*Update 4/22/21: Nature-Throid is not currently available. Please see this post for more updated information*
Is Nature-throid the missing link to helping you FINALLY feel better?
The short answer: Maybe...
Like most things in life, the answer is never straightforward!
And that's why I've created this guide.
I will show you which patients do best on Nature-throid when you should consider switching to NDT and what to do if Nature-throid isn't enough for your body.
But first, we need to dive into some basics...
What Is Nature-throid?
Nature-throid is a medication used to treat Hypothyroidism.
This particular medication is unique among thyroid medications in that it is created from desiccated (or dried up) animal/porcine thyroid glands.
It also contains other hormones including minor amounts of Calcitonin, T1, T2 and even Iodine.
All of these ingredients are normally found in thyroid gland tissue (even human thyroid gland) so it makes sense that they would all be in there.
In fact, it is widely believed that these extra ingredients found in thyroid extract may be why so many patients prefer this medication (1).
Nature-throid falls into the class of thyroid medications known as Thyroid extract or Natural Desiccated Thyroid (NDT for short) along with other medications which we will discuss in this guide.
One of the reasons you may have found this article is because you're currently being treated with Levothyroxine and you have heard that Nature-throid or Armour thyroid might be a better option for you.
And that may be true for many people...
But we need to discuss why:
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Is Nature-throid Better than Levothyroxine?
Many people actually do better on Natural Desiccated Thyroid hormone instead of T4 containing medications.
Not only is that popular opinion on the internet, forums and blog sites - it's also been confirmed in clinical studies (2):
These various studies show that many patients actually prefer to be treated with NDT over T4 only thyroid medications.
Some of this preference may have to do with the fact that patients who switched from LT4 medications to NDT experienced greater weight loss.
The authors of this study did not conclude that the patients experienced an improved quality of life, but if you lost weight without exercising or changing your diet, wouldn't you be pretty happy about that?
So why is that? Why do patients prefer these medications?
A big part probably has to do with the composition of thyroid hormone found in these desiccated thyroid extracts.
Nature-throid contains a combination of T4 and T3 thyroid hormone but more than that it contains it in a ratio of about 23% T3 to 76% T4 and this ratio is fairly close to the 20% T3 and 80% T4 that your thyroid gland produces naturally.
If you recall from basic thyroid physiology, T3 is the active thyroid hormone and T4 is the inactive thyroid hormone.
By providing your body with both sets of hormones you are re-creating normal thyroid physiology (or at least close to it).
This can be compared to treatment with T4 only thyroid medications which must be metabolized into the active thyroid hormone before they are usable by the body.
So why don't Doctors use these medications more frequently?
Most Doctors believe that providing T3 to the body is unnecessary as the body will take T4 and convert it into T4 at a constant rate regardless of the individual or genetic make-up of the patient.
The hesitation to use Nature-throid and other thyroid extract medication stem from a fundamental disagreement in thyroid management philosophy and the current treatment paradigm.
Patients Who should Consider Switching to Nature-throid
If you are one of the many patients who isn't feeling well on T4 only medication you're probably wondering right now if Nature-throid will help you feel better...
And for many patients, the answer is yes (though not everyone!).
Certain patients tend to better than others but the general theme is that if you are taking LT4 and not noticing a difference you may benefit from the switch.
In my experience patients who fall into these categories tend to do well on Nature-throid or other forms of Natural Desiccated Thyroid:
- Patients who have not felt better on T4 only medications like Synthroid, Levothyroxine or Tirosint (4)
- Patients with known or suspected DIO2 genetic defects (5)
- Patients with mild weight problems (6) or who are weight loss resistant
- Patients who have undergone thyroidectomy or RAI (7)
- Patients with low free T3 and low free T4 levels but with a relatively normal TSH (8)
If you fall into one or more of the categories above then there is a good chance that Nature-throid may be right for you.
Switching From Levothyroxine to Nature-throid
If you're on Levothyroxine and would like to try switching to Nature-throid there are a few really important things you need to know.
The dosing, side effects experienced and the lab tests all differ dramatically when you switch from LT4 medication to thyroid extract.
If you (or your Doctor) aren't familiar with these differences then you may falsely believe that something is wrong or that this medication isn't working for you when the opposite is true.
By making sure you follow the steps below it will ensure that you've given Nature-throid a fair chance at working for you.
1. Titrate Slowly
When switching from T4 only medication to NDT it is VERY important that you start out slow with your dosing.
T3 containing medications can be very stimulating to patients who have never been on them before.
Which means it's best to start with less medication compared to the equivalent T4 dosing, at least in the beginning.
During this transition, and as you drop your dose, you may feel slightly worse until the dose gets ramped up and as your body acclimates to the new medication.
This process of titration may last for several months.
If you find that switching medication is too stimulating for you it may be best to split your dose.
You can split your total dose into 2 or 3 smaller doses (while keeping the total dose the same) taken throughout the day.
A sample dosing schedule may look like this:
- Take half of your dose first thing in the morning
- Take the other half of your dose in the afternoon or evening
- You can even split it up even further into 6 or 8-hour intervals if necessary
This helps reduce swings in T3 concentration in your bloodstream and, therefore, in your tissues.
Symptoms of too much T3 in your body include:
- Increased anxiety or agitation
- Heart palpitations or rapid heartbeat
- Heat intolerance or hot flashes
- Uneasy feeling or overall feeling worse
- Increased fatigue
- Dizziness or the sensation of being light headed
If you have any of these symptoms it doesn't necessarily mean Nature-throid is NOT for you, instead, it might mean you titrated too quickly.
Starting doses may be as low as 16.25mg to 32.5mg taken at morning and/or in the afternoon.
If you experience the symptoms above they may resolve over time, or they may not - if they persist beyond 2-4 weeks, it's likely that they will stay.
If this happens you may need to switch to T4 + T3 combination medication or back to LT4 medication.
2. Get Your Dose Right
Dosing is also very important when switching medications.
Any time you add T3 containing medications the TSH will always drop very quickly (9).
Because of this many Doctors will unintentionally under-dose thyroid patients when switching from LT4 to NDT or Nature-throid and then use that as an excuse that the medication doesn't work.
Of course, your TSH will rise when switching medications if you are under-dosed or if your new dosing is not equivalent to your old dose.
The only way to determine if your medication is sufficient is to follow TSH, Free T3, and Free T4 both before and after the transition.
If these values do not align afterward then you know your dosing is insufficient.
When switching medications it's important to start low and titrate slow.
That means a starting dose of 16.25-32.5mg with an increase every 10-14 days unless you experience symptoms of excess T3 (stated above).
Instead of basing dosing off of the TSH, dosing with T3 medications should be based on a combination of the following: lab tests (free t3/reverse t3/sex hormone binding globulin), subjective symptoms, body temperature, metabolism, and heart rate.
This approach creates space for differences among individuals including genetic differences, the presence of medical conditions and other factors which may alter dosing at the individual level.
Newer studies have shown that in order to achieve normal free thyroid hormone levels, it is necessary, and safe, to lower the TSH to non-suppressive ranges (10).
Using this standard, the traditional dosing recommendations based on TSH may result in under treatment for many patients.
3. Monitor your Symptoms
Whenever you switch to T3 containing medications I recommend that you follow both your resting heart rate and basal body temperature.
Both of these will increase when taking T3 containing medications (direct effect from thyroid hormone) and tracking them will help prevent accidentally overdosing.
In addition, make sure to track your symptoms of Hypothyroidism.
The rise in body temperature and heart rate usually indicate an increase in metabolism as your body produces more energy and more heat.
The rise in body temperature stems from an increase in energy production from improved mitochondrial function.
This is from the direct effect of T3 on your mitochondria (11).
Will Nature-throid Help you Lose Weight?
Many people want to know if Nature-throid will be the magical medication to help them lose weight.
The answer to that is almost always no.
While it is true that Hypothyroidism can damage your metabolism and lead to weight gain, at most this usually leads to an excess of 10-20 pounds of extra weight.
If you have gained more than that amount of weight it is almost always due to another hormone imbalance.
To explain this effect further I've elaborated on the combination of hormone imbalances that occur in hypothyroid states which contribute to thyroid weight gain.
Having said that, some patients will experience some weight loss after switching medication.
Patients more likely to experience this weight loss usually are those who don't have problems with T4 to T3 conversion or who have relatively low reverse T3 levels.
Generally, the higher your reverse T3 levels and the more metabolic damage you have (from calorie restricted dieting), the less likely Nature-throid will help you lose weight.
That doesn't mean it won't help you feel better - because even if it doesn't help with weight loss it still is more likely to help reduce your symptoms when compared to levothyroxine or Synthroid.
But the weight loss you are most likely looking for may not occur unless you also address other factors such as hormone imbalances, damage to your metabolism, your diet and so on.
How to Get Nature-throid
While many patients stand to benefit considerably from switching to Nature-throid (or other forms of NDT), unfortunately, it can be difficult to obtain, especially from conventional physicians.
Most Endocrinologists and Primary care providers are not comfortable prescribing Natural Desiccated thyroid or any medication which contains LT3.
A portion of this hesitation stems from the fact that NDT contains the active T3 thyroid hormone.
In addition, they also erroneously think that NDT results in unstable thyroid levels and concentrations throughout the day and that the exact dosages of T4 and T3 in each grain of NDT are not standardized.
The current standard of care and treatment paradigm within the insurance model is to treat hypothyroidism with T4 only thyroid medication and base dosing off of the TSH.
Unfortunately, this treatment usually results in persistent symptoms of hypothyroidism, consistent weight gain among hypothyroid patients, and overall a reduction in quality of life.
The takeaway here is that you may need to spend some time and energy searching for an open-minded physician who is willing to work with you.
Finding this kind of physician to help you may be difficult but is certainly worth the wait.
In my opinion, you can't put a price of finally feeling healthy and getting your life back and the single most effective thing you can do is find someone to help guide you along the way.
Managing your thyroid is very complex and involves multiple hormone systems, so figuring this out on your own may be possible but will take a considerable amount of time.
Consider these resources to help find someone who may be able to help you further:
Note: Try to find providers which can prescribe medications including thyroid hormone replacement as these form the corner-stone of thyroid management.
How much does Nature-throid Cost?
Compared to other forms of Natural Desiccated thyroid, Nature-throid is reasonably priced as you can see from the chart below:
If your insurance will not cover Nature-throid you can use Goodrx.com to find the cheapest cash price near you.
Goodrx.com will provide you with a coupon you can use to take to your pharmacy to get a cash "discount" on medications (including other prescription medications you may be taking).
Simply go to the website, type in Nature-throid:
You will then be brought to this screen which will show you where the medication is cheapest and how to get your coupon for the discount:
You can even use Goodrx.com for other medications (including Armour thyroid, levothyroxine, etc.).
The average price of Nature-throid will depend on both your location and local pharmacies, but you should expect to pay no more than $10.00 per month for a 1 month supply.
What is in Nature-throid?
Are you a sensitive person that reacts to fillers/dyes/etc.?
Nature-throid has a very limited amount of ingredients as you can see below:
Active ingredients include:
- Thyroid USP (desiccated porcine thyroid)
- Triiodothyronine at 9mcg per grain
- Thyroxine at 38mcg per grain
Inactive ingredients include:
- Colloidal silicon dioxide, Dicalcium Phosphate, Lactose Monohydrate, Magnesium Stearate, Microcrystalline Cellulose, Croscarmellose Sodium, Stearic acid, Opadry II 85F19316 Clear
Dosages and Formulations include:
- 16.25mg (1/4 grain)
- 32.5mg (1/2 grain)
- 48.75mg (3/4 grain)
- 65mg (1 grain)
- 81.25mg (1 1/4 grain)
- 97.5mg (1 1/2 grain)
- 113.75mg (1 3/4 grain)
- 130mg (2 grain)
- 146.25mg (2 1/4 grain)
- 162.5mg (2 1/2 grain)
- 195mg (3 grain)
- 260mg (4 grain)
- 325mg (5 grain)
It also does not include artificial flavors, artificial colors, fish, rice, soy, gluten, peanut, egg or shellfish.
It does, however, contain porcine (pig), so if you don't consume animal products you should take this into account.
It's also important to note that WP Thyroid has even fewer ingredients, so if you react to Nature-throid you may want to consider WP thyroid as an alternative.
What to do if Nature-throid isn't Working
While Nature-throid may be enough to alleviate the majority of your symptoms and issues it may not be enough to get you back to 100%.
If you have any of the following then you may need further treatment beyond thyroid medication:
- High levels of Reverse T3 ( >15 ) or signs of thyroid resistance
- Leptin resistance (Leptin level > 12)
- Diabetes, prediabetes or insulin resistance
- Extremely low body temperature despite being on Nature-throid or NDT
- Personal history of bipolar disorder or a strong family history of mental health disorders
- Personal history of Fibromyalgia or Chronic fatigue syndrome (15)
In these instances, it may be beneficial to consider adding T3 (Cytomel or Liothyronine) to your Nature-throid or NDT.
Cytomel is a medication that contains pure T3 thyroid hormone and is the most powerful thyroid hormone medication available.
Use Caution if You Have Autoimmune Thyroiditis or Hashimoto's Thyroiditis
Any patient with autoimmune thyroiditis or a known diagnosis of Hashimoto's thyroiditis should be careful when using Nature-throid or any other form of Natural Desiccated Thyroid.
Because NDT is porcine-derived, meaning it is an animal product and may contain porcine tissue.
Even though the hormones themselves are bio-identical (meaning they are the same hormone your body would have produced naturally), components of the animal still remain in the formulation.
Like any piece of foreign tissue, it is possible for your body to create an immune response to it (16).
For this reason (and many others) some patients may actually feel worse when switching to Nature-throid and feel like their symptoms come back even though their TSH may be normal or low.
This leads patients and providers to believe that the medication doesn't provide stable thyroid levels and this isn't necessarily true.
It doesn't mean you shouldn't take Nature-throid if you have Hashimoto's or autoimmune thyroiditis, but you should take this into consideration when switching medication and monitor for adverse effects.
If this does occur, you can check your thyroid antibody levels to determine if they raised in conjunction with starting nature-throid.
If this occurs you may need to stop the medication.
Treating any GI related issues like low stomach acid can improve your digestion and absorption of nature-throid and may reduce any antigenic stimulus from the medication.
Nature-throid vs Armour thyroid
Even though Armour thyroid and Nature-throid are both forms of natural desiccated thyroid they are NOT the same medication.
Believe it or not, I've had many cases of patients who have simply switched from one form of NDT to another and have had many of their symptoms resolve spontaneously.
This same sort of effect is seen in patients switching from Levothyroxine to Synthroid or Synthroid to Levothyroxine even though they technically contain the same active ingredients.
I want to provide a word of caution to you, especially if you fall into this boat.
Don't assume that ALL forms of NDT (Nature-throid, wp thyroid, Armour thyroid, etc.) won't work for you if one of them isn't currently working for you.
Much of this tolerance is likely due to the various fillers and binders used in each medication.
While all forms of NDT do contain the same amount of bio-identical thyroid hormone, they differ in these inactive fillers and binders.
In the case of Armour thyroid, the formulation was recently changed which reduced the amount of dextrose and increased the amount of methylcellulose in the formulation.
This change either dramatically improved or worsened the tolerance of the medication in some patients.
The binder methylcellulose acts like a "glue" in the body and delays absorption of medication.
This is the same binder that compounding pharmacies use for sustained release T3.
This example really highlights the importance of these fillers and binders and helps to explain why some people do very well on certain types of medications.
If you are on Armour thyroid and it isn't working for you, then it would be worth a trial of switching medication to see if the switch improves your symptoms.
You can find more information about Armour thyroid here.
Heart Palpitations with Nature-throid
One of the more concerning symptoms that patients may experience while taking Nature-throid is the sensation of a rapid heart rate otherwise known as heart palpitations.
These palpitations result from the T3 that is inside the medication.
Recall that Nature-throid contains a combination of both T4 and T3 thyroid hormones, compared to levothyroxine or Synthroid which contains T4 only.
T3 is the active form of thyroid hormone in your body and it activates certain receptors in all tissues in your body.
In your heart T3 acts different than it does elsewhere by directly activating calcium channel pumps (18).
This may lead to an increased force of contraction of the heart combined with an increase in the heart rate (19).
Because serum levels of T3 usually spike around 2-3 hours after ingestion of thyroid hormone, this is usually when patients experience heart palpitations.
These palpitations don't necessarily indicate that the medication is harmful to your body, but it may mean that you are getting too much T3 too quickly.
You can combat these symptoms by changing how you take the medication.
Simply spacing your dose (take half in the morning and half at night) may be enough to alleviate this problem.
Alternatively, taking your thyroid medication at night may improve your symptoms by altering how quickly your body absorbs it.
Many patients report heart palpitations in the middle of the night (usually 2-3am) which likely stems from changes in cortisol levels and other hormones.
You can learn more tips and tricks on how to take your thyroid medication in this article.
Nature-throid is a medication that contains both the inactive T4 and the active T3.
Because of the active T3 and combinations of other thyroid hormones (listed above) many patients actually do much better on Nature-throid instead of T4 only medications like Synthroid and Levothyroxine.
If you are considering switching to Nature-throid (especially if you are switching from T4 only medications) make sure to start LOW and titrate SLOW.
That means starting at a lower than normal equivalent dose, but increasing your dose slowly every 10-14 days.
Doing this will prevent unwanted side effects from the T3 in the medication.
And remember that Nature-throid is not a magic weight loss pill, but it can help some individuals lose up to 10-20 pounds.
Now I want to hear from you:
Are you currently taking Nature-throid?
Did it work for you?
Do you believe you need a different thyroid medication?
Why or why not?
Leave your comments or questions below!
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