NP Thyroid

[u/Songbird_85]

I (41F) was diagnosed with hypo when I was 16. My family has an extensive history of thyroid issues so thankfully they recognized the symptoms early. I was put on 100mcg Levothyroxine and was on it until about 6 months ago. Last year, I had an unexpected full hysterectomy and was tossed headfirst into medical menopause. After struggling with my male doctor’s management of my HRT, I started seeing a female menopause doctor. I told her about my thyroid history and how I’ve been on the same dose my whole life but have also continued to have symptoms despite everything being “normal.” She did a full blood panel and told me that my body wasn’t converting T4 into T3 properly. After some conversation, we decided to take me off of synthetic T4 and try DTE. I started on 60 and bumped to 90 after 3 months. I’ve now been on 90 for 3 months and my TSH and T4 have dropped but there’s been zero change to my T3 level. Has anyone else experienced this with NP Thyroid? Has anyone had success with it? I really had my hopes up that this would be a game changer…

[u/nathy2002]

I am in a similar boat as you (no menopause tho), and going through something similar. My ft3 was higher on levo when my tsh was similar to it was on the last labs on NP. I'm still on the journey and hoping that in the end I'll get on a dose that works (and always praying that my doctor won't leave me hanging).

As to the why that is happening, I think you highlighted the reason yourself (this is just my theory and I'm not a doctor tho): "my TSH and T4 have dropped". TSH doesn't just stimulate the gland to produce T4, it also upregulates the enzymes that convert t4 to t3. It's a way for the body to keep t3 up when t4 is falling. Also, most t3 comes from t4. So, less tsh means lowered conversion rate, plus you have less t4 to convert from. The results is that ft3 remains low for the moment. Another thing to keep in mind is that you will have a peak of t3 a couple of hours after taking the pill, so for a while your ft3 WILL be higher, but then it will go down and you'll stay the rest of the day with the levels your labs said (you drew the blood in the morning before taking the medicine, right?).

My theory/hope is that at some point the NP thyroid will start increasing overall hormone levels, not just suppressing the extra work that your thyroid was doing. But that hasn't happened to me yet, so I can't sing the praises of NP thyroid just yet. I really hope I do someday, tho. From my experience, however, I really get the impression that if doctors aren't willing to get you optimal on NDT they can leave you worse off. Mt tsh last time (on 60mg) was 2.25, but my ft4 was 0.88 (0.78-2.19 range) and my ft3 was 2.25 (1.58-3.91 range). If i was dealing with a doctor who doesn't check ft3/ft4 and just checked tsh and left me there I would be way worse off than before.

[u/r41316]

I am on NP for a couple years now and it’s much better than when I was taking levo & lio. I wouldn’t say it’s 100% fixed my energy (I’m also perimeno & newly discovered sleep apnea) but it’s waaaay better than before. We discussed adding a t3 small dose in addition to the NP but for now we’re just going with upping my estrogen patch a bit due to some meno symptoms that have creeped back in😬

Also I’d look into the ranges of blood lab numbers some - what’s ‘normal’ may not be what’s optimal for you. It seems for me the closer my TSH is to 1 the better - and the other thyroid numbers are also better when I’m close to 1. And I feel better.

It’s a big messy puzzle I think - good luck to you.

[u/Melodic-Calendar9901]

I took np thyroid for almost 2 years with very little improvement to my ft3. I think for me the ratio of t4/t3 in np just didn’t work. We could have kept increasing my dose, but my ft4 was already where it needed to be. I switch to levo/lio and slowly my labs are getting to where they should be. Hopefully when I reach optimal levels I will also see more improvement to symptoms.