If you’re treating patients with thyroid dysfunction, and especially if you’re integrating it into your HRT protocols – this quick thyroid dosing guide is for you.
There’s a lot of confusion around how to start and titrate desiccated thyroid extract (DTE), like NP Thyroid, Armour Thyroid, or compounded porcine powder. But it doesn’t have to be complicated.
The Problem with Starting Too Low or Titrating Too Slowly
Many providers start patients at 15mg DTE. That’s almost always too low.
And then they wait months to increase the dose. By that time, the patient’s own thyroid production has dropped off, and the medication dose isn’t enough to fill the gap.
Here’s what happens:
- Patients feel great the first 1–2 weeks (because they’re still making their own thyroid hormone).
- Around weeks 2–4, their endogenous thyroid function drops.
- Now they’re relying solely on the med, and it’s not enough.
What do they say? “I feel worse than before I started.”
Here’s What to Do Instead
Start at 30mg DTE for most patients.
Not 15mg (too low). Not 60mg (too much).
Then titrate by 30mg every 2 to 4 weeks until symptoms resolve.
If the patient is dealing with severe fatigue, depression, or low motivation, titrate sooner—at the 2-week mark. Don’t let them crash before the new dose kicks in.
Why This Matters in HRT Protocols
Thyroid hormone is one of the most overlooked tools in HRT.
If you’re optimizing estrogen, progesterone, testosterone, DHEA, and cortisol—but leaving thyroid behind—you’re not giving your patients full support.
In fact, most HRT patients will see faster and more stable improvements in energy, mood, and metabolic rate when thyroid is dialed in early.
Learn the Full Thyroid System Inside HRT University
Inside the HRTU Master Course, we walk you through:
- A complete thyroid dosing and troubleshooting guide
- When to use labs vs. symptoms to make decisions
- How thyroid interacts with cortisol, sex hormones, and metabolism
It’s the most detailed thyroid module available anywhere, and it’s built for real-world providers like you.
Because when you master thyroid, you change lives. And your patients will thank you for it.
