Dangerous Metabolic Supplements

A few weeks ago a new patient arrived at my office to discuss treatment for her thyroid disease. She was diagnosed with an under active thyroid several years prior but treatment with Synthroid was unsuccessful. She stopped using the medication on her own, at least a year ago. Blood tests obtained by another doctor a month before her visit with me, were diagnostic of hypothyroidism (low thyroid levels with elevated TSH) . During our session she described typical symptoms of hypothyroidism including fatigue, feeling unusually cold, dryness of the skin, brittle nails and puffiness around the eyes. On exam her thyroid was enlarged and had a gritty texture typical of Hashimoto’s Thyroiditis. Her sister and mother also had thyroid disease, increasing the likelihood of the diagnosis of Hashimoto’s. Since her latest thyroid blood tests were only a few weeks old I felt comfortable beginning her on thyroid hormone replacement, in this case, Armour Thyroid, which I prefer due to its excellent clinical effectiveness.

My new patient was also on a number of supplements and vitamins including a non-prescription “metabolic complex” given to her recently by her chiropractor. By law in the U.S. supplements like these do not possess thyroid hormone and, in my experience, have no impact on thyroid hormone levels, either to increase or decrease them. As a precaution, we obtained a new set of thyroid hormone levels along with the test for Hashimoto’s Thyroiditis (anti-thyroid antibody panel).

Several days later, the patient called complaining she was “allergic” to the Armour Thyroid, developing jitteriness, anxiety, feeling flushed and a rapid heart rate. My first thought was she received the wrong dose of medication but a quick check of her records indicated this was not the issue. I called the lab and was surprised to learn the TSH at the time of her visit was already low, indicating excess thyroid levels or hyperthyroidism. What could have caused the sudden switch from hypo to hyper thyroidism? Rarely, patients with Hashimoto’s Thyroiditis can convert to hyperthyroidism, an event I call the Zombie Thyroid because the thyroid comes back from the dead. More likely was that one of her supplements contained actual thyroid hormone, so I asked the patient to get me the labels from these products. In the meantime, I instructed her to stop the Armour Thyroid and the supplements until I could figure out what was happening. Her allergic symptoms resolved in a few days.

Examination of the supplements’ labels indicated that one manufactured in New Zealand did in fact have thyroid extract in it. It had so much thyroid hormone in it that the patient was already becoming hyperthyroid at the time she first came to the office. Signs and symptoms of hyperthyroidism didn’t develop until she started taking Armour Thyroid along with the supplement. The mystery was solved but I am left feeling much less secure that my patients will not injure themselves with products obtained from outside the country either via the internet or from practitioners who provide it, perhaps unwittingly.

As I have in the past, I urge everyone to avoid medications and supplements produced outside the country which can contain active ingredients with potential health hazards. Always check with a physician before beginning a supplement which is obtained from the internet or mail order.

Gary Pepper, M.D.
Editor-in-Chief, metabolism.com

This information is for educational purposes only and is not intended as medical advice or treatment. Some details of this case have been altered to protect the patient’s identity.

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  • Sam Hain

    I was wondering if this supplement from New Zealand should not be fully discounted? Maybe more research shoudl be done into it. Maybe its an affective alternate remedy for hypothyroidism? What I’m saying is that (I’m not a thyroid patient so my knowledge on this subject is limited) I presume Armour is expensive and difficult to get the last time i checked and maybe this New Zealand supplement can help some people? Maybe it can be used properly.

  • I am 33 & have been smoking daily since i was 16. Over the years i gave up for 1 year only but started again (stupidly). Had a bit of a rough time through teens & when i was 23 had an ectopic pregnancy which resulted in losing the baby & 1 of my tubes. from there I found out I wouldn’t be able to have children naturally, smoking has put these things to the back of my mind which was great short term but long term i have ran away & never faced up to these things.

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    I guess it would be definitely important for a person to make sure that he or she consults a doctor before starting on a supplement or medication of sorts, no matter how harmless they may seem.

  • Ron

    if we may ask, what suppliment was she taking that she didn’t know had (thyroid) supplimented? Would like to see if the stuff was properly labeled?

  • Altmed

    Hi Dr. Pepper all,

    There are supplements labeled here in the US that also contain active thyroid, generally T3. The fact is, most of our meds are made outside the US & many are re-labeled by US companies or for US companies… others don’t say, and still others are accurately labeled & can be used safely IF you know what you are doing with them.

    I’ve not only had a “zombie thyroid”, but had a recurrence of Graves’ (hyperthyroid) twice, once after surgical removal, and again after 131I treatment at experimental (very high) levels.

    I’ve gotten Levothyroxine that both myself & my old endocrinologist questioned the dosage, as generics are too often made outside the US. I did better on Synthroid, but never felt quite right. I had been on Armour thyroid before the Synthroid, then returned to Armour thyroid after having an immune system that never quite worked right, especially after nasal Kenalog.

    While I prefer Armour thyroid, as it works far better for myself. I underwent extensive lab work by 2 separate labs for the year or so after use of nasal Kenalog. The results of the Kenalog can be disastrous for thyroid level stabilization, and are used as well in paste preparations used in endodontal & possibly other dental work.

    Corticosteroids can, and often do, make a mess of labs & the treatment of hypothyroidism & hyperthyroidism, so if your patients have had corticosteroids, it is critical you know if a patient has been on ANY of these drugs, or had ANY exposure to them within the last 3 years. These drugs can cause the “Zomie Thyroid” you mentioned, as well as later cause thyroid levels to dive very sharply, defying the medical literature as to how fast a patient’s levels can fall. Sadly, corticosteroids can cause levels to bounce for at least 1.5 to 2 years, and quite possibly longer, or create thyroid tumors and positive antibody tests (anti-thyroid, ANA, and even raise or lower lab CRP & Vitamin D levels..) Generally, ANAs will be intermittently positive, CRP levels will elevate while vitamin D levels will generally drop. Osteopenia & osteoporosis are common, as is osteoarthritis, sometimes even more than 3 years post-exposure, so as always, a very detailed history is necessary. Any use of corticosteroids can create a difficult to treat thyroid condition & other health problems. The use of these routinely in endodontal work, especially in root canals, can be difficult to document, as a patient my not be aware of the exposure. This alone could account for your, “Zombie thyroids”.

    All the best & I hope your article brings to light exposure of ALL medication from abroad, including those we are trained to trust.

    I know several people who have successfully used T3 preparations.