Dr. Jacob Teitelbaum's Column
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Monday, August 4th, 2008:
The Pharmacy Ran Out of Armour Thyroid. How can I get it?
by Jacob Teitelbaum MD
There is a mix of issues here. In the past, there have been cases where some pharmacists misinformed patients about Armour Thyroid (in part because of misinformation given by competing drug reps) to try to switch them to Synthroid. In these cases, I have recommended the patient switch pharmacies.
Fortunately, this problem with overt dishonesty does not seem the case lately. Recently there has been a temporary stop in production of higher strength Armour pills, till October 2008. Lower strengths are sometimes available, so one could take, for example, three 60 mg tabs instead of a 180 mg tab. These lower strengths are also becoming unavailable, as people use them to make up for the back ordered higher strengths. Your pharmacy can also use Westhroid or Nature-throid as substitutes, as these are acceptable equivalents. Nature-throid is less allergenic than Armour and may even be preferable. Unfortunately, most pharmacies do not carry these and do not know how to order them. Do NOT let the pharmacist substitute Synthroid or other thyroid hormones that do not also contain the active T3 hormone. An alternative is to combine Synthroid (T4) and Cytomel (T3) tablets to get the proper strength. Unfortunately, Cytomel only comes in 5 mcg and 25 mcg strengths, making this tricky.
A Simple Solution to the Problem
We have not had a problem, because we usually use a compounded T4/T3 combination in our Fibromyalgia and Fatigue Center patients to avoid the small risk of allergic reactions to other components in the Armour thyroid glandular. Each grain (one grain = 60 mg) of Armour is equivalent to a 38 mcg T4/9.5 mcg T3 mix, and they can be compounded in many strengths. There has been a significant problem with potency issues with T3 that has been compounded. Because of this, I recommend that the compounded thyroid be ordered from ITC Pharmacy (888-349-5453, sent by mail) as they go to great lengths to assure proper potency. I had the pleasure of reviewing this pharmacy's procedures for preparing T3 hormone at length, and am very impressed with their pharmacists (Allan and Gary) and procedures. They create ¼ grain, ½ grain, 1 grain, and each strength (by ½ grains) up to 5.5 grain. You can ask your physician to call in your prescription and the pharmacy can mail it to you.
For more information on this problem and solutions, click here to read an excellent article by Mary Shomon, one of my favorite thyroid experts (she also has an awesome free thyroid newsletter. Click here to sign up to receive it).
Used with permission from Dr Jacob Teitelbaum's free newsletters-available at www.Vitality101.com
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