Question: My compounding pharmacies are not able to obtain the smaller doses of Armour Thyroid (30 and 60 mg). They have to cut the 120 mg tablets, which is not an easy task. I also recently read that the original formulation has been changed. What is going on?

Dr. Brownstein's Answer:

I have been following the situation closely and trying to sort through the mess. Here is how I see it: Natural, desiccated thyroid hormone (NDT) comes in different brands, including Armour Thyroid, Nature-Throid, and Westhroid. The problem began nearly a year ago, when the supplier of raw thyroid changed its manufacturing process. This caused both major manufacturers of desiccated thyroid, Forest (Armour Thyroid) and RLC Labs (Nature-Throid and Westhroid) to have problems with their manufacturing process. This started the first wave of desiccated thyroid shortages.

After this problem was rectified, Forest decided to alter the formula for Armour Thyroid. This alteration caused a lot of patient problems as the drug was not having the same beneficial effect as before. I had many patients report a sudden decrease in effectiveness with the “new” form of Armour Thyroid.

The next problem began when Forest Pharmaceuticals, the maker of Armour Thyroid, recalled a large portion of its thyroid doses because of stability concerns and back-ordered all of its strengths. Forest is the largest manufacturer of NDT. This created an immediate nationwide shortage.

At this point, I was hearing from my patients who were rightfully concerned about being able to get their prescription. I was prescribing Armour thyroid as well as RLC Labs Nature-Throid and Westhroid to my patients. I spoke to RLC Labs, where a representative told me, “RLC is in for the long run. We are fully committed to stand behind our product and supply patients with a quality product. We will see this through.”

Right now, I suggest that those patients who use Armour Thyroid try RLC Labs Nature-Throid or Westhroid. I have used these products for years. In fact, with the recent formulation change by Armour, I have been switching many of my patients to Nature-Throid. I personally have found it a very good product for my own thyroid condition. If Nature-Throid or Westhroid are not available, a compounding pharmacist can fill your desiccated thyroid hormone needs temporarily.

Finally, ensure that you have adequate iodine intake. I have found many fewer problems switching between thyroid medications when iodine levels are maintained at optimal levels.