Thyroid hormones, either alone or combined with other medications, should NOT be used for the treatment of obesity and should NOT be taken by patients with uncorrected adrenal cortical insufficiency, untreated thyrotoxicosis, or apparent hypersensitivity to thyroid hormones. NATURAL DESICCATED THYROID EXTRACT tablets should be used with caution in patients with cardiovascular disease. Thyroid hormone may increase symptoms of diabetes mellitus, diabetes insipidus, or adrenal insufficiency. Adjustment of treatment measures for these endocrinological diseases is necessary if thyroid hormone therapy is added. If THYROID EXTRACT is used in the treatment of myxoedema coma, glucocorticoids should be administered. Adverse events other than those indicative of hyperthyroidism are rare and usually the result of therapeutic over dosage

1) Armour Thyroid is the most well known of the natural desiccated thyroid medications. However, more and more sufferers of the symptoms of hypothyroidism are using the Canadian licensed thyroid extract by Erfa simply called Thyroid, and many use the US RLC Inc. Labs. to obtain Nature Throid and Westhroid. There are other brands of natural desiccated thyroid extract, but the above are the brands that the Medicines and Healthcare Products Regulatory Agency (MHRA) in the UK say doctors can prescribe for their patients if they dont do well on levothyroxine (T4) alone.

Thyroid extract has been used since 1884 and has been used successfully for well over 100 years. Thyroid extract contains the same hormones that your own thyroid would produce-T4, T3, T2, T1, calcitonin and other enzymes, and that is why natural thyroid is superior to synthetic thyroxine (T4). Armour meets the stringent guidelines of the US Pharmacopoeia and is approved by the FDA.

2) It is always wise to start taking a very small dose of thyroid extract for the first 7 days to see if this treatment would cause you any adverse effects. The reason for this is that your body may need to adjust to the active hormone triiodothyronine (T3) because for some people, T3 may cause palpitations, dizziness and feeling spaced out. Your body needs time to adjust to this new hormone, and your adrenal glands may have become stressed (as they may well have if you have suffered hypothyroidism for some time and been without treatment). You may also find that you are low in essential minerals or vitamins needed to help the thyroid hormones get into the cells. Ask your doctor to test your ferritin (stored iron), vitamin B12, vitamin D3, magnesium, folate, copper and zinc to see if any of these are low. If any of these are low, you must supplement with the appropriate vitamin or mineral.

3) It is important to understand that you will need to raise your natural desiccated thyroid hormone (NDT) within 3 to 4 weeks, to prevent your hypothyroid symptoms returning. At times, you may feel you are suffering more symptoms, but this does not mean that NDT is bad for you or that it isnt working. Most of the time, it simply means your body is crying out for more hormones, or it may mean that you need to cut back on your dosage. Dont worry all will become clear…I promise!

4) For most people, they can stop taking synthetic Thyroxine (T4) one day, and the following day replace it with NDT, but for others, who may well have stressed adrenals, it is best to stop taking any thyroid hormone replacement for at least a week and start treating with adrenal supplements. (See’ Treasure Chest’ at the top of our website home page, or ‘Resources’ at the top of the forum Home Page. Click the category ‘Associated Conditions’ and then the sub-category ‘Adrenals’ to find all the information you need.)

5) The most biologically effective way to take the Erfa Thyroid is by placing the tablet between your gums and cheek. This way, it is absorbed directly by the tiny capillaries that line your mouth – taking the hormones direct to your blood, bypassing the stomach. Swallowing also brings stomach acid into contact with the Calcitonin in NDT, and you may lose up to 45% of other hormones and some of the benefits to your bones. However, its OK if you would rather swallow your medication you will still get great benefits! NDT has a very interesting smell and you will soon become used to it. The smell used to be very strong, but a recent new formulation has made the smell fainter. The other brand NDTs are not designed to be taken sublingually, and should be swallowed with plenty of water.

6) It is important to avoid taking iron, oestrogen and calcium supplements at the same time as NDT, since both bind the thyroid hormones to some degree. T4 needs time to build up in your system so, you may find your optimal dose fairly quickly, but more likely, it may take up to 6 weeks. Personally, I started to feel really great on day 9 after starting Armour. It appears that the average dose is between 2 and 3 grains but we are all different…remember this, you take the amount of NDT you need to make you feel good – you do not dose according to the results of laboratory blood tests. Keep an eye on your symptoms, and either raise your dose or lower it according to how you feel.

Dont be afraid. You have come a long way in deciding that the only way you are going to have a chance to regain your normal health is to take your thyroid health into your own hands.

7) Most folk find that dividing their dose twice a day is optimal for them. NDT contains T3, which has a half-life of 6/8 hours and peaks in the blood about 2 hours after you take it. If you are taking 2 grains (120mgs), an example is to take 1 grain (60mgs) before breakfast and another in the early afternoon. Some people dose 3 or more times a day. A few decide to take their dose at one go in the morning, and find that to be effective, but most notice a difference when they multi-dose…. it stops that afternoon slump. Experiment to find what is best for you. And remember: a normal thyroid gives you what you need throughout the day instead of one dump, thus, multi-dosing is a way to replicate that.

8) Before blood tests were developed (around 1960s) doctors ALWAYS treated patients solely by symptoms, clinical examination, and basal temperature test…. and successfully. One important symptom is your temperature. Temperature reflects metabolism, and metabolism is controlled by your thyroid. Find a MERCURY THERMOMETER, shake it down and place it on your bedside table. First thing before you get out of bed, place the thermometer under your tongue and leave it there for at least 3/4 minutes. Normal temperature is 98.4 degrees Fahrenheit. If your temperature is 97.8 or less (and you might find it MUCH less), and you have symptoms of hypothyroidism and showing signs of hypothyroidism (see Signs and Symptoms of Hypothyroidism in the FOLDER Hypothyroidism) then tell your doctor. It is a good idea to start taking your temperature every morning when you begin taking NDT and check to see if it rises as your body gets used to this thyroid hormone replacement.

9) Unhappily, as we are all aware, your doctor is going to put a HUGE reliance on thyroid function tests over symptoms. These tests do NOT tell the whole story, especially if you are taking NDT and not levothyroxine alone. If you are faced with such tests, then your goal is generally to get your free T3 and T4 in the upper half of the range, but you have to figure out where YOU feel best, based on symptoms. When you get your free T3 at the top of the range, (or when you dose yourself to eliminate all symptoms) you will often find that your Thyroid Stimulating Hormone (TSH) is BELOW the so called normal reference range but that does NOT mean you are going hyperthyroid. Your doctor must learn that the TSH is less important once you start natural thyroid extract treatment, and just because one’s TSH can get lower than 1 while getting the free T3 up, does NOT mean you have become hyperthyroid. Your pituitary gland doesnt need to push out TSH as NDT provides all the hormones a normal thyroid makes.

10) Most doctors are not aware of the efficacy and safety of the branded NDT’s. You can read more about this in our ‘Treasure Chest under ‘Resources’ www.tpauk.com under the Category ‘All About Thyroid Hormones’ and then the sub-category Abolut Natural Thyroid Extract’. Be prepared for your doctor to tell you that what you have learned is incorrect and that levothyroxine (T4)-only works for everybody. Always ask these doctors to cite the references to the scientific evidence so you can check this out for yourself they will never give you any because there is none!

11) If your doctor refuses to prescribe NDT for you, then you may consider changing your doctor. If you live in an area where there are several pharmacies, then please visit them and ask the pharmacist if there are any doctors within the area who prescribe any of the NDTs. You may also wish to be referred to an endocrinologist who may look sympathetically on your individual case.

12) Note that T4-to-NDT conversion charts that you will find on many websites (including the manufacturers of Armour www.armourthyroid.com are VERY inaccurate.)

13) Often, there are other areas that need assistance when you are treating yourself with NDT. For one, many folks need to optimise their ferritin level (storage iron), which is low in many with hypothyroidism. We are not yet sure why low ferritin can cause similar symptoms to those in hypothyroidism, or can cause you to have hyper-like symptoms when you try to raise the NDT dose. The ferritin reference range is very wide. In women, it is 20 to 200 and in men, it is 30 to 300. For a woman, you should aim to get your level somewhere between 70 and 90. In men, you should aim for a level of 150 to 180.

14) If, upon starting NDT, you experience symptoms, including anxiety, insomnia, shakiness, sweating, dizziness, feeling spaced out its a strong sign that you may need adrenal support. Either adrenal hormones or Nutri Adrenal Extra is needed to distribute thyroid hormones to your cells, and if you are not making enough cortisol from stressed adrenals, your blood will be high in thyroid hormones, producing the above symptoms. This is why we advise taking adrenal support before starting ANY thyroid hormone replacement, synthetic or natural.

15) If you are already taking NDT and suffer these symptoms, you may need to stop the thyroid extract and get on adrenal support for a while before starting to take NDT again.

It is strongly recommended that you get an adrenal test Genova Diagnostics and Lab21 both do an excellent 24 hour salivary adrenal profile to check the levels of your cortisol and DHEA at four specific times during the day – and this is FAR superior to the one time blood test that doctors will use on you.

It is advisable to take Selenium 200 mgs daily with your main meal. This helps with the T4 to T3 conversion. Zinc and Vitamin C also play a role here. Your need for vitamin B will increase as you improve. Again, you can check out the recommended supplements in this Thyroid Problems: The TPA Guidance. Extra copies can be ordered by using the Order Form on our website.

16) If you have a large quantity of NDT tablets, store them according to the manufacturer’s instructions (if available). Usually if they come in a glass bottle or jar a desiccant sachet will be included to keep the NDT dry. There are different views about storing NDT. Many keep their NDT in a cool dark place. Some keep them in the freezer or refrigerator taking out about 1-2 months supply at a time but others believe that moisture could get in storing NDT in this way. There are useful discussions on the main forum about storing NDT.

How to Dose with Natural Desiccated Porcine Thyroid Extract

If you are particularly sensitive to thyroid hormone, then start taking a quarter of a grain (15mgs) only, and stay on this for 7 days. If no adverse effects (i.e. palpitations or feeling strange), then increase by another quarter of a grain, but take this second quarter grain about 2.00 to 3.00p.m. If still no adverse effects, then, after 3 to 4 weeks of taking half a grain, follow the same instructions below for those who are changing from T4 only to NDT who will start

Day One taking quarter of a grain (15mgs) in the morning and quarter of a grain in the afternoon and stay on this for 7 days. If no adverse effects, then…

Day Eight: increase your dose by another half grain (30mgs) a day. Take half a grain in the morning and half a grain in the afternoon and stay on this dose for at least 3 weeks. If no adverse effects, then…

Three Weeks: increase by another half grain and take 1 grain (60mgs) in the morning and half a grain in the afternoon. Stay on this dose for 3 weeks and again, if no adverse effects, then…increase by another half grain and take one grain in the morning and one grain in the afternoon and stay on this for another 3 weeks.

By this time, you are probably beginning to feel some real difference and noticing that many of your symptoms and signs are disappearing. However, if at any time during this period you begin to feel any palpitations, dizziness, shakiness and generally feeling spaced out (and you may feel a little frightened if this happens) then you need to STOP all your thyroid medication and stay off it for 24 hours at least in order to get the T3 (the culprit!) out of your body. This could happen a couple of hours or so after you have taken your morning dose as the T3 (the active thyroid hormone) peaks in the blood between 2 to 4 hours after taking it. Dont be alarmed, nobody has ever died of this, honestly, and you will be surprised at how soon you begin to feel normal again. Dont take any more NDT that day. After 24 hours, start taking your NDT again but drop your dose by the extra half-grain that probably caused this to happen to you. Start taking the dose you were on before the increase.

After 3 to 4 weeks try adding just a quarter of a grain and see how you go from there. This is how many NDT users throughout the world have found what works best for them when increasing their dosage. You will probably only know where your sweet spot is when you do actually go over the top, because there is really no other way to find this out. I repeat there is nothing to be frightened about; the T3 in NDT leaves your body very quickly. Just try to relax until it has settled down.

Because the T4 and T3 in NDT is standardised to USP specifications, you may find the T4 and T3 hormone balance in NDT may not be the right one for you. You may need a little more thyroxine (T4), or you may need a little more triiodothyronine (T3) and you might need to experiment with this, but many others are happy with NDT on its own.

If you would like to ask your doctor to prescribe one of these brands of NDT this might be a little difficult, as the vast majority are not acquainted with the facts. However, please do join our Internet Thyroid Support Group where we have lots of information and sample letters that may help you achieve your goal.

This is a big adventure for you all. Always remember that since 1894 to the early 1970s desiccated porcine (pig) thyroid extract was the ONLY medication for all those suffering the symptoms of hypothyroidism. It has proven VERY successful for the treatment of hypothyroidism for those who didnt do well on levothyroxine-only therapy.