I like the way you think. You have done your research and your facts are pretty good. What is important to remember however is that what you are quoting are the average amounts of the various hormones in humans which cannot be applied to individuals. (The ratios in Armour are standardized and are more or less constant). I like to use the analogy of shoe sizes. The average shoe size may be size 7 but that doesn’t mean everyone with a normal foot can fit in a size 7 shoe. My thyroid may produce a very different amount of thyroid hormone in different ratio’s then your thyroid but both of us are normal. Do you see the point? The situation becomes even more tricky when the thyroid is not working properly.
Finding the proper dosage for thyroid replacement is harder than just treating the averages. Also I disagree that everyone converts T4 to T3 at the same rate or with the same efficiency and there is recent research to explain that.

In my book Metabolism.com I devote a lot of time explaining my philosophy and approach to these issues. Have a look!http://www.metabolism.com/shop/metabolism-book

Thanks and I hope this helps.

Dr. P.

I have read several times that pigs produce less T4 and more T3 than humans do, so that patients taking Armour and other desiccated thyroid meds end up having low free T4 and high free T3 levels. I recall seeing the figures 5%T3-95%T4 in humans as opposed to 20%T3-80%T4 in pigs. It was also stated that T4 to T3 conversion is normal in hypothyroid patients.

So my question is: why aren’t all patients on NTH put on a combination of NTH and thyroxine, to duplicate what a healthy thyroid would be doing?

I read recently that a healthy thyroid gland contains about 200 mcg of T4 and 15 mcg of T3, but that that does not represent the amounts of thyroid hormone circulating in the blood as T4 is converted to T3. But would you say that those are the amounts of hormones produced by a healthy thyroid gland each day, and something one should aim for when on thyroid med replacement?`

This is a great forum! I have some questions that I hope you will be able to answer:

I was recently prescribed NTH and asked the pharmacy to give me both Armour and Erfa (I wanted to be able to compare the two). Luckily, the pharmacist agreed. So now I have been on NTH for three months and have discovered the following:

- I seem to need around 5 grains a day for optimal results and symptom relief (I used to be on 250 mcg of thyroxine)
- on 5 grains of Armour, I get more stable results than with Erfa. With Erfa, I feel slightly hyperthyroid at times, even though 5 grains of Erfa contains slightly less hormones than Armour (181 mcg of T4 and 40 mcg of T3 as compared to 192 mcg of T4 and 45 mcg of T3 in 5 grains of Armour). How is that possible?

- many reputable sites, like Stop the thyroid madness and Mary Shomon’s thyroid.about.com claim that Armour was reformulated in outmost secrecy and that neither patients nor doctors or pharmacists knew anything about it. They go on to claim that it was discovered only because many patients became hypothyroid again and went back to the pharmacy to check if they had indeed been given the right drug. They even say that Forest has refused to communicate with patients. But according to what you write in a post above, “When a drug is reformulated the FDA is involved which is included in the public record. When the reformulated drug is released to the medical community that information must be updated to all prescribing medical professionals.”, it would not be possible or even legal to reformulate a drug without informing anyone. So what is true???

Mike