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  • Hitting Hyperthyroid while ramping up NDT

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    Old 02-09-2013, 08:09 AM   #1
    junk43yard
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    Hitting Hyperthyroid while ramping up NDT

    Hello,
    I am in the process of ramping up my Erfa from 0 (never have taken it before) to 2 grains. I increase dose by 30mg every two weeks, as recommended. My fear is going hyper prematurely! (Maybe I am one of those people that only needs 1 grain, and during this initial ramp up will overshoot?)

    If you become hyper while increasing dose, how long will it last? I know the T3 in NDT has a short half life, but the T4 has a half life of weeks, so I am afraid that once I realize I have gone hyper I will be stuck that way for a month -- suffering! -- even once I back down my dose?

    Is this realistic? Or is it mainly the T3 that pushes you over the edge, and so if you overshoot and go hyper you really only suffer for a day or two once you back your dose down?

     
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    Old 02-09-2013, 11:15 AM   #2
    telus
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    Re: Hitting Hyperthyroid while ramping up NDT

    Junk43yard 9feb2013

    I don't think you need to worry about it.

    A normal thyroid produces about 90 to 100 mcg of T4 and 6 mcg of T3 per day. Some of the T4 is converted to T3 by your tissues for a further 24 mcg of T3. Call this the physiologic dose.

    If you take 2 grains of ERFA, it contains 70 mcg T4 and 16 T3. As you ramp up your ERFA, your thyroid down-regulates itself. So you should not go hyper unless you take more than a physiologic dose.

    Actually you may need to go beyond 2 grains. In the old days doctors found that 180 mg (3 grains) natural desiccated thyroid (NDT) was about the minimum dose that people needed to feel good, which in the case of ERFA Thyroid contains 106 mcg T4 and 24 mcg T3. Which kind of makes sense when you compare it to the physiologic dose. (Also keep in mind that you do not absorb 100% of your meds.)

     
    Old 02-09-2013, 05:30 PM   #3
    junk43yard
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    Re: Hitting Hyperthyroid while ramping up NDT

    Hi, thanks for the reply. I understand I may need to go beyond 2 grains... at the 2 grain point I will continue to increase my dose, but more slowly and with blood work. So long as I am not feeling better, I plan on bumping the dose. At some point I will probably go past the threshold, and into hyper territory? And this is what I am wondering...

    When I hit hyper -- say it happens at 3.5 gains -- how long will I be having hyper effects for, even after going back down to 3.25 grains or even 3 grains?

     
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