Here is some information for patients who are currently taking Armour, the natural desiccated thyroid produced by Forest, and are having problems with Armour's availability, or with the effectiveness of the reformulated Armour, or who are considering starting on natural desiccated thyroid treatment for hypothyroidism.
First, except for the 3 grain size, Nature-Throid and Westhroid are fully in stock, and there are no other shortages or backorders. All dosage sizes except for 3 grain are fully available. And, according to RLC CEO Rick Cox, "We are 100 percent dedicated to doing everything we can to make there is a consistent supply of natural desiccated thyroid medication in the marketplace."
Second, realize, however, that many pharmacies and even drug distributors do not understand natural desiccated thyroid drugs, and they mistakenly seem to think that Armour is the name for all of these drugs. So when they are hearing about the severe shortages and backorders of Armour, they are wrongly assuming that this applies to all natural desiccated thyroid drugs, and that is clearly not the case. So if you have a prescription for Nature-Throid or Westhroid, and the pharmacist says he/she is unable to get this drug for you due to shortages or unavailability, ask the pharmacist to call RLC Labs directly at 877-797-7997 and RLC will provide them with information on how to obtain Nature-Throid or Westhroid.
Third, if you are switching from Armour to Nature-Throid or Westhroid, you and your doctor may be confused about how to switch, because 1 grain of Nature-Throid and Westhroid is listed as being a "65 mg" tablet, while 1 grain of Armour is listed as "60" mg. But switching is actually very simple. As far as the ingredients, 1 grain of any prescription natural desiccated thyroid drug must, by FDA regulation, contain a guaranteed potency of 38 mcg levothyroxine (T4) and 9 mcg liothyronine (T3). That means that 1 grain of Armour is equivalent to 1 grain of Nature-Throid or Westhroid, in terms of active ingredients. Same for 1/4 grain, 1/2 grain, 1 1/2 grain, 2 grain and 3 grain sizes. So making the switch is easy because you take the same daily amount in grains. (Note, however, that because you might metabolize one medication somewhat differently than another, that after you've changed, you'll want to have your levels and symptoms rechecked in about six weeks, to see if your dosage needs any further adjustment.)
Fourth, if you are unable to get Armour, Nature-Throid or Westhroid, or you are a patient who has sensitivity to any of the ingredients that are used to produce any of these natural desiccated thyroid drugs, Dai Jinn suggests that patients talk to their physicians about getting a compounded natural thyroid drug. Your doctor would need to ask for compounded Thyroid USP. (Thyroid USP is the prescription desiccated animal thyroid powder that goes into Armour, Nature-Throid and Westhroid). Either vegetable or gelatin capsules can be used, and the Thyroid USP typically is mixed with one "filler" ingredient in order to fill small capsules. Rice flour is a filler option, as it is less likely to cause sensitivity or allergies than other fillers. A good compounder can work with you to find a filler that works for you. Keep in mind that compounding tends to cost more -- as each pill has to be hand-filled. Also, while a good compounder will work to ensure quality control and consistency, compounding may not be able to deliver quite as precise a dosage in each capsule, compared to a tablet form, where fillers/binders are added to stabilize the tablet, and manufacturers are overseen constantly for quality assurance.
Note: not all compounding pharmacies have experiencing working with thyroid medications. One that I can highly recommend is a terrific compounding pharmacy in my area. (Full disclosure: I have my prescriptions filled there, including compounded thyroid medication.) They accept prescriptions by phone or fax from doctor's offices around the country, and can send out prescriptions by mail.
10400 Connecticut Ave, Suite 100, Kensington, MD 20895
Phone: 301-942-7979 / Fax: 301-942-5544
(Important Update: As of Sept 9, 2009, Knowles is no longer able to fill orders for natural desiccated thyroid, due to the product shortage. )
You can also look up pharmacies that are members of the International Academy of Compounding Pharmacists (IACP).