Recent shortages and discontinuations of certain desiccated thyroid medications have put patients in the position of quickly finding alternative medications. Some patients, who may have taken the same thyroid medication for years, suddenly found themselves needing to find a new brand. Since each thyroid brand may quantify their dosages differently, it is not always an easy 1 to 1 conversion.

Thyroid medication is typically taken for life so it is important for patients to have a consistent way to obtain their medication. A compounding pharmacy can be helpful for bridging any gaps in availability due to manufacturer shortages.

Desiccated Thyroid Brands

All desiccated thyroid brands that are commercially available use porcine thyroid as their active ingredient.  In all brand name desiccated thyroid extract medications, the active ingredient is Thyroid USP which means it must meet the same standard. It should also be noted that the process for making Thyroid USP involves lactose. This means there will be trace amounts of lactose in all formulations. However even in patients who are lactose intolerant the amount is very small and often has no effect.

Nature Throid and WP Thyroid: These desiccated thyroid formulations were manufactured by RLC Labs but are not currently in production. Nature Throid’s inactive ingredients include colloidal silicon dioxide, dicalcium phosphate, magnesium stearate, microcrystalline cellulose, croscarmellose sodium, stearic acid, and opadry II 85F19316 clear – tablet coating. WP Thyroid’s inactive ingredients include inulin and medium chain triglycerides.

Amour Thyroid: Manufactured by Allergan, Armour Thyroid has not experienced any shortages recently. Some patients have decided to switch to this brand after other brands issued recalls. Inactive ingredients include calcium stearate, dextrose, microcrystalline cellulose, sodium starch glycolate, and opadry white.

NP Thyroid: This thyroid medication is manufactured by Acella Pharmaceuticals. The inactive ingredients of NP Thyroid include calcium stearate, dextrose (agglomerated), and mineral oil. NP Thyroid experienced recalls recently but remains in production.

Conversion Chart

It is important to note that thyroid dosing is dependent on the individual’s unique needs. Adjustment is often necessary on a regular basis not just when switching brands. When converting to a new brand or type of thyroid medication, testing and monitoring of symptoms is always necessary to determine if adjustments are needed. The numbers above are based on the United States Pharmacopoeia – Drug Information, 20^th Edition.

Thyroid Hormones and Hypothyroidism

The thyroid gland produces levothyroxine (T4) and L-triiodothyronine (T3). Each individual produces a different level of hormones and requires an individually determined level of supplementation if they are hypothyroid.  The thyroid hormones T4 and T3 affect all physiological processes of the body. This includes metabolic rate, muscle control, brain development, heart function, and the maintenance of bones. Hypothyroidism refers to a condition where an individual does not produce enough thyroid hormone to keep their body functioning properly. The only way to treat this is to supplement the diminished hormones with a thyroid medication.

T3 is considered the active form of the hormone. About 20% of T3 is excreted directly from the thyroid gland while the rest is converted from T4 throughout the body. Treatment for hypothyroidism frequently involves the prescribing of a synthetic form of T4. Since T4 is converted to T3 in the body, the reasoning is that T3 supplementation is therefore not needed. Many patients do well taking T4-only therapy, however some respond better to a combination of T4 and T3 or to a desiccated thyroid product. Desiccated thyroid extract contains T4, T3, and various other thyroid co-factors naturally present in the thyroid glands.

Compounded Desiccated Thyroid

Compounded desiccated thyroid can be made to match the dosage of any brand that is currently unavailable due to shortages or recalls. Right now our pharmacy is compounding natural desiccated thyroid to match any dosage of Nature Throid or WP Thyroid. Our compounded product uses the same ingredient that was used in these brand formulations.