Thyroid: NDT Dosing Guidance
Natural Desiccated Thyroid, NDT, contains T4, which converts to T3, and also T3, the active hormone. T3 acts more quickly than T4 and sometimes needs to be taken twice a day because it only lasts a few hours in the body before it runs out.
STTM recommends addressing adrenals and low iron before starting NDT, as Reverse T3 will be produced making you feel worse.
After addressing adrenals and low iron start with one tablet (60/65mg) and raise by 1/2 tablet (30/35mg) every two weeks. Some may be optimal at 120mg per day.
Keep a daily diary of dose, timing, and symptoms.
A maintenance dose is 2 to 3 65mg tablets or 120 to 180 mg daily.
The first dose on waking should be the biggest followed by a lower amount in the early afternoon. eg 120mg, 60mg. Some people take three doses: morning, early afternoon, and four hours later in the late afternoon. eg 120mg, 60mg, 30mg.
Once you get to 120 to 180 mg per day, hold for 6 weeks and monitor your symptoms before testing again.
Some people may need to increase to 180 to 300 mg per day until symptoms are relieved.
I would recommend reading the Stop The Thyroid Madness book for further information about increasing and dosing.
Adults on Liothyronine
I was advised to take 90mg NDT on waking to maintain adequate Free T4 levels. I then took my Liothyronine at 0900, 1200, and 1600.
Dr L’Hermitte at the Hertoghe Clinic in Brussels recommends Nature-Throid by RLC Labs and NP Thyroid because they make 15mg tablets. If you can’t get them you will need to cut up a 30mg tablet.
Don’t start NDT until you have addressed adrenals and stabilised on an optimal dose of ACE for two weeks. STTM also recommends addressing low iron.
Start with 1/4 grain / 15mg (1/2 30mg tablet) on waking for 14 days. Make sure the tablet is crunched for optimal absorption.
After 14 days increase by 1/4 grain / 15mg to 30mg (1 x 30mg tablet). Give half in the morning on waking and the other half after lunch.
After another 14 days increase by 1/4 grain / 15mg to 3/4 grain / 45mg (1 x 30mg tablet + 1/2 30mg tablet) max before testing again. Give 1 x 30mg tablet in the morning on waking and half a 30mg tablet (15mg) after lunch.
If reactive give only 7.5mg or 1/2 of a 1/4 grain, 1/8 of a grain.
Dr L’Hermitte and STTM warn that more might be required in the winter so you might want to add in another 15mg dose four hours after the first dose and then time the afternoon dose four hours after that.