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Mary Shomon

Armour Thyroid Shortages Worsening: What Can Thyroid Patients Do?

By September 10, 2008

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Back in June, I gave an update on the availability problems plaguing Armour Thyroid, the top-selling natural desiccated thyroid drug, which is manufactured by Forest Labs. All spring and summer, Forest has been having serious supply problems, leaving many patients without any options for refilling their prescriptions.

As of June, Armour's spokespeople had indicated that several dosage sizes of Armour Thyroid were undergoing "extensive enhancement process for quality control" and were not currently in production. The dosages included:

  • 120 mg / 2 grains
  • 180 mg / 3 grains
  • 240 mg / 4 grains
  • 300 mg / 5 grains
At that time, Forest was saying that these dosages would be available again in October of 2008.

Unfortunately, according to the latest status update on Armour -- which you can hear by calling their toll-free Armour information line at 1-866-927-3260 -- those out of stock dosages that are currently being "enhanced" are not going to be available in October. Instead, the hotline indicates that these dosages "should be available late 2008." This is not good news for thyroid patients.

According to Forest, the dosage sizes still being produced include the following:

  • 15 mg (1/4 grain)
  • 30 mg (1/2 grain)
  • 60 mg (1 grain)
  • 90 mg (1 ½ grains)
Not surprisingly, given Armour's obvious inability to ramp up its manufacturing, or meet demand from all Armour users with just several dosage sizes, there is still a massive shortage around the nation. And at present, Forest is significantly back-ordered on all of the above dosages, except for the 15 mg (¼ grain) size.

That means that the ONLY dosage size of Armour currently available from Forest is the 15 mg size. Some of the other dosages may be available with distributors and pharmacies, but it's likely that those outlets will soon run out.

The hotline claims that the other dosage sizes will be available the week of September 22, 2008.

Given these problems, I am still receiving calls and emails from patients around the country who are unable to get ANY Armour Thyroid from their pharmacies. These include patients trying to get prescriptions filled at local pharmacies, as well as chains like Walmart, CVS, and Walgreens.

Clearly, Armour has not been forthcoming with thyroid patients, and has offered no information as to the reformulation, only ever-shifting timeframes, and promises they aren't keeping. Frankly, the lack of concern for their patient population is obvious in their cavalier attitude toward their customers.

That said, if you are one of the many patients who is struggling to deal with the shortage of Armour, I have some solutions for you.

What Can You Do? How Can You Get Your Thyroid Medication?

First, be careful. Your pharmacy or doctor may suggest switching to an easily-obtained synthetic drug, like Synthroid or Levoxyl, or the generic, levothyroxine. They may claim "It's the same thing." It's definitely not. Synthetic thyroid hormone replacement drugs like Synthroid operate very differently; they are not the same as natural thyroid medication. People who do well on Armour Thyroid may not do well on synthetic substitutes. So my suggestion is, if you are doing well on natural thyroid, work with your practitioner to stay on natural thyroid, even if it means switching to another brand name natural thyroid drug.

For those of you who rely on natural thyroid, there are ways to get prescription natural thyroid medication.

Armour Thyroid Availability

A reputable compounding pharmacy, Knowles Apothecary, has a decent supply of Armour Thyroid available. The pharmacy is located in Kensington, Maryland. (Full disclosure: It's the pharmacy that fills my prescriptions, and I love them. They're very knowledgeable and thorough!) They fill prescription drug orders by mail, but your doctor's office will need to fax or call in a valid prescription. Make sure it's written for nothing larger than Armour 60 mg -- so if you take 3 grains or 180 mg a day, the prescription should be for a total of three 60-mg per day tablets. Ask your doctor to write you a decent supply -- at least three months or more -- to carry you through the shortage period.

(Important Update: As of Sept 9, 2009, Knowles is no longer able to fill orders for natural desiccated thyroid, due to the product shortage. )

Knowles Apothecary
10400 Connecticut Ave, Suite 100
Kensington, MD 20895
Phone: 301-942-7979
Fax: 301-942-5544
Knowles is likely to face shortages as supplies dwindle, you have the doctor include on the prescription that if the Armour is unavailable, substitution with the Western Research products Nature-Throid and Westhroid is acceptable. That way, the pharmacy will fill your prescription with the other brand name desiccated thyroid, manufactured by Western Labs.

Nature-Throid and Westhroid

Western Research Labs manufacturers Nature-Throid and Westhroid. These are both prescription natural desiccated thyroid drugs, like Armour Thyroid. The primary difference is that Nature-Throid is hypoallergenic, for those who might be sensitive to some of the filler and binders. It comes in the same dosage sizes as Armour Thyroid.

To get Nature-Throid and Westhroid, you can:

  • See if your pharmacy considers Nature-Throid/Westhroid equivalent to Armour, and fill the prescription with Nature-Throid/Westhroid. If so, your pharmacy may be able to order it for you through their distributors.
  • If your pharmacy can't get it through their distributor, ask them if they will order it directly from Western Research, by calling toll-free 1-877-797-7997
  • If your pharmacy doesn't consider Nature-Throid/Westhroid equivalent to Armour, ask your doctor's office to call or fax your pharmacy a new prescription for Nature-Throid/Westhroid.
  • If your pharmacy can't get Nature-Throid or Westhroid and won't order it directly, then have your prescription sent to you by mail. Have your doctor call or fax your prescription for Nature-Throid or Westhroid prescription to:
    Knowles Apothecary
    10400 Connecticut Ave, Suite 100
    Kensington, MD 20895
    Phone: 301-942-7979
    Fax: 301-942-5544
Again, be sure to ask your doctor to prescribe at least a three to six month supply if possible, so that you are sufficiently stocked for the shortage.

For Doctors Who Prescribe Armour

If you are a doctor who prescribes Armour, be aware that the shortages of Armour are likely to get worse until the end of 2008, at best. You may want to consider direct-ordering Nature-Throid or Westhroid so that you have it in stock for your thyroid patients who take natural thyroid. Call Western Research Labs toll-free 1-877-797-7997 for more information. (Patients, if you have a doctor who does a lot of work with Armour Thyroid, you might encourage him or her to also consider stocking Nature-Throid or Westhroid for their patients.)

SHARE YOUR THOUGHTS NOW!

Are you fed up with trying to get Armour Thyroid?
Share your thoughts in the forum now!

Photo: Clipart.com

Comments
September 11, 2008 at 6:11 am
(1) polygonum says:

When I look at the copies of the prescribing information for Nature-Throid and Westhroid, I see that the tablets are in ‘traditional’ grains – i.e. 16.25/32.5/65/130/195 – not in the ‘metricated’ grains that Forest Armour comes in (15/30/60/etc.)

From Nature-Throid:

“They provide 38 mcg levothyroxine (T4) and 9 mcg liothyronine (T3) for each 65 mg (1 Grain)
of the labeled content of thyroid”

From Forest Armour:

“They provide 38 mcg levothyroxine (T4) and 9 mcg liothyronine (T3) per grain of thyroid.”

Although the therapeutic effect might be negligibly different, this difference in stated tablet sizes just might cause problems with some pharmacies when asking for substitution. (It was one of the factors that caused problems in getting hold of Nature-Throid via Idis in the UK. Another was the price difference!)

(Funny – elsewhere in the document Nature-Throid refer to doses of “15–30 mg”!)

September 12, 2008 at 6:35 am
(2) Meg says:

i live in Columbus, Oh and this month was the first I had in difficulty in filling my prescription. I take 2- 60 mgs of Armour. The pharmacy called the other day to te leave a message that they were not able to get Armour. In calling them bck, it was obvious in speaking with the tech she could care less that I needed the medication. To mak a long story short, both the pharmacy and the doc’s office told me to start calling around to different pharmacies to see if any had some in stock. It was a difficult task since I am a teacher and had only a 30 minute prep. The new pharmacist advised me to call my insurance company to tell them I may be pharmacy hopping to fill my script. Forrest should be ashamed of what they are doing to their customers!

September 12, 2008 at 8:14 am
(3) Cathy says:

I was from Florida and now living in the Caribbean. Just before our move I had trouble getting Armour Thyroid; since I am on bio-identical hormones that are from a compounding pharmacy, my practitioner called in a prescription for thyroid meds to be compounded. It seems to have worked fine other than they cannot fill a script for more than apx. 3-4 mo. For someone living in the U.S. with a compounding pharmacy close by, that is no problem, for me, there are no compounding pharmacies on my small island so I have resort to Fedex which is expensive, but still worth it.

September 12, 2008 at 1:09 pm
(4) Heidi says:

I am wondering why Mary doesn’t reccomend westhroid. It is also natural like armour. For me, the westhroid works better, and there is no shortage of it

September 12, 2008 at 4:16 pm
(5) Abbey says:

I haven’t been able to get Armour since April of this year. After discussing it with my endo and the Walgreen’s pharmacist, we decided to use the compounding service offered by Walgreen’s. I have had three blood panels since then, and my levels are actually better with the compounded version–which leads us to think that there were some storage issues with the Armour.

Just another option to those who don’t trust mail-order pharmacies. As a chemist, I know how just a few degrees temperature can affect certain drugs. Hope this helps some of you!

September 12, 2008 at 4:33 pm
(6) Pat Sharp says:

My pharmacist told me they, Forest Laboratories, were discontinuing Armour thyroid. I called Forest’s NY office, and was told that they are backlogged with providing supplies, but going to continue making it, with no change in ingredients.
I worked very hard ( 6 years of research & trial & error) to get on this medication. Synthroid/Levoxin..don’t contain the T2 that I needed for sharp mental functioning. I was a zombie. Synthroid .2 was too much .175 too little Armour 1 grain way too little, finally someone wrote a book equating grain-mgs……
I lost 6 productive years going into retirement.
I have no thyroid, was a vicitm if the experiment irradiating tonsils as a child!

September 14, 2008 at 12:55 am
(7) Katherine says:

When the government runs all of the programs the country is called communist or socialist. Having watched the citizens of China over the past few weeks, I am increasingly fond of our dear republic. You’re right Armour may stop making thyroid medicine, but someone else will step in because the free market system will demand it…maybe it will even be a better drug!

September 15, 2008 at 5:58 pm
(8) Richard says:

And until that happens the consumer is left with nothing!
A little socialism ain’t all that bad particularly when it comes to consumer rights.

September 16, 2008 at 11:27 pm
(9) Jill says:

My local Walmart just refilled a 3 month script of Armour for me, but said that I got the last of it. When I asked about the alternatives, they said that they would gladly fill a script for Westhroid or Naturethroid if the doctor writes it. I talked to my doctor about the possibility, and he would consider the option.

As far as lack of availability from Forest is concerned, it erks me to no end when some people assume that lack of availability means that a drug is being reformulated, and that the drug manufacturer is to blame. If you were to search the FDA website, you would find that Forest had to respond to an FDA recall for a product stability issue on the higher dosages. Do you want them to ignore FDA requirements so that you can get a drug that may have a stability problem? Forest can’t ignore the FDA. I used to work in the industry, and it often takes longer than initial projections to complete a process change, validation, and FDA approval of the change. In the meantime, at least we have some viable equivalent natural thyroid alternatives.

September 19, 2008 at 7:20 am
(10) Richard says:

The issue is this isn’t the FIRST time that Armour has had a distribution problem. This problem of availibility has occurred off and on albeit not to this degree for the past several years. And this problem has not been limited to the higher doses. With the more recent fiasco couldn’t Forrest forsee that taking higher doses off the market would dramatically increase the demand for the other doses? Is increasing the production on the other doses physically impossible or just a lack of planning? Certainly their lack of communication to the public as well as the wholsale customers can only invite speculation and criticism.

September 19, 2008 at 9:07 am
(11) Lauren says:

I recently made an appointment with my doctor to discuss my getting off of levothyroxine and going to Armour Thyroid. I think my hair is falling out because of the synthetic. Anyway, now I’m confused…if there is no Armour Thyroid to be had what is the problem with going to Westhroid or Nature-Throid? They are all natural thyroid medications. Why is Armour held above the rest? Thanks for any help with this.

September 19, 2008 at 10:29 am
(12) Misa says:

I have been on Armour for several years after trying the alternatives. It’s the only one that works for me. I have been having pharmacy issue since the beginning. My pharmacy even once substituted a synthetic without telling me and since i didn’t look in the bag and read the label til i got home… well, let’s say i paid for my mistake – literally. Is it possible that this “problem of stability” is rather more about “Big Pharma” sending their junkyard dog, the FDA, to shut down any company that has any share of the market? We’re seeing a rise in FDA raids on health food stores again. Recent muscle flexing by the WHO (World Health Organization)is trying to limit our access to vitamins and natural remedies to just those prescribed by a physician, and in quantities so small they will have negligible health effects. Since you won’t hear about these issues on the nightly news, Google “FDA, Natural Health, CODEX” Can you speak to this Mary? Is this a factor in the Armour shortages?

September 19, 2008 at 12:35 pm
(13) Richard says:

Misa, I believe you are totally on the right track. In the larger scope this is NOT simply a thyroid issue or a manufacturing issue. It is a POLITICAL issue. I’m no conspiracy theorist by any means but what you allude to certainly has teeth when one digs a bit deeper. I can only hope Mary will further focus on the political aspect as this will further serve the interests of her readers. An informed group can serve as a powerful lobby. Take a look at the Credit Unions for instance. Oh how the banks would love to see them taxed and eliminated. Fortunately for us they are entrenched and here to stay. We need to do the same with vitamins and natural therapies. The consumer needs a choice.

September 22, 2008 at 2:20 am
(14) Jill says:

Richard, I agree that you could question whether Forest’s lack of the lower dosages is due to poor planning, or physically impossible due to their production line’s capacity. It would be hard to speculate why they have not been able to fill the high potency demand vortex with lower dosages. However, Misa, I would not agree that “Big Pharma” has any say in the matter when it comes to the FDA recalls. Both “Big Pharma” and “Little Pharma” are subject to the FDA microscope, as well as any natural remedy manufacturers making unsubstantiated claims. I’m all for natural remedies, but it’s best that they keep label claims minimal.

For Forest’s latest lot recalls of Dec-2007, it certainly didn’t help that they had other prior lot recalls in May-2005 involving the lower potencies of 30mg, 60mg, 120mg, due to “Subpotent: Product may not maintain potency throughout shelf life.” All Armour dosages have had recalls for various stability failures between May-2005 and Dec-2007. Stability testing of each production lot is ongoing after the product has been distributed, and continues past the shelf life to ensure potency to the end of shelf dating. If any lot fails any stability specification, it would be reported to the FDA and a recall issued. “Big Pharma” would have no jurisdiction in “Little Pharma” Forest recalls.

Also, if Forest were the only source for this necessary thyroid medication, approval of any new process changes would likely be pushed on a fast track for FDA approval. However, equivalent Western Research products seem to be widely available. I’ve read of people on these forums who seem happy with their grain equivalent dosages. If Armour is not available when I call in for another 3 grain refill in 2 months, I can only hope that I will also be content with the switch to either Nature-throid or Westhroid. They may not taste as good without the Armour sugar coating, but that won’t really matter to me. It’s far better than Synthroid or Levoxyl, as I’d never go back to T4 only medictions.

September 25, 2008 at 11:21 am
(15) Richard says:

I got interested in natural remedies and vitamins strangely enough as a kid when my health was fine. I used to listen to Dr. Carleton Frederichs, a public health advocate on the radio. He has been dead for several years I believe, but made his mark promoting natural remedies as well as railing against the FDA and anti-vitamin establishment. I think it naive to for anyone to think that a government agency like the FDA has the public interest at heart in spite of many people who might work there that are dedicated to the cause of public welfare. It seems evident that the large pharmaceuticals have some influence if not a great deal of control over our regulatory agencies. This is not unlike other industries and their relation to Congress and the Feds. Mary has filled a niche that needed to be addressed, appears to have good journalistic abilities, and has informed her readers with much needed knowlege. So much however of what I recall her talking about has political overtones and underpinnings, I wish she would expand her topic to a broader context. It doesn’t seem to me that the treatment of thyroid disease is rocket science. It has been around a long time. It doesn’t seem to me that a drug that has been around for eons should have chronic supply and distributon problems. It doesn’t seem to me that patients who only respond well to natural thyroid treatments such as Armour would have trouble finding a doctor to prescribe them. So what is the problem? It must be political in nature. This is not surprising as just about everything in life has political connections. So I do appreciate the information addressing all the mini-political firestorms that pop up. The information Mary provides is as I said helpful to me and I’m sure other readers. I just think it would be additionally helpful to focus on this issue from a more holistic and broader context. I believe the issues and associated problems surrounding this topic are not unlike many other healthcare concerns.

September 26, 2008 at 1:08 pm
(16) Jennifer says:

I have taken Nature-throid for the past 9 years and it works really well for me, thank God. Once I forgot to bring my meds on vacation and took Armour instead for 5 days. No difference at all from the Nature-throid. Please do not worry about Nature-throid or Westhroid as a substitution for Armour.

September 28, 2008 at 9:16 pm
(17) Vikki says:

Mary,
My Doctor told me they were discontinuing Armour Thyroid last week and wanted to put me back on Synthroid. He tried telling me that Synthroid is closer to Human Thyroid because they grow actual Human Thyroid cells in a petrie dish, and that it was better for me. He then tried to tell me that Armour comes from pigs, cows, & even horses, and has been connected to Prion infection which is like Mad Cow Disease.

I told him that I don’t want to switch until I researched what he told me. How much of this is True?

Thanks
Vikki

September 28, 2008 at 10:37 pm
(18) Mary Shomon says:

Vikki

Armour is from pigs only, and doesn’t carry a prion/mad cow like disease risk. They don’t “Grow” human thyroid cells to make Synthroid.

I think it’s time for a new doctor.

October 1, 2008 at 5:27 pm
(19) Florida on Armour says:

YOU NEED ARMOUR???? FINALLY got around to CONFIRMING with the Primary Pharmacist who makes most of my meds that THEY CAN MAKE ARMOUR!!!!! It’s called FAMILY CARE PHARMACY, Plant City, FL at 1-813-659-9777 and they SHIP ANYWHERE – I even have my meds shipped since they’re an hour away. He agreed he could make COMPARABLE ARMOUR – same amount of T3/T4 and you can choose what other “inert” ingredients you may want (they’ll help with that). And you can also choose the form (normally) in subligual, pills, caps, or liquid. Prices WAY BELOW regular Pharmacies. This is the ONLY PHARMACY my Top Thyroid Doc in Brandon trusts. About the cost, you have to pay ahead, but most insurance carriers will reimburse you and the cost is, for everything I’ve orderd, FAR BELOW PHARMACY PRICING!!! You norally just fill out forms and get your $$ back. But what’s great about it is that it’s all NATURAL. And you can help choose the “inert” ingredients too – if you want. For me NATURAL MEDS WITH PHARMACEUTICAL GRADE INGREDIENTS IS BEST FOR MY BODY – no side effects from any meds they’ve made – had to go there since of the many side effects from regular Pharmacy Meds – and I ONLY TAKE BRAND!!! Anyway, GOOD LUCK – they’ll do EVERYTHING THEY CAN TO HELP! Blessings to All!! Teri in St. Pete, FL

October 2, 2008 at 6:55 pm
(20) Amanda says:

I agree, time for a new Dr. Everything he told you is total bs, do some research!

My mom, sister and I spent years trying to find a Dr that would give us Armour. We found one that would give us the minimal dose but it just didn’t work. I by accident found the Dr that we go to now when I was searching for cancer treatments for my dad. I feel like I owe this Dr my life! I never truly knew how sick I was until he worked me up to 3 grains of armour. I feel like a new person! But now I’m having to run around from place to place trying to get my script filled…. I hope this ends soon!

October 6, 2008 at 3:57 pm
(21) John says:

Thyroid is a complex issue and those of you that are having problems with finding Armour, keep trying. While many people can do ok on levothyroxine many can’t. Levothyroxine(t4) is manufactured in a lab but is bio-identical. This means is is the exact thyroid the body produces. The problem is it needs to be changed to T3 to be active. Many people don’t do this efficiently. This is the reason that dessicated thyroid can be a better choice. Another way to provide this is for a compounding pharmacy to provide a compounded product that contains both t4 and T3. T3 is eliminated from the body quickly so it is then compounded into a times release capsule. If your physician wants to change you back to synthroid or equivelent and you are doing well on dessicated thyroid, do not let him switch you back. whoever goes to a Doctor that says they create thyroid cells to produce levothyroxine needs to find a new doctor. John RPh compounding pharmacist

October 31, 2008 at 3:16 pm
(22) Vidya says:

The problem with accessing the natural thyroid now extends to Nature-Throid (used to be called Westhroid) as well. On speaking with Forest Labs, the maker of Nature-Throid, I found out that the cause of the problem is the FDA, not the manufacturers. The FDA is holding up the products with testing, and the testing is taking much longer than the FDA had said it would. With both the Nature-Throid and Armour Thyroid only certain dosage pills are available, mainly the lower dosages, ie 1 grain of the Nature-Throid and 90 mgs of the Armour. The FDA is testing the higher dosages to see what amounts of T3 and T4 they contain. This sound suspiciously like another attempt to take the natural products from the market, although that is not what is being stated. In order to get one’s proper dosage, one needs the doctor to call in an rx for the dosage that is available, increasing the number of tablets to the eqivalent dosage.

March 11, 2009 at 7:46 pm
(23) Tom says:

One year ago, in February 2008, I purchased my annual supply of Armour Thyroid (5 gr, #365) for less than US$35. This year, I went to the same pharmacy and was offered the same medication for US$145 – a 4X price hike which I am refusing for now. Ridiculous. No offer of alternate natural products, either.

I have been on USP thyroid since 1973, but now I am going to try generic levothyroxine for a while. If this is not a good, maybe the market will get sorted out soon.

August 26, 2009 at 5:52 pm
(24) Pam Toy says:

Update your site – this is old news as it is dated 2008.

August 30, 2009 at 11:58 am
(25) Manda says:

Any update on this topic? I have been on Armour Thyroid for 5 years and for the first time in the spring of 2009 my pharmacy is having trouble getting in.

September 9, 2009 at 11:41 am
(26) Julia says:

I work for a DO who prescribes Armor Thyroid. Most of the pharmacies locally do NOT carry this at the moment due to the shortages from Forest Labs. However, our local compounding pharmacy, Vital Care Compounder, has a time-release version of Armor in all standard sizes (1/4 grain or 15 mg, 1/2 grain 30 mg, 1 grain 60 mg, etc. etc.). They are the only pharmacist locally who still has a supply.

(To my knowledge, they can ship it, but obviously you’d need to have your prescription faxed in to them. They can be reached at 601-261-0503, and their fax is 601-261-0127.)

To satisfy my curiousity, I just went to the Armor Thyroid website (http://www.armourthyroid.com) and they had a little message up that they are still back-ordered and now cannot give a definitive date when the product will again be available. When you call the 800 number given (866-927-3260), it additionally informs you that the only strengths currently available are 240 mg (4 grain) and 300 mg (5 grain). This concerns me because when I called two months ago, the message stated that 3 grain, 4 grain, and 5 grain were all available. Now only two strengths are available.

I don’t know what the cause of this shortage is, but I’d very much like to know whether or not Armor Thyroid will continue to be available in the future, as I’m constantly hearing rumors (from pharmacists every time) that Armor Thyroid is being discontinued. Can someone at least confirm or deny this?

March 23, 2010 at 3:37 pm
(27) Lynn says:

We are here to help you with Thyroid Medications – we’ve been serving People & Pets in the same location since 1965.

The Owner/Pharmacist has served on the Florida Board of Pharmacy.

May 27, 2010 at 12:12 am
(28) Karla says:

Why is this still going on I’m on a very High does of Armour I take 3 1 grain and 1 5 grain a day and now there is no more of the 5 grain left. I can’t take the synthetics do to the dyes in them and they never worked for me. the Armour is the only one that works for me. I am getting tired of the ups and down ride with not having the medication I need to maintain good health . When will there be any help for all of us ?

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