NP Thyroid Recall for Superpotency: What you need to know

NP Thyroid Recall for Superpotency: What you need to know

NP Thyroid Recall by Acella

Thyroid news report:

On May 22nd, 2020 Acella Pharmaceuticals issued a voluntary nationwide recall of certain lots of NP thyroid due to superpotency

Don't worry, I'm going to explain in plain English what this all means and how it applies to you. 

If you aren't already aware, NP thyroid is a prescription thyroid medication which falls into the class of medications known as NDT or natural desiccated thyroid

NDT medications contain a combination of both T4 and T3 thyroid hormones whereas most other thyroid medications, like levothyroxine, contain only T4 thyroid hormone. 

This recall was issued for only SPECIFIC lots of NP thyroid and it does NOT apply to all of the doses that they offer. 

What this means is that certain lots (which I will explain more below) were incorrectly adjusted in regards to their dose and they ended up with more thyroid hormone then they were supposed to. 

This superpotency problem applies ONLY to specific lots (13 of them) and ONLY to 30mg, 60mg, and 90mg NP thyroid tablets. 

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What is Superpotency?

Superpotency is a word used to describe how powerful something is. 

When using this term in regards to thyroid medication, we are talking about how strong any given tablet of thyroid medication is. 

All formulations of NDT thyroid (including NP Thyroid) are controlled and regulated to have a very specific amount of thyroid hormone in each grain. 

For NP thyroid that magic number is 38mcg of T4 and 9mcg of T3 in each and every 'grain' (which is a unit of measurement of thyroid medication). 

This particular issue only affects the amount of T3 in each formulation of NDT. 

So instead of having 38mcg of T4 and 9 mcg of T3 in each grain of NP Thyroid the medication is superpotent because it contains 115% of T3 or 15% more than what it is supposed to have (and what the label shows that it has). 

Put into real numbers, this means each grain of NP Thyroid of this lot has 38mcg of T4 and 10.35mcg of T3 (instead of the regular 9 mcg). 

You can see that this small change really isn't anything to write home about nor is it likely to cause any problems but we will talk more about that below. 

The lots affected by this superpotency problem are listed below: 

list of lots affected by the NP thyroid recall
  • M329A19-1
  • M329H18-1
  • M329J18-1
  • M329J18-2
  • M329J18-3
  • M329M18-2
  • M330J18-2A
  • M330J18-3
  • M331G18-1
  • M331J18-1
  • M331J18-2
  • M331M18-1
  • M331M18-2

What are lots? 

Lots are just a way to describe a large group of medications (but this also applies to supplements) which are created under the same circumstances including ingredients, doses, etc. 

Placing your medications into lots allows you to keep an eye on manufacturing and to help you manage problems as they arise. 

Without these lot numbers, NP thyroid would have to potentially recall every single dose of medication that they suspect has problems. 

It's also important to note that if your medication does NOT fall into one of these lots then you do not have anything to worry about. 

How do you find your lot number?

You should be able to find the lot number of your medication, usually abbreviated "Lot No.:" near the expiration date like the picture below:

lot number of prescription medication

What Should you do if your lot is affected?

What should you do if you find out that your lot of NP Thyroid is affected by this superpotency issue? 

The standard thing you will hear is to go back to your doctor to get the medication swapped out for a lot that isn't a problem. 

And I would agree that this is probably the best course of action for most people. 

Why?

Because there is a very small risk (emphasis on very small) that taking these super potent doses may cause hyperthyroid symptoms

But it's also worth pointing out that the risk of this happening is INCREDIBLY small. 

Remember, there's only a 1mcg difference in T3 between the superpotent dose and the regular regulated dose. 

In reality, this small change in dose is not likely to cause any changes to how you feel except it may actually help you to feel better (because most people do better on more T3). 

If possible, though, you would want to swap it out for a non superpotent lot simply because it may impact your thyroid lab tests and cause confusion for you and your doctor as you try to figure out what doses will work for you. 

If, on the other hand, other lots of NP thyroid are NOT available to you (due to backorders, pharmacy stock problems, etc.) there's a strong argument that it would be better to stay on the super potent dose as opposed to swapping over to something like levothyroxine. 

I would be very hesitant if your doctor insists that you switch medications because of this recall. 

This is only an isolated one time problem and staying on the superpotent dose would likely be better for your body than swapping medications entirely, especially to a T4 only thyroid medication. 

The False Belief that NDT isn't Regulated

Even though this is a less than ideal thing to happen, especially to NDT medications which already have a bad reputation among endocrinologists, there is some silver lining. 

One of the main tools or reasons that doctors insist on not prescribing NDT formulations such as Armour thyroid and NP thyroid is that they believe that these medications are not regulated. 

A common talking point that you will hear from doctors goes something like this:

"NDT comes from a pig and is not regulated so you don't know how much thyroid medication you are getting when you take it."

This statement, in all its forms, is used as a justification to NOT prescribe these types of medications even though they can seriously benefit and help many people. 

This recall, while a terrible thing, actually proves that this point is not true. 

If it were true that these medications were not regulated and contained various amounts of thyroid hormone in them there would be no reason for Acella to recall the medication. 

And this recall shows that they ARE regulated and each formulation is supposed to contain a specific amount of thyroid hormone in each grain of NDT. 

So this recall can be used by you, as a thyroid patient, as a tool to help your doctor understand that this common belief is absolutely wrong. 

Your Next Steps

What should you do if you are taking NP thyroid? 

Check the lot number on your medication bottle and determine if you are taking a lot which is affected. 

If you are, you can call your pharmacy or your doctor's office and they can help you with getting a new prescription with a non super potent lot. 

Now I want to hear from you:

Are you currently taking NP Thyroid?

Are you taking an affected superpotent lot number?

If so, have you noticed any changes in your symptoms?

How are you handling this recall?

Leave your comments or questions below! 

NP thyroid recall for superpotency pin
Dr. Westin Childs

Dr. Westin Childs is a Doctor of Osteopathic Medicine. He provides well-researched actionable information about hormone-related disorders and formulates supplements to treat these disorders. He is trained in Internal Medicine, Functional Medicine, and Integrative Medicine. His focus is on managing thyroid disorders, weight loss resistance, and other sex hormone imbalances. You can read more about his own personal journey here.

29 thoughts on “NP Thyroid Recall for Superpotency: What you need to know”

  1. Hello!

    Have you come across any cases where T3 (not an excess of) causes leg tremors? I started experiencing these tremors in 2018 after I had been on NDT (Armour to Nature-throid to NP thyroid) for over a year. My doctor had me stop NDT for a few days to see if my leg tremors subsided and they did. I decided to switch to synthetic T4 (Euthyrox) to see if the issue was from the T3 in NDT. I was happy to report that my leg tremors stopped! So I thought my problems were solved and the cause was from NP Thyroid itself when I heard of the recall. However now that I’ve been on T4 only for two weeks, my leg tremors are back. I know T3 is the key hormone the body needs but can my body just not react well to T3 in general? Could my low end cortisol and ACTH be the culprit? I cannot get answers from my any of my doctors because they’ve never come across this problem.

    Reply
  2. I started NP Thyroid four months ago. I’ve had trouble titrating up past 90mg, originally on 88mcg of Levo. Checked my sample bottles the Dr gave me and no recall on those, however I already threw the other empty sample bottles away and I don’t know the lot numbers or expiration dates on my pharmacy bottles.
    I understand NDT is pretty consistent, however I tried Nature Throid for a short time and it seems it may not be as potent as NP Thyroid, which in my case could be a good thing.

    Reply
    • Hi Janiece,

      It’s probably not a potency issue but instead an absorption issue. The various inactive substances found within thyroid medications can impact how well they work for each person.

      Reply
  3. I am currently taking 30mg NP Thyroid. I have noticed over the last 2-3 months I have had heart palpitations. They are random but at times I will wake up during the night and get them. Can’t seem to figure out why or what’s behind them. (I am hypo)
    To be sure on the recall I spoke with my Pharmacist. I live in a small town and according to her I am the only one they dispense to. Her recommendation was to bring what I had left and she would replace them with some from a new bottle just to be safe.
    As of a week later I am still experiencing the heart palpitations at times.
    Makes me wonder if they are because of something else going on, dosage, or changes going on??

    Reply
  4. Thanks for the information, I must say 115.0% sounded really high! I received a letter today about the recall from my pharmacy and I decided to do a little more research on it. Today is 6/9/20 and I’ve been taking these since 5/21/20. I really have not noticed anything different so I don’t think I will go through all of that. I really don’t like changing to different medications and this one works well.

    Reply
  5. I started taking NP Thyroid of the recall lots listed, on 3/11/2019. By 4/17/2019 my heart rate rose to 200 bpm for more than an hour. I went straight to the hospital. The cardiologist diagnosed Arrhythmia, and put me on Metoprolol. Still on it mor than a year later. I wonder if I have suffered permanent heart damage.

    Reply
  6. I was on 90 mg 1 tablet and half. 135 mg. once a day end of last
    year. I would cough and my body felt hot. It would go away.
    I ended up with a heart attact and my blood work showed high
    from taking thyroid. Did not have this problem until the end of
    last year. I have the paper receipt; but no empty bottle.

    Reply
  7. I received my recall notice in the mail but there are no NDC or Lot Numbers or identifiers listed on my Bottle from Walgreens. It’s dispensed in an amber vial not in the manufacturer stock bottle. Therefore there is no way to determine if my bottle is part of the recall. Thyroid NP 0.5GR (expires 5/30/21)

    Reply
  8. I have also noticed heart palpitations since starting this product. I am going to have my doctor replace with something else. This is pretty scary. I have only been on it for 2 months and that coincides with the heart palpitations.

    Reply
  9. I have been on generic synthroid and Cytemel for years . First just the synthroid then The cytemel was added. I have leg pain and foot pain on and off. Is this a side effect of these medications. I have hashimoto since 1990. I’m 60 years old now so have been on for 30 years.

    Reply
  10. We were on np thyroid and had our tsh jump to 34. We swtiched to levo out of desperation. Now the levo is causing bloat and weight gain. Have read others had similar problems with np thyroid, separate from this recall..

    Reply
      • Can you speak on those separate issues, Dr. Childs? Wondering why my NP smells kind of like cat urine (started last summer.) I’m sweating buckets at night, along with the heart palps others are mentioning, plus nausea after taking, dizziness/weird spaced-out feeling that’s hard to describe. Looking into alternatives because of this. Thanks!

        Reply
  11. Hello. I was on armour for about 20 years then changed to NP last year to save money. I did get on the bad batch. My dr switched me back to Armour because my Free T3 was 5.3. It’s been 3 months and I just did lab work and it’s 5.0. I’m worried the NP has caused me to be hyper thyroid

    Reply
  12. I’ve been on Nature-Throid 32.5 mg for two years and did well. When I tried to refill last week, they substituted NP Throid 30 mg. because Nature-Throid was “unavailable” (due to recall, I later learned). After less than a week on NP, I’m experiencing fatigue, cold, and most annoying, my ears are ringing constantly! Haven’t changed anything else but the thyroid med. Not sure if the NP is too strong or not strong enough….

    Reply
  13. I was on Nature Throid for yrs, worked fairly well then got recalled recently. So put on NP Thyroid 90 mg week ago, feel so much better in just one week on this med and dose than Nature Throid but my pharmacy CVS faxed my dr saying ALL doses of NP Thyroid recalled have to try something else like Armour Thyroid much more expensive and lacking 1 ingredient that’s in NP T. This and another article I read said 15 mg and 120 mg not recalled so I called CVS myself and they said ALL doses and lots recalled. Dont want to buy Armour Thyroid. If available somewhere I could get 120 mg and just take 2/3 of pill would equal 90 mg. What’s the truth on recall, have they now recalled all NP Thyroid?

    Reply
  14. …..and I received a letter in the mail for the second NP recall. I found NP Thyroid to be effective but not consistent when filling new prescriptions. Glad I left it behind. I’m on Unithroid and Greenstone pharm T3 now for a week. I need consistency and Unithroid has never been recalled and is the closest in potency to my old generic. The downside is that I don’t like the dyes and fillers but nothing negative observed so far.

    Reply
  15. I was on NP thyroid for years until July of 2020. My insurance company stopped paying for it so my doctor changed me to Levothyroxine and Liothyroinine. In September, I received a letter from Walgreens saying that my NP had been recalled. Didn’t think much about it because i was off of it. Then, later in the month, I started feeling like I was in Afib. Have had paroxysmal afib for 8 years so was surprised that I was actually noticing it. Asked my PCP to do bloodwork. My TSH was 0.010. My endo doc has been adjusting the medication since then. My cardiologist is frustrated because my TSH is not getting back to normal. I had 3 cardioversions and my heart did not go back into sinus rhythm. My last TSH done 2 weeks ago was 0.159. I’m on Eliquis also and very worried about having a stroke or heart attack. I’m 78 years old.

    Reply

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