Natural Vs Synthetic Thyroid Replacement Therapy
There are two main categories of thyroid replacement therapy:
- Natural products, which are made from grinding up dried thyroid glands from animals
- Synthetic products, which are made in a laboratory
Within each category, there are several different products available.
The natural products have been used as replacement therapy since the 1890s, even before the U.S. Food and Drug Administration and its regulations existed. Many years later, scientists learned how to create synthetic versions of T3 and T4.
One challenge with natural products has been the variability in their potency because the amount of hormone in an animal’s thyroid gland may vary. This has resulted in reports of failed response from too little thyroid hormone or side effects from too much thyroid hormone, as well as drug recalls of some natural products over the years.
As a result of the difficulties with variability in potency and the availability of synthetic forms of thyroid hormone, the natural thyroid products fell out of favor in the 1980s, but they may still be prescribed today and benefit some patients.
None of the current natural thyroid products on the market are approved by the FDA.
What Is Compounded Desiccated Thyroid
The word desiccated means to remove the moisture from something, usually to preserve it. Desiccated thyroid is usually made from the dried and powdered thyroid glands of pigs, which contain all active and inactive forms of thyroid hormone. There is not a significant amount of processing required to make this into a medication for human use. The first medications that were used to treat hypothyroidism were made with desiccated thyroid.
Desiccated thyroid is often contrasted with synthetically produced thyroid hormone. This type of thyroid is made in a pharmaceutical lab and is called levothyroxine. Levothyroxine is the synthetic equivalent of thyroxine, also called the T4 hormone. The synthetic version of T4 is one of the most frequently prescribed medications in the United States.
While many patients find success with the use of levothyroxine, there are a growing number of patients that are choosing to use desiccated thyroid. Many patients report that they feel better when taking medications made with a naturally derived thyroid extract. Even though medical professionals have tended to avoid them in the past, many are now prescribing thyroid extracts for their patients.
Disadvantages Of Natural Desiccated Thyroid
- Comes from a pig, which is objectionable to vegetarians, Orthodox Jews and other religious groups, and others who find it distasteful
- A smaller range of dosages available than the synthetic, so sometimes a combination of pills must be used to get in-between dosages
- At times, there has been a shortage of natural raw materials, limiting its availability
- Many mainstream doctors will flat-out refuse to prescribe it
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Information For The Patient
Patients on thyroid hormone preparations and parents of children on thyroid therapy should be informed that:
1. Replacement therapy is to be taken essentially for life, with the exception of cases of transient hypothyroidism, usually associated with thyroiditis, and in those patients receiving a therapeutic trial of the drug.
2. They should immediately report during the course of therapy any signs or symptoms of thyroid hormone toxicity, e.g., chest pain, increased pulse rate, palpitations, excessive sweating, heat intolerance, nervousness, or any other unusual event.
3. In case of concomitant diabetes mellitus, the daily dosage of antidiabetic medication may need readjustment as thyroid hormone replacement is achieved. If thyroid medication is stopped, a downward readjustment of the dosage of insulin or oral hypoglycemic agent may be necessary to avoid hypoglycemia. At all times, close monitoring of urinary glucose levels is mandatory in such patients.
4. In case of concomitant oral anticoagulant therapy, the prothrombin time should be measured frequently to determine if the dosage of oral anticoagulants is to be readjusted.
5. Partial loss of hair may be experienced by children in the first few months of thyroid therapy, but this is usually a transient phenomenon and later recovery is usually the rule.
Tips For When You Start Taking Ndt
When you’re starting or taking NDT, here are a few guidelines to keep in mind:
- Take your NDT in the morning with a glass of water, ideally on an empty stomach, at least 30 to 60 minutes before eating breakfast.
- Wait at least an hour after taking your NDT before drinking coffee or milk, because both beverages can negatively affect absorption.
- NDT absorption can also be affected by antacids that include calcium, aluminum hydroxide, magnesium, iron and calcium supplements, multivitamins containing iron or calcium, and beverages like calcium-fortified juices. Take NDT four hours before or after these medications, supplements, or drinks.
Also, keep in mind that because the T3 in NDT peaks rapidly in the bloodstream, some patients enjoy the best results with a split or divided dosage, taking some NDT in the morning and the rest in the afternoon or evening.
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Natural Desiccated Thyroid And Autoimmune Thyroid
It is thought in some circles that Natural Desiccated Thyroid will aggravate patients with Hashimotos autoimmune thyroid condition. The thinking is that there is an immune attack on the enzyme thyroperoxidase and the protein thyroglobulin when it is released from the NDT, perpetuating the autoimmune attack.
Wow, this could be huge and sounds viable in theory. I have had a few patients who did not respond well to NDT, but I was not able to determine if it aggravated an autoimmune attack or if there was some filler ingredient they did not tolerate.
A literature review has not shown any evidence of the theory, though. In fact, one citation showed NDT was actually beneficial because it induced tolerance, calming the immune attack, instead of aggravating the condition.
Natural Thyroid Medicine Alternatives To Levothyroxine
- Liv HEALTH Team
People have been switching to natural remedies in recent years. The same is happening in the field of hyperthyroidism treatment.
Natural thyroid medicine is the preference for hyperthyroidism patients nowadays. They are opting for natural alternatives to levothyroxine.
What exactly does natural medicine for thyroid do for you?
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How Is Synthroid Made Where Does It Come From
Question posted by eironbull on 28 Feb 2011
Last updated on 28 February 2011 by jaroslaw666
I have hypothyriodism and I like to know about what I am taking and I would like to know How if there is no “natural” substitute where synthroid/levothyroxine comes from.
If you want my ‘bottom line’ advice, I’d suggest you stick with Synthroid IF your thyroid profile is normal AND you are essentially symptom-free, i.e., you feel ‘normal’. Certainly adding both Zn and Se won’t hurt and might even help. The latter is a very potent antioxidant which reportedly helps reduce arterial plaque formation resulting from high cholesterol. Zn is said to help with male sexual function and may delay prostate enlargement.
Desiccated Porcine Thyroid Medication
Desiccated animal thyroid extract was an early way to treat hypothyroidism.
This is a powder for medical use. It is also a combination of T3 and T4 hormones.
Common brands of this NDT include:
- Acella NP Thyroid
This type of levothyroxine alternative contains a higher concentration of the T3 to T4 ratio. Therefore, taking too much can lead to excessive thyroid hormone production.
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Indications And Usage For Armour Thyroid
Armour® Thyroid tablets are indicated:
1. As replacement or supplemental therapy in patients with hypothyroidism of any etiology, except transient hypothyroidism during the recovery phase of subacute thyroiditis. This category includes cretinism, myxedema, and ordinary hypothyroidism in patients of any age , or state primary hypothyroidism resulting from functional deficiency, primary atrophy, partial or total absence of thyroid gland, or the effects of surgery, radiation, or drugs, with or without the presence of goiter and secondary , or tertiary hypothyroidism .
2. As pituitary TSH suppressants, in the treatment or prevention of various types of euthyroid goiters, including thyroid nodules, subacute or chronic lymphocytic thyroiditis , multinodular goiter, and in the management of thyroid cancer.
Thyroid hormone preparations are generally contraindicated in patients with diagnosed but as yet uncorrected adrenal cortical insufficiency, untreated thyrotoxicosis, and apparent hypersensitivity to any of their active or extraneous constituents. There is no well-documented evidence from the literature, however, of true allergic or idiosyncratic reactions to thyroid hormone.
Natural Desiccated Thyroid For Weight Loss
One important note worth mentioning is that of weight loss and NDT.
Some studies, like this one, have shown that switching to NDT does result in modest weight loss in certain patients.
This particular study took a look at 70 patients that were already taking T4 medication .
This group of patients was taking this medication and despite having a normal TSH still had some symptoms of hypothyroidism.
These patients were then randomized and given NDT for 16 weeks and then placed back on their old medication.
During the period that these patients were taking NDT, they noticed around a 3 pound weight loss on average and roughly 50% of patients taking NDT wanted to stay on it.
Not only did they lose weight but they also reported feeling much better on the medication in a subjective sense .
3-4 pounds may not sound like a big deal to you, but when you realize that weight is incredibly difficult to lose when you have hypothyroidism this is actually a great feat.
But does this mean that the weight loss is due to NDT itself or simply due to the T3 in the medication?
While we don’t have definitive studies, it’s logical to believe that the same results would have been achieved by simply adding T3 to existing doses of T4 in these patients.
So, while NDT can certainly help you lose weight if you have hypothyroidism, don’t fall into the trap believing that the weight loss is caused by the NDT itself.
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Ageneral Effects Of Thyroid Hormones
After the administration of thyroid extracts or T4, its first physiological effects are noted in 24 to 28 h and its maximal effects are noted in 7 to 10 days . The T4 requirements for these effects vary. The requirement for T3 also varies, and less is required for equivalent activity and it acts more quickly. T3 is now recognized as the active form of the thyroid hormone within the target cell. The T4 that is transported into the target cell is rapidly deiodinated to the active T3. However, rT3, which is also produced in the cell in the deiodination process, is an inactive form of thyroid hormone and is simply degraded.
Table 20-2. Effects of Thyroid Hormone
G. Morvan-Dubois, … B.A. Demeneix, in, 2013
Fda Advises Patients Not To Use Porcine Thyroid Medicine Labeled As Westminster
Additionally, on August 9, 2018, Westminster Pharmaceuticals LLC voluntarily recalled all unexpired lots of levothyroxine and liothyronine 15mg, 30mg, 60mg, 90mg, and 120mg. These products were made using API from Sichuan Friendly. FDA laboratory testing confirmed inconsistent levels of levothyroxine and liothyronine. Therefore, FDA recommends patients not use porcine thyroid drug products made by Westminster.
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Hypothyroidism And Desiccated Thyroid
Hypothyroidism is a condition that can affect the entire body and plays a role in many essential processes. Symptoms can include fatigue, weight gain, hair loss, cognitive issues, loss of libido, and more. The only way to treat this condition is by restoring levels of thyroid hormone. There are two types of thyroid medications for doing this which are synthetic and naturally derived. Synthetic thyroid hormones are levothyroxine and liothyronine , which can be taken separately or combined into one capsule. Desiccated thyroid hormone is made from the glands of pigs and includes T3 and T4 along with the thyroid co-factors T1 and T2. It is made from the entire dried gland so it includes all forms of the thyroid hormone.
One of the main concerns that some healthcare providers have with T4-only supplementation is that not all patients are able to effectively convert it to T3. There are many situations where patients do not respond to T4-only medication. NDT is often the preferred treatment as it provides comprehensive supplementation of all thyroid hormones. In addition, a compounded formulation can be free of additives that causes issues for some patients. Our compounded NDT is made with only one filler microcrystalline cellulose and contains no additives.
Fda Inspection And Adverse Event Reporting
FDA inspected the Sichuan Friendlys facility in 2017 and discovered serious quality deficiencies, including:
- use of an incorrect formula to calculate the potency of the API, which means there may be inconsistent levels of levothyroxine and liothyronine present in the API, and
- multiple batches of API released with certificates of analysis containing inaccurate potency and stability data, and
- no stability data to support the claimed shelf-life of the API.
Health care professionals and patients are encouraged to report any adverse events associated with porcine thyroid medications to the FDAs MedWatch Adverse Event Reporting program:
- Complete and submit the report online at www.fda.gov/medwatch/report.htm or
- Download and complete the form, then submit it via fax at 1-800-FDA-0178.
FDA will continue to provide additional information as it becomes available.
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Advantages Of Natural Desiccated Thyroid
- A natural mix of all 4 thyroid hormones T4, T3, T2, T1
- T4 is the predominant thyroid hormone produced by our thyroid glands, but it is minimally active until converted to T3
- A small amount of the metabolically active T3 helps people who dont effectively convert their T4 into T3
- Contains thyroglobulin protein which slows the breakdown of T3, the active hormone so that it will keep you going all day without having to dose again during the day
- T2 has been found to play a role in metabolism and fat burning
- The glandulars in the NDT can help strengthen and rebuild you own thyroid gland, provided you still have it
- Also one grain NDT contains 120 micrograms of iodine. The adult RDA is 150 mcg, with the WHO recommending 220 mcg for pregnant women.
- Relatively low price pigs thyroid glands are sold at a low cost to manufacturers
- No one can patent a pig thyroid gland, so name brands are already at generic prices
A Note From Paloma Health
If you’re interested in finding an NDT-friendly thyroid doctor, you can always start right here with Paloma Health. Our thyroid doctors work in partnership with you to determine the right treatment option for you – including natural desiccated thyroid – based on your symptoms, medical history, lifestyle, and lab results.
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What Is Ndt Or Natural Desiccated Thyroid Hormone
NDT or natural desiccated thyroid hormone is simply a type of thyroid hormone medication.
It can be used to treat people who have low levels of thyroid hormone in their body from conditions like Hypothyroidism and Hashimoto’s thyroiditis.
NDT is often claimed to be one of the “best” thyroid medications out there because it’s considered to be all natural.
So, with this in mind, let’s break apart what NDT actually is.
NDT is porcine-derived which means that it comes from pigs.
To get NDT, people must take the thyroid gland of pigs and desiccate or dry it out.
From there it is standardized to a specific dose and contains 38mcg of T4 and 9mcg of T3 in each grain.
Grain is just a way to standardize the dose of NDT between different brands.
Natural desiccated thyroid also contains other hormones and prohormones such as other types of thyroid hormone .
These hormones are not nearly as active as T4 and T3 but they are thought to play an important physiologic role in the body otherwise, why would your body produce them?
Each grain of NDT contains around 76% T4 and around 23% T3 which is a ratio close to the 80% T4 and 20% T3 that your thyroid produces naturally when it is healthy.
For this reason, and because it contains prohormones, and because it comes from a natural source, many people believe it is one of the most complete thyroid medications out there!
While this may be true, it doesn’t mean that it works equally well for every single person.
Desiccated Thyroid: Be Wary Of Doctors Who Prescribe It
Desiccated thyroid extract, made from dried animal glands, was the most common form of treatment for hypothyroidism before the individual thyroid hormones were discovered and became commercially available. During the 1960s, science-based physicians stopped using it because its potency can vary from batch to batch, which would make it harder to optimize the patients thyroid hormone levels. The most commonly used brand of desiccated thyroid is Armour Thyroid®, which is made from pig thyroid glands by Forest Pharmaceuticals, Inc., a subsidiary of Forest Laboratories, Inc., of St. Louis.
Forests Web site displays the slogan achieve normal thyroid levelsnaturally throughout its Web site. However, the American Thyroid Association points out:
While desiccated thyroid contains both T4 and T3, the balance of T4 and T3 in animals is not the same as in humans, so the hormones in animal thyroid pills arent necessarily natural for the human body. Further, the amounts of both T4 and T3 can vary in every batch of desiccated thyroid, making it harder to keep blood levels right. Finally, even desiccated thyroid pills have chemicals in them to hold the pill together, so they are not completely natural. Desiccated animal thyroid is rarely prescribed today, and there is no evidence that desiccated thyroid has any advantage over synthetic T4 .
The British Thyroid Association also advises against the use of desiccated thyroid:
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Skeletal Development And Growth
To investigate the relative importance of T3 and TSH in bone development, two contrasting mouse models of congenital hypothyroidism were compared, in which the reciprocal relationship between thyroid hormones and TSH was either intact or disrupted.30Pax8/ mice lack a transcription factor required for thyroid follicular cell development and hyt/hyt mice harbor a loss-of-function mutation in Tshr. Pax8/ mice have a 2000-fold elevation of TSH129 and a normal TSHR, whereas hyt/hyt mice have a 2000-fold elevation of TSH but a nonfunctional TSHR. Thus, if TSHR has the predominant role these mice should display opposing skeletal phenotypes. However, Pax8/ and hyt/hyt mice each display characteristic features of juvenile hypothyroidism.30 Nevertheless, the actions of thyroid hormone and TSH are not mutually exclusive, and the consequences of grossly abnormal thyroid hormone levels in Pax8/ and hyt/hyt mice may mask effects of TSH on the skeleton.