Natural Thyroid Medications

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Natural Thyroid Medications

If you have been diagnosed with low thyroid function, or hypothyroidism, you and your doctor have a number of medications to choose from. As a Naturopathic Physician, my focus is to choose the medication that fits your needs, to individualize your prescription so that you are adequately treated and your symptoms are relieved.

idiotsthyroidIf you have researched thyroid disease and treatments, no doubt you have come across widely different approaches and convincing arguments for each. I will not go into those here.

I encourage you to actively participate in your medical decisions, and encourage a balanced approach. Getting into an adversarial relationship is not productive, and a mix of openness and skepticism will most likely bring you to your most appropriate treatment. One authoritative and balanced resource I recommend is The Complete Idiot’s Guide to Thyroid Disease, by Dr. Alan Christianson and Hy Bender.

The purpose of this article is to discuss natural thyroid medications to bring distilled information to your open skeptical mind.

Natural vs Synthetic

Natural thyroid medications are prescription medications made from the thyroid glands of pigs. You might find it called

  • Desiccated thyroid
  • Glandular thyroid
  • Natural Desiccated Thyroid
  • NDT

It is the only thyroid medication that contains all four thyroid hormones that our bodies make: T4, T3, T2, and T1. In addition, its iodine, thyroglobulin protein and glandular tissue content have useful functions in the body.

NatureThroidbottleTrade names of this Natural Desiccated Thyroid include:

In addition, compounding pharmacies may use whole desiccated thyroid porcine glandular in their individualized prescriptions.

Most mainstream doctors prescribe a thyroid medication that is synthesized from chemicals in a lab and contains the hormone T4 only. This is available in both trade name brands and generic forms. Synthroid is in the top 10 most synthroidcommonly prescribed medications. Common forms include:

In addition, synthesized T3 hormone is available by prescription as well as compounded. The brand name is Cytomel and the generic form is known as liothyronine.

Women’s International Pharmacy has compiled a chart of thyroid hormone therapy options which make it easy to evaluate. It contains additional useful information and may be accessed  here: thyroid_hormone_therapy_options.

Advantages of Natural Desiccated Thyroid

  • A natural mix of all 4 thyroid hormones T4, T3, T2, T1
  • T4 is the predominant thyroid hormone produced by our thyroid glands, but it is minimally active until converted to T3
  • A small amount of the metabolically active T3 helps people who don’t effectively convert their T4 into T3
  • Contains thyroglobulin protein which slows the breakdown of T3, the active hormone so that it will keep you going all day without having to dose again during the day
  • T2 has been found to play a role in metabolism and fat burning
  • The glandulars in the NDT can help strengthen and rebuild you own thyroid gland, provided you still have it
  • Also one grain NDT contains 120 micrograms of iodine. The adult RDA is 150 mcg, with the WHO (World Health Organization) recommending 220 mcg for pregnant women.
  • Relatively low price – pigs thyroid glands are sold at a low cost to manufacturers
  • No one can patent a pig thyroid gland, so name brands are already at generic prices

Disadvantages of Natural Desiccated Thyroid

  • Comes from a pig, which is objectionable to vegetarians, Orthodox Jews and other religious groups, and others who find it distasteful
  • A smaller range of dosages available than the synthetic, so sometimes a combination of pills must be used to get in-between dosages
  • At times, there has been a “shortage” of natural raw materials, limiting its availability
  • Many mainstream doctors will flat-out refuse to prescribe it

Issues which are debatable as advantages / disadvantages

T4:T3 ratio

The human thyroid gland makes a ratio of T4 to T3 of approximately 10 to 1. The pig gland in NDT contains a ratio of 5 to 1. This makes an excess proportion of T3. Some patients can use this higher proportion if they have trouble converting T4 to T3. In addition, there is some evidence that in cells, the proportion of T4 to T3 is closer to the 5 to 1.

Standardization

The first thyroid hormone supplements came from animal glandular tissue. At that time, the potency was determined by measuring its iodine content, because that was the best technology could do.

synthroidbottleIn 1955, Synthroid first came to the market. In an aggressive marketing campaign, it was promoted as new and modern and the desiccated thyroid was portrayed as old fashioned and inconsistent from batch to batch. Then there was a report in a major medical journal of one patient who was severely under-treated due to the inconsistency of the natural desiccated thyroid. This sealed the fate of NDT in some physician’s minds and showed the shining advantage of the money-maker Synthroid.

All thyroid hormone medication manufacturers must follow the guidelines of the United States Pharmacopeia (USP), a highly respected authority which sets the standards. With the advent of new technologies in the mid-1980’s, natural desiccated thyroid manufacturers could now measure the actual amounts of T3 and T4 in their pills. So now there is absolutely no difference in standardization between synthetic and natural forms of thyroid, as long as the manufacturers are adhering to the standards.

In fact, the USP standard allows a 10% variation in T4 and 10% variation in T3 in the manufacture of thyroid medications. This can account for some of the brand variations. And look at the history of recalls on medications due to mistakes: synthroid has had several and so has Armour.

NatureThroidsRLC labs stands out from all the other manufacturers in that their in-house policy is to only allow less than or equal to 2% variation in the T3 and T4. RLC labs tablet natural desiccated thyroid into

  • NatureThroid
  • WesThroid
  • WP Thyroid

And they have had no recalls.

Natural Desiccated Thyroid and Autoimmune Thyroid

It is thought in some circles that Natural Desiccated Thyroid will aggravate patients with Hashimoto’s autoimmune thyroid condition. The thinking is that there is an immune attack on the enzyme thyroperoxidase and the protein thyroglobulin when it is released from the NDT, perpetuating the autoimmune attack.

Wow, this could be huge and sounds viable in theory. I have had a few patients who did not respond well to NDT, but I was not able to determine if it aggravated an autoimmune attack or if there was some filler ingredient they did not tolerate.

A literature review has not shown any evidence of the theory, though. In fact, one citation showed NDT was actually beneficial because it induced tolerance, calming the immune attack, instead of aggravating the condition.

What distinguishes NDT medications – The Issue of Fillers

Why can’t medication manufacturers just put the thyroid in a pill and leave it at that?
Why are there fillers?

grainofsaltThyroid hormone is so very potent that the body only makes about 94-110 micrograms T4 and 10-22 micrograms T3 daily.

To appreciate how little this is, a milligram is less than a grain of salt, so 100 micrograms of T4 is one-tenth of that and 10 micrograms of T3 is one-onehundredth of that!

So if a thyroid medication has 38 micrograms of T4, you can appreciate how tiny an amount that is. That is why there are fillers.

Now, at first the manufacturers used cornstarch and other problematic fillers. Some people still have undesirable reactions to the fillers.  Current commonly used one include:

  • Microcrystalline Cellulose
    • synthetically derived fiber base
    • utilized to provide volume and bulk
  • Dicalcium Phosphate
    • derived from a mined ore
    • utilized as a binder to hold all the ingredients together during tableting
  • Colloidal Silicon Dioxide
    • derived from a mined ore
    • utilized as a natural desiccant to ward off moisture and humidity
  • Sodium Starch Glycolate
    • Synthetically derived starch molecule
    • utilized for proper disintegration of the tablet in the stomach
  • Magnesium Stearate
    • Derived from a vegetable source
    • utilized as a lubricating agent so the tablet doesn’t stick to the molds
  • Hydroxypropyl Methylcellulose
    • Derived from a plant cellulose base
    • utilized to provide bulk and density to the tablet for proper compression
    • also part of a clear coating solution
  • Polysorbate 80
    • an inactive water soluable emulsifying agent
    • blends the ingredients to prevents separating
  • Stearic Acid
    • Derived from a vegetable source
    • utilized as a binder to hold all the ingredients together during compression
  • Carnauba Wax
    • Derived from the pores of the leaves of the Brazilian wax palm tree
    • utilized to provide a complete seal in the final stage in tablet coating
  • Polyethylene Glycol (PEG)
    • Synthetically derived, water-soluble, waxy solid.
    • utilized with Hydroxypropyl Methylcellulose as part of the clear coating solution.
  • Lactose Monohydrate
    • Present in traceable amount as part of Thyroid USP
    • diluent for the NDT powder

Is there an alternative?

wpthyroidYes. Now, RLC labs is producing a “Pure” form of its WesThroid called WP Thyroid (formerly called Westhroid-P)which only has two natural inactive ingredients:

  1. inulin from chicory root (a natural fiber)
  2. medium chain triglycerides from coconut (easily absorbable fats)

It is interesting to note that the formulations of the WesThroid and NaturThroid have been identical for years. They continue to make both because of name recognition.

It turned out that they were more easily able to gain an alteration of the WesThroid so that is this new product. Effective August 2013, RLC labs changed the name of the product form Westhroid-P to WP thyroid to minimize confusion between the existing Westhroid and Westhroid-P.

I have it available in my office. Ask if you would like to try it instead of NatureThroid.


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Comments

Natural Thyroid Medications — 17 Comments

  1. Thank you, Cheryl, for your very informative article on the various thyroid medications out there. You answered many questions that I’ve had! ~Dr. Marta Adelsman, Life Coach in Communication and Consciousness

  2. Sounds like a great product. We check to see if it will be good for me. Thank you for keeping us informed as to what is available to us.

  3. Excellent article and I am so happy to learn about this new alternative! I have been on Nature-Throid for a few years now and was told, in November, by my doctor (who moved away 2 months ago) that I needed to go gluten free. The reason for this was she felt the gluten was causing my body to attack my thyroid. I have not been that happy with Nature-throid results (still have symptoms) even after an increased dosage. I had been giving thought to trying Armour Thyroid. I would love to try the Westhroid-P and see if it makes a difference. How do we proceed with this? I am in between D.O.’s right now and won’t see new one until June. I am in Indianapolis, IN. Thanks so much! PG&L, Carol

  4. thanks so much Doctor for this very informative article I am on Dessicated thyroid compound filled with sodium bicarbonate and need to take it 3 times in 24 hours doing fine I am hypothyroid with just my left thyroid the right one removed due to a large nodule I was wndering if I can switch to West Thyroid P (nocellulose fillers) and just take the medication once daily thank again
    M Bacchin

    • Hi Maria,
      Thank you for your attention to your health and inquiring about the thyroid medications. Any natural dessicated thyroid medication should achieve a steady state in your blood after a few days, and the blood test marker TSH stabilized in three months of constent dosing. Thyroid medications need to be taken on an empty stomach, and wait at least 30 minutes to eat in order to absorb the most from your pill. Westhroid-P is indicated to be dosed once a day, taken at a consistent time. It will provide a steady state in the blood and your tissues, so once a day is all that is needed.
      In health,
      Dr. Cheryl

  5. First I would like to THANK YOU so very much for such a wonderful thorough article on the medications for hypo-thyroid issues. I have searched for years looking for such info. Not sure why the “bots” found this article now but glad they did.

    I am currently on Armour and have been for several years (since 2008) and have always had issues with inconsistency and heart racing to mention two. I am going to try the Westhroid-P or the Naturthroid. My question I have read that there are compounding pharmacies that produce the medicine locally and are much better at keeping the formulas consistent. Is this ture in your experience and if so what are the names of ones you would recommend?

    • Hi Antoinette,
      I am glad the bots found this article for you, too!
      If you remember what I wrote about the actual amounts of T3 and T4 in these medications, you know they are very tiny, less than a grain of salt. Can you imagine working with such tiny amounts? I would prefer to leave the quality control of the measurements of these to RLC labs, since they only allow a 2% variation in amounts and test every batch.
      Compounding pharmacies are great, they do patients a great service. My mentor Dr. Alan Christianson and the author of the book I mentioned in the beginning, cited an incident where a patient was put in a life-threatening thyroid storm from taking too much thyroid medication due to a mistake by the compounding pharmacy. Once it is in your system, there is nothing you can do to get it out, only manage the symptoms of racing heart, and so on. Mistakes do happen, thankfully not very often. I would prefer not to risk it since there is such a great product from RLC labs.
      Wishing you health on your journey,
      Dr. Cheryl

  6. Dr. Cheryl, I would just like to confirm with you that the only “Lactose” free NDT is Armour, Is that correct? I have allergies of gluten, dairy, soy most often found in medications.

  7. I was so excited to read about WP Thyroid as I am concerned with the fillers that are being put into so many medications. I am currently taking Armour 15 MG & 30 MG each day because I need 45 MG of medication and there is not one pill available in that dosage. I, too, am gluten intolerant. Where can I find WP Thyroid? Do I need to go through my doctor or online pharmacy? Can you explain the MG dosage of this brand? I look forward to your reply. I will print your article & take it to my next doctor appt. Thank you so much! Lynn

    • Hi Lynn,
      Thank you for your interest in WP Thyroid for treating hypothyroidism. It was developed exactly for those wary of fillers in medications.
      WP Thyroid is a prescription medication, and must be prescribed by a licensed health care professional with the ability to prescribe medications.
      It is supplied in many dosages, in quarter grain increments. It looks like you are describing the Armour quarter-grain and half-grain tablets. WP Thyroid does make a three-quarter grain tablet.
      The manufacturer, RLC Labs does help patients find a prescribing physician in your area. Call them at 877-797-7997, but realize they might not have a complete list. Also check for licensed Naturopathic Physicians, because it is in our scope of practice in most states.
      In health,
      Dr. Cheryl

  8. Want to go more natural in low thyroid synthroid 100mcg. Please give me a list of doctors in the 91752 zip code.

    • Hi Jane,
      RLC Labs, the makers of Naturethroid, Westhroid, and WP Thyroid keep a list of doctors who recommend their products, and they can help you out. Please call them MST business hours at 877-797-7997.
      In health,
      Dr. Cheryl

    • Hi Sandy,
      The makers of WP Thyroid, RLC labs, maintains a referral list for doctors friendly to their products.
      Please call RLC labs at 877-797-7997 for a referral for your area.
      In health,
      Dr. Cheryl

  9. Hi Cheryl:

    I took WP thyroid, RLC Labs, thinking it was totally pure. (This was well before I spotted your website). However, I’m quite allergic to pollen and ragweed. I have much later (after many welts), learned chicory isn’t recommended for use with pollen and ragweed allergy sufferers. I discovered this fact on Web MD, when doing my own research. RLC Labs unfortunately, doesn’t mention this anywhere in their literature.

    I called RLC Labs yesterday and reported this. I spoke to customer service who was shocked to hear my story. I asked to speak to a manager and she wasn’t sure who to funnel my call to so I am awaiting their return call. WP uses inulin from chicory as a filler.

    My body reacted severely to any insect bites with WP in my system. Inulin is also found in Chobani yogurts, certain fiber bars, certain cereals (Kashi), certain ice creams, and other foods. Thankfully, I don’t and won’t eat any of those. I will be reading labels even more carefully than ever going forward.

    Both my NP and local pharmacist were alarmed by this news but concurred with my finding. They ALL encouraged me to contact the manufacturer and said they would tell allergy sufferers they see not to use WP thyroid.

    I’m now going to be changing to Nature-Throid which has no chicory filler, but it does have more fillers. I do hope it works out well.

    The bug bite welts swelled up so much that they looked like huge spider bites. They have been horrifying! This went on for over a year. It started soon after I started taking WP thyroid, Neither of us saw any correlation. My NP was stumped just telling me to stay away from bugs. I used so much nasty insect repellent last year. I thought you and your readers may be interested in this discovery I finally made by connecting the dots. You can be sure that I am…..

    Wellwishes,

    Lisa

    • Hi Lisa,
      Thank you for sharing your story. It certainly is highly unusual, from my experience.
      I am sorry you suffered those intense allergic reactions. It shows how hyper-reactive the immune system can become.
      That leads me to wonder about your adrenal hormone status, since that has to do with allergy and inflammation.
      All thyroid medication inserts warn against taking thyroid with severe adrenal problems, as it can make them worse. I cannot comment in your case, but I see lots of people who present with thyroid symptoms that need adrenal treatment as well. None of my patients had severe adrenal problems, but when the adrenal hormones were optimized by natural means, everything got better.
      You might look into compounded natural desiccated thyroid medications, as most compounding pharmacies can put the NDT into whatever medium you like. I talked to Wally Simmons from Women’s International Pharmacy and he said they mostly use olive oil as the filler so it is easily absorbed and hypoallergenic.
      Thank you for sharing your experience, as it may help others sort out any adverse reactions from inulin from chicory.
      In health,
      Dr. Cheryl

  10. Thank you for your kind reply, Dr. Cheryl!

    I do want to add that I used to get my NDT prepared through a compounding pharmacy. When I did, my body was quite happy. Where I live, they don’t use olive oil as a filler but they did use a filler that my body was willing to accept. I also don’t tolerate cornstarch well which was a typical filler this pharmacy used until I told them that I don’t do well with cornstarch either. The happy news is that I know that I can tolerate NDT.

    Unfortunately, my drug plan was switched after me taking that compounded preparation for several years. Under the new plan, it would only help me pay for a fraction of the $120 cost. This motivated me to switch to WP which my drug plan nicely helped me to pay for. Since I will likely be taking this medication for a number of years ahead (since I’m planning to living until AT LEAST 100 :^), I figured it was smart to try a cheaper NDT.

    Can you recommend the NDT called NP thyroid? My NP recommends that to her patients. I had opted not to take that originally when I switched as it too, has fillers, but not quite as many as Nature Throid. I also wanted to stick with RLC Labs as their products are highly recommended by Mary Shoman who is the thyroid guru online. In fact, I read that Mary takes Nature Throid. I will only go back to a compounded NDT if Nature Throid or NP thyroid doesn’t work out well for me.

    Also, a while back, I had my adrenals checked and I was told they were normal although as I recall, my cortisol level numbers looked somewhat low. I thought they looked a little low but my NP sounded like that was good and said nothing about them being abnormal as I believe they must have been in range.

    I truly doubt my adrenals have severe problems as my stress level is now low since I retired 5 years ago. Could past numbers indicate a current problem? I appreciate you reminding me of as it’s been quite some time since that level was checked.

    Is cortisol all I should have checked? And can a patient take adrenal supplements while also taking an NDT? I know they sell adrenal supplements at Whole Foods. I would like to add those to my drug regimen if that would help me in any way. If yes, is there a particular brand(s) you can recommend?

    Thank you in advance for all of your good information and answers, Dr.Cheryl. If I lived near AZ I would come and see you. However, I am on the east coast. I sincerely appreciate any info that you’re willing to share with me and your readers. Sorry for so many questions but you sound wonderful!

    Appreciatively,

    Lisa

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