I Have Tried It All: T4, T3-only, T3/T4-combo, NDT. Here I Share What I Learned

[Peater Pan]

I am a med student in my last year. For years I have been replacing multiple of my hormones.

Thyroid was the first hormone I started to replace. I have tried it all: T4, T3-only, T3/T4-combo, NDT. Here I share what I learned.

Because there is just so much misinformation around, I wrote guides about what I have learned along the way. Had I known what I know now, it would have saved me lots of time, money, happiness, effort, researching, experimenting. And suffering.

Here is a guide how I´d go about replacing thyroid. Most importantly, how to do it safely. What and how to check for low cortisol, what products to choose. And important things to keep in mind.

How To Replace Thyroid Hormones.

Enjoy. I hope some of you find value in it .

What do you think of Kenneth Blanchard's protocol?

Blanchard, Kenneth. Functional Approach to Hypothyroidism. Hatherleigh Press.

 

[MitchMitchell]

I require a high amount of thyroid to be normothyroid. Dr. Wilson said patients can take up to the amount of was taking so long as they work up to it.

I take about 200mcg of t4 and 50mcg of t3 today in the winter.

sounds like a lot of reverse t3 with all that t4. Nay?

 

[ecstatichamster]

sounds like a lot of reverse t3 with all that t4. Nay?

well not really. Because this happened on a T3 regiment a la Dr. Wilson. T3 isn't supposed to produce rT3.

It can also be lowering stress hormones that raises the need for thyroid. I am hoping over time that I won't need as much but who knows.

 

[PhoenixGaia]

Thanks @thingsvarious, although very slowly improving, my symptoms according to your reports, most closely correlate with low GH.

High androgens, high adrenals including cortisol. Low mood, low libido, poor sleep, reduced exercise capacity and recovery.

Might be something I can discuss with gp and get tested.
Ahead of that does anyone have any suggestions to improve gh naturally.
Low bodyfat and fasting are going to come up I guess.

And I know that Peat doesn't like gh but I think this is a balance thing. If it is low it's low...

I've done GH myself. While I wasn't deficient before, if your GH levels are low, you will see large improvements. Sadly it costs so much to continuously take...
For testing, just get your IGF-1 tested (testing GH makes no sense due to its pulsatile secretion)

 

[pippocui]

Hello @thingsvarious, I would like some advice on how to deal with the thyroid, since I enjoyed reading what you wrote. the ssri triggered me hashimoto hypothyroidism. I have very low temperature, low libiso, slow metabolism and hair loss. My tsh was at an altitude of 20 !!! Very high!

I have tried all the therapies, both T3 and T4 together, both NDT and only T4. My TSH is back in range mainly thanks to the combination therapy between T3 and T4, but the symptoms have not disappeared. Also my temperatures can't go up. They range from 95.4 to 95.8 .. really very low! I increased my hormone dosages, but nothing has changed! What is the reason in your opinion? And what can I do to change this situation? Thanks!!!

 

[Guacamayo]

@thingsvarious I've also got long-running issues with my thyroid that I haven't been able to fix no matter the dosage.

I've gotten my Free T3 and Free T4 in their proper places (that is, T4 in the middle of the normal range and T3 in the upper quadrant of the normal range) but it's not translating to better symptoms...at least not when I was taking T3 only and my FT3 was in the middle of the normal range and FT4 was really low.

I did experience a good moment last year that lasted for no more than a month. I was on T3 only for a long time (around 100mcg) and then added in Ancestral Supplements' Thyroid (it's like a liver and thyroid NDT mix). That removed most of my hypo symptoms for a while...but pretty soon they returned and I kept upping my dose of both T3 (got it up to 140mcg), Ancestral Supplements and also NDT until the positive effects eventually wore off too...

But here's the thing...even with those massive thyroid doses I did not have hyper symptoms. I actually had hypo symptoms. Low body temps every morning, constipation, etc.

Bear in mind, my blood work still showed that my FT3 and FT4 were in the healthy ranges (FYI, my TSH went suppressed the minute I started taking T3), but it just wasn't translating to how I felt before.

I didn't go back to feeling as bad as I did before I started taking my thyroid meds, but it was nowhere the "normality" I felt when I was on T3 only and had introduced NDT in the first few weeks.

This tells me that thyroid isn't the only thing at play here and the other hormones matter...I just can't figure out which ones. I've tried preg, progesterone and they haven't done much. I don't know where to get DHEA - if you're based in Europe, maybe you could let me know? And also, I haven't found a doc yet that will give me HC...but even if they did I'm not sure how long to take it. It might be the same issue as with T3/NDT/T4, where it works well initially and you feel amazing but then the effect stops. And you're left wondering, do I stop and restart in a week or two, or do I increase the dose even more?

Let me know if you have any ideas on what to do, because you don't know how much it sucks to have only been given 1 month of a "normal" life and years and years of chronic sickness because no one can help me figure out what to do, and I'm just plugging around in the dark.

 

[PhoenixGaia]

Hello @thingsvarious, I would like some advice on how to deal with the thyroid, since I enjoyed reading what you wrote. the ssri triggered me hashimoto hypothyroidism. I have very low temperature, low libiso, slow metabolism and hair loss. My tsh was at an altitude of 20 !!! Very high!

I have tried all the therapies, both T3 and T4 together, both NDT and only T4. My TSH is back in range mainly thanks to the combination therapy between T3 and T4, but the symptoms have not disappeared. Also my temperatures can't go up. They range from 95.4 to 95.8 .. really very low! I increased my hormone dosages, but nothing has changed! What is the reason in your opinion? And what can I do to change this situation? Thanks!!!

Have you tried looking into other hormonal axis deficiencies? Is your lifestyle and sleep on par?

 

[thingsvarious]

@thingsvarious I've also got long-running issues with my thyroid that I haven't been able to fix no matter the dosage.

I've gotten my Free T3 and Free T4 in their proper places (that is, T4 in the middle of the normal range and T3 in the upper quadrant of the normal range) but it's not translating to better symptoms...at least not when I was taking T3 only and my FT3 was in the middle of the normal range and FT4 was really low.

I did experience a good moment last year that lasted for no more than a month. I was on T3 only for a long time (around 100mcg) and then added in Ancestral Supplements' Thyroid (it's like a liver and thyroid NDT mix). That removed most of my hypo symptoms for a while...but pretty soon they returned and I kept upping my dose of both T3 (got it up to 140mcg), Ancestral Supplements and also NDT until the positive effects eventually wore off too...

But here's the thing...even with those massive thyroid doses I did not have hyper symptoms. I actually had hypo symptoms. Low body temps every morning, constipation, etc.

Bear in mind, my blood work still showed that my FT3 and FT4 were in the healthy ranges (FYI, my TSH went suppressed the minute I started taking T3), but it just wasn't translating to how I felt before.

I didn't go back to feeling as bad as I did before I started taking my thyroid meds, but it was nowhere the "normality" I felt when I was on T3 only and had introduced NDT in the first few weeks.

This tells me that thyroid isn't the only thing at play here and the other hormones matter...I just can't figure out which ones. I've tried preg, progesterone and they haven't done much. I don't know where to get DHEA - if you're based in Europe, maybe you could let me know? And also, I haven't found a doc yet that will give me HC...but even if they did I'm not sure how long to take it. It might be the same issue as with T3/NDT/T4, where it works well initially and you feel amazing but then the effect stops. And you're left wondering, do I stop and restart in a week or two, or do I increase the dose even more?

Let me know if you have any ideas on what to do, because you don't know how much it sucks to have only been given 1 month of a "normal" life and years and years of chronic sickness because no one can help me figure out what to do, and I'm just plugging around in the dark

For many people, fixing thyroid issues until adrenals are taken care off is futile. Yesterday I updated my guide about it, how to best start thyroiod treatment if someone has low levels of cortisol. You might give it a read.

Hope it helps you.
Best wishes

 

[PhoenixGaia]

For many people, fixing thyroid issues until adrenals are taken care off is futile. Yesterday I updated my guide about it, how to best start thyroiod treatment if someone has low levels of cortisol. You might give it a read.

Hope it helps you.
Best wishes

HI,do you believe everybody should take hormones?

 

[Elize]

For many people, fixing thyroid issues until adrenals are taken care off is futile. Yesterday I updated my guide about it, how to best start thyroiod treatment if someone has low levels of cortisol. You might give it a read.

Hope it helps you.
Best wishes

Great thanks so much. What I needed to know more about.

 

[thingsvarious]

Great thanks so much. What I needed to know more about.

I am glad you found value in it. If you have any questions just let me know

 

[Guacamayo]

@thingsvarious just wanted to let you know that I don't have low cortisol. My cortisol is actually too high. Both morning, mid-day and mid-afternoon. The only time it's low is at night - even then it's on the lower end of the normal range, not below range.

Also, my estradiol is too high - it's at 8.3 pmol/L (1.0-6.0 normal range).

And my testosterone is on the lower end - 170.9 pmol/L (100 - 720 normal range).

My DHEAS is on the lower end as well - 9.7nmol/L (5 - 30 normal range)

 

[PhoenixGaia]

@thingsvarious just wanted to let you know that I don't have low cortisol. My cortisol is actually too high. Both morning, mid-day and mid-afternoon. The only time it's low is at night - even then it's on the lower end of the normal range, not below range.

Also, my estradiol is too high - it's at 8.3 pmol/L (1.0-6.0 normal range).

And my testosterone is on the lower end - 170.9 pmol/L (100 - 720 normal range).

My DHEAS is on the lower end as well - 9.7nmol/L (5 - 30 normal range)

Why have you not tried TRT yet?

 

[thingsvarious]

Update on my thyroid protocol:
1.5 grains NDT -> 75mcg T4 + 3x 5mcg T3 (each taken around six hours apart). Why the switch over to synthetic? Firstly, I do not need to worry about the bioavailability of T4 later in the day due to food intake (which would not be the case on NDT which I used to take twice per day). Secondly, I have noticed that the additional nighttime T3 improves various parameters of my sleep (esp. better REM-sleep while no changes in SWS). Furthermore, I feel extremely energized and ready instantly after waking up. Out of bed. A few pushups. Ready to go.

 

[thingsvarious]

Why have you not tried TRT yet?

Wonder this myself. Although there are risks involved. In my opinion, thyroid should be optimized first

 

[thingsvarious]

Update on my thyroid protocol:
1.5 grains NDT -> 75mcg T4 + 3x 5mcg T3 (each taken around six hours apart). Why the switch over to synthetic? Firstly, I do not need to worry about the bioavailability of T4 later in the day due to food intake (which would not be the case on NDT which I used to take twice per day). Secondly, I have noticed that the additional nighttime T3 improves various parameters of my sleep (esp. better REM-sleep while no changes in SWS). Furthermore, I feel extremely energized and ready instantly after waking up. Out of bed. A few pushups. Ready to go.

Also, I should add, whenever I am fasting (2x per month for 36h) I take an additional 12.5mcg of T3 per day

 

[thingsvarious]

Also, I should add, whenever I am fasting (2x per month for 36h) I take an additional 12.5mcg of T3 per day

Personally, I never "adapt" my hormones based on circumstances. The only time when I do change the doses of my hormones is during my quarterly 5 day fasting-mimicking diet. During this time I take an additional 12.5mcg of T3 per day (as rT3 rises) and also an additional 10mg HC (as naturally HPA-output would double or triple but my HPA is partially inhibited due to my replacement of glucocorticoids). If I do not increase said hormones, I feel weak and like "***t", whereas with this adaptation, I feel completely normal and do not even notice much that I am fasting. Currently on day 4 of my FMD. Looking forward to my "breakfast" in two days :)

 

[Elize]

What dose of HC are you taking when not fasting? Thanks

 

[thingsvarious]

What dose of HC are you taking when not fasting? Thanks

Hello, I do not take HC because it is much more dangerous. I take 25mg of cortisone acetate (which is around 20mg of HC equivalent), although tissue exposure with the CA is lower compared to the HC

 

[Elize]

Thanks so much.

Is it an over the counter medicine?