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If you take Armour Thyroid or another brand of NDT (Natural Desiccated Thyroid), you may know the frustrating pattern: one week you feel great, and the next you feel wiped out. Maybe your doctor tells you your T3 is too high. Other times, it’s too low. And you are stuck chasing numbers, chasing symptoms, and wondering why it never feels stable.
Here’s the uncomfortable truth: for many people, this isn’t primarily a “bad medication” problem. It is usually a dose stability problem, and more specifically, a problem rooted in the T4 to T3 ratio and how your body processes it.
Let’s walk through the three key steps that help a lot of people get off the thyroid roller coaster and move toward steadier symptom control.
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Table of Contents
Step 1: Confirm You Actually Need Thyroid Medication (And That It Is The Right Approach)
Before adjusting anything about Armour Thyroid, there’s a foundational question that gets skipped: Do you even need thyroid medication?
Roughly 85% of people taking thyroid medication are taking it unnecessarily. And that is not a judgment. It’s a practical observation that shows up in clinical practice. When people take thyroid hormone when they do not truly need it, they can experience the same symptoms as true hypothyroidism.
In other words, low thyroid lab results do not automatically mean medication is the best move. Sometimes the underlying issue is not thyroid hormone deficiency. And in some cases, taking hormone when it isn’t needed can even lead to hormone resistance, leaving you feeling more hypothyroid than before.
If you suspect you may be in that category, consider reviewing your diagnosis and the logic behind medication decisions. (This matters because tinkering with NDT (Natural Desiccated Thyroid) won’t solve a problem that does not exist.)
Medication is also not a “one-size-fits-all” choice
Even if someone truly needs thyroid hormone, NDT is not recommended for everyone. Certain groups are generally advised to avoid it, even if they still need treatment. That includes:
- Pregnancy
- History of thyroid cancer
- Elderly individuals (commonly defined as 65+)
- Cardiovascular disease
- Kidney disease
If any of these apply, it is worth having a careful, conservative plan with your clinician.
––Key insights: Before adjusting NDT, ensure you genuinely require thyroid medication, as 85% of users may be taking it unnecessarily. Low labs do not automatically mean medication is the best move.
Step 2: Fix The Conversion Bottleneck And Prevent Harsh T3 Spikes
Now for the core of the roller coaster. The big problem people run into with Armour Thyroid is the T4 to T3 ratio.
There is a lot of talk about converting T4 to T3 for people on Synthroid or levothyroxine. But what often gets ignored is something equally important: converting T3 to T2. That second conversion step is one reason some people feel like they get a sudden lift and then crash.
Why the T4 to T3 ratio is the real culprit
In the human body, the natural ratio of T4 to T3 is roughly 10 to 12 to 1. The body also prefers to produce hormone action in a controlled way, so you do not get an excessive “blast” of T3 all at once.
But Armour Thyroid (and other forms of NDT) have a much different ratio. The effective ratio in NDT products is closer to about 4 to 1 (T4 to T3), which means proportionally more T3 is present.
So what sounds like “natural” is actually a processed product with a different hormonal composition than your body would make on its own. The issue is not that T3 is “bad.” The issue is that the ratio and timing can create T3 spikes that your system does not tolerate well.
Why NDT ends up with a different hormone mix
People sometimes speculate that it is because pigs have more T3 than humans do. That is not accurate. Pig thyroid tissue shows a similar T4 to T3 ratio to humans.
The difference appears during processing. Thyroid hormones degrade outside the body. When thyroid tissue is dehydrated, extracted, solvent processed, defatted, minced, chopped, and exposed to heat, the hormones undergo chemical changes. One key shift is that T4 breaks down into T3, along with some reverse T3 formation.
Because the end product must be shelf stable, this processing inevitably changes the final hormone ratio. That leads to a higher T3 proportion in the tablet than what you would naturally have.
The hidden testing problem: thyroid lab timing
Even if the dose is “right,” inaccurate interpretation can make it feel impossible. One of the biggest drivers of confusion is thyroid lab timing.
If you test T3 shortly after taking your NDT dose, it can look artificially high. Not because the body is truly overshooting over the whole day, but because you’re seeing an absorption spike.
Practical rule: test before your tablet, ideally right before your next dose. That way your labs reflect baseline levels instead of a momentary post-dose peak.
There are some rare scenarios where post-dose testing is justified, such as screening for risk of side effects from a T3 surge. But that is not typically how clinicians determine whether a dose is “working.”
Use thyroid conversion nutrients to smooth the transition
Once the hormone profile is arriving with a relatively high T3 proportion, the next question is: can your body convert hormones efficiently and steadily?
This is where thyroid conversion nutrients come in. Your goal is twofold:
- Support conversion of T4 to T3 pathways
- Support conversion of T3 to T2, so the benefits are not purely “spike and crash”
When those pathways work smoothly, the T3 spike tends to feel less dramatic, and side effects are less likely.
Common nutrients that can support these pathways include:
- Selenium for thyroid function and deiodination processes
- L-D-limonene (from citrus compounds) to support conversion dynamics
- Oleanolic acid (found in pomegranate compounds)
These nutrients are available through food, and some people also use supplements designed to support conversion pathways. The point is not to “overcomplicate” thyroid care. The point is to give your body the biochemical support it needs so that the T3 you receive is handled more gracefully.
––Key insights: To prevent confusion in testing, always test thyroid labs before your next NDT dose to reflect baseline levels instead of a momentary post-dose spike.
Step 3: If Your Dose Is Still Unstable, Adjust The T4 To T3 Ratio With An Add-On
Sometimes you can do everything “right” in Steps 1 and 2 and still feel unstable. You may be getting symptoms consistent with too much T3 action, such as:
- Racing heart
- Overstimulation or jittery energy
- Quick improvements followed by a crash
At that point, the most effective lever may be ratio tuning. One common approach is to change how much total T3 is delivered by pairing NDT with a small dose of T4.
Why adding T4 can work
NDT (like Armour Thyroid) contains both T4 and T3, but it tends to be relatively T3-heavy after processing. If you lower the NDT dose and add in a small amount of a T4 medication (commonly Synthroid or Tirosint), you can create more natural hormone balance across the day.
This gives you a wider range of possible T4 to T3 ratio combinations than NDT alone can provide.
But I don’t want synthetic
Many people resist combining with T4 because of the word synthetic. It’s understandable. But the terminology in thyroid care can be misleading.
When Synthroid was developed, “synthetic” was meant to communicate purification and consistency. In hormone replacement discussions, however, the word “natural” gets used differently. For example, when people talk about natural estrogen, that is also synthetic or manufactured (it is just chemically the same or similarly derived).
In thyroid hormone terminology, “natural” often ends up meaning “animal-sourced,” which is not the same as “chemically different.” The key point is that certain manufactured hormones are chemically identical to what your body produces.
So if someone responds poorly to T4-only therapy, it often may be because the body needed a better balance and dosing strategy, not because the medication is inherently “foreign” or toxic.
Think of the goal as matching your physiology, not matching a label.
––Key insights: If symptoms of too much T3 action persist (e.g., racing heart, jittery energy), the most effective lever may be ratio tuning by lowering the NDT dose and adding a small amount
The Practical Summary
Armour Thyroid and NDT (Natural Desiccated Thyroid) can be a great fit for many people. Many clinicians prescribe it because it can work well. But for the people who get unstable, the pattern usually points back to three tools:
- Make sure you truly need thyroid medication and that NDT is appropriate for your health situation.
- Improve conversion and reduce harsh T3 spikes by supporting thyroid conversion pathways (for example with selenium for thyroid and other thyroid conversion nutrients) and by optimizing thyroid lab timing so tests reflect baseline, not post-dose peaks.
- Tune the T4 to T3 ratio if needed by adjusting NDT dose and adding a small T4 medication to achieve a more stable balance.
If things have not felt stable yet, it’s easy to assume you just “can’t get it right.” But instability often has a mechanism. Once you understand the T4 to T3 ratio reality of NDT, the impact of thyroid lab timing, and the role of thyroid conversion nutrients in smoothing out T3 spikes, the process becomes less like guessing and more like precision.
You don’t have to give up. You just need the right adjustments.
P.S. Whenever you are ready, here is how I can help you now:
- Schedule a Thyroid Second Opinion with me, Dr. C, Click Here for Details
- Need help to choose supplements? Click ‘Help Me Decide Here'
- Get my top books Here
Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Hormone Healing Cookbook, The Metabolism Reset Diet, and The Thyroid Reset Diet.
Dr. C’s gift for figuring out what works has helped hundreds of thousands reverse thyroid disease, heal their adrenals, and lose weight naturally. Learn more about the surprising story that started his quest.
