What is the role of natural desiccated thyroid (NDT) in treatment?
Natural Desiccated Thyroid (NDT) is a different treatment for hypothyroidism prepared from powdered and desiccated thyroid gland powder from pigs with thyroxine (T4) and triiodothyronine (T3) hormones in their natural state. NDT can occasionally be replaced as a treatment with synthetic thyroid hormone medication like levothyroxine (T4) if the patients are not comfortable with the synthetic treatment or prefer something natural.
Role of NDT in Hypothyroidism Treatment
Combination of T4 and T3:
NDT provides both T4 (inactive thyroid hormone) and T3 (active thyroid hormone). Although synthetic levothyroxine (T4) is the most widely used drug for hypothyroidism, NDT provides a combination of T4 and T3.
Others with hypothyroidism may have difficulty converting T4 to T3, so they are symptomatic even when their TSH is normal. NDT will improve the condition of these patients because it provides both hormones in their active state.
Alternative for Patients Who Don’t Respond Well to Levothyroxine
A small minority of patients with hypothyroidism are symptomatically unfulfilled on levothyroxine alone, despite stringent TSH control. They may report chronic tiredness, depression, weight gain, and other symptoms despite good thyroid blood work.
In such cases, NDT has been prescribed from time to time to cover both T4 and T3, which may address the impaired T4-to-T3 conversion issue. Little scientific evidence, however, has been demonstrated that NDT is superior to synthetic T4 in symptom improvement or long-term outcome.
Personal Preference and “Natural” Treatment
A few patients prefer NDT because it is naturally derived from animal sources and is more “natural” to a few than man-made thyroid hormones. These individuals may feel more at ease with a product that closely mimics the body’s own natural thyroid hormones.
But it should be noted that NDT is not always “natural” or better than traditional treatments in the opinion of physicians, since it can be more variable in its hormone content, with dosing thus less consistent than with synthetic hormones like levothyroxine.
NDT for Individuals with Both T4 and T3 Deficiency
Others with hypothyroidism also have a hard time converting enough T4 to T3, even with synthetic T4. Since NDT contains both T4 and T3, it can be beneficial for some people who need both the hormones in their active state to function well.
This can be especially important for those with secondary hypothyroidism (a condition where the problem is with the pituitary or hypothalamus, which leads to inadequate TSH secretion and stimulation of thyroid hormones).
Issues with NDT:
Irregular Dosage: The biggest issue with NDT is that the hormone composition of one batch is different from the other. Because of this lack of predictability, it becomes difficult to determine the right dosage to properly manage hypothyroidism.
Risk of Overdose: Because of its natural composition, NDT carries the risk of having higher concentrations of T3 than synthetic thyroid hormone medication, and the T3 hormone is very active, which raises the risk of overdose or side effects like a fast heart beat, nervousness, or insomnia.
Limited Scientific Evidence: While many patients report feeling better on NDT, few large, good-quality studies have compared NDT with synthetic thyroid hormone medications. This makes NDT a more contentious option, supported by less science than levothyroxine.
Possible Side Effects
Hyperthyroid Side Effects: Some people may develop hyperthyroid side effects (e.g., palpitations, jitteriness, or heat intolerance) if their T3 is too high because NDT contains a significant amount of T3.
Irregular Absorption: Since NDT is a desiccated form of animal thyroid glands, it may not absorb as evenly as synthetic thyroid hormone is absorbed and could possibly form irregular hormone levels.
Hashimoto’s Thyroiditis: Some patients with Hashimoto’s thyroiditis, an autoimmune condition that results in hypothyroidism, may prefer NDT if they tolerate levothyroxine alone poorly, but the use of NDT in autoimmune thyroid disease is controversial. NDT addresses none of the underlying autoimmune process and thus is not indicated in all patients with Hashimoto’s.
Thyroidectomy or Radioactive Iodine: Those patients who have had a thyroidectomy or undergone radioactive iodine therapy and need lifelong replacement with thyroid hormones can take NDT as an alternative, but they must be carefully monitored to administer proper hormone levels.
Summary
NDT is used in the treatment of hypothyroidism only for those patients who prefer it to synthetic thyroid hormones or are not completely symptom-free on synthetic levothyroxine alone. It offers a combination of both T4 and T3, which may be useful in individuals with impaired T4-to-T3 conversion. But NDT is not necessarily the first line of treatment, nor is it suitable in everyone due to variability in hormone content, potential side effects, and a lack of large-scale evidence of efficacy. As with any thyroid treatment, it is important to work closely with a doctor to determine the most appropriate treatment and to monitor thyroid levels regularly.
Treatment of hypothyroidism is typically followed by a series of routine blood tests, symptom follow-up, and clinical evaluation to monitor whether thyroid hormone levels are appropriately regulated and whether the patient is operating appropriately with treatment. The following manner is how treatment of hypothyroidism is followed:
1. Blood Tests (Thyroid Function Tests)
Blood tests are the primary method of monitoring hypothyroidism treatment. Blood tests monitor thyroid hormone levels and TSH (Thyroid Stimulating Hormone) which provide feedback regarding the functioning of the thyroid gland and whether levothyroxine dosage is appropriate.
TSH (Thyroid Stimulating Hormone): The most common marker to assess the function of thyroid is TSH. When levels of thyroid hormones are low, the pituitary gland releases excess TSH to stimulate thyroid. An increase in TSH level suggests the body is still trying to overcome a deficiency in thyroid hormone. A normal or low level of TSH suggests the treatment is highly effective. The goal is to maintain TSH within normal reference range.
Free T4 (Thyroxine): Free T4 is the unbound, active thyroid hormone. Levothyroxine replacement increases T4 levels. Evaluation of the free T4 level helps to determine if the thyroid hormone dose is adequate. Normally, the free T4 level should be normal to indicate enough thyroid function.
Free T3 (Triiodothyronine): Although less commonly done, doctors can also test for a free T3 level if symptoms persist despite a normal TSH and T4 reading. The active thyroid hormone is T3, and an abnormally low or high free T3 reading might suggest that the body is having trouble converting T4 to T3.
Anti-Thyroid Antibodies: In the event of hypothyroidism due to autoimmune disease like Hashimoto’s thyroiditis, certain blood tests are done to assess for thyroid antibodies (i.e., anti-thyroid peroxidase (TPO) and anti-thyroglobulin antibodies). Quantification of these antibodies can help assess the evolution of autoimmune thyroid disease.
2. Symptom Monitoring
While blood tests are required to test thyroid function, it’s also important to monitor for symptoms. When the dose of levothyroxine is adjusted, it’s important to watch for signs of improvement or persistent hypothyroidism symptoms such as fatigue, weight gain, cold intolerance, dryness of the skin, or constipation.
If a patient’s symptoms do not improve after adjusting the dose, further testing may be warranted. This would include a repeat check on the dosage, screening for other disease, or checking for possible medication absorption issues (e.g., secondary to dietary influences or other medications).
3. Follow-up Testing Schedule
Initial Treatment: When starting levothyroxine, TSH and free T4 are usually drawn 6–8 weeks after starting the drug so that the body has time to adapt and thyroid hormone levels stabilize.
Monitoring on Ongoing Basis: After stable thyroid hormone levels have been achieved, patients typically are drawn for blood every 6–12 months to ensure their TSH and T4 level is within a target range. Some individuals will require more than this frequency monitoring if they have their dose being titrated or if they develop symptoms suggesting they are not optimal yet.
In Pregnancy: Pregnant women with hypothyroidism need more frequent monitoring, often every 4–6 weeks, to ensure sufficient thyroid function for both mother and fetus. Pregnancy increases the body’s demand for thyroid hormone, and changes in levothyroxine may be necessary.
If laboratory results on a blood test continue to show TSH as elevated or free T4 as low, the levothyroxine dose may be escalated. If TSH is decreased or signs of hyperthyroidism (such as nervousness, tachycardia, or insomnia) develop, a dose reduction may be required.
It is important to taper the dose gradually to avoid fluctuations in thyroid hormone levels which can result in signs of hypothyroidism or hyperthyroidism.
5. Variables That Might Interfere with Levothyroxine Absorption
There are various variables which could interfere with levothyroxine absorption and require careful monitoring:
Dietary Factors: Foods high in fiber, soy, or calcium may interfere with the absorption of levothyroxine. It is generally advised to take the medication on an empty stomach, usually 30 minutes to an hour before eating.
Other Medications: Certain medications such as iron supplements, antacids, and cholesterol-lowering medications interfere with levothyroxine and affect its absorption. All such medications should be brought to the notice of the doctor to alter the treatment regimen accordingly.
Illnesses: Certain illnesses like celiac disease, liver disease, or gastrointestinal illness (e.g., Crohn’s disease) can affect the absorption of levothyroxine. Regular follow-up may be required in order to establish optimal dosage adjustment.
6. Other Clinical Examinations
Physical Examination: In certain patients, the doctor may conduct a physical examination to assess the patient’s overall health, look for signs of hypothyroidism (e.g., dry skin, goiter), and assess whether treatment is improving the clinical presentation.
Bone Health: Levothyroxine therapy over an extended period of time, with doses that are too high, has a chance of leading to bone loss or osteoporosis. For the patient at risk, a test of bone density may be recommended.
In Summary:
Hypothyroidism treatment monitoring is a combination of blood tests, symptom evaluation, and follow-up appointments. Significant tests like TSH and free T4 are employed to guide medication adjustment in order to keep thyroid hormones within the optimum range. Symptoms also need to be monitored as they may point out whether or not the drug is effective, or if a change in drug is required. Follow-up and continuous assessment must be undertaken to properly treat the condition and prevent complications.
The Hypothyroidism Solution™ By Jodi Knapp The Hypothyroidism Solution™ By Jodi Knapp Jodi has provided a stepwise guide in the form of The Hypothyroidism Solution to help you in regulating the levels of your thyroid in a better and natural way. Along with curing hypothyroidism, it can also care a number of other health issues experienced by people all over the world. No side effect due to this program has been reported so far. So you can follow this program without any financial as well as emotional risk