Why is Desiccated Thyroid Not Recommended by Doctors?

Desiccated thyroid hormone is one of the most popular medications among thyroid patients but probably the least popular among doctors.

In fact, if you were to ask your doctor for a prescription, he or she would tell you that it’s either:

a) Potentially dangerous to use, or b) Wouldn’t work anyway.

But is this really true? Not exactly.

Let’s go over some of the biggest objections doctors have about desiccated thyroid so you can understand the truth:

#1. Inconsistent Hormone Levels

The most common objection is that desiccated thyroid contains a fixed ratio of T4 (thyroxine) to T3 (triiodothyronine).

They claim that this ratio is different from what the healthy thyroid gland produces and is, therefore, dangerous to the body.

The only problem?

It’s not true.

Each standard grain of desiccated thyroid is standardized to contain 38 mcg of T4 and 9 mcg of T3 which is a ratio of about 80% T4 to 20% T3.

And this ratio matches pretty darn closely with physiologic data which suggests that the healthy thyroid gland itself produces 80% T4 and 20% T3 (1).

But it gets a little more complicated than this because the reality is that each person will produce slightly more or less T4:T3 depending on their age, activity level, genetics, and more.

So this static number is not very helpful no matter how you slice it.

But, at the very least, it should definitely not be used as a blanket reason to suggest that desiccated thyroid contains too much T3 or too little T4.

The only real way to determine how much you need is at the individual level.

#2. Limited Customization

Some doctors will also suggest that desiccated thyroid should be avoided because it has limited customization.

What does this mean?

It means that each dose is standardized to contain the same T4:T3 ratio no matter how much you take.

In other words, you don’t have the ability to individually titrate your T4 dose and your T3 dose because you will always be getting the same ratio of roughly 80:20.

This does pose a problem for some people, based on what I just mentioned above (2).

There will be some people who are more sensitive even small doses of T3, so this static dosing may be a problem for them.

I would be more willing to give doctors a point for this objection if it weren’t for the fact that they are still unwilling to prescribe a combination of T4 and T3 to patients.

#3. Risk of Overmedication

Is there a higher risk of overmedication with desiccated thyroid?

Sure.

But it’s not much higher than what you’d get from taking levothyroxine and the question about whether or not you should use it can’t be distilled down to just the risk of overmedication.

The real question is whether or not the benefits outweigh the risks and in this case, it’s pretty clear that they do for most people.

Most thyroid patients are willing to accept a slightly higher risk of overmedicating themselves if it means faster weight loss, more energy, and less depression.

But if you are someone who doesn’t, guess what? You can stick to levothyroxine.

But to suggest that everyone ought to avoid desiccated thyroid extract for this reason doesn’t make sense.

#4. Lack of Consistent Manufacturing Standards

This one is somewhat true, but the reality is that no medication is perfect and every single pharmaceutical company has run into consistency troubles at one point or another.

There does seem to be a higher rate of inconsistency among the manufacturers of desiccated thyroid extracts, however.

This can be seen in full display with the relatively recent recalls in multiple NDT formulations including WP Thyroid (3) and NP Thyroid (4) and is at least part of the reason that some of these are no longer available.

But let’s not kid ourselves into thinking this only happens to NDT formulations, because it has also happened to T4-only medications as well (5).

The question is, is this a big enough concern to not prescribe it at all?

I don’t think so, but it should be something that you keep in mind when using it.

If there’s any concern over the consistency of the dose that you are taking then just make sure to get your labs checked regularly and you are good to go.

#5. Insufficient Evidence

The insufficient evidence point is a bucket that can’t hold a lot of water.

Why?

Because desiccated thyroid extracts were among the first thyroid hormones ever discovered and used!

In fact, they have been in circulation and in use since the late 1800s and early 1900s (6).

For comparison, levothyroxine wasn’t discovered until 1927 and put into large-scale use in the 1960s.

There might be a point here if both of these medications were considered different, but they are more alike than they are different.

The active T4 thyroid hormone found in levothyroxine is the exact same T4 found in desiccated thyroid. The only difference is that T3 content.

So whether or not these medications work has more to do with their T3 content than their T4 content and even the T3 found in DTE is bio-identical.

While it is true that there are more large-scale studies of levothyroxine (7), this doesn’t automatically mean that desiccated thyroid is harmful or shouldn’t be used.

#6. Insurance and Accessibility Challenges

This definitely is a big problem and one that should be discussed.

Desiccated thyroid is, on average, much more expensive compared to levothyroxine.

And this is a big driver among physician prescription habits.

Do you think your insurance would rather pay $4 per month for a prescription of levothyroxine or over $100 per month for a prescription of Armour thyroid?

They are going to go with the cheaper route every. Single. Time.

So as an advocate for desiccated thyroid, I think the cost definitely needs some TLC and attention.

#7. Misconceptions About “Natural”

Patients will argue that desiccated thyroid is “natural” and therefore better than the synthetic alternatives (like levothyroxine).

While it is sort of true that the sourcing of DTE is considered natural in that it comes from an animal, this doesn’t automatically mean that it’s healthier or better than synthetic alternatives.

What matters more than the source is whether or not it’s bioidentical and all thyroid medications are bioidentical.

You may prefer a more natural source, for whatever reason, but that’s not an argument for or against its use on a large scale.

What matters more than the source is whether or not it works for each individual patient and what determines this is your genetics and personal history.

The Bottom Line

I personally like desiccated thyroid and have prescribed it to many patients over the years, but if you are asking me if it’s my favorite type of thyroid medication, the answer is no.

I actually believe that most patients do better on a combination of T4 and T3 thyroid hormone prescribed at individual doses.

This strategy allows you to take supplements that contain many of the same ingredients as desiccated thyroid while individually titrating your T4, T3, and T2 doses to meet your body’s demands.

But I definitely don’t like false information being shared or propagated by uneducated doctors.

The more you know as a thyroid patient, the more likely you are to get the results you are looking for.

By the way, if you are interested in getting many of the same benefits that desiccated thyroid provides, you may want to look into bovine thyroid glandulars.

These are available over the counter and contain many of the same ingredients as DTE with a slightly different source.

You can learn more about them here.