2020 Has Been a Rough Year For Thyroid Patients
2020 has been a rough year for everyone but especially for thyroid patients!
We’ve had to deal with several recalls of thyroid medications over the year which has caused a significant amount of stress for those who suddenly had to switch medications or dosages.
This blog post is meant to keep you up to date with all three of the major thyroid medication recalls which occurred over the last 5-6 months.
Many thyroid patients know about some of the recalls because it personally affects them but you should be aware of all three.
These recalls may have a serious impact on your ability to get thyroid medication and they may have a serious impact on the regulations of NDT thyroid medications going forward.
With that in mind let’s jump in:
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Thyroid Medication Recap for 2020
#1. NP Thyroid Recall for Superpotency – May 22nd, 2020
The first recall happened on May 22nd for NP thyroid (1).
This recall was for super potency, meaning that a handful of lots/dosages (30mg, 60mg, and 90mg tablets) contained MORE thyroid hormone than they claimed.
As I stated in a previous blog post specifically about this recall, those people who were taking more thyroid hormone probably felt better than they did previously.
But certainly, a handful of people may have experienced hyperthyroid symptoms from the slightly increased dose.
In order to be classified as “superpotent”, the doses of NP thyroid must have been higher than 110% of the stated dose.
So you were really only getting an extra 10% of thyroid hormone in certain capsules.
What’s important to remember here is that not ALL dosages/lots were affected.
Only the 30mg, 60mg, and 90mg tablets needed to be recalled.
#2. Nature-throid and WP Thyroid recall for Subpotency – September 3rd, 2020
The second recall was a much bigger deal than the first.
This recall happened on September 3rd (2) and included ALL lots and dosages of active WP Thyroid and Nature-throid medications.
If you were taking ANY dose of either of these medications then you were required to switch to a different medication altogether.
This recall was for the exact opposite reason as the first.
It was because the lots of Nature-throid and WP thyroid were considered to be “sub potent”, meaning they did not have ENOUGH thyroid hormone.
If you were taking these medications then you were getting around 89% of the stated dose on the bottle.
As an example, if you were on 1 grain of WP thyroid (which contains 38mcg of T4 and 9mcg of T3) you were only getting 89% of that total dose (~33mcg of T4 and ~8mcg of T3).
Again, not a huge discrepancy but certainly enough to cause problems and certainly out of the therapeutic range that brands of NDT medications are required to fall within.
#3. Np Thyroid Recall for Subpotency – September 17th, 2020
The last recall occurred on September 17th (3) and was again for NP thyroid.
This time, however, it was for sub potency and not super potency and it included the 15mg and 120mg tablets.
The bottom line for NP thyroid was that they were having issues with both super potency and sub potency on almost all dosages/lots.
What Does This Mean for NDT Going Forward?
I wouldn’t be surprised if this series of recalls has some serious ramifications on the processing and regulation of NDT going forward.
One of the reasons that NDT gets a bad rap from conventional doctors like endocrinologists is because they wrongly believe that the dosing of NDT is inconsistent from batch to batch.
These sorts of recalls give them ammunition for this type of thinking and it’s something that we should take a second to discuss further.
NDT brands are not classified as narrow therapeutic index drugs.
Narrow therapeutic index drugs are required to have a consistent dosage across all lots, usually within a 5% margin higher or lower than the stated dose.
For instance:
For levothyroxine (4), each dose of 100mcg of levothyroxine must be between 96mcg and 104mcg.
Believe it or not, it’s very difficult to get the dose of any medication exactly right but some prescription medications have serious consequences if the dose is either too high or too low.
To fight this problem, the narrow therapeutic index was created to ensure that pharmaceutical companies produce medications with the dosage that they claim on the bottle.
NDT medications are allowed a more broad range, a 10% margin of error higher or lower than the stated dose.
This means your dose of 1 grain of NDT can contain 90% of the stated dose or up to 110% of the stated dose and still be considered “okay”.
This means that technically speaking, levothyroxine is more consistent in its dosing compared to Armour thyroid, WP thyroid, Nature-throid, etc.
But the difference between these two medications is only 5% either way.
Does this broader range impact thyroid hormone management for thyroid patients and thyroid doctors?
It may play an important role in certain patients and populations, but it’s probably not a big deal for most people.
But now that we’ve had 3 recalls in a matter of a few months, it may be the case that the FDA imposes stricter regulations on the makers of various brands of NDT.
They now might be required to match levothyroxine in terms of its narrow therapeutic index.
This wouldn’t necessarily be a bad thing for thyroid patients and may increase the likelihood that endocrinologists may prescribe it.
How Long Will it Be Until NDT is Readily Available?
What if you were taking these medications and previously doing well on them?
What does this mean for you in terms of how long you will have to wait to get them back in active stock?
Unfortunately, when mass recalls like this happen, it tends to take quite a while for the stock to be replenished and for everyone to get back on their previous doses.
These sorts of recalls tend to create large shortages in many pharmacies, especially for other brands of NDT (even those which were not directly affected by the recall).
Here’s why:
Let’s say you were doing really well on 1.5 grains of Nature-throid and you had your symptoms under control.
You are now told that you can no longer get Nature-throid so you look for an alternative.
Because NP thyroid isn’t available, you have to switch to Armour thyroid.
But you aren’t the only one.
There are people who were previously on NP thyroid, Nature-throid, and WP thyroid who are now suddenly all trying to switch to Armour thyroid.
This creates a huge demand for Armour thyroid and puts it at risk of going on backorder simply due to the demand.
And this also happens with various dosages of different brands of NDT as well.
Think of it like the toilet paper debacle of 2020.
Even though toiler paper companies were pumping out toiler paper like crazy, it still took them several months to actually catch up to the demand.
A similar thing may happen with other brands of NDT so be wary of that.
Unlike toilet paper, brands of NDT are not as commonly used by thyroid patients so the amount produced is not nearly as high as say, levothyroxine.
This means it may be several months before we see stock of NP thyroid, WP thyroid, and Nature-throid in regular box pharmacies.
This is one reason why I always recommend that you keep an extra stock of whatever thyroid medication you are using on hand!
What Should you Use For Now?
What should you do if you have been affected by these recalls?
First of all, don’t worry.
There are still many great thyroid medications and options available to you.
And, in the worst-case scenario, these medications will eventually make their way back to the market.
In the meantime, you can still find success with the various other thyroid medications available.
I have a list of combinations that I am recommending in 2020 due to the problems with these NDT recalls and other issues that thyroid patients have been experiencing.
Final Thoughts
Even though thyroid patients have been dealt a bad hand in 2020, you still shouldn’t lose hope.
The silver lining may be that these recalls result in changes to NDT manufacturing which results in more consistent dosing and better medications for thyroid patients in the future.
The downside is that it may be more difficult to get WP thyroid, Nature-throid, and NP thyroid over the next several months.
But now I want to hear from you:
Have you personally been impacted by these recalls?
If so, how are you proceeding with your thyroid medication?
Are you changing to a combination of T4 + T3 or are you switching to Armour thyroid?
If so, how is your transition going?
Leave your questions or comments below!
Been taking compound thyroid..working like a charm…
Thanks for this info. It will be super tough for me as I live in Ecuador and I can’t get NDT here. I travel back to the states to get my meds. So getting the cytomel and tyrosine will be even harder for me to learn my dose. My only choice where I live is synthroid (as far as I have been able to find). Any thoughts?
2020 has been a HORRIBLE year for me and my thyroid. I’ve been on naturethroid for a while, and in September my doctor had me switch to Armour. My acne has gotten horrible, and I had to stop taking it altogether a month ago because I was having symptoms of hyperthyroidism, including anxiety/panic attacks, heart racing, insomnia, lightheaded ness, dizziness, and I was unable to eat enough to keep my body moving. It was so strange, but one I stopped (with my doctors recommendation) I felt better. I’m still waiting for my doctor to hear about what I should do next, we did bloodwork and all but she’s super backed up. In the meantime I’ve had to start antidepressants because my mood swung so severely in the opposite direction. I’m exhausted, and I just want a medication that works.
Pharmaceuticals should NOT put SOY in Armour Thyroid Forest Manufacture medicine.
SOY given to pigs/cows makes them FAT.
FOREST PHARMACEUTICALS IS PUTTING SOY IN Armour. I believe has created my having a third nodule and my second nodule has grown bigger. I have NEVER had BELLY FAT before now.
SOY IS IN ALL OUR FOOD CREATING BELLY FAT. GET–IT–OUT–NOW !!!
Sorry, but you are being unreasonable. If the tablet weighs 100 mcg of medication plus 50 mg of other ingredients, the amount of soy is possibly 3 mg, or 330 of those pills to make 1 gram. 1 gram is 1/28 of an ounce. Your body might not like a soy bean that contain 1/8 of an ounce, but your pill contains about 1/900th of an ounce. Maybe it’s time to check your arithmetic skills. Sorry for the tone, but being hysterical doesn’t help you.
It’s doctors like you that give thyroid patients nightmares. I pity your patients.
I take Armour Thyroid and Cytomel and I have for a few years. This year rhe Armour Thyroid went from about $70 for three months up to $110 for three months. I’m wondering if it’s because of increased demand from those other recalls
What the hell? Why did they change the WP tabs after they finally got them back on the market after the last issue a few years back?! I got the new tabs, which were completely different in texture and taste, and then those got pulled. I used them for 2 weeks before I found out about the recall, and I did not feel as well during that time. I have had best and most consistent results with NP, and their recalls were more limited. The company that produces NT and WP has been a mess for two many years in terms of shortage, no supply and recalls. For now, I’ll stick with NP.
I was on nature-throid and could not get it any longer because it was recalled. My doctor switched me to NP thyroid. I have not experienced a problem with my NP thyroid prescription yet. I can only take NDT because Synthroid did not help me at all.
Thank you for sending this email. I have been on this NP product for one year and one month ago l changed doctors. She was and is ignorant about this product. I received three warning letters from Acella about the recalls. My two prescriptions weren’t on the list. My prescription were 60mg and 15mg, which added up to 75mg. During this time taking these two medications, l began getting very tired, breathless, weary, enormous muscle aches, loss of appetite, and an unreal loss of hair and many other problems. It was after this 3rd letter from Acella that l had a long talk with the pharmacist. They are so careful about what they say about this product, so l phoned the company, even though they weren’t on recall. UNHAPPY WITH THEIR EXPLANATIONS. I immediately phoned a doctor in my area that has good reviews and reputations and got in the next day. She ordered lots of thyroid tests and two days later phoned and said she didn’t like my report and was phoning in a prescription for levothyroxine, 0.88mg. It is unreal how the above problems have improved. I will be seeing the doctor on Dec. 18 and my blood tests again will be done to see if l need more or less. The hair loss is still of great concern, but l guess it will take more time for it to stop. My question is to you is do you think l should ask for the brand name of levothyroxine. Would this compound be more effective and safer?? There is a difference in the price. 90 days of this generic is only &11.00. THE BRAND NAME IS &66.00
Thank you for any help you can suggest. I don’t approve of anything pig anyway be it medicine or food.
Levothyroxine is not the same medicine at all. It only has one of the T’s in it verses amour, NP thyroids have T3 and T4 both
After being diagnosed with hypothyroidism in Oct. 2019, I started with Armour and then they added Cytomel to that, still not good, took me off all that, put me on Nature, and gradually increased Nature to grains. I was doing OK on that for awhile, but still not completely symptom free or losing all the weight I had gained. Now that Nature was recalled, I was put on 120mg NP, felt so bad I couldn’t even get out of bed, headache, bodyache, irritability, anger, hunger, carb cravings. I stopped taking it after a week and learned that it too had been recalled. So I found 1 of my old bottles of .5 grain Armour and have been taking 4 of those to make up for what I had been taking, but this bottle won’t last me long. Not sure what I should do when I run out or what supplements I can add?? Really tired of dealing with this Thyroid CRAP!!! And feeling like crap for over a year!
I was affected by all of these recalls. Now I’m taking Armour and will be getting the results of my first thyroid panel in a week or so. I feel OK, so much better than when I was switched to Levoxyl and compounded T3. (Had to find another doc who would try me on Armour, so glad I did.)
I tried to get my presription for Armour filled at CVS; it took me over three weeks. Eventually I received one month’s worth. In the meantime I asked my doc to try a compounding pharmacy. They were efficient, but much more expensive. It’s all very trying. I hope you’re right, Dr. Westin, that this will result in better NDT medications. Thanks.
I have been taking Armour 30mg for the past three years
My doctor was not familiar with it so he was hesitating to prescribe it for me; however, I insisted and after a day, he did prescribed it. (He must have studied about it and approved it).
So after three year, I am still taking it. My insurance does not cover it! It is less than $90
for three months.
Dr does order thyroid tests when I get my blood exam.
Just lately I do find much more hair in my hairbrush 🙁
Gam
I took Naturthroid for 2 years (1/2 grain), then couldn’t get it. So Naturopath placed me on NP Thyroid for about 8 months. Last October I got a couple of bad smelly batches and felt VERY unwell for 2 months. I switched over to TIROSINT (13mcg) and Liothyronine 5mcg. I have been SLOWLY adding in more hormones and now I’m at 7.5 mcg TIROSINT and 13 mcg 4 days per week with 26 mcg 3 days per week (almost every other day, but not quite.) I’m not feeling as good as I was before the bad batch last October, however. My adrenals were tested by both serum and saliva and appear to be good. I took two labs tests 3 days apart.
The first was FASTING and WITHOUT TAKING THYROID MEDS THAT MORNING: TSH 1.17, FT3 2.0, FT4 0.9 RT3 13.0
The second was FASTING and WITH THYROID MEDS 3 hrs. prior:
TSH 1.294, FT3 3.8, FT4 0.99, RT3 13.5
Three months prior at a lower dose my values were:
TSH 0.874, FT3 2.6, FT4 1.01, RT3 22.1 (TOOK MEDS 4 hrs. PRIOR)
I felt hypothyroid, however. I don’t think I convert well, and may have absorption issues.
Any comments please?
You have a major conversion problem and T4 is going to RT3 instead of FT3. See your doctor about using more of T3 instead of T4
ndt may be hard to get for a bit. the derecho that hit the midwest states caused a lot of crop damage. midwest usually grows corn and soybeans for cattle, pigs, and chickens. so with the food source wiped out, i am thinking that maybe there will be fewer animals for a while. gonna have to slaughter what they cant feed. since ndt comes from pigs and maybe cows, well…..
I was prescribed NatureThroid and now taking Armour. And I am happy for the change as I am feeling much better with Armour than I ever felt with NatureThroid. I get a better nights sleep! So, I am glad for the change
I am on 2 grams WP thyroid and import to Ireland as not prescribed here. I have 3 bottles left of the affected batches. As I paid customs etc to import I decided not to send back and still taking them. I feel less optimal, but not too bad. I am hoping they will see me through to the new batches! I hope I am doing the right thing! Bloods tomorrow will tell. I have picked up a bit of weight, but coping so far
I was taking Nature-thyroid until it recalled. I’ve been switched to NP Thyroid which apparently is still available here. However, I feel I’m not responding to it well. I’ve been on it for over one month now and have gained weight without changing my diet. I also think my thyroid has enlarged. I’m waiting on lab results that I did today to discuss with my Dr. I’m frustrated with all of this but trying to remain optimistic.
I take Metformin 500 mg.
However the 750mg has been recalled.
Does this affect me as it is soon to refill this medication
or should I ask for something that would be good for me.
I only take Levothyroxine, my doctor will not give me T3. In fact I take .137 mg. and he said to stop one day each week as my result came out too high.
It is so confusing.
I was effected by the recall. After having an endo really mess me up through his inept practices, its a long story which I’m still quite bitter over. As anyone would be week is 100 pounds over their normal weight due to someone else’s total disregard of protocol and making accusations of a patient without checking the validity of their claims. Anyway, I was being treated with only 66% of the actual dose I should be taking and my primary care doctor found this during a physical. He upped it to 146.35 of Nature Thyroid but a month or two later, the recall happened. I did research as I always do and when I met with my primary, I told him I would like to try Tirosint with Liothyronine. He agreed so I am taking 175 Tirosint and 10 of Lio. Its just unfortunate that we do not have doctors like you around this area. This weight makes me feel like I am trapped in a Halloween costume. This isn’t me and I am not comfortable with myself at all. I recently spoke with a doctor at University of Utah who is currently pulling all my medical records. I am concerned that he is very old school because when I mentioned advances in thyroid, he told me the best test for thyroid is TSH and Levo is the best medicine. Those are horrible things to hear from a doctor. But it is better than the doctor I considered from my city. He told me that I’m not kidding weight because my body still thinks I’m 150 pounds and didn’t find it necessary to shed pounds. Secondly, he started that medicine and science have really key us down on this weight loss front. There is really nothing they can do for being overweight. Mind you, this is coming from the prominent doctor at a big name hospitals endocrinology diabetes and metabolism center. This is what I am up against here. If the University let’s me down, I don’t know where I’ll turn. Things seem so bleak. I apologize. This was meant to be about the recall. I think the Tirosint is alright. I like it better than Levo by far. I love that it has no fillers. But honestly, NDT just gives me an overall sense of well being. That is the only way I have found to describe it. Unfortunately, I have never in the 13 years I have dealt with this ever been Euthroid. I have never felt like I did before I was stricken with this terrible disease. I had Papillary Thyroid Microcarcinoma (no nodules) which was discovered after a partial thyroidectomy. RAI was offered as a choice. Five years later, I had a different doctor who said she wouldn’t have made it a choice. So after five years of toting around half a thyroid which most likely was riddled with PTMC, I did RAI. I just had my 1st US after 6 years (I know they should be more often but as I said inept doctor), I have went from one concerning left side lymph node to two left side lymph nodes. Metastatic? Who knows? I swear doctors who can’t make it anywhere else migrate here. Well, as usual, great presentation. Thank you for being a doctor without tunnel vision and thinking outside the box. I have learned a great deal from you. I don’t sure back and take my health with a grain of salt. I constantly research, reading medical abstracts, and try, to the best if my ability, understand what could be causing issues with my body. I am 6 feet tall and always, for 40+ years maintained a weight between 130 to 150. I am now 240 and considered obese. If this weight remains, I’m sure it won’t be long before I an adding diabetes and heart condition to my research. At least, i have low blood pressure. You have to try and find that silver lining even on the bleakest days.
I have to say I am scared. I have tried Armour, Levothyroxine, Tirosint, and Synthroid but felt severe fatigue and brain fog on all of them. WP thyroid was like the clouds parting and letting in the sun. I really don’t know what I am going to do since I cannot get WP refilled now.
Been on NDT for about 20 yrs. Did well on 2-60 mg tabs till Armour had issues a few years back. Switched to NP and was doing well. I always got some extra tabs and would kick up or down a 1/4 grain for optimal. Sometime early 2019 I was going backwards and never recovered. By summer this year on the 2-60’s I was really getting anxious and palpitations returned. I am in the process on weaning back to see how I feel. Armour is now unaffordable for me at $1 a pill on medicare. $180 for 90 day compared to $64 on NP. God bless.
I have been on thyroid meds for a few years. Never been on synthroid. My NP started me on Nature Throid. I was on 130 mg until the recall. My NP gave me a Rx for Armour. I called my pharmacy and they had to order that strength as they didn’t have it on hand. I confirmed with them that my insurance covered Armour. When I went to pick it up, it was 120 mg of NP Thyroid. My insurance considers Armour “name brand” and NP “generic.” They wouldn’t cover the Armour apparently – unless we went through a special process to see if they would make an exception. In any event, been on it 4 days thus far. So far, so good. When should I get my labs rechecked? I know both are NDT but isn’t it recommended to re-check after switching brands?
Hi FS,
A recheck after 6-8 weeks is usually ideal but it can be pushed back under certain circumstances.
My NP put me on Thyroid pills a month after I had a devastating cancer operation along with the death of my Mother. I’ve been on every kind of pills for 3 years now and I can’t tolerate any of them. They all make me deathly sick. I decided to just stop taking them a month ago and I feel GREAT. Has she misdiagnosed me and I don’t have a thyroid problem?
Hi Betty,
It’s hard to say without a lot more information. I can tell you, though, that many people initially feel better off of their thyroid medication for about a month before it hits them.