My start on NDT

[Gman86]

Has anyone done the 24 hour cortisol saliva test through the stopthethyroidmadness.com site? Or any other recommendations for how/where to do this test? I would like to get this done before my consult with Defy. My RT3 is high, which I only realized after starting my TRT journey about 2 months ago. Since it is "in-range" my primary care doc never mentioned it. Just trying to have as much info as possible to present to Defy to hopefully streamline the process. I'm hoping that addressing any Thyroid issues combined with TRT will deal with my particular symptoms, which have for years been trouble sleeping, lack of focus and brain fog - some days worse than others. My labs are below.

View attachment 6887

I’m not sure about the cortisol protocol, but I do know that the standard protocol to lower RT3 is to not use T4, or NDT, and to just use T3. Along with whatever dietary protocol you can find to lower RT3. Also, something that hasn’t been talked about, but is extremely important, is using thyroid medication without any fillers or binders. I believe you can only get this through compounded pharmacies. MANY people can have issues with certain thyroid medications, even NDT, and think it’s the dosage that’s causing the problem, when it can just be the specific fillers/ binders in that product. Luckily Defy uses Empower Pharmacy, which is one of the best compounding pharmacies in the country. So to just increase your chances of success as much as possible, I would get your T3 through them.

Check this guy out. His channel is literally just about the thyroid. Amazing guy, and amazing info.

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[Vtail]

I’m not sure about the cortisol protocol, but I do know that the standard protocol to lower RT3 is to not use T4, or NDT, and to just use T3. Along with whatever dietary protocol you can find to lower RT3. Also, something that hasn’t been talked about, but is extremely important, is using thyroid medication without any fillers or binders. I believe you can only get this through compounded pharmacies. MANY people can have issues with certain thyroid medications, even NDT, and think it’s the dosage that’s causing the problem, when it can just be the specific fillers/ binders in that product. Luckily Defy uses Empower Pharmacy, which is one of the best compounding pharmacies in the country. So to just increase your chances of success as much as possible, I would get your T3 through them.

Check this guy out. His channel is literally just about the thyroid. Amazing guy, and amazing info.

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Good info - thanks!

 

[Canada878]

Re: my iron and thyroid protocol to Gman. I’d love for you to check out my thread here:
New Member is Canada w/ pre-TRT bloodwork
Just so we don’t hijack this one. My apologies for it not being as up to date as it should be. I got follow up bloodwork drawn today so should have those results posted late next week. FWIW i’m on TRT, NDT and have been taking iron and vit c. I’m still tweaking everything but i’m beginning to have a theory on iron and how it is vitally important to my mood. Blood tests next week and in several months should help me get some clarity on the subject.

 

[Canada878]

I just finished reading your two threads to get back up to speed with your case. Wrench could you comment and post your full protocol that you are on right now.

 

[WrenchHead80]

I just finished reading your two threads to get back up to speed with your case. Wrench could you comment and post your full protocol that you are on right now.

I'm on nothing now for my thyroid. I have started taking selenium (400 mcg a day) again with vitamin C and E though to help with my antibodies in the mean time.

I also stopped taking any iron pills around the time I stopped taking my NDT.

BTW: I finally found a local endo Dr. to hopefully address my problem. I hope they will be good since I have to wait till April 12th to even start with them.

 

[WrenchHead80]

Well I waited over a month to find out I'm going to be jerked around again by another doctor most likely. Had the appointment today with a local Endo and wasn't happy.

1) She didn't seem thrilled with Defy's TRT protocol
2) Isn't a fan of NDT
3) Says the 4 panel cortisol saliva test is only used to check for high levels of cortisol.
4) Wants to test my cortisol with the once in the morning cortisol blood test.
5) Check out what labs she wants to run in photo included. Shes going to base a protocol off only those I'm guessing?
6) Didn't seem thrilled I educated myself on this stuff
7) She said just because I have elevated TPO #'s doesn't mean my thyroid is being attacked.
8) She actually said do you believe maybe its not a hormonal problem your having? I've heard of dr's that like to pass this off as a mental problem so I told her I'm already on zoloft and I'm now seeing a therapist and physiologist and they both feel I should address my thyroid issue. Also said did you look at my labs?

I don't know what to do anymore. Its really upsetting. I had a really bad winter and went into a dark place and I'm lucky to even be here to write this now. I was really trying to stay positive that I would get the help I needed but now I'm starting to feel hopeless again.

I did find a website that sells the zrt cortisol saliva test to new york which the PA at defy said he would work with, But this is also the same person that didn't believe I was pooling on a low NDT dose protocol or my iron was low because my "ferritin" level did come up. Members here and in the STTM book I have since been reading say otherwise.

I was hoping Dr. Saya would have commented in this thread but I guess he hasn't seen it.

I know Chris the mod here said Dr. Saya knows his stuff. Should I give Defy another chance at my thyroid issue but spend the extra money for Dr. Saya?

Any suggestions on what I should do?

 

[OMI100]

what state do you live in?

 

[Gman86]

I’m with defy, but I see nurse Jill. We just started me recently on NDT. She seemed pretty knowledgeable in regards to the thyroid. Dr. Saya would probably be even more knowledgeable, that guy is on top of his game. Very intelligent, and clearly very dedicated. Seems to always be up on the latest research.

When you say “give defy another chance” are you not with them currently?

 

[WrenchHead80]

what state do you live in?

NY and wouldn't want to travel that far. I found out the lady that wrote the STTM book has a FB forum and may have some telo-doctors like Defy but who specialize in strictly the thyroid she can recommend.

I’m with defy, but I see nurse Jill. We just started me recently on NDT. She seemed pretty knowledgeable in regards to the thyroid. Dr. Saya would probably be even more knowledgeable, that guy is on top of his game. Very intelligent, and clearly very dedicated. Seems to always be up on the latest research.

When you say “give defy another chance” are you not with them currently?

If you read the first page of this thread it discuss my start with thyroid treatment with Defy and how it didn't work out for me.

I still use Defy for my TRT needs and I'm very happy with the PA and the service in general I get from Defy for my TRT needs. I'm thinking maybe they should leave thyroid treatment up to more knowledgeable staff there though.

 

[Gman86]

NY and wouldn't want to travel that far. I found out the lady that wrote the STTM book has a FB forum and may have some telo-doctors like Defy but who specialize in strictly the thyroid she can recommend.



If you read the first page of this thread it discuss my start with thyroid treatment with Defy and how it didn't work out for me.

I still use Defy for my TRT needs and I'm very happy with the PA and the service in general I get from Defy for my TRT needs. I'm thinking maybe they should leave thyroid treatment up to more knowledgeable staff there though.

The thing I love about defy, or at least nurse Jill, is that she takes into consideration the knowledge that we have as patients, and she allows me to take part in the decisions that are being made in regards to my treatment. For instance, we both agreed on the fact that it may be beneficial to do a trial run of thyroid medication. It was me that wanted to try NDT. She thought that was a good idea, and even allowed me to pick the specific brand of NDT I would like to use. We talked about how to dose it, and she took my opinions into consideration, which was awesome. In my experience, defy has been the perfect balance of them applying their knowledge, and taking into consideration the patients knowledge, in regards to dictating the direction of treatment.

But I understand what you’re saying. You want a doctor that is extremely knowledgeable in regards to just the thyroid. To get that, you usually have to find a doctor that basically devotes his entire practice to that one hormone system. One of the best doctors that I’ve come across that has basically devoted his life’s work to the thyroid, is Westin Childs. I’m sure there are others, but he’s the best that I’ve come across.

 

[WrenchHead80]

The thing I love about defy, or at least nurse Jill, is that she takes into consideration the knowledge that we have as patients, and she allows me to take part in the decisions that are being made in regards to my treatment. For instance, we both agreed on the fact that it may be beneficial to do a trial run of thyroid medication. It was me that wanted to try NDT. She thought that was a good idea, and even allowed me to pick the specific brand of NDT I would like to use. We talked about how to dose it, and she took my opinions into consideration, which was awesome. In my experience, defy has been the perfect balance of them applying their knowledge, and taking into consideration the patients knowledge, in regards to dictating the direction of treatment.

But I understand what you’re saying. You want a doctor that is extremely knowledgeable in regards to just the thyroid. To get that, you usually have to find a doctor that basically devotes his entire practice to that one hormone system. One of the best doctors that I’ve come across that has basically devoted his life’s work to the thyroid, is Westin Childs. I’m sure there are others, but he’s the best that I’ve come across.

I agree totally. The PA I use is very friendly also and is totally cool with me being educated with TRT and us working as a team together. I've never had a problem at all involving TRT with him. The endo I just saw locally I could tell was not thrilled I was educated going into this appointment and that I had opinions on things which didn't align with her views.

They should be knowledgeable for sure. After re-reading and finally understanding what Chris wrote here a few times trying to get me to understand what was going on, I feel it wasn't that complicated of a thing and my PA should have known it. I was having a hard time understanding what Chris was trying to tell me when I'm hearing something else from my PA and on top of that learning thyroid labs can show a number that can mean two different things. Example being my FT3 looking nice at 4.whatever it was but Chris knowing I shouldn't be at that number on only 1grain of NDT so I was pooling. Defy PA said I was not pooling even after explaining what Chris wrote. Or me thinking my iron is fine cause the PA says my ferritin came up yet my iron serum was still low. I've even since learned inflammation can raise ferritin levels.

I will add the STTM book was very helpfull in getting me to better understand this thyroid stuff and this forum.

 

[Gman86]

I agree totally. The PA I use is very friendly also and is totally cool with me being educated with TRT and us working as a team together. I've never had a problem at all involving TRT with him. The endo I just saw locally I could tell was not thrilled I was educated going into this appointment and that I had opinions on things which didn't align with her views.

They should be knowledgeable for sure. After re-reading and finally understanding what Chris wrote here a few times trying to get me to understand what was going on, I feel it wasn't that complicated of a thing and my PA should have known it. I was having a hard time understanding what Chris was trying to tell me when I'm hearing something else from my PA and on top of that learning thyroid labs can show a number that can mean two different things. Example being my FT3 looking nice at 4.whatever it was but Chris knowing I shouldn't be at that number on only 1grain of NDT so I was pooling. Defy PA said I was not pooling even after explaining what Chris wrote. Or me thinking my iron is fine cause the PA says my ferritin came up yet my iron serum was still low. I've even since learned inflammation can raise ferritin levels.

I will add the STTM book was very helpfull in getting me to better understand this thyroid stuff and this forum.

Ya I’m still learning more everyday about the thyroid. It’s blowing my mind how much I didn’t know about it, and how much most people don’t know about it. Which is fckn crazy, considering how many things the thyroid can effect. STTM has a ******** group that I’m a part of. It’s been very helpful. Learned a lot through it so far.

So what do you think about NDT bringing down your RT3 to 4? Do you think that means pooling? I’ve never heard about low RT3 being associated with pooling. And what was your RT3 before starting NDT?

 

[WrenchHead80]

Ya I’m still learning more everyday about the thyroid. It’s blowing my mind how much I didn’t know about it, and how much most people don’t know about it. Which is fckn crazy, considering how many things the thyroid can effect. STTM has a ******** group that I’m a part of. It’s been very helpful. Learned a lot through it so far.

So what do you think about NDT bringing down your RT3 to 4? Do you think that means pooling? I’ve never heard about low RT3 being associated with pooling. And what was your RT3 before starting NDT?

Yes I requested to join a few days ago and just got allowed access. So I do plan on posting a thread there. Hopefully they can recommend a good place if I decide to go that route.

I'm thinking about calling Defy when I have a chance and explaining my previous situation. I'll just come out and say find my labs on the first follow-up after starting NDT with you guys and share those labs with your team and whoever agrees I'm pooling and has a lot of thyroid experience I'll work with and make the appointment and give it another go. Or just ask to share my labs with Dr Saya and if he see's the problem I'll then make the appointment.

Your second paragraph isn't what happened. Read it from the start. Their is a lot of good information in this thread.

 

[Robotics]

Figured I'd start a new thread involving my journey to fix my thyroid issues to help others cause I know I'll be asking questions, so others can read and learn too. I left off with thyroid discussions on the last few post here to get up to speed here (other members had good info, worth reading) -> Hello, new member here. Questions about my start so far on TRT

I started taking NDT (30mg pills) June 1 from Defy. I take 1 pill in the morning. Within a couple days I became very tired by the early afternoon. I don't think it was in my head cause I figured it was going to do the opposite. So a little after a week, June 11 I spoke to Defy and was given the ok to raise it to 2 pills a day. Which I take 1 in the morning and the 2nd one around 2pm. After doing that within 2 days the sleepiness started to go away. After a weeks time I felt I had energy all day, nothing crazy but good enough to finally be able to stay up till 10-11pm without a problem if I wanted to, which is what I wanted. Was still able to fall asleep when I wanted to lay down and fall asleep though, which I also wanted. I remember reading you should wait 2 weeks before doing a small raise but as I said I was really tired. I was also monitoring my blood pressure, body temp and heart rate to keep a eye out for elevated numbers and I had none at all. So I figured it was a safe bet I could raise it.

I had no anxiety during this time which I was worried about getting since I knew my iron was low and I never had a cortisol saliva test done. Two things I learned here that need to be good for your thyroid meds to work right. Now since May 7th I started to take 2 forms of a iron supplements with Vitamin C till my levels become good again. I also take 200mcg of Selenium with the iron pills and C at night on a empty stomach before bed. So I'm hoping my numbers came up some before I started the thyroid meds.

Pros so far:
I can stay awake all day into the evening. Before I'd want to sleep by 8-9pm.

My abs are starting to show now. Wasn't overweight but definitely had a layer of fat. Haven't changed my exercise routine. I did start a reduction in diary and almost completely eliminated my milk consumption ( I used to drink a lot every day). So it could be that, probably more likely the reason. I'm doing it to see if it reduces my thyroid antibodies. Read how people have eliminated their hashimoto by diet changes.

Cons so far:
I started to experience anxiety again which really disappointed me. If others remember in other threads I've mentioned how glad I was to be on TRT since it also helped eliminate a lot of my anxiety issues. So to have it come back was a kick in my balls. I'd say it started three weeks (around June 25th) after starting to take the second pill. I've read t4 takes longer to build up so maybe I didn't get the full effect of taking only 1 pill a day or maybe I was finally getting the full effects of taking those two pills now. I will say I feel the anxiety is finally starting to go down a little this week. Or maybe I'm just getting better at handling it. I'm hoping maybe its just a case of needing a little more or maybe less thyroid meds. But I don't want to adjust the meds farther till I had labs done.

July 2nd in the morning before taking my morning Test shot and fasting I went to get my labs done. I only took my NDT pill before giving blood. I also stopped taking my iron supplements 3 days ago, to get accurate iron lab numbers.

I also added a couple extra labs

1)SHBG to see if it has risen since starting NDT (raising my T3).
2)Prolactin since I never got it tested
3)Selenium since I want to know if I'm taking to much or too little (never tested it before starting Selenium)
4)My thyroid Antibodies to see if they came down. Want to see if my reduction in dairy and taking selenium now is helping.
5)My RBC, Hemoglobin and Hematocrit to see if I'm digging myself into a hole trying to raise my iron numbers by taking iron supplements.
6)My TT and FT since if my SHBG did change I'd like to see the effect it had on those.
7)Estradiol Sensitive to make sure I'm still in a good range

I'll include my last labs so its easier to reference when I upload my new labs as soon as I get them. Hopefully next week, so I can load them here to learn more and to make my Defy follow up appointment.

so did your shbg end up increasing?

 

[WrenchHead80]

No it didn't. But I wasn't on the right dose or couldn't have been because I was pooling. I'm assuming taking more NDT wouldn't have helped the situation of having low iron at the time and unknown cortisol levels.

 

[WrenchHead80]

I'm excited to say I got my labs done including my cortisol saliva test and made a appointment with Dr. Saya at Defy in two weeks! I'm really hoping everyone here is correct and he can take care of my thyroid problems.

I noticed evening though I have been supplementing with different types of iron and eating more iron containing foods my iron didn't budge up much. Can this be caused to having a lowered metabolism from being hypothyroid which decreases the production of hydrochloric acid in my stomach, which in turn leads to a malabsorption of iron?

I included my current iron and cortisol labs here. Do you guys feel they are good enough to start NDT again?

 

[Gman86]

I'm excited to say I got my labs done including my cortisol saliva test and made a appointment with Dr. Saya at Defy in two weeks! I'm really hoping everyone here is correct and he can take care of my thyroid problems.

I noticed evening though I have been supplementing with different types of iron and eating more iron containing foods my iron didn't budge up much. Can this be caused to having a lowered metabolism from being hypothyroid which decreases the production of hydrochloric acid in my stomach, which in turn leads to a malabsorption of iron?

I included my current iron and cortisol labs here. Do you guys feel they are good enough to start NDT again?

I wonder what that means when your iron is low, but ferritin is on the higher end. Not the higher end of the range, just the higher end of “optimal” for ferritin, according to the research I’ve come across.

 

[WrenchHead80]

I wonder what that means when your iron is low, but ferritin is on the higher end. Not the higher end of the range, just the higher end of “optimal” for ferritin, according to the research I’ve come across.

From what I read you treat iron not ferritin. Ferritin can be high or "normal" from inflammation. If the inflammation was gone the number would be lower.

 

[Gman86]

From what I read you treat iron not ferritin. Ferritin can be high or "normal" from inflammation. If the inflammation was gone the number would be lower.

I’ve also heard this. I’ve recently been focusing on raising my serum iron levels as well. Finally got them over 100. They say around 130 is a good level for men.

 

[WrenchHead80]

I’ve also heard this. I’ve recently been focusing on raising my serum iron levels as well. Finally got them over 100. They say around 130 is a good level for men.

I've heard the same too. Tommorow is my appointment with Dr Saya. I'm excited to get my thyroid problem taken care of. I feel its the missing link.