632. NDT (Natural Desiccated Thyroid) Medication Might Be Making You Worse

Summary

Podcast Summary: The Thyroid (and Hormone) Fixer Podcast

Episode 632: NDT (Natural Desiccated Thyroid) Medication Might Be Making You Worse
Host: Dr. Amie Hornaman
Date: May 22, 2026

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Episode Overview

In this episode, Dr. Amie Hornaman tackles the controversial and often misunderstood topic of Natural Desiccated Thyroid (NDT) medications. While many patients seek out NDT for its “natural” label, Dr. Amie explains that, in some cases, NDT can actually worsen hypothyroid symptoms or lead to other unintended health issues. She breaks down the science, common patient misconceptions, three main reasons NDT can backfire, and how to know if this “OG” thyroid medication is right (or wrong) for you. The episode emphasizes self-advocacy, listening to your body, and thoughtful, personalized care—not one-size-fits-all dogma.

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Key Discussion Points & Insights

1. What is NDT and Why Do People Choose It?

[04:52–10:00]

• NDT (Natural Desiccated Thyroid) is an older form of thyroid medication, derived from dried pig thyroid glands.
• Many practitioners and patients prefer it for being "natural," but Dr. Amie warns not to be misled by the label.
• While some patients do “thrive” with it, NDT isn’t inherently better—optimal therapy depends on the individual.
• NDT is still a pharmaceutical product, often containing fillers and produced by large pharma companies (e.g., AbbVie owns Armour Thyroid and Synthroid).
• "The right thyroid medication is the one that works for you, in the combination and dose that works for you. Don’t get hung up on the name." — Dr. Amie [06:48]

2. Why “Natural” Doesn’t Always Mean Effective

[07:30–10:00]

• NDT is not always “purer” or “better” than synthetic alternatives. Manufacturing still involves pharmaceutical processes.
• Some smaller brands may have fewer fillers, but NDT’s pig origin does not guarantee better patient outcomes.
• If a provider prescribes only NDT and nothing else, it can indicate a lack of nuanced thyroid knowledge.

3. Three Reasons NDT Might Make You Worse

[13:10–33:20]

a) Reverse T3 Conversion Issues

[13:10–18:49]

• NDT is typically 80% T4, 20% T3. If your body doesn’t efficiently convert T4 to T3 (the active hormone), the extra T4 may be shunted to reverse T3, which is inactive and causes worsening symptoms.
• Example: Amanda’s story—her NDT prescription led to a reverse T3 of 22 (optimal is <12). She needed T3-only therapy and improved dramatically once her regimen changed.
• "Reverse T3 is a built-in mechanism of our bodies to protect us if we’re fighting for our lives. But if you’re just living your life, you don’t want your body in lockdown survival mode." — Dr. Amie [14:53]
• Symptoms of poor conversion: fatigue, weight gain, brain fog, constipation, low body temp.

b) Triggering Autoimmune Attacks in Hashimoto’s Patients

[23:55–25:54]

• In some (approx. 20%) of patients with Hashimoto’s, NDT (being pig thyroid gland) may provoke an immune response, worsening inflammation and thyroid destruction.
• "You taking NDT medication can—not will—can potentially kick up an autoimmune attack." — Dr. Amie [25:55]
• Some feel better at first (likely due to receiving T3 for the first time), but then symptoms regress as autoimmunity flares.

c) Underdosing: Too Low of a Dose

[25:55–31:10]

• Many providers start patients on very low doses (e.g., 15–30 mg/day), which isn’t enough to optimize thyroid levels and may suppress the body’s own hormone production, causing a net-worse situation.
• NDT (or any med with T3) should be split-dosed, not taken all at once.
• "There’s no gold star for being on the lowest dose of thyroid medication. If you stay at a baby dose... you are going to get worse. I guarantee it." — Dr. Amie [29:56]

4. Understanding Thyroid Hormone Conversion

[18:49–23:55]

• T4 is inactive; must be converted to T3 for effect. Numerous factors hinder conversion: insulin resistance, estrogen dominance, vitamins/mineral deficiencies (e.g., magnesium, selenium), genetics, inflammation, etc.
• Many people today struggle to convert efficiently due to modern lifestyle and environmental stresses.
• "T4 to T3 conversion is like running 10 Tough Mudders. It’s really hard for your body to do." — Dr. Amie [19:21]

5. How to Tell If NDT Is Right for You

[13:00–34:25]

• Monitor your symptoms and labs, especially reverse T3 and free T3.
• If starting NDT makes you feel better then worse, consider these three factors.
• Sometimes, simply adding T3 to your NDT may correct the ratio and relieve symptoms.
• Never stick with any medication out of dogma (“natural is best”)—individualize care.

6. Empowering Self-Advocacy and Collaboration

[00:00–34:25]

• The episode starts and ends with calls for patient empowerment: ask questions, collaborate with clinicians, and don’t blindly follow protocols.
• "You know your body better than anyone.... Be your own patient advocate." — Dr. Amie [31:10 & 33:10]
• Look for providers who assess thoroughly and tailor your medications, rather than using only a single treatment modality.

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Notable Quotes & Memorable Moments

• “The right thyroid medication is the one that works for you, in the combination and dose that works for you.”
  — Dr. Amie [06:48]

• “Reverse T3 is your body’s way of saying, 'you don’t need to burn fat, Amanda, you don’t need to feel good, you just need to lie here and survive.'”
  — Dr. Amie [14:53]

• “Don’t get locked into ‘I just want to use something natural because there’s natural in the title.’ Well, no, it’s made by a pharmaceutical company. Sorry.”
  — Dr. Amie [22:25]

• “You taking NDT medication can—not will—can potentially kick up an autoimmune attack.”
  — Dr. Amie [25:55]

• “There’s no gold star for being on the lowest dose of thyroid medication.... If you stay at a baby dose... you are going to get worse. I guarantee it.”
  — Dr. Amie [29:56]

• “You know your body better than anyone.... Be your own patient advocate.”
  — Dr. Amie [31:10 & 33:10]

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Timestamps for Key Segments

• [04:52] – What is NDT? Historical perspective and misconceptions.
• [06:48] – “The right thyroid medication is the one that works for you...”
• [13:10] – Story of Amanda: NDT, poor T4-to-T3 conversion, and the dangers of high reverse T3.
• [14:53] – Explanation of reverse T3; why high levels are problematic.
• [15:59] – The science: T4, T3, and conversion challenges.
• [18:49] – Factors impacting T4-to-T3 conversion in modern life.
• [23:55] – How NDT can trigger autoimmunity in Hashimoto’s.
• [25:55] – The dangers of underdosing: “There’s no gold star...”
• [31:10] – The importance of self-advocacy and being an engaged patient.
• [33:10] – Final empowerment messages and reminder: “You know your body best.”

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Final Takeaways

• NDT is not a “miracle natural solution” for all. It can worsen symptoms in those with poor T4-to-T3 conversion, provoke autoimmunity in Hashimoto’s, or be ineffective due to underdosing.
• Reverse T3, free T3, and symptoms must be monitored to determine the best therapy.
• Self-advocacy is critical: have informed, collaborative discussions with your provider and don’t settle for one-size-fits-all protocols.
• If NDT works for you—great! But if you feel worse after a few weeks, it’s time to reevaluate with these core issues in mind.

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For more on thyroid testing, medication options, and troubleshooting, Dr. Amie’s book “The Thyroid Fix” offers a step-by-step guide to personalized thyroid care.

Transcript

[A]

Be educated enough to know what's going on in your body. Listen to your body. Don't just dismiss and blow things off and go, well, the thyroid clinic told me NDT was the best and my functional provider just does NDT because it's natural. Get out of that mindset. Stop. Think for yourself. Pay attention to your own body.

[B]

Welcome to the Thyroid and Hormone Fixer podcast. If you've been told everything is fine, but you're gaining weight despite doing all

[A]

the right things, struggling with brain fog, mood swings, low libido, or feeling like

[B]

a stranger in your own body, you're in the right place. I'm Dr. Amy the Thyroid Fixer, and I want you to know right now,

[A]

I see you, I believe you, and

[B]

you don't have to figure this out alone anymore. We're going to do this together. But I'm also not here to play nice with bad medicine or empty promises. This show is meant to disrupt the entire health space. We're going to challenge the status quo, connect all the dots other providers miss, and give you real practical science back.

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Tools you can use.

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Today, you're not going to get any more recycled biohacking advice, just truth, strategy and hope. Let's get you back to feeling like the badass human you're meant to be. Do you want to burn fat while just sitting around? Do you have extra weight to lose? Do you want less inflammation? Do you want to reduce your oxidative stress? Do you want to improve your lipid panel? Maybe become more insulin sensitive? And once again burn fat while you're sitting there at rest at your desk or on your couch watching Netflix? Well, now you can, with the power of T2 that is in Thyroid Fixer. Now, Thyroid Fixer is not just for those with a thyroid problem. It's for anyone looking to lose body fat to improve their metabolism to have better energy. Thyroid Fixer actually works at your mitochondrial level, so it is stimulating your metabolism. It's also activating ATP, which gives you more energy, nice and steady through the day. Here's the other really cool thing that Thyroid Fixer does. It turns on a gene that prevents fat from accumulating all over your body. So that means, yeah, if you slip up and you have the Oreo cookie or the sweet potato fries, which are my two favorite, they're my downfalls. That is not going to put extra fat on your butt, your hips, your thighs, and your abs. Oh, and your arms. You don't want those jiggly arms. So why don't you just improve your fat burning potential and actually turn on

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on your body with the power of thyroid fixer. So as a listener of the Thyroid Fixer podcast, your first time purchase, you can use the code listen 20 L I s t e n 20 we'll put that down in the show notes

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you just want to save a little something, something extra, then use the code listen 10L I s t e n 10 and grab some thyroid fixer. Stock up today because it will help you burn extra body fat and who doesn't want that? If you are exhausted, gaining weight, you have brain fog, you just feel off and you're tired of doctor hopping and wasting money. Listen closely. So many women bounce from provider to provider trying supplements, protocols and then functional approaches that never truly address progress. The thyroid months turn into years and you're still stuck feeling like garbage, wasting your precious life. So this is why we offer a thyroid and hormone solution call. It's not a lab review. It's not treatment. It's clarity and strategy to determine whether you're a good fit for working with our clinic. We specialize in thyroid optimization and hormone optimization together because they go hand in hand. You can't do one without the other. You have to do them both. We prescribe in all 50 states and if you become a patient, we take care of you from start to finish. Testing, treatment, optimization and ongoing support. You don't have months or years to waste feeling this way and you shouldn't

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have to keep throwing money at people

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who don't truly understand the thyroid and hormones. So if you're ready for real help, go to Dr. Amy.com that's D R A M I E dot com and click book a call in the top right corner to schedule your thyroid and hormone solution call and just let us help you get your life back and be that badass human that you are meant to be, that you deserve to be.

[A]

Are you taking armor thyroid, NP thyroid, some type of compounded T4 and T3? And are you getting worse? Well, the truth is, is that NDT could be making you worse and pushing you more into a hypothyroid state. Now today. Don't throw stones. Don't give me hate mail. I know that there are going to be many of you out there that are thriving on your natural desiccated thyroid medication and that is fantastic and we're really, really hoping that our government doesn't pull that away from you. I firmly believe in having all options available on the table to optimize patients everywhere. And really finding what's going to work for you in the combination that works for you and the dose that works for you is key. But today I want to talk about a reality that I think many people don't talk about enough. Now, we certainly have this conversation with our patients because we make sure that we find exactly what combination is going to work for them, whatever that looks like. But many patients will come into the office and they'll say, well, you know, I was taking this NDT for about two, three weeks, four weeks, and I felt better at first and then I got worse. So we're going to address that today as to the why. And then others are coming in saying, you know, I really only want to go on natural desiccated thyroid medication because isn't that supposed to be better for me? Isn't it more natural because there's natural in the title, we're going to break that down as well. Okay? So as always on the show, I always give you the real, real. And whether you want to hear it or not, whether you're like, oh, no, don't tell me that, Dr. Amy, it doesn't matter. We need to lay it out there because at the end of the day, you need all of the information at your fingertips so that you can make the best decision for yourself and so that you can be be educated enough to have that conversation with your doctor as to what exactly you do need. Now, in my book, the Thyroid Fix, I go over all of this and I give you that roadmap, that step by step guide, kind of like a choose your own adventure book, where we look at your labs and then we look at the optimal ranges and we look at what medication you're on right now, and then I guide you into what exactly you do need to change so, so that then you can take that and implement it. However that looks, whether it's having a conversation with your current doctor that's managing your thyroid or whether it's finding someone new that I guide you through, as well as to what to look for, what to ask for before you book the appointment, before you hand over your money. So now when we're talking about ndt, natural desiccated thyroid medication, what is it? First of all, what is it? Well, it's actually the OG thyroid medication from the 1800s. This is where we are drawing out pig's thyroid glands and, and giving them to people who weren't feeling so good. You know, doctors really knew so much more back then. And had so much more common sense than we do now because they weren't run by big Pharma. They knew the natural ways of supporting our body. They knew that if someone was sluggish or had myxedema or a moon face, if they started blowing up, if they started gaining weight because we didn't have processed foods back in the 1800s. So why the hell would people gain weight unless they're just, what, over consuming potatoes and cows? I don't know. But if they started to blow up, if they started to have fatigue, if they started to have swollen features, if they were constipated, if they had joint pain, if they were cold when the rest of the tribe was totally normal, they would actually give them thyroid glandular, I. E. Dried up pig thyroid gland, I. E. Natural desiccated thyroid, in order to cure them, in order to help them. And. And it was working. Now, NDT never became FDA approved. And that's why we're in the mess we're in right now with the federal government, because they're basically saying this medication, this OG thyroid medication that's used by millions of people for over a century all of a sudden might not be safe. Oh, okay. So all the millions of people over a hundred years, nobody ever died from taking arm or thyroid, by the way. So it is not a bad medication whatsoever. The point of this podcast is to educate you as to why it might. Might. Might be making you worse. Might be making you worse. Okay, so that is ndt. It is dried porcine thyroid gland. So now, obviously, if you have any kind of religious beliefs against consumption of animals or anything from pigs, then you have to avoid NDT entirely. That's not the point of this conversation. The point is for those who are open to taking anything and who can consciously and religiously take any form of medication, we want to break down if NDT is actually right for you. Now, I'm going to kind of work in reverse order with the objections or the we'll say, the requests that we get from patients. I want to be on natural desiccated thyroid because it has the word natural in the title. All right, let's actually break that down. Yes, it is naturally derived from a pig thyroid gland, but it is still owned by AbbVie. AbbVie Pharmaceuticals owns Synthroid. They are a pharmaceutical company. That drug is made in a pharmaceutical factory. There are different fillers and preservatives. There are things such as gluten in that natural desiccated thyroid medication, depending on which kind you get. Now, if you go to Ren Thyroid, then that's different. That's a smaller company. It's not AbbVie. Yes, they are still a pharmaceutical company, but it's a much more pure form of that ndt, but regardless, still derived from porcine thyroid gland. So I want you to break out of that mode. Don't think that just because it has natural in the title that it's naturally better for you. No pun intended, because it's not necessarily, again, the right thyroid medication is the one that works for you and the combination that works for you and the dose that works for you. Don't get hung up on a name. Don't get hung up on what you see on Instagram. And certainly if you are working with a functional or integrative practice, that either. Well, let's say that claims to know what they're doing with a thyroid and all they do is prescribe ndt. Because if all they do is prescribe ndt, then they actually don't know what they're doing with the thyroid. Okay, that's your first sign. That's just functional medicine or integrative medicine trying to, to. To bullshit their way that, yeah, we can help your thyroid, Mary. It's not a problem. We got you. We're just going to give you some ndt and then we're going to increase your ndt and then we're going to give you more NDT because, you know, we don't deal with the synthetics because it has that word synthetic in it. And we're, you know, functional and integrative and woo. So we only use NDT medication. Well, they're doing good disservice if they do that. And they actually don't know what they're doing with the thyroid if all they do is prescribe ndt. I tell the story of my patient Amanda over and over and over again because it hits. It hit me so hard. And I think this story just really drives the point home that Amanda had seen a functional doctor and went to a thyroid clinic and the functional doctor just totally messed her up. Just totally had a cab on how much T3 he would give. Wouldn't give her more than 20 micrograms. Loaded her down with Synthroid. I don't even get it. I mean, this is, again, people using the term functional just to charge you money. And they're really practicing conventionally now. He did give her T3, but he had a cap on it. And you'll find out why as I move through the story why that was detrimental for Amanda. Then she went to A thyroid clinic only did ndt and then they kept raising her NDT and they claimed to be a thyroid clinic, but nobody was paying attention to the reverse C3 was a freaking 22. A22. Her reverse T3 was a 22. Now listeners even listening to me for a while, you know that your reverse T3 needs to be less than 12. Reverse T3 optimal is less than 12. She was a 22. What is reverse T3? I go into it in depth in the thyroid fix, but basically it is a built in mechanism in our body, thank God, to protect us if we're fighting for our life in the ICU or the er. Trouble is we really don't want it high and we don't want our bodies thinking that we are in a lockdown survival mode if we're trying to walk around, live life every day. So reverse T3 of 22 meant her body was taking all of that T4 in natural desiccated thyroid and pushing it to reverse and putting her body into a state where basically her body was saying, you don't need to burn fat, Amanda, you don't need to feel good, you don't need to have energy, you don't need to think, you don't need to poop every day, you don't need to be warm, you just need to

[B]

lie here and survive.

[A]

And she wasn't just lying in the hospital bed trying to survive, she was living her life. So pushing up NDT only using ndt, that is absolutely detrimental. So right there off the bat, that's your way of telling if you are with somebody who knows what they're doing with a thyroid or not. If all they're using is one modality, that's bad. So then Amanda came to us and we're like, oh my gosh, your reverse T3 is a 22. Through proper optimization of her thyroid, we actually found out that she requires T3 only. She's one of those rare cats like myself that require T3 only and that made her thrive. We pulled her off at NDT, put T3 only and we did not have a cab like her last functional doctor because she actually needs a higher dose, very similar to me. I even said that when I first talked. I'm like, oh, I have a feeling you're going to be like me. I just have this gut feeling. And she is, she needs a higher dose of T3, she needs T3 only. That is how she thrives. And now she is thriving. She's living her best life ever. But you can see how NDT was actually making her worse. Because the reality is is that NDT is 80% T4 and 20% T3. And if you put 80% T4 into a person who doesn't convert at all, they're going to get worse if you only use NDT in someone who is a halfway non converter. So let's say your reverse T3 is coming back at like a 16, a 17. You know, it's not full blown up into the 20s, but it's definitely indicating that you're struggling converting and that you have way too much T4 on board. Then using NDT only and keeping someone in that 8020 split, that 80 20% lockdown is also going to make them worse because there's not enough T3 on board to give them that T3 that they need. And because they have that tendency to take the T4 and push it to reverse, that means that the T4 is not getting pushed down to free T3. So let me pause here for any newbie listeners and explain what I'm talking about.

[B]

I need to talk to every woman who's been told that your labs are normal while your body is screaming at you and rebelling against you. Fatigue, brain fog, the weight that will not come off, mood swings, hair loss, feeling dismissed, frustrated and confused. I get it. And that is exactly why I wrote my new book, the Thyroid Fix. The no nonsense guide to fix fatigue, fogginess and fat that won't budge. That just says it all. And it is now available for pre sale. So I need your help to spread the message. I am giving you an ask as my listener and a promise at the same time. If you pre order the Thyroid Fix, my promise to you is to continue delivering all kinds of free advice, information, content, education, empowerment. Because that's what I love to do. Whether it's here in the just fix your thyroid Facebook group or I'm on

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live, I will give you everything I

[B]

possibly can if you do me one favor which will be a favor for yourself as well and pre order the Thyroid Fix. Now, this book is not another list of supplements, vague advice. It's not a diet plan. It's not filled with recipes. It's it is a clear, honest guide. It is the Thyroid Bible. It is the last thyroid book that you will ever need because it teaches you how to read your own labs. No other book has done that. It teaches you what medication and dose you need. No other book has ever done that. It will help you to understand why you are being misdiagnosed while you're being undertreated and why you can't talk about hormones, weight loss or menopause without talking about the thyroid. I called it Thyroid Bible because like I said, this is going to be the thyroid book of the next few decades. When you pre order, you're not just supporting me, you're telling the publisher. This message matters and it needs to get out to the world and it needs to get into the hands of women who have been ignored for far too long. So will you go to thyroid fixbook.com and pre order a copy of yours today? It'll be shipped to you on May 12th and you will get free entry to our all day live event where I will be there answering your questions live, teaching live and bringing in amazing guests for you to also connect with and ask your questions too. So thyroid textbook.com pre order yours today.

[A]

T4 is a non thyroid hormone. It's inactive. It has to go through a conversion process to become T3, which is the active thyroid hormone. That's the only thing that's going to attach to any receptor site in your body. Any receptor site on your cell requires T3, not T4. So if you bring in too much T4 into a person who struggles with that conversion process like many of us do, there are so many things that get in the way of T4 to T3 conversion. Insulin resistance, estrogen dominance, lack of iodine, low magnesium, low vitamin D, low B vitamins, low selenium, genetic snips, high cortisol, low cortisol, high fetin, low ferritin. All of these to any kind of inflammation, gut dysbiosis, clogged liver. I mean all of these things interfere with T4 to T3 conversion and we're living in a toxic soup environment. So you can see why I constantly say that. That T4 to T3 conversion is like running 10 tough mudders. It's really hard for your body to do so. That is why we talk about whether or not you are a converter or a non converter. Look at your reverse T3 because reverse T3 gives us that insight. Reverse T3 shows us how well you are converting. And remember that T4 can only go down one or two pathways. If it's pushing down the reverse T3 pathway and it is not pushing down the free T3 pathway, that means you are not getting that active thyroid hormone that your cells need and you have a zero percent chance of having any kind of metabolism, of feeling any better, of eliminating that brain fog, of getting any kind of energy back, of growing your Hair, of strengthening your nails, of improving your skin, or of pooping every day, you have a zero percent chance because all you're doing is loading your body down with exactly what it doesn't need. T4, T4, T4. And all that's going to do is push down that reverse T3 pathway. So if you are a non converter, you can see where using NDT only can be detrimental. Now, does that mean that you have to pull the NDT completely out? Maybe, maybe not. Sometimes just by adding T3 to the mix, adding T3 to your NDT, that's just enough to change that ratio. So now you're not in that 8020 ratio split. Now you're more like, oh, you know, like a 60, 40, 60% T4, 40% T3. Or we can even change it. Flip it, Totally flip it. We go 40% T4 and 60% T3 because of what we're bringing in in the T3 department. So it's not that you have to shit can the NDT, but you might have to bring in some T3 to change that ratio up. That's all I'm saying. So I am not bastardizing or villainizing natural desiccated thyroid medication, but I am saying that you might want to look at the ratio. Is it right for you? Do you need to change anything? And please don't get locked into. I just want to use something natural because there's natural in the title. Well, no, it's, it's, it's made by pharmaceutical company. Sorry. And if you listen to the episode that I did breaking down this FDA ban on ndt, you will also find some very controversial things in there. In that if you look at AbbVie as a pharmaceutical giant who owns Synthroid, you know what they're doing right now? They're basically trying to cannibalize their own product. They are doing this clinical trial where they're pitting Armor Thyroid versus Synthroid because they make Synthroid. They're pitting those two against each other to see, get this, which one will hold the TSH within normal limits? Oh, oh, I know, I know. Teacher, teacher, pick me, pick me. The winner's gonna be Synthroid, because anything with T3 in it is gonna lower the TSH. Not that we have a problem with it. We certainly don't. You know, in the thyroid expert world, we know better. We don't care if your TSH goes to zero. Don't care. But they're doing this study to see which one stays within those pretty TSH limits. Meaning you're going to be between like a, a 1 and a 4.5. So if you come in at a 2 or a 3, the winner is Synthroid. So that means they're going to cannibalize their own product. It's ridiculous. Who the hell knows what's going on behind the scenes there? Who the hell knows? So go listen to that episode. But the bottom line is. Yeah, natural. No, just because it's natural, desiccated thyroid. You know, ABV isn't hiring organic pig farmers and going to the farm to dry that pig's thyroid gland and carrying it in a, in a little copper vessel to put into your capsulated medicate. No, now, made in a factory. It's all the other drugs and there's fillers and there's all kinds of stuff in it, too. So again, it might be best for you, it might not be best for you. You got to keep an open mind. That's the point of educating you. The other thing that I see happen in a select few people, and I can't even give a percentage because there's never been a study done, I would say based on the tens of thousands of patients that we've treated over the years and that I've worked with over the years, I would give it. If I'm just kind of giving a rough estimate, you know, I would say probably 20%. It's a low percentage, but still, about 20% of those people on natural designated thyroid who have Hashimoto's actually get worse. What I mean, okay, so natural designated thyroid, remember it's pig thyroid gland. Okay, so we're just going to remember that. Now let's move over here. And when we're talking about Hashimoto's, I love using analogies. I always talk about, you have soldiers that are programmed incorrectly, they're confused. So whenever you have antibodies, you look at your TPO and your TGA antibodies. That's what determines you have Hashimoto's. Remember, any antibody is an antibody. We want those antibodies at zero. So any antibodies and antibody. So we look at those and we say, okay, Susie, you have a hundred soldiers, you have 300 soldiers, you have 500 soldiers that are going out and they're beating up your thyroid gland on the daily. And your thyroid gland isn't too happy about that because if I came over and beat you up, you, you wouldn't work real well. Certainly not producing the correct amounts of thyroid hormone. Probably struggling to convert that T4 to T3 as well. Those soldiers think that your thyroid is a bad guy. Now let's say someone with Hashimoto's takes a thyroid glandular I E N D T medication. And those soldiers see that NDT coming in, they go, hey buddy, that invader, that bad guy, the thyroid. Yeah. So it's coming in again. Yeah.

[B]

I think it's time to start a war.

[A]

So you taking NDT medication can not will. Can potentially kick up an autoimmune attack. So this is where you'll hear someone say, and this can really happen in both camps. It can happen in the camp of people who struggle to convert. It can also happen in the camp of people who are going to increase an autoimmune attack that you start taking NDT and you might feel better at first because the first time in your life you're getting T3, right? Especially people who have transitioned from T4 only, which we know doesn't work. Then they add in NDT medication and then it's kind of like, woo, ooh, I'm getting me some of this T3. This is amazing. And it's like they actually feel better for a little bit and then the decline starts to occur and then they feel worse. Now this can also occur for, from practitioners notorious, especially in the functional and integrative world, for starting someone on too low of a dose of ndt. So I'm going to get to that third. But any one of these scenarios can equate to you feeling worse after you've been on it for a week or two. So let me know if that is you. Okay? So moving on. That is also a possibility. I have not seen actual evidence of this. I'll say there are camps of belief that if you take NDT it somehow confuses the immune system to calm down the autoimmune attack. I don't really know if this actually occurs or not, but we do have a large subset of people who have Hashimoto's who take natural desiccated thyroid and they feel better and they are optimized. I will say it usually requires some T3 added in because that 80:20 ratio isn't really great for most people. That goes back to our point number one. So it does take some T3, but they're doing fine on the NDT with that T3 added in. Totally fine. Totally fine. Now, the third reason why you might be feeling worse on NDT is if your prescriber put you on too low of a dose. So I have seen this over and over again. 15mg once a day, 30mg once a day, sometimes even 30mg, twice a day isn't enough. And by the way, NDT or anything with T3 should be split dosed. You should not be taking it once a day. It's going to be in and out of your system. It's going to be gone by the afternoon, you're going to crash. You're not going to have metabolism, make sure you're split dosing it. But too low of a dose is also detrimental because what that does, just giving you this little baby dose, it still sends that signal back to the pituitary. The hypothalamus talks to the pituitary, the pituitary talks to the thyroid. Pituitary puts out thyroid stimulating hormone to stimulate the thyroid gland to make thyroid hormone. So when you have too low of a dose, but it's just enough that your brain goes, you know what, there, there's thyroid hormone here. We're good. It's just enough for your brain to lower that TSH and basically shut down your own thyroid production. So now you're adding in thyroid medication which are lower than you were before. Sometimes we can see this in your labs as a lowered T3. This is where people would say, wait a minute, I'm taking thyroid medication. And my free T3 just went from a 2.7, which wasn't great, down to a 2.2. What gives? Well, yeah, because prior to going on that thyroid medication, no, you weren't making enough of it, but you were making some. Now you brought in too low of a dose and you shut down your own production. When you're properly optimizing someone, you have to increase that dose, which there's nothing wrong with it. It's about finding the dose that's going to work for you. For goodness sake, keep an open mind. Who cares if you have to increase the do? There's no gold star given out for those who are on the lowest dose of thyroid medication. Did you get a gold star? Did you get a gold star for taking that 5 micrograms of T3?

[B]

No.

[A]

You just felt worse. Did you get a gold star when you started on the 30 milligrams of armor? No. You just got worse. That's your gold star. That's the black star that you got. There's no gold star given now for taking the lowest dose of thyroid medications. You want to take whatever is right for you. But the bottom line is if you stay at a baby dose or if your practitioner keeps you at a baby dose, you're going to get worse. I guarantee you, you are going to get worse. You know, there's a lot of people out there, and I think guys get away with this more, but they'll be like, I'm just taking a little bit of thyroid. I'm taking a little bit of that desiccated thyroid just to help me out a little bit. It's like, okay, first of all, why. Why are you taking it if you don't need it? And secondly, it's going to make you worse. Like, if you're taking just a little bit of something, it's going to produce a negative feedback loop. I want to be like, dude, would you take a little bit of testosterone? No. Because if you took 100 milligrams a week instead of the 200 milligrams a week that you need, going to shut down your own production, you're going to come out with a lower testosterone than what you started. All hormones have that negative feedback loop, but at the end of the day, we don't care because if your body isn't making enough of that hormone, we need to add it in anyways. However, we don't want to add in just a little bit, because then that's going to make us lower than we were before. So there you go. There are the three reasons why your NDT might be making you worse. And again, I'm gonna say it again for the people in the back, you don't have to go off your NDT if it's working for you. If it's working for you, this episode isn't for you. But for my people who are resonating, going, oh, my God, that's right, I did when I started on armor. Yeah, I was about like two, three weeks in. Felt like I went backwards. Then step back. And were you on too lower dose? Do you feel like maybe you spurred on autoimmune attack? You got really inflamed all of a sudden? You started, like, gaining weight when you were on armor. Maybe that could also happen with number one NDT only with that 80, 20 split, because you don't convert very well because you have a tendency to push the reverse T3. And nobody changed that ratio. They just keep increasing your ndt. So this is food for thought, to allow you, as I do. I love empowering you to be your own patient advocate, be educated enough to know what's going on in your body, listen to your body. Don't just dismiss and blow things off and go, well, the thyroid clinic told me NDT was the best, and my functional provider just does NDT because it's natural. Get out of that mindset. Stop. Think for yourself. Pay attention to your own body. Get all the information by listening to shows like this so that you can actually have that conversation, that educated conversation which you have every right to have with your collaborating. Collaborating. Notice how I use that word, collaborating. Physician or practitioner who is collaborating with you in your health, they're not dictating, they're not God. They don't have the final say and they don't know everything. You know your body better than anyone. Just like as advanced Thyroid and Hormone clinic we will guide you. We will give you our best knowledge, all the knowledge that we have from helping tens of thousands of patients over the years. But you know what we're also going to ask you? How do you feel? Because it's all about you and your unique biochemistry that's called personalized medicine, finding exactly what that combination is for you. And it might take some trial and error. We might nail it on the first try. But your feedback and you listening to your body and you not being this passive participant in your health helps. So this episode, I hope, helps you if you have been feeling worse on NDT medication. And as always, make sure you share this episode because I guarantee you there's so many more people out there that are struggling in the same way you do that you are. So share this episode with your sister, with your friend, with your neighbor, with your co worker. Subscribe to the channel and and as always, I will keep loading you down with this information to make you better. Make sure you grab a copy of the Thyroid Fix as well. Go to ThyroidFixbook.com or Amazon or wherever books are sold because this is your thyroid Bible. Everything that I talk about on this podcast, years and years and years and years of experience, is in that book for you. It's your little handbook, Thyroid Bible, Last thyroid book you'll ever need. And I did this out of pure love for all of you.

[B]

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