Informational Posts / My Personal Experiences

NDT Before and After Photos

NDT Before and After Photos
Originally published on 23rd March 2016
Last updated on 23rd May 2022

Before and after photos of switching thyroid medication from something that wasn’t working to something that does, are powerful and say volumes. 

The most common ‘before and after photos’ we see in the thyroid community tend to involve a ‘before’ on Levothyroxine and an ‘after’ on a different medication type such as Natural Desiccated Thyroid.

In my Facebook support group, members have told me they find them really helpful and inspiring to look at. So, I committed to taking photos of myself throughout my thyroid journey of switching to NDT, to show the difference it has had on me, too.

First and Foremost…

Some important details to share:

Armour and Levothyroxine Together


March 2015 – Diagnosed with Borderline Hypothyroidism, Hashimoto’s “Off The Charts” but not on thyroid medication

This picture makes me feel sad whenever I look at it.

A selfie of Rachel looking very ill before NDT

Taken in March 2015

When this photo was taken, I was at my worst, symptoms-wise. I felt like no one believed how awful I really felt. I was lost, confused and pretty darn scared. I was overwhelmingly exhausted, my body ached like the worst flu I’d ever had, and so I knew something wasn’t right. I’d been feeling this way since September 2014 and it was only getting worse as time went on.

Doctors eventually ran a bunch of blood tests in April 2015, after I hadn’t gotten any better seven months later, and it came back with my TSH being ‘borderline‘ high, at around a nine, when the range used was 1-10, and I was also shown to be anaemic (low in ferritin).

I was put on iron tablets for the anaemia but thyroid medication was withheld. I was told to wait another two months to see if the iron tablets would ‘fix the thyroid problem’. Then we’d look at thyroid medication.

Of course, I felt nothing but worse, two months later. At that point, my TSH was even higher, and I was started on Levothyroxine for my hypothyroidism in July 2015.

The most noticeable differences in how I looked here, compared to when I was a healthy twenty-year-old, include the huge bags under my eyes, uneven skin tone, pinky-purple lash lines, thinned eyebrows, and a gaunt look to my face. I generally look very sick.

October 2015 – Four Months on Levothyroxine

A photo of Rachel looking tired whilst on Levothyroxine

Taken in October 2015

I had been on Levothyroxine for almost four months when this photo was taken. My face had started getting puffier and my symptoms only got worse with time. You can see I still had the big bags under my eyes. My skin was looking somewhat better.

I had over 20 total symptoms by this point, meaning I had gained more since starting Levothyroxine. I could tell that it wasn’t working for me and I was frustrated about that.

Symptoms included, but were not limited to:

Doctors carried on telling me that my TSH was ‘in range’ so I was being ‘optimally treated’. They told me all these symptoms were all in my head and that I needed to ‘let them go’.

I searched for information in research, studies and books about why I could still be feeling unwell with a ‘fine’ TSH, and I started to realise that my doctor going by TSH alone wasn’t the correct way to measure how I was doing on my thyroid meds.

I started looking at other thyroid medication options too, piecing together that I likely had a conversion problem as to why Levothyroxine unfortunately wasn’t helping me.

January 2016 – One Month on NDT

By November, I decided that I wanted to try a medication that made a lot more sense to me than Levothyroxine; NDT. However, after asking many doctors (GP’s at my surgery plus endocrinologists I was referred to), none would prescribe it so I decided to self-source it from Thailand.

I must stress here though that I never recommend this lightly and always suggest obtaining it from a doctor wherever possible. Buying your own medication online is incredibly risky and can be dangerous. 

A selfie of Rachel looking healthier just after starting NDT

Taken in January 2016

I started it in mid-December, and I was seeing results within a couple of weeks. By January, I was feeling significantly better, and all but one symptom had gone; my fatigue. I was so pleased that I was able to exercise and workout again, that I took this photo.

Please see my blogs about my detailed NDT journey here.

All of those symptoms mentioned above, besides the fatigue, had gone.

I also found out in January that I had adrenal dysfunction (though it is more accurately referred to as hypothalamic-pituitary axis dysfunction), likely the culprit for my ongoing tiredness, so I started working on fixing this.

Needless to say though, I was feeling loads better just by switching to NDT.

You can see in the photo that my skin was more even and healthy looking, the puffiness in my face was gone, the bags under my eyes were a lot better and I generally looked and felt a lot healthier than before.

July 2016 – Seven Months on NDT

I was still on NDT and doing well, although still had adrenal issues, but my quality of life was good and I was generally doing well day-to-day. My GP was happy with my progress on the medication and continued to run thyroid blood tests every few months, adjusting my dosage with me (we would discuss how I felt and what I felt was the best move forward with his input too).

A selfie of Rachel looking healthier and happier

Taken in July 2016

It was from this time that I started being able to live without my hypothyroidism being a  conscious thought or problem.

This is how I’ve ‘looked’ since, and I don’t think there is any improvement to be had in terms of looking any healthier. You can see it in my skin, eyes, face shape etc. that I was much healthier on the NDT compared to nothing at all a year earlier, or Levothyroxine just eight months prior.

See my NDT milestones here.


NDT has made a huge difference to my quality of life, but my needs have changed over the years. From being on NDT alone to now being on a combo of NDT and Levothyroxine. I am always open to reviewing what my body needs from me and providing this so that I can live my best thyroid-healthy life.

However, I can’t deny that I am one of the many thyroid patients who need that direct T3 in their thyroid hormone replacement medication in order to have that quality of life.

You can click on the hyperlinks in the above post to learn more and see references to information given.

Do you look back at old photos and realise just how unwell you looked?

Be Your Own Thyroid Advocate Book CoverSee also:

The book Be Your Own Thyroid Advocate: When You’re Sick and Tired of Being Sick and Tiredwhich builds on this article in detail. It tells the story of how I went from being undiagnosed and very ill with hypothyroidism, to taking back control and thriving again.

About Author

Rachel Hill is the highly ranked and multi-award winning thyroid patient advocate, writer, speaker and author behind The Invisible Hypothyroidism. Her thyroid advocacy work includes writing articles, authoring books, producing her Thyroid Family email newsletters and speaking on podcasts and at events about the many aspects thyroid disease affects and how to overcome these. She is well-recognised as a crucial and influential contributor to the thyroid community and has a large social media presence. Her bestselling books include "Be Your Own Thyroid Advocate" and "You, Me and Hypothyroidism".


  • Sawara
    March 29, 2023 at 4:48 am

    Im really trying to switch to NDT but getting the worst sore throat and muscle aches! is this something I need to push through or is it not for me? I dont feel amazing on levo but this switch has me far worse so far 🙁

  • Lucy
    December 3, 2022 at 10:08 am

    What is the actually diagnostic criteria for hashimoto’s versus hypothyroidism? I realise hashimotos is the autoimmune disease that drives up to 95% of hypothyroidism. Have had sub clinical hypothyroidism for a year and recently being diagnosed by by GP and private endo as hypothyroid. However my Anti TPO is 1400! That to my understanding is clearly indicative of my being autoimmune. My GP seems clueless as does the endocrinologist.

    • Rachel Hill
      December 4, 2022 at 8:41 pm

      Hi, yes, Hashi’s is usually diagnsoed with TPOAB and / or TGAB above range. I was diagnosed with a TPOAb of >1300.

  • Danni
    November 23, 2021 at 9:27 pm

    Its very sad to look through how poorly you was 🙁 so glad you worked it out and made yourself better than you was.

    I’d love to source NDT safely and take control myself, im completely miserable and being told all is good and to ‘think’ positive 😪 as my TSH is now 2 from 147

  • Ann
    November 5, 2021 at 9:22 pm

    Hi! I am new to your site. I glanced at your list because one of my specialists tested my T4 and T3 midweek. She mentioned Hypothyroidism. I have been referred to an Endocrinologist by an ENT a month ago but no one has contacted me about scheduling follow up. Do you have any advice as a new person advocating. I have been telling people something is wrong for 20 years and now I am getting at least referred to someone. I think I have 23 symptoms listed above. I see my Internist on-line next week. I appreciate your courage to share your story. If you pray, please say a prayer for me so I get answers. I appreciate it. Graciously, Ann

  • Anastasia
    February 26, 2019 at 12:41 am

    Rachel,please,can you connect with me by my email [email protected].
    I really need your advice about Thyroid.

  • Catherine
    November 15, 2018 at 3:36 pm

    Wow, your improvement on NDT is amazing!
    I am also on NDT (self-sourced) but am having trouble fine-tuning the dosage….I spent 16 years on T4 only and felt terrible (plus put on almost 30 kilograms of excess weight), and I have managed to lose most of it while on NDT, but I have started developing some unpleasant symptoms lately. They are symptomatic of both hypo- and hyperthyroidism which may be considered normal since I have Hashimoto’s disease where you supposedly swing from hypo to hyper back to hypo, but I have had Hashi’s for over 20 years and these symptoms have developed recently which makes me think I’m doing something wrong…either getting too much T3 from the NDT, or not enough T4, meaning the T3:T4 ratio in NDT is wrong for me and it would be wise to add some synthetic T4 to the mix…however, I’ve also wondered if the brand I’m using (Thai brand Thyroid-S) is the problem as it contains over 20 fillers and binders. I have been considering trying another brand of NDT with fewer fillers to see if it makes a difference. Can I ask you which brand of NDT you’re on, and how much you’re taking? Also, do you have any idea what your free Ts should ideally look like when optimally dosed on NDT (midrange, close to upper or lower normal limit), just to give me a general idea? I understand the TSH is unimportant as it will be below range when you take T3, and mine has been undetectable ever since I went on NDT.
    Thank you.
    Kind regards,

    • Rachel Hill
      November 17, 2018 at 5:05 pm

      I’m on Thyroid-S and take 150mg (2.5 grains). I feel best with my free t3 high within the range (not over medicated or above range, just high in range).

      • Paul Blair
        June 7, 2019 at 6:15 pm

        Natural Dessicated Thyroid is measured in mg’s not mcg’s like t4. So to say you are on 150 is wrong. However, saying you are on 1.5 grains is correct. 1.5 grains is equal to 90 to 95 mg and contains approximately 57mcg of t4 and 13.5 mcg of t3.

        • Rachel Hill
          June 7, 2019 at 6:19 pm

          Thyroid S is 60mg a tablet. That was a typo above! I was on 2.5 tablets (which is 150mg) at the time I wrote that comment. It shouldn’t say 1.5 but 2.5.

          • Rachel Hill
            June 7, 2019 at 6:21 pm

            I’ve corrected the typo now!

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