Thyroid Medications for hypothyroidism (NDT, T3, etc)
Welcome to the ULTIMATE PAGE of thyroid medications to choose from for hypothyroidism whether a non-autoimmune cause or Hashimoto’s.
TO CHECK MOST ANY MEDICATION FOR GLUTEN CONTENT (you want the starch not to be wheat derived). The following could come from a wheat source, too: dextrins, maltodextrin, dextri-maltose, dextrates: https://pillbox.nlm.nih.gov/pillimage/search.php
1) Natural desiccated thyroid (NDT) products in BLUE. They contain T4, T3, T2, T1 and calcitonin. The porcine thyroid powder is stated to meet the guidelines of the US Pharmacopeia. A grain of most NDT’s = 60 mg. They use the “synthetic” names for T3 and T4, “levothyroxine” for the T4, and “liothyronine” for the T3…but they are NOT synthetic products. If you have any questions about any brand, be sure and call the pharmaceutical.
2) Over-the counter (OTC) brands in GREEN These do not list the amount of T4 and T3 in their products so as not to be seen as prescription. It’s important to watch carefully one’s free T3 and free T4 and get optimal.
3) T3-only brands in PINK below. Some are gluten free. Others, we are not sure yet. Check the ingredients list. Patients have reported that adding T3 to T4 is the way to go. Be sure and read information from any company that makes T3, then ask the company or pharmaceutical any questions.
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NATURAL DESICCATED THYROID (below are three US-made working prescription brands, which are pig/porcine) ,
1) ARMOUR This NDT still works well if you understand to be optimal. You also need to check RT3 to make sure it’s in the bottom of the range or below range. Armour is made by Activas Pharmaceuticals / used to be made by just Forest labs (still says so even though it’s bought out), and was always quite popular by patients, especially because it could be placed under the tongue, and had a slight sweet taste. When Activas bought out Forest from 2015 onwards, the price tripled, and an awful lot of patients, who had done well on it for years, reported problems. At the present time, though, patients report doing well on it. It now has no sweet taste, seems harder.
Strengths: 1/4, 1/2, 1, 1 1/2, 2, 3, 4 and 5 grain tablets. The 3 and 5 grain tabs are scored., One grain is 60 mg and contains .038 mg (or 38 mcg) of T4 and 9 mcg of T3, plus unmeasured amounts of T2, T1 and calcitonin. The latter three are not removed, as rumor occasionally states. Each tablet contains:
2) ADTHZA **New as of March 2023: 65mg = one grain. https://adthyza.com/. NOTICE: one ingredient is Mannitol, which is a sugar alcohol. There are some who are very sensitive to sugar alcohols, which can cause bad gas, bloating and diarrhea. Please let STTM know if you have these symptoms. On the good side, the site also states it’s free of corn, lactose, and gluten. The site states that 32.5 (1/2 grain) is a typical starting dose–not sure why they are saying that. Patients have been starting on a full grain successfully for years. The site also states that 65 mg (one grain) to 130 mg (two grains) are “maintenance doses”. We as patients have definitely not found those doses to be maintenance, as we see a return of hypo symptoms on those over time. The site also states that “Adequate therapy usually results in normal thyroid-stimulating hormone (TSH) and T4 levels after 2 to 3 weeks of therapy.1. We as patients note that adequate doses, which are higher, normally lower the TSH much lower, without it being an issue. This is our goal based on years of experiences: optimal. Read what we have learned in the use of any NDT.
These tablets provide 38 mcg levothyroxine (T4) and 9 mcg liothyronine (T3) for each 65 mg of the labeled content of thyroid. The inactive ingredients are calcium stearate, colloidal silicon dioxide, dextrose, mannitol, microcrystalline cellulose, and sodium starch glycolate. (from their website)
3) NP THYROID After it’s recall, it’s back. By Acella.
To see RECALLS of former brands, go here.
LABELING INFORMATION: Like all NDT’s, you will only see mention of T4 and T3 on the label in their synthetic names, but they are porcine desiccated thyroid tablets and do contain all five thyroid hormones. The label says “once a day” but thyroid patients know it’s better to take NDT twice a day, like morning and early afternoon, since the T3 has a short half-life.
THE NEXT ARE OVER THE COUNTER, called NATURAL THYROID SUPPLEMENTS & ORDERED OFF THE INTERNET:
THYROID-S (non-prescription: 300% increase in price in late 2018 onward; became unavailable by 2019. Will it return?) is from Sriprasit Pharma Co., Ltd. in Thailand (sister company of Sriprasit Dispensary R.O.P.) Advertising states that Sriprasit Pharma is “a leading importer of pharmaceutical products, and has been a GMP and ISO 9002-certified manufacturer of pharmaceutical products.” Patients report they are quite pleased with this product. Sriprasit states Thyroid-s is gluten-free, but a patient has reported classic gluten digestive symptoms with it. To see a photo of the tablet, go here. Tablets are light brown, round, coated. The ingredients, according to Pongsak Songpaisan of Sriprasit are:
Thyroid extract USP
Lactose (a milk sugar and is a filler)
PVP K90 (Polyvinylpyrolidone; water soluble coating/binder; no known hazard)
Avicel (microcrystalline cellulose; holds product together)
Aerosil (silicic acid powder; help disperse the ingredients)
Sodium starch glycolate (helps dissolute/disintegrate the pill)
Magnesium stearate (filling agent)
Eudragit (a common sustain-released coating)
Methocel (a water soluble cellulose – helps bind pill)
Talcum (a filler)
Ponceau 4r lake (red additive-aluminum)
Tartrazine lake (yellow additive-aluminum)
Brilliant blue FCF lake (blue additive-aluminum)
Sunset yellow FCF (yellow additive)
Titanium dioxide (white)
PEG 6000 (water soluble polymer; binder)
Dimethicone solution (Thanks to Ruth-Ann for obtaining the ingredients list above; descriptions added)
On 8-2009, received an email from a US Doctor who received the following list after emailing Sriprasit:
Fillers used: Corn starch, actose, Avicel (microcrystalline cellulose; MCC); Binders used: PVP K-90 (Polyvinylpyrrolidone); Preservatives used: Methyl paraben, Propyl paraben; Content in one tablet (60 mg thyroid extract): approximately 38 mcg Levothyroxine (T4) and 9 mcg Liothyronine (T3); Source of extract: Porcine
Patient states: The Thyroid-S tablets are brown with a hard coating, they do not dissolve well as is, but can be chewed. They have a papaya like taste similar to “Thiroyd” below. They are ordered over the internet.
THIROYD (This has been unavailable ) Yes, that’s how they spelled it, non-prescription–as of march 2019, it’s stated prices are going UP. Also, it’s been heard that the maker, Greater Pharma Ltd., a leading Thai Pharmaceutical Manufacturer, is now ceasing to make it. An email to a patient by Greater Pharma states that “thiroyd” at one grain contains T3 at 8.31 microgram; T4 at 35 microgram, which is 0.013% and 0.058% respectively. Thyroid patient Samantha states: The Thiroyd tablets are white and have a sweet taste almost like papaya or a similar fruit. They dissolve very well sublingually and seem to have a very good potency. Entire paper insert with info is written in English: Greater Pharma Manufacturing Co. Ltd , 55/2 Phutthamonthon, Nakhon, Pathom. LikeThyroid-S, this is ordered over the net.
Another thyroid patient, Daniella, was told by the makers of Thiroyd that is free of aluminum, which is good news if you are avoiding excesses of aluminum for any reason.
As of 5-2013, here are potential fillers as sent to me by a patient in Guam: Lactose, Tapioca Starch, Sodium Starch Glycolate, PVP K-30, PVP K-90, Isopropyl Alcohol, Colloidal Silicon Dioxide, Magnesium Stearate.
To see a photo of the Thiroyd tablet (and two others), go here. They are ordered over the internet.
NUTRI-MEDS BOVINE, a non-prescription brand of natural desiccated thyroid which was around even when Janie Bowthorpe started this patient-to-patient movement. There have been periods (such as 2018) of being unavailable then available. Before has contained the following:
- Lyophilized Bovine Thyroid Tissue
- Gelatin from free range sources,
- NO sugar, starch, salt, wheat, corn, yeast, dairy or soy derivatives.
THYROGOLD, called a “dietary supplement” to meet FDA rules, though patients report it working very well. Was created by the now-deceased John C. Lowe. Comes in 150 mg and 300 mg tablets. The mgs is NOT equivalent to the same mgs in prescription NDT tablets. i.e. 150 mg may be “similar in effect” to 1 1/4 grains, but that’s a subjective opinion by some. The thyroid powder in the tablets are from New Zealand pasture-fed cows, plus there is 25 mg of Coleus forskohlii, which is said to promote thyroid function. It is a popular OTC product because of effect, who created it, and it’s length of time on the market. BUT, 2019 to the present has seen some ineffective batches causing a return of hypo. This product has had complaints in 2020, plus it ran out then.
*More information on the use of BOVINE for religious reasons here.
NOTE: a lot of complaints on Thyrogold began at the beginning of 2020, as if the source of powder was bad. Supplies ran out by late 2020. It came back.
THYROVANZ, relatively new to the OTC world, is said to be “natural whole food supplement”, and made from “100% pasture fed New Zealand prime beef”. They state it does not contain, gluten, soy, eggs, sugar or dairy, but its fillers are gelatin (the capsules and from a bovine source), Long Rice Flour (filler and non-allergenic, they state), Vegetable (Magnesium) Stearate (sourced from palm oil which is non-hydrogenated, non-GMO, and used to “to ensure encapsulation machinery functions correctly”), and silica (to ensure dosages are accurate).. Made by Provanz Nutrition Ltd. Since they, like other non-prescription NDT makers, do not measure the T4 and T3 in their product, we can make no guarantees and have not seen enough lab work to verify anything.
Patients rarely see their free T4 and free T3 optimal on Thyrovanz. We’re not sure why. And many on Thyrovanz have too high levels of RT3. Bottom line, just keep track of labs on any OTC you choose. 🙂
T.R.: stopped being manufactured (as of 2019)
MORE DESICCATED THYROID PRODUCTS
AUSTRALIA’s compounded thyroid: Desiccated thyroid in Australia is mostly done through compounding pharmacies and is usually called “thyroid extract”. A patient asked Australian Custom Pharmaceuticals, Australia’s largest compounding-only pharmacy, about their ingredients. It was stated that the only ingredients put in the capsules are the active ingredient (thyroid extract) and microcrystalline cellulose as the filler. But note: not everyone does well with cellulose fillers, so just in case, might be a good idea to ask for a different filler. Examples: rice base, turmeric, ginger, even vitamin C powder. Make sure you can tolerate what you ask for.
At ACP, 60mg (equivalent to 1 grain) contains 33.4mcg T4 and 8.37mcg of T3. However , together T4 and T3 may potentiate each other giving a therapeutic effect equivalent of 25mcg of T3 and 100mcg of T4 per 60mg. The thyroid extract in porcine derived, and it is bought from an overseas supplier. Australian Custom Pharmaceuticals Ph. 1300 853 620 Fax. 02 8536 4155 (Thanks to Juanita for providing this information)
CANADA’S “THYROID” aka ERFA, formerly by Pfizer and is now by Erfa. Note: beginning around May 2014 and continuing to today, many patients have reported Erfa was now causing a return of hypothyroid symptoms. Erfa denies a change. Click here.
Tablets come in 30, 60 and 125 mg tablets. They contain:
- Dried Thyroid
- Magnesium Stearate
- Sugar (tiny amounts of both sucrose and lactose)
Erfa’s Canadian Thyroid has slightly different ratios than the USP ratios of US brands:
30 mg tablet embossed ï¿½ECI 30ï¿½, has 18 mcg. of T4; 4 mcg. of T3 (as compared to 19/4.5 in US brands) Equivalent to the US one-half grain.
60 mg tablet embossed ï¿½ECI 60ï¿½, has 35 mcg. of T4 and 8 mcg. of T3 (as compared to 38/9 in US brands) Equivalent to the US one grain.
125 mg tablet embossed ï¿½ECI 125ï¿½, 73 mcg. of T4; 17 mcg. of T3 (as compared to 76/18 in US brands) Equivalent to the US two grains. http://www.erfa-sa.com/thyroid_en.htm, plus they have a question & answer forum: http://erfa-sa.erfa.net/
DENMARK’S THYREOïDUM for NETHERLANDS from Biofac in Kastrup, Denmark. Imported into the Netherlands from BUFA/Fargo, importers of pharmaceutical products.
Â½ grain = 29 mg (12.7 mcg T4 and 4.5 mcg T3)
1 grain = 57 mg (25.3 mcg T4 and 9 mcg T3)
2 grain = 114 mg (50.6 mcg T4 and 18 mcg T3)
Some websites state the T4/T3 ratio can vary from 2.3: 1 to 3.8: 1 depending on the lot. Meets standards of US Pharmacopoeia. Contains Microcrystalline cellulose as a filler. Also may contain lactose, sodium, chloride, starch, sucrose or glucose. (Thanks to thyroid patient Julia of the Netherlands for alerting me of this desiccated thyroid!)
DENMARK’S COMPOUNDED: The Thyroid in Denmark is made as a compound Thyroid, and is made at this pharmacy: Glostrup apotek. Contact person: Kristian Ã˜stergaard Nielsen, Phone number: (??)-43960020; mail: 109KN@apoteket.dk
60 mg Thyroid from Glostrup pharmacy contain: 9.15 mkg T3 and 36,3 mkg T4. Filler: lactose, potato starch, gelatine, magnesiumstearat og talcum. Glostrup pharmacy have Thyroid in 60mg and 125 mg.
(Thanks to thyroid patient Lone for this information)
GERMANY’S THYREOGLAND from Munchen (Munich), Kloesterl Apoteke, Waltherstrasse, 80337 Muenchen. Phone: 089 54343211. Requires prescription.
1 grain Armour=100 mcg levothyroxine=40 mcg Thyreogland. Clear gelatin capsules with loose powder inside. May have magnesium searate as a filler. The 25 mcg tablet specifies “25 mcg T4 and circa 6 mcg T3” on the label. Thanks to thyroid patient Amy for the above information.
Anna sent me this: the Kloesterl Apotheke (pharmacy) Munich Tel: 0049 (0)89 / 54 34 32 11 offers 4 different strengths: 25 mcgr T4+5.9 mcgr T3; 50 mcgr T4+11.8 mcgr T3; 75 mcgr T4+17.8 mcgr T3 ; 100 mcgr T4+23.7 mcgr T3. The 75 mcgr one is nearly exactly the equivalent of 2 grains of armour. Also they add the amino acid tyrosine in the capsules as a filler. She advises all Germans to phone them and get the leaflet. It’s more or less the only information about natural thyroid treatment available in Germany that one can take to a doctor.
Also available in Germany: compounded pork thyroid, aka Schilddruesen-Extrakt, in different grains. Obtained from pharmacy Receptura, Altenhoeferallee 3, 60438 Frankfurt am Main, Germany. Phone: +49-69/92 880 300 E-Mail: email@example.com (not for shipment to USA or Canada) Fax: +49 (0)69-92880 333 PC-Fax: +49 (0)69-92880 25 460 e-mail: firstname.lastname@example.org (thanks to Debby for extra info)
NEW ZEALAND’S Whole Thyroid, which is compounded desiccated thyroid by Pharmaceutical Compounding New Zealand (PCNZ). Phone: 09-442-1727 Fax: 09-442-5851 Email: email@example.com Website: http://www.pharmaceutical.co.nz/
T3 MEDICATIONS (synthetic, also called Liothyronine Sodium)—a star is in front of those that are stated to be gluten-free; others may not be. Be sure and read any information from the pharmaceutical that makes any brand, and ask them any questions you have about what you read or heard about T3.
CYTOMEL by Phizer
starch (from corn)
Phizer states they add no gluten-containing products, but can’t confirm cross contamination. Formula has been the same since 2005.
* LIOTHYRONINE SODIUM (Generic) by Libertas Pharma — formerly by Mayne Pharma, formerly Paddock/Perrigo) 5 mcg and 25 mcg and they have 220 on one side of the tablets, and the 5 or 25 on the other side (do they still?). The 25 mcg has a score line. They state no gluten, no corn. But some wonder if the fillers are from corn. Need more experiences from patients who have Celiac or gluten sensitivity on this one
colloidal silicon dioxide
LIOTHYRONINE SODIUM (Generic) by Sigma Pharm, 5 mcg, 25 mcg and 50 mcg. Has an 18 on one side, a greek E on the other.
Calcium Sulfate Dihydrate
LIOTHYRONINE SODIUM by Sun Pharma in India It was obtained from Costco. Sun Pharma makes their meds primarily for India and the United States. Comes in 5 mcg, 25 mcg and 50 mcg. Inactive ingredients consist of corn starch, croscarmellose sodium, gelatin type B, magnesium stearate, mannitol (a sugar alcohol), and microcrystalline cellulose.
LIOTHYRONINE SODIUM by Teva Pharmaceutials USA Comes in 5mcg, 25mcg and 50mcg. They are white in color, have TV embossed on one side, and are scored on the other side, which makes cutting them in half easier.
LIOTHYRONINE SODIUM by Uni Pharma in Greece They are 25ug tablets. Nothing written on tabs. A slightly rounded off white kind of magnolia colour.
Sodium Starch Glycolate
Egg Yellow Lake
Silicon Dioxide Colloidal
LIOTHYRONINE SODIUM by Greenstone, a Phizer company .
Inactive ingredients: calcium sulfate, corn starch, gelatin, stearic acid, sucrose and talc
KPI is on the tablets. They are round, white to off-white, and available as follows:
- 5 mcg: debossed with KPI 15 on one side and 115 on the other side, or similar.
- 25 mcg: scored on one side and debossed with KPI and 116 on the other side
- 50 mcg: scored on one side and debossed with KPI and 117 on the other side
TIROMEL from Turkey and said to be made by Abdi Ibrahim. 25 mcg tablets. Ingredients stated as following:
Polivinil pirolidone (mineral origin binder)
Starch (unknown source)
TERTROXIN by Aspen (also Glaxo) which comes in 20 mcg tabs, and contains
acacia (used as a binder)
LIOTHYRONINE SODIUM by ZYDUS PHARMACEUTICALS
The pill is hard, but is slightly sweet. List of the inactive ingredients.
Calcium sulfate dihydrate
TRIOSTAT is an injection version of synthetic T3 (1), where each ml contains 10 mcg of liothyronine, as well as
alcohol, 6.8% by volume
anhydrous citric acid, 0.175 mg
ammonia, 2.19 mg, as ammonium hydroxide
“CYNOMEL” LIOTHYRONINE SODIUM by SANOFI-AVENTIS This a french pharmaceutical, now known as simply Sanofi as of 2011. 0.025 tabs.
May contain gluten—need more specific ingredient list
CYNOMEL, a Mexican version of T3 only
Calcium Sulfate Dehydrate
Sterate acid powder
LIOTIR, a liquid form of Liothyronine and is taken in drops. Said to contain alcohol. (Patients have expressed fear of accuracy if it’s just based on drops.)
OTHER BRANDS OF KNOWN T3 (though more info needed in ingredients):
Berlin-Chemie Trijodthyr (headquartered in Florence, Italy, though a German subsidiary of the Menarini group)
Henning Berlin — Thyrotardin N
Merrell Dow- Cynomel of France
Nycomed AB Liothyronin (contains Lactose Anhydrous)
Tijodthyronin (available in Austria)
THREE DEFUNCT DESICCATED THYROID MEDS or T3, i.e NOT AROUND ANY LONGER:
DIOTROXIN, by Aspen Pharmacare Ltd of South Africa, a combination of T4 thyroxine sodium at 90 mcg and T3 liothyronine sodium at 10 mcg. Discontinued in May of 2016
GENERIC NATURAL THYROID (which includes one called Qualitest) by TIME-CAPS LABS (as of 2009, this one appears to have been discontinued). It contained thyroid powder, microcrystalline cellulose, Dicalcium phosphate, Colloidal silicon dioxide, Sodium starch glycolate, Steric acid, Magnesium stearate, Hydroxypropyl methylcellulose, and ï¿½other ingredientsï¿½ (which we did not know). It was unpopular due to being weaker. Another generic maker was called URL, or United Research Labs, which is a sister company to Mutual Pharmaceutical. As of 8-07, it’s reported by a patient that Qualitest had the same smell as Armour, which is different than the lack of smell it had before. As of 2009, it may have also been discontinued. In 2009, an active generic still around by Major Pharmaceuticals, simply called Thyroid, or generic Thyroid, 31778 Enterprise Drive; Livonia, MI. 48150
THYROLAR: Thyrolar (liotrix), combination of synthetic T4 (levothyroxine sodium) and synthetic T3 (L-triiodothyronine), has not been available since 2009 with no explanation from Forest Labs. It had a ratio of four parts T4 to one part T3. No T2, T1 or calcitonin. The tablets needed to be kept refrigerated. Patients who’ve tried both Thyrolar and desiccated thyroid report the latter gives them far better results.
ITALY’s “CINETIC” dried thyroid (Sadly, this ceased being produced in 2011), produced by Teofarma srl — Pavia, Italy, contained: Dried Thyroid, Dextrate, dicalcium phosphate, microcrystalline cellulose, magnesium stearate, talc, sandarac resin, gum arabic, gelatin, saccharin, titanium dioxide, indigotine (E132), PVP, white beeswax. Active ingredients: 75 mg dried thyroid (equal to 25.5 mcg T4 and 7.5 mcg T3); organic iodine 0.150 mg in thyroid combination). Tablets were coated. 75 mg with 50 tablets in blister pack. Package insert recommended 1-2 tablets, 3 times a day (though that may end up being different according to your needs). They also recommended to swallow pills with water, without chewing and without dissolving. To be stored not above 77F/25C (Thanks to Beatrice for translating and sending the above information!)
LIOTHYRONINE SODIUM (T3 Generic) by Mylan Pharmaceuticals. Has ML on side; 11 on the other. This was announced by the FDA as stopping production by 2018–a company decision.
Want to order your own labwork to later show your doctor?? We have recommended labwork with several lab facilities, plus two on the top with STTM created labwork!
Need help interpreting your labwork? Go to www.stopthethyroidmadness.com/lab-values/
It’s VERY important that we become informed to get well and counter the poor information that too many doctors have. That’s why Janie Bowthorpe wrote these patient-to-patient books to help you be informed! See more here.
SOME INGREDIENT EXPLANATIONS:
- Microcrystalline Cellulose
- synthetically derived fiber base (similar to plant-derived). It is typically utilized as a filler in a tablet (to provide volume and bulk).
- Dicalcium Phosphate
- derived from a mined ore. It is typically utilized as a binder in a tablet (to hold all the ingredients during compression).
- Colloidal Silicon Dioxide
- derived from a mined ore. Typically utilized as a natural desiccant in a tablet (to provide barrier from moisture and humidity).
- Sodium Starch Glycolate
- Synthetically derived starch molecule (similar to potato starch). It is typically utilized as a disintegrating agent in a tablet (to aid in proper disintegration of the tablet in the stomach).
- Magnesium Stearate
- Derived from a vegetable source (typically palm oil). It is typically utilized as a lubricating agent in a tablet (to aid in proper compression of the tablet).
- Hydroxypropyl Methylcellulose
- Derived from a plant cellulose base (typically cotton blend or wood pulp). It is typically utilized as a granulating agent in a tablet (to provide bulk and density to the tablet for proper compression) as well as part of a clear coating solution (with PEG).
- Polysorbate 80
- An inactive water soluable emulsifying agent which blends the ingredients of mixtures and prevents separating.
- Stearic Acid
- Derived from a vegetable source (typically palm oil). It is typically utilized as a binder in a tablet ( to hold all the ingredients during compression).
- Carnauba Wax
- Derived from the pores of the leaves of the Brazilian wax palm tree. It is utilized in the final stage in tablet coating (to provide a complete seal).
- Polyethylene Glycol (PEG)
- Synthetically derived, water-soluble, waxy solid. It is utilized with Hydroxypropyl Methylcellulose as part of the clear coating solution.
- Lactose Monohydrate
- Present in traceable amount as part of Thyroid USP (diluent)