We've been conditioned to think that we are really only allowed to get 1 month of medication at a time.
But who created this arbitrary set of time?
Why couldn't we get 3 months or 6 months worth of medication?
The 1 month time period is created as a number to keep you coming back for more medication and to keep you paying for medications each month.
But this time period doesn't necessarily serve you.
What happens if you find that the thyroid medication that you rely on is suddenly unavailable?
Thyroid Medication is Unique and Important
Believe it or not, this actually happens probably with a higher frequency than you suspect.
Thyroid medication can go on back-order (we've seen this with WP thyroid and Nature-throid).
Thyroid medication can suddenly increase in price, making it unaffordable (we've seen this with Armour thyroid).
It can be recalled for any reason (we've seen this with Synthroid and liothyronine).
It can be discontinued (we've seen this happen in countries like the UK).
Or any number of other reasons can occur which make it difficult or impossible to get your medication (1).
It's not important to focus on those things which haven't happened yet and which are out of your control, but it is important to focus on those things which are in your control.
And one of those things is to build up an extra supply of thyroid hormone in case of a rainy day.
Imagine a scenario in which you finally have found the type and dose of thyroid medication that works for you.
Then imagine (like what happened recently) that your medication was placed on back-order for 6-12 months.
During that time period, you would basically be forced to use a different type of medication which doesn't work as well for you.
That means for 6-12 months you may have fatigue, weight gain, constipation, hair loss, and so on.
But, you could prevent this by stocking up on your medication and it doesn't cost as much as you probably think!
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What Happens if You Can't Get Thyroid Medication?
Is being without your medication for a short period of time going to kill you?
But it can potentially cause you to feel unwell and revert back to a state of hypothyroidism, even if you are just switching medications.
This problem is amplified if you have had your thyroid removed or if you have had your thyroid ablated with radioactive iodine.
People who fit into this category are much more reliant upon medication than those with run-of-the-mill hypothyroidism or Hashimoto's thyroiditis.
They are also much more sensitive to smaller changes in their thyroid dosing because their body cannot produce thyroid hormone on its own.
Whether you have a thyroid or not, if you are taking thyroid medication then you are suppressing the pituitary release of a hormone known as TSH.
When this hormone is suppressed (or even managed), your ability to produce thyroid hormone on your own is limited.
If you suddenly stop taking thyroid medication, it takes your body a period of weeks to months to get back to a normal state.
And that 'normal' state is not really normal. It's just 'normal' for your body.
If you have long-standing Hashimoto's thyroiditis (a condition which destroys your thyroid gland over time (2)) then you may only be able to produce thyroid hormone at 50% of what healthy person can produce.
During this period without medication, you will then start to experience the symptoms of hypothyroidism.
And beyond those symptoms, there are also other costs that need to be appreciated.
- It can be very difficult to get a new dose
- The price of other medications can be much higher
- Many people may be stuck for a period of time without their medication (causing significant symptoms)
- It may cause a significant amount of stress to your body
These are just a few of the reasons why you'd want to stock up on thyroid medication.
With that in mind, let's talk about some practical ways that you can go about doing just that.
How to Stock Up on your Medication
Stocking up on thyroid medication can be difficult but it shouldn't be impossible.
My recommendation to you is to openly and honestly discuss why you want to have extra thyroid medication.
If you approach it this way then you will probably have success in having your doctor work along with you.
#1. Double or Triple up on your Current Dose (But Continue using your same dose)
The first, and probably easiest, way to get medication is to simply ask your doctor to double or triple your existing dose.
You don't want to actually TAKE this dose, so don't misinterpret what I'm saying here.
Instead, you want to take whatever your normal dose would be (even though your prescription is higher) and then keep whatever is left over as a reserve.
A practical example would look something like this:
Let's say that you are currently using 100mcg of levothyroxine each day.
You can go to your doctor and ask him/her to provide you with a prescription for 300mcg of levothyroxine to be taken each day in 3, 100mcg tablets (they can specify this on the prescription).
You would then continue to use your 100mcg of levothyroxine each day while saving 2 tablets of the other 100mcg dose for your 'stockpile'.
You can then rinse and repeat this process until you have 6-12 months of extra medication built up.
In this model, you should be able to get insurance to cover the majority of the cost, even though you are technically getting more than you typically need in a day.
This is the strategy that I use on my own family members to both keep the costs low (often your co-pay is the same regardless of the dose that you are prescribed!) and to allow for a reserve to be built up.
The only reason a doctor wouldn't want to do this is that they would be worried that you would take more than you need and thus put both you and them at increased risk of negative outcomes.
So, as long as you can assure them that you will not and that you will be compliant with your existing medication dose then you shouldn't have a problem getting it.
#2. Get a Second Thyroid Medication Prescription (For Another Medication)
Another option, although not preferred over option #1, would be to get a second prescription for a different thyroid medication.
This may be necessary if you are currently using an expensive medication or if your doctor is unwilling to increase your dose to allow you to build up a stock-pile.
A practical example would look something like this:
Let's say that you are currently taking 2 grains (135mg) of Nature-throid.
If your doctor isn't willing to prescribe you 4 grains per day of Nature-throid then they may be willing to prescribe you an equivalent dose of levothyroxine 'just in case'.
Even though this isn't preferable to stocking up your existing medication (the medication that is currently working for you), it's still better to have something on hand instead of nothing.
In this case, you would want to get a second prescription for levothyroxine or Synthroid at 100-150mcg per day and then keep that stock-pile in the event that you ever ran out of your existing medication or any other problems arise.
You could also do this for virtually any other thyroid medication (it doesn't have to be like the example I've listed above).
#3. Ask for Samples
If all else fails, you may be able to get free thyroid medication by asking your Doctor for extra samples.
Doctors are often given medication samples which they can give out to patients as a way to get people to try new medications.
Doctors only have a limited supply of these samples, but it's definitely worth asking about, especially if you can't afford to buy extra!
Paying for Extra Thyroid Medication
The next question you should ask yourself is what will it cost?
Most insurance companies have no problem shelling out money (minus a co-pay) for a monthly prescription, but they generally aren't generous enough to allow you to double or triple your dose.
The good news is that most of the cash prices for thyroid medications are fairly cheap even if you don't have insurance.
But, before you can get your extra thyroid hormone you will have to make it through the pharmacist.
For whatever reason (probably because most patients do not like paying cash for medications), your pharmacist will probably tell you that you can't fill your prescription more than once in a month.
What they really mean by that statement is that you can't fill a medication more than once a month and have insurance pay for it.
But you can definitely just tell them that you want to fill the prescription and that you are willing to pay cash for it.
This may sound crazy, but most pharmacists don't realize that the cash price for generic medications (even if insurance won't cover it) are incredibly cheap.
Even without insurance, you can get a 1 month supply of medications for around $4.00.
And this holds true for many thyroid medications as well.
This isn't true for all thyroid medications (especially those name brand medications such as Tirsosint), but you don't necessarily have to build up a 1 year supply of the medication that you are currently using (more on that below).
The amount of money it will cost you to build up your supply will depend on which medication you are using.
Below you can find the average monthly cash price (assuming insurance won't cover it) of various thyroid medications:
- Levothyroxine 100mcg cash price: $4.00 / month
- Synthroid 100mcg cash price: $11.83 / month
- WP thyroid 2 grains (135mg) cash price: $25.43 / month
- Armour thyroid 2 grains (130mg) cash price: $46.19 / month
- Nature-throid 2 grains (135mg) cash price: $12.37 / month
- Liothyronine 25 mcg cash price: $17.82 / month
- Cytomel 25mcg cash price: $17.82 / month
- Levoxyl 100mcg cash price: $13.79 / month
- Tirosint 100mcg cash price: $127.25 / month
- *Note: prices may differ in your country (these prices are based on the current rates in the United States as of 11/30/2018)
Medications Don't Really 'Expire'
My recommendation is to plan to get around a 1 year supply of extra thyroid medication that you can fall back on in case of an emergency.
Medications (even thyroid hormone) are exceptionally stable and can be used long after they are technically 'expired'.
You should NOT think about the expiration of medications in the same way that you think about the expiration of food.
When food expires, it's probably not safe to consume it.
But, when a medication expires, it still contains MUCH of its original potency despite being 'expired'.
The expiration date on medications is there to describe a time when the medication is no longer 100% effective, but even after 15+ years of being 'expired' almost all medications still maintain 90+% effectiveness (4).
Put in other words:
A levothyroxine medication dose of 100mcg which is 1 year old will probably provide your body with 100mcg of levothyroxine.
A levothyroxine medication dose of 100mcg which is 15 years old will probably provide your body with an equivalent dose of around 90-95mcg of levothyroxine.
Does this mean that the expiration date is a ploy to get you to keep renewing your medications in fear that they won't be effective?
I'm not convinced of that, but it is important to know that most medications still remain highly potent LONG after they are technically expired.
This means that you can safely stock up on thyroid medication and have it on hand for decades (or more) in case of an emergency.
And stocking up really won't cost you that much.
The cash price of levothyroxine 100mcg (generic) is $4.00 per month at Walmart.
That means the cash price of stocking up for a 1 year supply of thyroid medication is only $48.00!
And if you consider that this medication will be good for at least 10 years you are only paying an average of $4.8 / year for the peace of mind to have extra thyroid medication on hand.
That's a very reasonable deal.
You can get this cash price with a coupon code using the website goodrx.com and you can also find other coupons for thyroid medications there as well.
But what should you do if you are on another medication like WP thyroid or Nature-Throid?
Your best option is to try and find a 1 year supply of the medication that you are currently using.
If you can't, or if your doctor is unwilling to prescribe it, then you can always get another cheaper form (like levothyroxine) as a back-up medication just in case of an emergency.
While you probably won't tolerate the new medication quite as well as your old medication it's still better to have something rather than nothing.
While it may not be at the forefront of your mind, it's important to understand that having a backup supply of thyroid medication is incredibly important.
For various reasons, your thyroid medication can be placed on recall, it can be discontinued, or it can be held up for other reasons.
In the event that any of these things happen, it's important to have a reserve so that you can continue to function and feel well.
My recommendation is to work with your doctor to get an extra year supply of thyroid medication that you can fall back on in case of an emergency.
Now I want to hear from you:
Do you have extra thyroid medication on hand in case of emergency?
How did you go about getting your extra medication?
If not, why haven't you?
Leave your questions or comments below!
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