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Have you been hearing this, that and the other thing about natural desiccated thyroid (NDT)? Well, today I want to talk to you about some of the biggest myths surrounding this form of treatment. Have you heard that you cannot take it if you have Hashimoto’s? Well, this article is for you! Please enjoy this article while I discuss these controversies, and much more, today.
Let’s Talk About NDT
First, we should take a moment and define what NDT is all about. I want to really break it down, so let’s go word-by-word so that you can have a clear and total understanding of what NDT is built upon and how it is created:
- Natural – means that it is from a natural source. In prescription medications, that will typically come from pig thyroid (also known as porcine thyroid).
- Desiccated – this means something that had its moisture removed, like desiccated coconut.
- Thyroid – it’s thyroid hormone!
One of the things I want to start off with is that sometimes people think of NDT as Armour. While Armour is the brand name, NDT is the compound. It’s kind of like how Kleenex makes facial tissues, but there are plenty of facial tissue companies out there – Kleenex is not the only one making it, and when it comes to NDT Armour is not the only option. Personally, I prefer WP Thyroid as NDT for treatment.
Now that we have a solid understanding of what goes into NDT, let’s break down the myths:
#1: NDT is not okay for those with Hashimoto’s disease
The argument goes something like this: somehow, ingesting thyroid will raise your thyroid antibodies against your “original” thyroid. That would obviously not be ideal for those who are dealing with Hashimoto’s. In fact, I have actually heard doctors tell people that they cannot take NDT at all and that it can even worsen your immune state.
I do not want to jump to conclusions about what is true and what is a myth without unpacking the myth itself because then we can approach it logically. Let’s think about it: people who take thyroid do so because they have hypothyroidism (where their gland simply is not making enough hormone for their body). Those who have hypothyroidism, almost universally, have Hashimoto’s disease.
In Conclusion: If those with Hashimoto’s could not take NDT, then who would? They are the only real group who NDT would be meant for to help.
Well, to track back to the argument about taking natural thyroid and raising your antibodies against your thyroid, this is something we need to focus on. There actually have been a couple studies done on exactly this topic.
Those that I found showed that orally taking natural thyroid lowers your body’s immune response against your thyroid. This is based on the model of “oral desensitization,” which is based on the idea that when you take something in your body, in a tiny amount, on a regular basis, your immune system tends to become more tolerant of that same substance.
Clinically, I have case studies to where patients have had high thyroid antibodies and erratic thyroid levels that came from that. Oftentimes, the one change we would make was switching to NDT as a form of treatment. This would ultimately result in the antibodies coming down, and the levels stabilizing.
In Conclusion: I have seen countless cases where thyroid antibody levels have come down from the thousands to zero, simply by switching to NDT for 6 – 8 weeks. Having said that, it might not work for everybody when it comes to lowering them completely, but it certainly does not raise them any higher.
Myth #2: NDT is a poor choice because it is not standardized
This argument is all about creating a consistent product, and it is based on the idea that synthetic thyroid (or Synthroid) because it is synthesized. It is made to have a set amount of hormone, and it is generally more predictable how much T4 (or T3) you are getting.
Remember how I mentioned before that NDT comes in certain brands? In the past, there were actually more brands of NDT then we have today. It was also more widely used in the past. The turning point actually occurred in the late 1970’s and early 80’s. Prior to that point, there were more doctors prescribing NDT than those prescribing Synthroids.
The means of standardizing hormone used to be based on iodine content. Back in the day, that was more difficult to do using NDT than Synthroid – because you could guarantee how much active hormone would be present. Unfortunately, this led to some sad cases of people not getting the amount of active hormone that they needed. This led to a change in the guidelines for how hormone treatments would be standardized.
Key Insight: You know it, and I know it, a lot of things have changed since the 70’s and NDT is no different! If we look today, science has come far enough that we can ensure that we get the right amount of active hormone from NDT that we need for effective treatment.
Now, let’s look at it from the other side, there have been multiple recalls for synthetic versions of thyroid over the years – upwards of a dozen in the last decade. This is chalked up typically to poor quality control, and not being as consistently manufactured to a high degree of quality.
In the last decade and a half, there has been one voluntary recall of NDT. So, NDT has actually had a better track record of helping patients over a longer period of time than Synthroid.
In terms of numbers:
- Synthroid – standardized to within 5% of prescribed recommended dosage.
- NDT – there are brands which are standardized to less than 2% variability.
In Conclusion: NDT brands like WP Thyroid, Westhroid and Nature Throid all have better standards than Synthroid alternatives. While they might not be standardized the same way, that’s a good thing, because they are standardized amongst themselves even better.
Myth #3: You have to take NDT multiple times per day to have it work
This is one that I hear all of the time. When it comes to prescribing medications, there are some terms that we hear a lot in the medical community. In order to help your understanding, here they are:
- QD – once daily
- BID – twice daily
- TID – three times daily
Many say that you must take thyroid BID or longer, or more frequently, to have it work properly. The logic behind this idea comes down to T3 absorption in our bodies. So T3, which is found in natural thyroid, is absorbed and peaks in a 4 – 8 hour window after you take it.
Many doctors have looked at that and suggested that you need to take it a couple times a day, or else that T3 absorption will drop off after that time period. This is where the problem starts.
Key Insight: We need to understand the key difference between “absorption” and “metabolism” – how quickly it comes in, and how quickly it goes out. How frequently you take a medication should not be based on the former, it should be based on how long it takes to actually leave your body.
The excretion of T3 from your system is actually 1 – 3 days, as opposed to that 4 – 8 hour window that we mentioned previously. Because of that, you can take it once a day and have consistent amounts in the cells – even though your blood levels shift after a dosage.
In Conclusion: In fact, it is better to take T3 once daily because thyroid hormones abide by a circadian rhythm. Your body releases the bulk of them during the late evening/early morning, so taking NDT before bed or early in the morning actually achieves what would be happening if your thyroid was operating normally.
Twice a day ingestion is not only not good for your circadian rhythm because it is an unnatural process that your body would not abide by if it was working at 100% health. It is also unhealthy because it ignores your body’s excretion levels, instead of providing too much all at once.
Myth #4: NDT affects your ratios of natural thyroid (T3/T4) impossible
Here’s the thought on this one: the T3/T4 ratios, once you are on a good dose, are more about:
- Your liver
- Your kidneys
- Your intestinal tract
- Your detox pathways
They are more about these things than they are about the dosage you are taking. But, more often than not, that someone is not on a good dose. That itself will skew those ratios, no matter what they are when you are taking it.
What I mean by this is that if you are taking too much thyroid hormone, you will get rid of T3 faster than you would get rid of T4. If you are on too little thyroid hormone, you will hold onto T3 longer than you would hold onto T4.
In Conclusion: The issues about ratios are more about dosage than the medicine being somehow wrong for us. Once the dosage is right, though, and those ratios are not perfect it would have more to do with peripheral thyroid metabolism.
In terms of how the ratios are found in NDT, compared to the body, many have said that it is a 4:1 ratio and that humans need a 10:1 ratio. The real question is, “what are we talking about when it comes to this ratio?” Do we mean:
- What’s in the thyroid?
- What’s in the blood?
- What’s in the cell?
Getting to the bottom and answering the “where” component of the question is going to be so important, especially as it concerns proper ratios. Our thyroid itself is actually at the same ratio as NDT, and when we first take NDT, the bulk of it gets bound up in carrier proteins in our body anyways. So, our body has the ability to unbind and “convert” as we see fit.
If we are on the right dosage, and our body is working well, then we can actually use NDT properly.
The Role of Testing
If someone is on NDT, and a doctor runs a test like:
In this case, the doctor might notice that T3 is too high. This will then lead them to believe that you need less, because of the fact that your ratio is too high. The real problem here actually is not the ratio, but the timing of the testing itself.
Key Insight: If you take a blood test right after taking your NDT tablet, your TSH and Free T4 might remain normal, but it can make your Free T3 score look shockingly high. This is only a question of timing, and nothing more!
Myth #5: NDT raises reverse T3 levels
This goes back to our same, earlier issue about ratios. If you are on too much thyroid, your body will ultimately compensate – this will result in your body converting more T4 into T3 than it otherwise normally would.
In Conclusion: High reverse T3, in nearly all cases, is more of an issue of the wrong dose rather than the wrong medicine. If you get the dose right, reverse T3 is apt to fix itself.
Dispel The Myths, Gain Knowledge
Now that we have gone over some of the most common myths about NDT, and worked to a better understanding of how it can benefit our thyroid, why not take the next step and really learn more about your thyroid today? Take the Thyroid Quiz (1), and learn a little bit more about this important part of your body. Are you concerned about the status of your thyroid? Get on the road to recovery by learning more about what could be wrong today.
Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet.
Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, and regain energy. Learn more about the surprising story that started his quest.