The traditional approach in the treatment of hypothyroidism is to use the synthetic hormone thyroxine (T4), which contains T4 hormone only; it has no triiodothyronine (T3).

You will often find that when you attempt to ask your physician for the natural desiccated porcine thyroid extract (NDT) that you are often made to feel quite stupid that you would dare to request an inferior hormone product from him/her. Unfortunately, physicians have little knowledge about this product as teaching about it in medical schools stopped suddenly in 1975 and they are untrained in its use. (See ‘Background Information’)

Medical practitioners will often tell you that the synthetic provides steady hormone levels, but what s/he tend to overlook is that a large minority of people are unable to convert the mainly inactive hormone T4 to the active form of thyroid, triiodothyronine (T3). Your doctor could easily confirm this if s/he measured the free hormone levels when they give you a thyroid function test, but not many of them do not bother to use these tests, or NHS laboratories refuse to test free T3 if they consider that your TSH and free T4 are within the reference interval.

If you have low T3 levels, the brain and body just don’t function properly. You must use a preparation that contains T3 because T3 does 90% of the work of the thyroid in the body. You should use a combination of T4 and T3 that compensates for the inability by some people to convert T4 to T3. Natural thyroid is desiccated thyroid and has T3 and T4 plus calcitonin and probably (unassayed) T2 and T1 plus other unspecified enzymes/hormones.

Desiccated thyroid extract can be used by itself, as a complete thyroid hormone replacement product, sometimes in combination with synthetic T4 or T3 to change the ratio of T4 to T3. The ratio of T3 to T4 is fixed, so it can’t be adjusted unless T4-only or T3-only pills are taken as well.

Nearly all doctors in natural medicine tend to use NDT, which is a mixture of mono and di-iodothryonine and T3 and T4, the entire range of thyroid hormones.

The dosage of NDT is determined by the indication and must in every case be individualized according to patient response and laboratory findings. The safest starting dose for patients with hypothyroidism who are taking NDT is usually instituted using low doses depending on the cardiovascular status of the patient.

The usual starting dose is 30 mg (1/2 grain) with increments of 15 mg (1/4 grain) every 2 to 3 weeks. A lower starting dosage, 15 mg (1/4 grain) per day is recommended in patients with long standing hypothyroidism, particularly if cardiovascular impairment is suspected, in which case extreme caution is recommended. Thyroid extract should be taken twice a day, half after breakfast and the other half after lunch. The tablet can be cut in half with a pill cutter (available from most chemists). Taking NDT after meals also helps to reduce volatility of the blood-level of T3.

The TSH, Free T3 (if possible!) and Free T4 are then repeated in six weeks and the dose is adjusted. Unlike thyroxine, whose coating needs breaking down in the stomach, although the manufacturers did not make the Erfa ‘Thyroid’ to be taken sublingually, many patients say they find allowing it to dissolve under the tongue works for them better, which means it is likely to be absorbed direct into the blood stream to work instantly, and can be taken at the same time as foods which may otherwise interfere with it. However, Armour Thyroid, Nature Throid and Westhroid should be taken orally.

Taking thyroid extract twice a day overcomes traditional medicine’s major objection and resistance to using natural thyroid preparations its variability in its blood-levels. Your doctor may not be aware that NDT should be used twice daily and NOT once a day. The reason for this is that T3 has such a short half-life and needs to be taken twice daily to achieve consistent blood levels. Some patients find taking it 3 times a day works best for them.

The dose should be increased on a monthly basis until the TSH falls below 0.4. You then need to optimise these two thyroid hormones by using the Free T4 and Free T3 levels.

The FT3 and FT4 tests are used to monitor your treatment. They should be above the middle but below the upper end of the laboratory normal reference range. Healthy young adults should have numbers close to the upper part of the range. For cardiac and/or elderly patients, the numbers should be in the middle of its range. Once a therapeutic range is achieved the levels should be checked at least once a year. A small number of large, overweight, thyroid-resistant patients may need high doses of NDT or the equivalent of thyroxine per day (counting 100mcg of T4 as 1 grain of thyroid extract).

If you are already on once daily NDT, then it would be wise to begin taking it twice a day, as stated above. Since the only change will be in the FT3 level, which has a short half-life, the serum FT4 and FT3 levels (and TSH, if indicated) can be measured 48-72 hrs after the splitting of the doses if the patient had been on the hormone for 4-6 weeks before the splitting of the doses. This is because the Free T4 hormone is the one that takes a number of weeks to build up to its steady-state serum-level.

The many advantages of taking desiccated thyroid extract are that it provides all the thyroid hormones in one pill. It is absorbed more completely and consistently than pure T4 because all the hormones are protein-bound, which is the natural way for the hormones to be absorbed. In the natural, T3 appears to spread out its effects more evenly, causing fewer of the ups and downs that patients often experience with synthetic T3, and for many patients, taking desiccated thyroid instead of T4 alone or even a T4/T3 combination relieves the symptoms that didn’t reverse on the synthetic medications.

Disadvantages are that it can be difficult to find a doctor who will prescribe Thyroid Extract. If the T4/T3 ratio isn’t optimal, another prescription is needed with it.

Symptoms of Excessive Thyroid Hormone

The beauty of taking natural thyroid extract is that if any of the following symptoms are experienced whilst taking it, you can stop your medication immediately as the T3 element, with its short half-life, will leave your body in 6/8 hours. These symptoms are frequently only temporary during the adaptation stage. The symptoms of excessive thyroid hormone may include:

1. Palpitations

 

1. Nervousness

 

1. Feeling hot and sweaty

 

1. Fine tremor

 

1. Clammy skin

Most patients do extremely well on natural desiccated thyroid. However, there are a small number of people who cannot tolerate thyroid extract. However, Tertroxin, which is T3 only, can be used in combination with Levothyroxine (T4) only synthetic preparations. It is important to remember that synthetic T3 should always be prescribed twice daily because of its shorter half-life. This is usually after breakfast AND after supper.

Once on twice daily dosing, you can then optimise both the T4 and T3 levels, with whatever thyroid preparation is required. This is not possible in most hypothyroid patients with T4 only preparations.

NDT doesn’t have the stability problems that synthetic T4 medications are known for. The ratio of T3 to T4 is fixed, so it can’t be adjusted unless T4-only or T3-only pills are taken as well. The T4 and T3 in NDT is standardised to the specifications laid down by the United States Pharmacopoeia (USP) and remains an unlicensed product as it was ‘grandfathered’ in because there have never been any problems regarding its safety and efficacy.

People Who Should Not Take T3

The only exception to pursue optimisation of the T3 level without using NDT is in severe acute cardio-pulmonary conditions, such as congestive heart failure, when the metabolic slowing effect of a low FT3 level can actually be life-saving. However, the vast majority of hypothyroid patients do not have this problem.

WARNING:

Drugs with thyroid hormone activity, alone, or together with other therapeutic agents, have been used for the treatment of obesity. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects. The use of thyroid hormones in the therapy of obesity, alone, or combined with other drugs, is unjustified and has been shown to be ineffective. Neither is their use justified for the treatment of male or female infertility unless this condition is accompanied by hypothyroidism.

There is calculator

HERE

that you can use to show you how T4 builds up in a typical person to provide rough idea of what is happening when you change doses.

Count how many days you feel great and look at what the final dose is on that day. e.g., if you feel great after five days, but then feel like it might be too much (you are getting more tired, heart racing etc), then look at what the calculator says the dose is for 5 days. You can see point 5 is 170, so then settle for an increase of 12.5 (which is 162.5) say, or even an increase of 25 (175). Just thought this may give you some idea of what happens. The half-life of T4 is about 6 or 7 days, it takes so long for the full effects of a dose change to be felt.

How to treat with natural thyroid extract