Patients Switching from Armour (Forest Labs) to Nature-Thyroid (RLC Labs)
A few months ago, Forest Labs reformulated their Armour Thyroid medication. Since then, a number of thyroid patients have raised questions and concerns about the new formulation posted on thyroid message boards and blogs. The comments fall into two categories:
Left image: thyroid gland courtesy of wikimedia commons
1) Many thyroid users notice a return of hypothyroid symptoms on the new Armour formulation, such as fatigue, hair loss and depression.
2) Many thyroid users notice elevation of TSH on the new Armour after the TSH was low and stable on the previous medication.
Here is what Janie Bowthorpe of the Stop the Thyroid Madness Blog says: (below quoted from STTM)
I Am Done with Armour, say a growing body of individuals:
Once again, (another) comment of someone who has had it with Armour, and is switching. On the new Armour, she states she has a return of her former hypo symptoms: hair loss, joint pain, fatigue, heart palpitations, low body temps are back, etc.
And you see it happening all over thyroid patient groups on the net. Many folks are done with Armour.
It’s too chalky. It tastes terrible. It doesn't break into smaller pieces well anymore. It’s lost the ability to be done sub lingually. And even worse, it has caused a return of symptoms.
In case you are wondering what this is all about, read the 40 current comments attached to the June 2nd post Trying the Newly Formulated Armour? Before that, you can read my May 7th post Why the party is over with Forest Pharmaceuticals and the current 37 comments. And especially powerful is the April 28th post Patients say PHOOEY to new Armour formulation and Forest Pharmaceuticals with a current 57 posts.
So what’s their next step?
Right now, doctors of patients on Armour on being asked for a prescription for Naturethroid. Many report it working wonderfully; some state they need a little more to be as optimal as Armour. A small minority aren’t sure about it yet. But overall, the majority are happy. (endquote Janie Bowthorpe).
Here are a few comments posted on the Stop Your Thyroid Madness Blog (quoted courtesy of Janie Bowthorpe).
Anon said: "my hypothyroid symptoms have escalated. Now Forest Labs changed the formulation and for the past 2 months, my hypo symptoms have come back, worse than I have ever had them in my life. It is back to square 1, if I can get out of bed or off the couch long enough to attempt this whole mess again, as I found out the civilian doctor I saw last summer moved away."
Left Image: a Pig, courtesy of wikimedia commons. Both NAturethroid and Armour are made from a pig thyroid gland and are called dessicated thyroid.
Debbie said:
I loved Armour. I’d been on it for a year and was just starting to feel myself again after 4-5 years of incompetent doctors. Then Forest switched Armour’s formula. At first, I didnt’t realize what was happening.
I didn't’t know if it was a problem with my adrenals (another problem I’ve been treating) or vitamin/mineral deficiencies (also being treated for them). I couldn't’t figure out why any of that would be happening because I had been feeling so well. My hair fell out. I became incredibly depressed. I was constipated for weeks and in serious pain from it. My hair and skin became very, very dry. My fingernails got ridges. Pain from inflamed joints returned. I gained 8 pounds in 4 weeks after having just lost 10. The worst was losing my hair, I think, and the heart palpitations and tachycardia and high blood sugars. I’m a Type 1 diabetic and have been so for more than 50 years (with no complications). My glucose became out of control. I questioned the strength of the insulin. I bought new insulin. I started eating much, much less carbohydrates. Nothing worked. I had to increase my insulin a tremendous amount and it still didn't’t help.
Then I read about the change in Armour’s formula. Suddenly, it all made sense. I switched to Nature-thyroid. My blood sugars returned to normal within a day or two !!! My hair stopped falling out and the depression disappeared. Forest put cellulose in Armour. I couldn't’t take it sub lingually anymore. People with thyroid problems often have digestion problems, too, so why would Forest put something into their medication which would require us to swallow it, thereby forcing us to try to digest it? And then that substance they put into Armour is cellulose, WHICH HUMANS CANNOT DIGEST !!!
Buy Nature-thyroid. I’m so glad that I read of other people’s success here taking that medication. I just hope it doesn't’t become scarce due to so many people switching to it now.
Gail said:
I can’t find when Armour was actually reformulated. Every site I find says “spring 09″. My bottle was filled in March – wondering if I have the old stuff – it smells pretty bad still – and I don’t take it sub lingually so I don’t know (but may try it that way tomorrow just to see!)
I do know that I have gone from .05 to 8.0 TSH and Ft3 way low. Guess I’m changing meds…
Above Image: Thyroid Hormone, T3, T4, Reverse T3 courtesy of wikimedia commons.
Liza said:
I started Naturethroid about two weeks ago (after being on Armour for 3 years) and I feel great already. Since the reformulation I was noticing very odd symptoms, including erratic body temps.
And the Naturethroid seems to work better than the old Armour (and I was an Armour advocate because of STTM). On Naturethroid my symptoms and body temps are already much more stable! And the terrible mood swings I always get on Day 19 of my cycle didn't’t happen, which was an absolute miracle. I am not sure if this is entirely related to Naturethroid but it seems significant. Overall I feel more stable.
But I am having to coordinate with the Pharmacy & Supplier to get my next refill for Naturethroid. But I gave the pharmacist the phone for RLC labs and sat there while they called to coordinate. Stay on top of it (like everyone here says) and you will succeed.
Lisa said:
I honestly think that if a thorough investigation was done, we would find that there is NO thyroid at all in the reformulation…I think we’ve all been duped and are taking empty fillers. I have felt so awful for the last couple months….have had arthritic carpal tunnel symptoms return, horrible anxiety and panic attacks, heart palpitations, and a much lower body temperature…AGAIN…after having all that stuff relatively under control. I started taking Naturethroid a week ago and already feel so much better…my energy is returning and I’m feeling some relief. No more Armour for me!
(endquote)
An Endorsement for Naturethroid from RLC Labs
Thanks to our long standing relationship with RLC Labs, Daryl Turner, and Thyroflex, we started using Naturethroid many years ago noting excellent results and high patient satisfaction over many years of experience with the medication. Why worry about possible problems with Armour when Naturethroid is available?
My office provides free samples of Nature-Throid tablets to our patients. Prescriptions for Nature-throid can be filled at any compounding pharmacy. Dessicated Porcine Thyroid manufactured by RLC Labs is preferred over Synthroid manufactured by Abbott Labs because of superior clinical results.
Financial Disclosures:
I do not accept money, gifts, perks or financial incentives from RLC labs, or any drug companies for that matter. I have NO financial relationship with RLC Labs, Abbott Labs, nor any other drug manufacturer.
Nature Throid from RLC labs is provided as free samples to my patients. These free samples are purchased at retail prices from RLC labs by my office.
I do not sell on the internet supplements or nutritional products to the general public. I do provide selected supplements at my office to my own patients with a small markup to cover my costs.
My book Natural Medicine 101 is available on Amazon, and accordingly, I receive an absurdly miniscule commission for each Amazon sale. My book is also available for free on my blog (see link on upper left sidebar)
Latest Update: as of 10-10-09, IF RLC Labs Naturthroid is on back-order, Natural Thyroid is available to US customers from ERFA Canada.
Dr Henri Knafo, Director, 8250 Blv Decarie, bur 110
Montreal, Quebec H4P 2P5 Canada (514) 931-3133
(514) 931-7330 http://www.erfa.net
ERFA LINKS:
Information page about the ERFA thyroid product
Steps for US customers to fill prescription at ERFA
More info on ERFA from Janie Bowthorp's stop the thyroid madness blog
Links to Articles With Related Content:
The Unreliable TSH Lab Test by Jeffrey Dach MD
Stop the Thyroid Madness by Janie Bowthorpe - Book Review by Jeffrey Dach MD
Hunt Study Shows Thyroid Prevents Heart Attacks by Jeffrey Dach MD
Reasons Why Thyroid Testing Can Be Unreliable by Jeffrey Dach MD
Hypothyroidism Type Two and Thyroflex by Jeffrey Dach MD
Links to Related Content About New Armour Formulation:
http://thyroid.about.com/od/thyroiddrugstreatments/a/armour-reformulation.htm
Armour Thyroid's Spring 2009 Reformulation Causing Problems - Some Patients Switching to Nature-Throid and Westhroid By Mary Shomon, About.com
Updated: July 24, 2009
--------------------------
My Thyroid Meds - Armour Changed Their Formulation Without Telling Patients
http://www.hospitalsoup.com/health-conditions/thyroid/my-thyroid-meds-armour-changed-their-formulation-without-telling-patients
http://www.hospitalsoup.com/health-conditions/thyroid/Armour%20Thyroid%20Medication%20Reformulation%20Part%20II
http://www.hospitalsoup.com/health-conditions/thyroid/thyroid-medication-nature-throid-vs-armour-thyroid
---------------------------
http://www.dr-bob.org/babble/alter/20090410/msgs/906983.html
Reformulation of armour thyroid
http://drbobsager.typepad.com/yhm/2009/07/new-armor-thyroid-formulation.html
New Armour Thyroid Formulation - Problems?
http://www.nytimes.com/2009/02/26/business/26drug.html?_r=3
Drug Maker Is Accused of Fraud - NY Times - The Justice Department charged the drug maker Forest Laboratories on Wednesday with defrauding the government of millions of dollars by illegally marketing the popular antidepressants Celexa and Lexapro for unapproved uses in children and teenagers.
http://www.consumeraffairs.com/rx/armour.html
Consumer complaints about Armour Thyroid
Jeffrey Dach MD
4700 Sheridan Suite T
Hollywood Fl 33021
954-983-1443
http://www.jeffreydach.com/
http://www.drdach.com/
http://www.naturalmedicine101.com/
http://www.truemedmd.com/
Disclaimer click here: http://www.drdach.com/wst_page20.html
The reader is advised to discuss the comments on these pages with
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Although identities will remain confidential as much as possible, as I can not control the media, I can not take responsibility for any breaches of confidentiality that may occur.
Link to this article:
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In my opinion, the New Armour is dangerous and shouldnt be used any longer!!
regards from, Bioidentical Hormones UK
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Thanks for your opinion and comment.
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The problem seems to be only occurring for those who have chosen to imbibe the medication SL (sublingual). Of note, taking the medication in this manner is not suggested anywhere on the PI. Note comments referring to "taste" and "texture". Since when do we judge a mediation by the way it tastes, or breaks down in the mouth when it is to be swallowed?
I have found no drop off in efficacy amongst my patients who take the drug in the prescribed manner. This is what happens when lay citizens on message boards and blogs think themsleves more clever then medical professionals. Of note, the founder of the aforementioned forum is, as of last notice, being prosecuted by the Missouri Office of the Attorney General for Practicing Medicine Without a License.
Dr. John Crisler
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Thanks John, for your comment about the new Armour formulation.
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In fact, when I noticed that my hypothyroid symptoms had reappeared, I wasn't aware that Armour had changed anything.
I am a patient of Dr. Crisler's, and notified his office of my trouble and requested a change to NatureThroid. I've been taking it for a few weeks and my symptoms are disappearing.
Jbx
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The problem also occurred with me, and I've never taken it SL. In fact, when I noticed that my hypothyroid symptoms had reappeared, I wasn't aware that Armour had changed anything. I am a patient of Dr. Crisler's, and notified his office of my trouble and requested a change to NatureThroid. I've been taking it for a few weeks and my symptoms are disappearing.
Jbx
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Dr. John Crisler
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While for all I know Dr. Crisler may be an outstanding physician in general, his comments here underscore just why forums and message boards where patients can share experiences have become so invaluable for ensuring receipt of quality care from medical care providers. The current Armour discussion is a good example of this.
Maybe if more doctors would tune into a few message boards, they could constructively learn more about what their patients are experiencing and thereby better help their patients.
Not saying that there isn't misinformation on such forums (then again, even physicians have been known to say some incorrect things in unguarded moments), but very good information is also quite abundant, especially regarding the kinds of things that have worked--or NOT--for others.
And by the way, Dr. Crisler, what is the reason why patients shouldn't take Armour sub-lingually?
C del D
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Thanks for your comment.
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Since I have founded five different forums, and have amassed well over 100,000 posts (more than any doctor in the history of the Internet) it's pretty hard to say I not in touch with the blog scene.
I would hasten to note most of the "information" on such forums is simple nonsense. I probably spend an hour each week dispelling bad information a patient of mine got from "some guy on a message board".
This is what happens when lay persons presume themselves more knowledgeable than physicians--even to the point of Practicing Medicine Without a License.
Dr John Crisler
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The simple fact is Armour Thyroid MUST contain the same amount of active ingredient as it did prior to reformulation of its binders and fillers.
I resent an unfair attack on this product. It reminds me of the falsified "study" concluding inconsistency in Armour Thyroid by the makers of Synthroid so many years ago. If memory serves, some corrupt folks received fines and lost their jobs over that fiasco. That bogus "study" is STILL quoted by naive physicians today as an excuse to deny patients the thyroid mix they need and deserve.
Dr. John Crisler
http://www.AllThingsMale.com
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Thanks for the comment John.
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"BH", do you have time to share your experiences, please?
Dr. John Crisler
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Kim, my executive secretary, just told me our beloved compounding pharmacy switched us to other natural thryoid product some time ago. I guess I don't have a horse in the race after all.
Dr. John Crisler
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Is it REALLY fair to complain when a medicine either does not work, or has its efficacy decreased, when soemone is taking it other than in the manner prescribed?
I do have to have a good laugh at myself, though. I recently took on three more clinics, and have been so darned busy I didn't even know my Compounder Pharmacy already switched products.
There no doubt is GREAT value for physicians to follow message boards--this very one is as good an example as I can offer. But it is run by an expert physician I know and trust (Dr. Dach), not a bunch of lay persons pretending to be doctors. Many have been seriously hurt by the info from such lay forums; now, by comparison, how many next to those by "conventional" doctors who refuse to use thyroid mixes? LOL
Dr. John Crisler
http://www.AllThingsMale.com
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Thanks to online patient forums, I do know of many, many women (mostly) who have in fact been "seriously hurt" by doctors who refuse to use natural thyroid, and instead rely solely on T4 only meds.
T4 only meds have been responsible for:
Women who have been unable to conceive, or repeatedly miscarry, women who have paid financially, physically and emotionally for infertility treatments.
Women who then go on to easily have subsequent pregnancies after adequate thyroid treatment.
Women who have been diagnosed with a host of maladies, including high cholesterol, cardiac issues, fibromyalgia, carpal tunnel problems, plantar fasciitis, depression, alopecia, arthritis, neuropathy, bladder issues, and on and on. Most of whom are then placed on medications for these illusory diagnoses, medications which at best band-aid the symptoms, but more often are both ineffective and harmful, in addition to their financial cost. All of the ailments I have mentioned (and many others) have been reported by patients to be resolved on adequate thyroid hormone replacement.
Women have lost years (and some have lost decades) of their lives to the fog of a low-thyroid state. Some live with the regret of short-changing their children and husbands. Many divorce because neither they nor their families could comprehend their malaise. Many have seen their jobs, careers and businesses falter - and often, disappear. Women who then strive mightily to pick up the pieces once their vitality is restored by adequate thyroid treatment with natural thyroid.
I assure you, doctor, maltreatment of thyroid disease by conventional doctors with T4 only meds is nothing to laugh about. Most women only arrive at the these thyroid forums after spending considerable time in ill health and misery.
By any measure, most of them have been "seriously hurt". Frankly, what I marvel at the most about the women on the forums I frequent is their resilience, good humor, and lack of bitterness towards the medical establishment that has served them so poorly and cost them so much.
gina
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I have had many patients come to me who have been hurt by the bad advice provided by the self-announted "gurus" on that forum.
Let me give some sound advice: allow at least a month between dosage increases. That forum advises almost daily jumps in dosages. That goes against the PK's of the meds in use.
Concentrate on the deiodinase enzyme D1 which converts T4 to T3. That is the centerpiece of thyroid optimization.
And make sure to address nutritional deficiencies. I have successfully treated many patients with iodine/iodide supplementation only. Many other nutrients may be a problem as well.
I hope this helps.
Dr. John Crisler
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Is Levotyroxine bio-identical? My Dr says it is. My progesterone is and so is my estrogen just want to make sure the thyroid medicine is also.
DB from Georgia
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Dear DB,
Levothyroxine is T4, and yes, it is bioidentical. However, dessicated thyroid is a better solution because it contains both T3 and T4, provides better clinical results, and is preferred over a pure T4 product such as levothyroxine.
regards,
jeffrey dach md
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In April of this year, I got a new refill on my Armour thyroid. -- I was in the middle of Spring house cleaning.
I started to feel really tired, but attributed it to the work I was doing.
Then my joints started to ache. I just thought that I was "over doing it".
Within two weeks, my hair started to fall out and my fingernails started to crack. -- The fingernails and hair were my wake up call. At that point I realized that my thyroid med wasn't doing it's job.
Evidently many others were having the same reaction, as when I called the pharmacy to tell them that the medication wasn't the right strength, I was told that I wasn't the only one to complain of this.
From then until now. (April to October 2009) it has been an absolute misery trying to find any kind of natural desicated thyroid medication available.
(I was previously on Synthyroid. It did absolutely nothing for me.)
I contacted Forest Labratories and was basically given the brush-off. Those with whom I spoke acted like there couldn't possibly be anything wrong with their product.
This company has not been forthcoming with the truth. It will be hard to ever trust them again.
I hope that Nature-throid will soon be able to totally fill the demand for natural desicated thyroid. So many of us are so miserable without it!
Charlotte
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Thanks for your comment, Charlotte. We have been lucky to find a good source of natural thyroid for our patients, and we have not been affected by the shortage. Hope thinks get better soon.
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I have been on armour for 3 years and was doing great.
All of sudden all my symptoms come back. I started researching and found out they had reformulated armour. I want to change to nature-throid but my doctor seem to have no idea of what I'm speaking of
I need help I'm getting depressed and just feel like giving up.
How can armour do this ? and why ?
If they are losing all these customers why stay with this new formula ?
Go back to what works.
Valerie H
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I agree with you and I have many of the same questions.
Thanks for the comment, Valerie
jd
disclaimer
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Dear Dr. Crisler, you mentioned above, "Concentrate on the deiodinase enzyme D1 which converts T4 to T3. That is the centerpiece of thyroid optimization." I do understand the function of the deiodinase enzyme; however, what do you mean by saying "concentrate" on that enzyme? Are you referring to some drug that contains this enzyme or increases the enzyme? Or are you simply talking about the desiccated thyroid which I suppose would contain some of this enzyme.
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In science in general, and medicine in particular, the burden is in proving something DOES work, not that it does not. In fact, no one has documented results we should expect when administering thyroid medication SL. This kind of medicine is tough enough already without adding yet another variable.
No one is claiming SL absorption cannot happen. But it is a fundamentally bad idea for lay persons to begin doing their own thing with medical therapies.
My patients standardize their treatment via normal (as in scientifically documented) oral consumption, with water, on an empty stomach. BTW, advising to chew up the tabs, as I have seen on the forums, results in portions of the tablet sticking in the crevices of the teeth, only to be exposed later on to various goitrogens (primarily calcium) in the food.
Dr. John Crisler
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Hi John,
RLC labs, manufacturer of Naturethroid recently added a micro-crystaline cellulose coating to their thyroid tablets.
In a conversation with the CEO, he actually recommended the patient chew the tablet to crack the coating.
This new coating could prevent dissoluton of the tablet in some patients with low gastric acid levels. So we have lately started recommending the patients chew the tablet at least once to crack the coating.
regards,
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I wish to focus attention on the conversion of T4 to T3, thus activity of D1 is paramount. Another perspective is that it is the processing of T4 through D1 (which does not happen with T3-only therapies, BTW) that brings health. We can definitely bring Free T3 levels to good range, and thus achieve good clinical results in the patient, but doing so does not promote D1 activity over D3.
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I'm sorry but I have a habit of asking why and asking for proof, because I've had docs telling me T4-only is better (I've switched to T3/T4 after reading testimonials from these forums and feel like I have my life back), and after years of docs telling me my thyroid is fine when it was not because inadequate tests were performed. I had one "endocrinologist" tell me that no prophylactic treatments are available for Hashimoto's thyroiditis; later I found several medical journal articles describing the contrary. You have to understand the frustration of patients and the value of these forum discussions because some of these docs unbelievably know far less than "lay" people on these forums.
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T4-only therapy works for many, but for those have inhibition of conversion of T4 to T3, health and happiness cannot be attained. Thus T3 must be added in.
True, addition of T4 when enzyme D3 is causing trouble CAN further elevate reverse T3. Removing the causes of D1 inhibition is important.
Your questions are the type Dr. Dach and I hear from intelligent patients all the time.
Dr. John Crisler
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