that, I stopped Isocort entirely.
  • A week later, I started to multi-dosing my NDT, then chewing it.
    • I knew that was making it more effective, so I cut it back to 3 grains then 2.
    • This was my saving grace: the decision to start multi-dosing plus knowing that doing so could make my NDT more effective. 
  • Shortly after, I started the Circadian T3 Method.
If I had only known then what I know now, how much easier would all of that have been?  Learn from my mistake and that of other STTM patients: start on 1 grain and slowly increase.