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Starting and Taking Natural Desiccated Thyroid

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Converting From Levothyroxine to Natural Desiccated Thyroid

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Whether you're starting or switching to natural desiccated thyroid, it's important to be knowledgeable about the dose, and the general conversion formulas. You can learn more on our "Levothyroxine-NDT conversion page. 

How to Take Your Natural Desiccated Thyroid

  • You should take natural desiccated thyroid (NDT) in the morning, ideally on an empty stomach, at least 30 to 60 minutes before eating breakfast.

  • It’s recommended that you take NDT with a glass of water.

  • Experts also recommend you wait at least an hour after taking your NDT before drinking coffee or milk, because both beverages can negatively affect absorption.

  • NDT absorption can also be affected by antacids that include calcium, aluminum hydroxide, and magnesium, iron and calcium supplements, multivitamins that contain iron or calcium, and beverages like calcium-fortified juices. You should take NDT four hours before or after these medications, supplements, or drinks.

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Note that other factors can impair NDT absorption, including:

  • Foods containing soy products

  • Foods containing cottonseed meal

  • Walnuts

  • Grapefruit juice

  • High-fiber foods and fiber supplements

  • Medications, like proton pump inhibitors (PPIs)

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The absorption of all thyroid medications, including NDT, can be negatively affected by gastrointestinal and digestive conditions such as Crohn's disease, celiac disease, reflux/GERD, and ulcers. Be sure to discuss these conditions with the practitioner treating your hypothyroidism. 

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Some Additional Considerations About How You Take NDT

  • Because the T3 in NDT peaks rapidly (within 2-6 hours) in the bloodstream, some patients have better results with a divided dosage, taking half the prescribed dosage in the morning, and half in the afternoon. 

  • Some patients do best when taking some or all of their NDT at bedtime. Be aware, however, that the stimulatory effect of the T3 in NDT can interfere with sleep in some patients.
  • Some patients and practitioners anecdotally report better absorption when NDT tablets are allowed to dissolve under the tongue, or chewed -- rather than taken with water. 

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Among the various NDT medications available in the U.S., some patients and practitioners report having better absorption -- and better management of thyroid levels and symptoms -- when taking the WP Thyroid® brand of NDT. Unlike other NDT formulations, fast-dissolving WP Thyroid® includes only natural excipients (extra ingredients), including inulin (derived from chicory root) and medium chain triglycerides (derived from coconut) that may be less likely to trigger allergies or sensitivities. WP Thyroid® is also gluten-free, and has no artificial colors or flavors, and contains no soy, yeast, egg, fish, shellfish, corn, peanut, or rice.

Note: Always discuss any changes in how you take your medication with your health care provider.

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Keeping Your Provider Informed

When taking NDT, make sure to tell the provider if you:

  • have any allergies to foods, additives, medicines, or supplement allergies

  • are pregnant, trying to conceive, or breastfeeding

  • are already taking any prescription or over-the-counter medications or supplements

  • start or stop any prescription or over-the-counter medications or supplements

  • suffer from any medical conditions other than hypothyroidism, especially heart disease, clotting disorders, or adrenal or pituitary gland problems

  • have diabetes

  • are taking anticoagulants (blood thinners)

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Contact Your Provider When...

Contact your healthcare provider right away if you experience any of the following symptoms while being treated with thyroid hormone replacement medication, including natural desiccated thyroid drugs

  • rapid or irregular heartbeat

  • chest pain

  • shortness of breath

  • leg cramps

  • headache

  • nervousness

  • irritability

  • sleeplessness

  • tremors

  • vomiting

  • diarrhea

  • excessive sweating

  • heat intolerance

  • fever

  • hives

  • skin rash

  • other unusual signs or symptoms