Tag Archives: Armour

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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What You can Learn from Sarah’s Struggle With Hypothyroidism


Every so often I like to bring attention to someone who has struggled to get properly treated for hypothyroidism. Not everyone shares the same dilemma regarding treatment of hypothyroidism because T4 by itself may be sufficient in many instances. But for those who continue to experience symptoms of hypothyroidism despite T4 treatment, adding T3 can be a life changing experience.

Here is Sarah’s story:

I was diagnosed with hypothyroidism in my early twenties and Synthroid did not help. I did not know at the time that many of my symptoms were due to hypothyroidism. After changing to my long time physician, I told her of my original diagnosis some years back. She did only the TSH and told me I was no longer hypothyroid! So for some 15 years after being in her care and continuing to feel crummy, then for the last 8 steadily gaining weight and feeling worse, I was not on any medication. I begged her for Cytomel several years back and was denied…she said she didn’t treat with that. When I finally was deemed hypo by her, she put me on the smallest dose of levothyroxine. It did not help. I finally went to see a shrink and he put me on 25 mcg of Cytomel. For the first time in my post pubescent life, I feel like living. My dose was upped to 50, and I felt even better but my thyroid levels were off, so we are now working on that and I am back to 25 mcg per day. If you can’t get Cytomel from your regular physician, you might get a psychiatrist to prescribe it. It changed my life and I finally feel alive. I’ve since switched primary physician because she wouldn’t listen to me, and she didn’t like that I was on Cytomel. I don’t know what it is about this medication that regular physicians don’t like and make them refuse to treat with it, especially when so many can benefit from it. I’ve lost only 12 lbs since being on it, but I gained nearly 35 unnecessarily while not being properly treated and was told to eat less and exercise more…I only ate about 1500 calories a day and walked my dog 2 miles each day, so I don’t feel it had anything to do with my diet!

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Smoking, Weight Gain and Hypothyroidism; Maya Shares Her Story


Maya Sarkisyan, a consultant with metabolism.com, shares her life experiences with smoking, gaining weight and hypothyroidism. If you want to ask Maya questions about her methods please do not hesitate to make use of our forum page. Once on the forum look for the “Latest Discussions” column and then click on Topic “Add New”. Then you are ready to post questions or your own opinions and comments.

Here is what Maya writes about her own life:

I replied some time ago to this thread and would like to add something. Everybody here posted a personal story of dealing with weight gain after quitting smoking. I went through that too. I smoked since I was 15, quit to have a child, picked up just that one cigarette a year after…, and than quit again 7 years ago for good. I did start gaining weight and was diagnosed with hypothyroid condition right prior to quitting. However what was effective for me is to modify almost all my life habits, not only eating and exercising. I did go to gym every day (and worked out hard) , ate small portions, meditated, made peace with few people in my life, looked at the bright side of things, etc. I even got certified as a fitness trainer! By no means it was easy but it was worthwhile doing. I wrote down all my life patterns and changed them all – even good ones modified slightly. I did it to reset my system completely. All the women in my family are very overweight and I’m not – only due to the discipline and frame of mind I choose to keep.
I started helping people to quit smoking with customized individual hypnosis sessions, because it is the best thing you can do – quit smoking forever. All it takes is a firm decision and sometimes some help.
I know that you can do anything when you make a decision to do it. Real firm once-and-for-all decision. I came to Dr. Pepper four years ago as a mess on Synthroid, and now with Armour, Selenium, meditation, and holistic medicine even my antibodies levels are going down. I decided to get healthier and did everything it took that is healthy for me. We all are not getting younger so I choose to take care of my body and eliminate unhealthy habits on daily basis, and help my patients do the same.
Good luck to you all, congratulations on quitting, and I wish you health.

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Pharma Expert Examines FDA Moves on Restricting Armour


Hank Frier has been involved with the pharma industry for a long time and helps us see through the news blackout in regards to the FDA actions on Armour. He is also suffering the same fate as many others in the U.S., having been successfully treated with Armour for many years, now forced to switch to other alternatives.

Hank writes:

I too have been switched back to Synthroid after several successful years of being on Armour. At this juncture it is too early to tell how this will impact me. Luckily, my physician had the foresight to also put me on Cytomel after I suggested this from my readings. The combination of Armour and Cytomel seemed to work quite well for me without any adverse events.

This next is my opinion so take it as such. I believe the makers of Synthroid (Abbott Ross) in an attempt to increase their sales of Synthroid put pressure on the FDA to require the makers of Armour to submit an NDA. It is a devastatingly poor tactic by Abbott Ross but typical of this industry.

It is unfortunate that the FDA is caught in the middle of this since by statute and law drugs must pass regulatory muster. Where the FDA has failed is in their lack of looking at the long past history of Armour, its lack of adverse events and its benefit/risk for those individuals that have been using this drug. As opposed to demanding an NDA from Forest Pharma they should have sat with them and reviewed the long history of this drug, the number of scripts written for this drug and even contacting those physicians/endocrinologists that have been prescribing it for their patients.

The only safety question in my mind is does Armour ingestion, a foreign protein, cause an immune response. This would have been reported by the medical profession if that were the case. Secondly, historically, large segments of the population have been eating pig and pig organ meats for generations without ill affects. The ingestion of a purified material from pig (Armour thyroid a protein) is probably benign. The FDA scientists should know this and counsel their legal staff as to the benign nature of the drug.

Hank

I too have been switched back to Synthroid after several successful years of being on Armour. At this juncture it is too early to tell how this will impact me. Luckily, my physician had the foresight to also put me on Cytomel after I suggested this from my readings. The combination of Armour and Cytomel seemed to work quite well for me without any adverse events.

This next is my opinion so take it as such. I believe the makers of Synthroid (Abbott Ross) in an attempt to increase their sales of Synthroid put pressure on the FDA to require the makers of Armour to submit an NDA. It is a devastatingly poor tactic by Abbott Ross but typical of this industry.

It is unfortunate that the FDA is caught in the middle of this since by statute and law drugs must pass regulatory muster. Where the FDA has failed is in their lack of looking at the long past history of Armour, its lack of adverse events and its benefit/risk for those individuals that have been using this drug. As opposed to demanding an NDA from Forest Pharma they should have sat with them and reviewed the long history of this drug, the number of scripts written for this drug and even contacting those physicians/endocrinologists that have been prescribing it for their patients.

The only safety question in my mind is does Armour ingestion, a foreign protein, cause an immune response. This would have been reported by the medical profession if that were the case. Secondly, historically, large segments of the population have been eating pig and pig organ meats for generations without ill affects. The ingestion of a purified material from pig (Armour thyroid a protein) is probably benign. The FDA scientists should know this and counsel their legal staff as to the benign nature of the drug.

Hank
hfrier@comcast.net
Hank Frier
1

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Dangerous Alternatives for Desiccated (Armour) Thyroid


Yesterday a patient of mine asked if I was aware of a source of desiccated thyroid produced in Thailand. I was immediately skeptical for a few reasons. Many countries do not have an agency that provides quality control for medications. Whatever the drawbacks to the FDA, it is reassuring to know that for the most part, they have been able to protect citizens in the US from dangerous or defective medications. Many other countries provide similar protection to their population. Unfortunately there are places in the world where potentially dangerous medication is still available without a prescription. Quality control of medication production is also lacking.

My concern is that in some parts of the world, possibly Thailand for example, that a medication like Armour could be made but no qualified individual or agency is available to certify its ingredients or standardization.

Today a well meaning member forwarded their comments on a product called Thyroid S produced in Thailand, which is a supposed substitute for Armour thyroid and is available without a prescription. My reaction is that until we can be certain of the formulation of a medication that the best thing to do is to avoid using it. Perhaps in time someone will be able to provide the necessary information required to evaluate this product but as editor-in-chief of this website I will try to guard our readers against becoming victims of scams and exploitation.

I welcome any information others may have on solid information about Thyroid S or similar compounds being marketed as Armour Thyroid substitutes.

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Dennis Wonders if Armour Thyroid Can Create Thyroid Hormone Dependency.


Dennis wonders if Armour thyroid hormone treatment can create a dependency on the medication. In his post (http://www.metabolism.com/2009/08/25/armour-thyroid-shortage-nation-wide-problem/#comment-2177) he suggests that this might explain why people experience such discomfort when trying to switch medication or go off. Thanks Dennis for your thoughts, as I imagine others share your concern.

Below I offer my response to this theory.

Dennis

I wouldn’t worry about a dependency problem from using Armour or other thyroid replacement drugs for two reasons: 1) Dependency implies that it is the medication which creates a need for itself. This occurs because over time the drug causes changes in the body to create an on-going need for more of the med. A narcotic, for example, will cause painful withdrawal symptoms if stopped suddenly after continuous use for weeks/months. More narcotic will relieve the withdrawal process almost immediately. This is very different than when a person takes thyroid hormone such as Armour to treat hypothyroidism. People use thyroid hormone replacement because the body is not making sufficient thyroid hormone in the first place. The medicine doesn’t cause the thyroid to stop making hormone, but it is a disease like Hashimoto’s that causes the thyroid to stop working.
2) It is true that the endocrine glands can become atrophied by administering the hormone that the gland makes for an extended period of time. This is most often seen by taking adrenal hormones like Prednisone, Cortef, Hydrocortisone, Dexamethasone etc. These drugs are very powerful adrenal suppressants used to treat asthma, and autoimmune diseases such as lupus or rheumatoid arthritis. If someone takes these drugs long enough and then stops suddenly a life threatening condition known as adrenal crisis can develop because the adrenal gland has atrophied. It can take up to a year of carefully withdrawing adrenal hormones before the gland is strong enough to function normally again on its own. The thyroid is much more resilient than the adrenal gland however. If someone with a normal thyroid gland takes thyroid medication for a year or two then stops the drug, the thyroid will be functioning normally again usually within weeks if not sooner. There is no severe withdrawal like that seen with the adrenal.

I hope this info eases your concerns about developing dependency on Armour thyroid or other thyroid hormones used to treat hypothyroidism.

My comments are for educational purposes only and do not replace the advice of your own physician.

Gary Pepper, M.D.

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Brenda Compares Her Experience with Compounding Pharmacy vs. Canadian Pharmacy


At present, two popular sources of dessicated thyroid products are compounding pharmacies and Canadian pharmacies. Brenda has experience with both and compares them for metabolism.com.

Brenda responds with the following in response to another members comments:

I suspect your doctor is mis-informed. Before I ordered and received my 30 mg Erfa natural dessicated thyroid medicine from Canadadrugs.com, I had the thyroid medicine compounded by my local compounding pharmacy. I still have some. The problem with that approach is it is ridiculously expensive ($39 for 30 doses of 1/4 grain/15 mg equivalent per month) and not covered by insurance. Of course it is an opportunity for the compounding pharmacies, and according to what I’ve read online, some greedy compounding pharmacies are charging much more–over $100 per month for the same thing. So far the FDA has made no noise about getting rid of compounding pharmacies. They serve a special need — and they are a little pocket of individually made medicines that are not dictated to by the FDA. On a parallel issue, they make bioidentical hormones, which Big Pharma is not happy about either, but the FDA doesn’t say you can’t make them, just that you have to be careful about claims made about them.

The great thing about the Canadian solution is that is it even cheaper than Armour used to be here, and they are regulated by the Canadian equivalent of the FDA. The maker of the Canadian “Thyroid” is Erfa, a Belgium company, is their niche is finding drugs that are being discontinued by other companies that they believe can be profitable and they have been making drugs since the 30’s, so I don’t think they are going to discontinue making it. I’m sure their plan is to make more! This is the jackpot for them! (If you want to know more about Erfa, and the Canadian version of Armour, go here: http://www.erfa-sa.com/thyroid_en.htm . They bought the brand from Pfizer Canada Inc in 2005 and have been making it since then. They are a Belgium company with a Canadian and international presence who buys and markets niche products from other drug companies that would be discontinued.)

Natural dessicated thyroid medicine is used around the world, so I don’t think it is going away. It is the madness of the FDA in cahoots with the Big Pharma at work in the US that is causing the problem with availability. I believe RLC, the maker of NatureThyroid (another brand of the same thing) here in the US has vowed that they will continue making the drug, even if they have to go through the entire expensive approval process to get it approved by the FDA. Of course that will make it much more costly for us, to be sure, because they will have expended the money to go through that process and they will be the only game in town when the dust settles.

Fortunately, while all this is being sorted out, we have the Canadian option. And it works just fine, and oh yeah, it’s cheaper.

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Armour Crisis Creates New Alliances


Good things can develop during a crisis situation. For me it was the eye opening experience I had this week by participating in The Thyroid Patient Community Call. The Thyroid Patient Community Call is a group internet telephone call hosted by Janie Bowthorpe, author of Stop The Thyroid Madness. During the 90 minute session I was able to interact with dozens of callers as well as Janie herself. Needless to say, Janie’s audience is mostly individuals who are deeply committed to maintaining Armour Thyroid as a treatment option and who are equally angry with the field of Endocrinology which backs the ban on dessicated thyroid hormone. I knew this audience wanted answers to some very tough and troubling questions. For a few days before the call I needed to review for myself just how this crisis developed, and how I became a lightning rod for the growing controversies. I believe this process was necessary and therapeutic.

Being a strong advocate of t4 plus t3 therapy and of Armour Thyroid, I was in sync with most of the topics being discussed on the call. What was hard for me was hearing the out pouring of stories describing how endocrinologists had alienated (infuriated) so many thyroid patients. How to explain but not excuse the inflexibility, wrong headedness and arrogance of a whole field of medicine on a topic central to its mission, my own field for the past 25 years? My head still hurts thinking about it. For those wanting to hear how this played out can visit Talkshoe.com which hosts these shows and follow the instructions for listening to past episodes of Janie’s show. Perhaps Janie can give more specific instructions by posting them here.

I came away from Janie’s session with a firm recognition that the field of Endocrinology is in serious need of a make-over. Imagine a Democrat walking into a room full of staunch Republicans and asking everyone to join him in a sensitivity training program. It is a lonely job.

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Eric Pritchard Brings Historical Perspective to “T4 Only” Treatment Bias


Eric Pritchard brings great insight showing how, for years, the field of endocrinology failed to acknowledge growing evidence of the inadequacy of “t4 only” therapy for hypothyroidism. Eric puts together the historical clues that should have paved the way for acceptance of t4 plus t3 therapy . We are now seeing almost irrefutable evidence ** (http://www.metabolism.com/2009/10/03/breakthrough-discover-t3-genetic/) ** that t4 by itself cannot in all cases provide enough active thyroid hormone to treat hypothyroidism. This is occurring at precisely the same time the practical solution to t4 plus t3 replacement therapy (dessicated thyroid hormone) is being chased from the shelves of pharmacies around the world.

Thanks Eric, for bringing your knowledge and insight to this crucial debate.

Eric writes to metabolism.com :

It is quite amazing that after 50 years of abusing some patients with the T4-only therapy, that medical is beginning to recognized that some patients do, in fact, require T3. It is about time for the practice of medicine to catch up with medical science. In 1960 Dr. Marshall Goldberg published a paper entitled “The Case for Euthyroid Hypometabolism,” which recommends a T3 therapy. About that same time researchers like Refetoff were noticing a resistance to T4. Refetoff, et al., discovered the cause, peripheral cellular hormone resistance in 1967. Subsequently, Braverman, et al., discovered peripheral conversion in 1970 and determined that 80% of all T3 comes from peripheral conversion. However, not to be swayed from the old thyroid-gland-is-directly-connected-to-symptoms paradigm, endocrinology has declared peripheral conversion to be fault free (really amazing) and simply ignores the potential for increased hormone reception. To support this wacky notion, they produced questionable studies that proved their old paradigm. These studies showed that the active hormone, T3, was ineffective and the inactive hormone, T4, was effective in spite of knowledge of the relative activity discovered by Gross and Pitt-Rivers in 1952.

All of this reminds us of medicine’s rejection of the empirical antispetic discoveries by Drs. Semmelweis and Lister. Why it was not minute particles of the cadavers that were being disected prior to surgery and child birth, it was the bad humors in the air. The post surgical infections and deaths could not upset the bad humors paradigm. Only after concerned heads of surgury demanded washing up before operating, the invention of the microscope, and Pastuer’s discovery of bacteria, did the merchants of death and illness realize reality.

Endocrinology laughed and dismissed Dr. Goldberg a half century ago, just as medicine drove Semmelweis to his death.

There are physicians who believe that medicine is an art. I have come to that conclusion as well, but not for the same reasons. I believe that medicine is an art because medicine does not have the discipline to be a real science. Real sciences react to counterexamples. We have seen counterexamples to the thyroid gland only diagnostics and T4-only therapy prescriptions. However, endocrinology and thyroidology have dismissed these suffering souls with diagnostic excuses such as “nonspecific symptoms” and “functional somatoform disorder” to blame medicine or blame the patient for the patients continuing suffering. Both of these diagnoses could be avoided if the differential diagnostic procedures had been followed — including all possible causes for the patient’s symptoms, euthyroid hypometabolism, deficient peripheral conversion, deficient peripheral cellular hormone reception. But in a perversion of the logic underlying differential diagnostics, medicine claims that the thyroid gland is first the only possible cause of the symptoms and second, when it fails, the symptoms have many causes — which were not tested.

Medicine is an art because it does not have the discipline to use clear language. In spite of demands for clarity of definition dating back to the 18th Century and undoubtedly earlier, and demands for clarity in medical guideline authorship protocols, “hypothyroidism” may be restricted to only the thyroid gland or may embrace the entire greater thyroid system. In either case, the diagnostics and the therapy recommendations are only applicable to the thyroid gland. Those who suffer from extra thyroid deficiencies in the greater thyroid system are simply allowed to suffer in spite of the existence of proven therapies.

Medicine is an art and not a science because it ignores counterexamples. There are patients who require T3 without any T4 as they will become thyrotoxic on the T4, but require the T3 to overcome hormone reception resistance.

There are patients who have had unsuccessful therapies with all synthetics but live well on desiccated thyroid. The laughter at the use of desiccated thyroid is a reminder that medicine does not have courage to recognize counterexamples and does not have the will to deal with them. Thus, endocrinology is really an art pretending to be a science as ignores suffering patients — perhaps a million in the UK and another 5 million in the US.

One could only wish that those laughing fools develop a thyroid related malady that endocrinology chooses not to recognize and then suffer the slings and arrows of mass medical malpractice that has been in vogue for the last half century.

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Obama Not to Blame for Armour Shortage, Says New Member


Will S., a new member of metabolism.com, offers these sensible comments on who to blame for the sad state of FDA oversight of prescription drugs like Armour Thyroid.

Will argues:

Gatekeeper: Just a suggestion to do a little more research on this situation before blaming it on Obama. It was several years ago, at the end of the Clinton and beginning of the Bush administration, that the FDA began to investigate and reveal that Armour Thyroid had never been officially approved by the regulatory agency. Membership on the FDA consists partially of highly paid executives that came from pharmaceutical companies. It makes sense that they have an interest in making sure that only the big pharmaceutical companies have the money to get their drugs approved. Situations like this are why we need health care reform now. Yes, you certainly can and should bring this issue to the attention of the current administration, but please place blame where it is due, as finger pointing in the wrong direction is unhelpful to those who are suffering.

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