"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.

Shedding a Little Light on my Cortisol Levels

Yesterday, I posted my new cortisol lab results and expressed my surprise at how low they are. 

A dear friend on the Adrenal support group tipped me off to what may be the difference between my two labs.  
For the first test, I stopped my doc's Adrenal Support blend 9 days before the cortisol test.  In the first instance, I felt horrible when I went off the Adrenal Support, so I took the test a little early so I could get back on. 

I didn't know at the time that the Adrenal Support has adrenal cortex in it.  All the bottle says is "adrenal." 

As I'm typing this, I'm immediately thinking, "When will I learn to ask more questions?"  But I am also remembering that I did ask at the nurses what was in it, and I never got a straight answer.  The nurses' answers are perpetually, "If would be better if you just asked doc at your appointment."  

For the second test, I stopped everything 10 days before the test.  I had been taking Rhodiola off-and-on for quite a while.  But about 15 days prior to the test, I had started taking it daily, as well as the Women to Women's Herbal Equilibrium, which has a small amount of ashwagandha.

The probability of skewed results makes everything make so much more sense. I can't believe that didn't occur to me before my friend's question!  I don't feel great now, but I do feel SO much better than I did in March. I just couldn't believe the difference in the results. (Gosh, I wish I knew what they really were back in March.)

New Cortisol Labs

I got my new cortisol labs. Everything is lower than it was on 3/15/12, which is good for the midnight, but nothing else. I can't believe it!

The results from 5/28 are:

AM 11.4 (2.4 - 33.7)
Noon 2.7 (1.2 - 17.8) (top quarter = 13.65)
PM 1.5 (.5 - 12.1) (5.8 = mid)
MN .6 (.3 - 11.0)

The results from 3/15 were

AM 18.2 (2.4 - 33.7)
Noon 6.9 (1.2 - 17.8) (top quarter = 13.65)
PM 5.4 (.5 - 12.1) (5.8 = mid)
MN 2.3 (.3 - 11.0)

I don't get why it's worse. I can understand why it's not better, but worse?

The only explanation is that I need that darn T3 medication.  More T3 would mean a higher Free T3 level. 

My 5/13 thyroid labs showed that my Free T3 was low (ideal levels would be in the top quarter of the range, which would be 3.8+).

FT4 .61 (.82 - 1.77)
FT3 2.5 (2.0 - 4.4) 
RT3 12.8 (13.5 - 24.2)
TPO 226 (0 - 34)
TgAb <20 (0 - 40)

Also, naturally, DHEA for most recent cortisol labs is down. My noon-PM average is 2.7 (.8 - 7.5). It was 4.1 in March.

I really believe in Recovering with T3.  I think T3 is going to be the missing link to everything.  But it's hard to get labs like these. 

My Success Story

After 12 years on Levothyroxine, I started taking Natural Dessicated Thyroid (NDT) in mid-January 2012.  By late March, I had found what I believed to be the right dose and method of taking NDT (for me, this was 2 grains upon rising, 1 grain at noon, and 1/2 grain at 4 PM).  A 24-hour saliva test had revealed that my cortisol levels were low in the morning, afternoon and evening, but high at night.  This confirmed exactly how I felt!  

In late March, I started the Circadian T3 Method (CT3M) to help treat my thyroid and heal my adrenals.     

In February, I made a list of all my symptoms and I came up with 77. Every couple of weeks, I have updated the list, categorizing which which ones improve and get worse from update to update. 

Over the past few months, every single symptom has improved.  22 of them are totally gone, the most notable being chronic fatigue, flu-like aches, suicidal thoughts, failure to ovulate, itchy legs, hands and feet.  

Thirty-four symptoms show continued improvement, including: hair loss, difficulty getting out of bed, taking hours after rising to feel awake, needing caffeine to wake up, foggy-thinking, excessive sweating, low stamina, long recovery period after any stress or activity, sinking feeling in the afternoon, feeling the need for caffeine and carbohydrates in the afternoon, feeling dramatically better in the evenings, abnormally energetic at night, dry eye, sensitivity to bright lights, thinning and crooked eye lashes, light headedness, dizziness.    

It is notable that as my symptoms improve, they fluctuate.  There is a rise and fall to their improvement.  One day will be great, while another day will feel just rotten.  I'll wonder if I'm sliding back, but upon evaluation, I'll see that things really are improving on the whole.  These good days and bad days correlate with my stress (good and bad) levels, level of physical exertion, and reproductive cycle.  As I write this (at the end of April), I can say that my worst days now are better than my best days in January.  

I believe many of my symptoms to be rooted in multiple, but related, health issues: hypothyroidism, type I (juvenile) diabetes, poly-cystic ovarian syndrome, and endometriosis.  I also suspect gluten intolerance and plan to test a gluten-free diet soon.  That being said, CT3M won't treat all of these issues.  However, 1. some of these health issues have overlapping symptoms and 2. having my thyroid and adrenals treated properly will no doubt help me get to a place where I can succeed in treating the symptoms I experience.  

I have some tweaking to with my CT3M right now: improvements mean changes in BP, HR and temps which require adjustments. But at this point I believe that my issues will be ironed out with work and time, and I can say with confidence that CT3M is working to treat my thyroid and adrenals, and is helping me get to a place where I can treat my other health issues. 

 

Cortisol Saliva Test Results

My cortisol results are in!  The lab ranges are in parentheses.

AM 18.2 (2.4-33.7 nM)
Noon 6.9 (1.2 - 17.8 nM)
PM 5.4 (.5 - 12.1 nM)
Night 2.3 (.3 - 11.0 nM)
Total 32.8 (8.2 - 50.9 nM)

Also, DHEA noon to PM average is 4.1 - (range being .8-7.5 ng/7.5) - which is good.
 
Janie lists the ideal ranges on her website.  Comparing my results to those: 

AM 18.2 (ideal = 33.7)
Noon 6.9 (ideal = 14-17.8)
PM 5.4 (ideal = 6)
Night 2.3 (ideal = 0.3)

Here is a less confusing way to look at it:

  

Morning is LOW.  Range is 2.4 - 33.7. The ideal is "top of the range." 
My noon is LOW.  The ideal range of the "upper quarter" would be 14-17.8.   
My PM is fairly good.  6 is ideal. 
My Night is HIGH. Needs to be 0.3.

Aside: Janie links to this which I found very helpful in understanding interpreting cortisol results, but not particularly relevant for my current situation. 
 
Update: I had a realization last night.  I kept thinking, "WHY do I feel so crummy in the afternoons if my cortisol levels are high in the morning and at noon?"  Duh.  I've heard them say on the STTM Facebook Group that high cortisol levels can have the same symptoms as low levels, so never guess and always get your levels checked.  My levels in the late afternoon/evening and at nighttime are high, which is why I get that sinking feeling, heavy eyelids, flu-like achiness, etc.  Aha!