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Major Pharm told to stop making thyroid–more to this story

FDA2

I have been receiving emails this afternoon from concerned patients about the latest blog post by health writer Mary Shomon. Her post states that Major Pharmaceuticals has received a notice from the FDA to stop making desiccated thyroid.  And Shomon questions:  is this the beginning of the end?

I think it’s important to mention something that I remember reading, but can’t right now put my finger on, that the FDA can stop production of desiccated thyroid if a company has started making it AFTER the FDA came into existence, and require it to file a New Drug Application, since it is “new” to that company.  Forest Labs and RLC do not fall in that classification. They were around before the FDA came into existence.

I did find this article about Morphine, which implies that as long as a drug (like desiccated thyroid) has not changed since it’s inception, it can avoid the New Drug status. It states:

Under a grandfather clause, a drug marketed prior to the 1938 Federal Food, Drug, and Cosmetic Act, and labeled with the same conditions of use as prior to the Act, was not considered a new drug. These drugs did not require an approved new drug application, but many thought tacit FDA approval was implied. It’s the drug company’s burden to prove an assertion that its product is grandfathered. But FDA believes few drugs are entitled to grandfather status because many differ from previous versions in some respect (e.g., formulation, strength, dosage form, route, indications, intended population).

The above statement makes you pause about Armour, which WAS changed by Forest Labs. But I’m not at all sure RLC’s desiccated thyroid has changed at all, which can be good news for all of us.

Check out page 332 of Good Manufacturing Processes for Pharmaceuticals by Joseph D. Nally which also outlines the above issue of grandfathered drugs.

All in all, it’s downright MADDENING and INEXCUSABLE how the FDA would tell these generic pharmaceuticals–Major and Time-Cap Labs, to stop producing the medication when we already have a shortage.

Here is what the FDA states in their 2006 Compliance Manual, Section 7132c.02 titled Marketed New Drugs Without Approved NDA’s and under A: Reason for This Guidance, please note what I have italicized in their statement:

Manufacturers of drugs that lack required approval, including those that are not marketed in accordance with an OTC drug monograph, have not provided FDA with evidence demonstrating that their products are safe and effective, and so we have an interest in taking steps to either encourage the manufacturers of these products to obtain the required evidence and comply with the approval provisions of the Federal Food, Drug, and Cosmetic Act (the Act) or remove the products from the market. We want to achieve these goals without adversely affecting public health, imposing undue burdens on consumers, or unnecessarily disrupting the market.

To the contrary, the FDA has IN FACT adversely affected public health and has imposed undue burdens on consumers by these ridiculous actions!! A large body of those now on desiccated thyroid will tell you that being on anything BUT desiccated thyroid ruins their health and well-being. I am one.

Under III. FDA’s Enforcement Policy, they define two areas of concern: drugs with potential safety risks, and drugs that lack evidence of effectiveness. You and I know very well that the latter has been stated ad nauseum by the FDA and certain individuals, and yet THE EVIDENCE IS IN HUNDREDS OF THOUSANDS OF US who have switched to desiccated thyroid is ignored, as it the continuing symptoms representing lack of effectiveness in T4 meds!

You can continue reading this FDA Guidance policy and use the Comments to see what hits you, as well.

I have compiled the above fairly quickly, so if I have left anything out, or you can offer more clarification, use the Comments.

P.S. A recommendation: if you are very optimal on your current desicccated thyroid, I would recommend trying to decrease your dose every other day. For example. 4 grains, 3 1/2 grains, 4 grains, 3 1/2 grains, etc.  Not everyone can do this, but if you can, it will help draw out the amount of desiccated thyroid you do have without adversely affecting you. Again, this may only work for those who are quite optimal, and without adrenal fatigue or other issues.

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More good info on Canada’s “Thyroid” by Erfa

erfathyroidJust had a good conversation with Dr. Henri Knafo, the Director of Medical Affairs at Erfa Canada, Inc.

On my post below from yesterday, you will see hopeful information on getting this excellent Canadian desiccated thyroid. And below is more information you have been asking for as patients who know the efficacy of desiccated thyroid.

Erfa’s “Thyroid” comes in three strengths: 30 mg, 60 mg, and 125 mg.  Amounts you can order, and costs, are as follows:

30mg             500 tablets  $52.00 US;    100 tablets $18.00 US

60mg             500 tablets  $70.00 US;    100 tablets   $39.00 US

125mg          500 tablets  $100.00 US;   100 tablets  $ 50.00  US

Erfa will charge a 10$ handling fee (for first time users) and shipping is around $20 US.  Knafo states the prices are equivalent to Armour.

Erfa’s Thyroid has been in production for 30 years and they have 5000 Canadian patients on it.

Erfa’s Thyroid is approved by Health Canada (their equivalent to FDA).  Erfa spoke to the FDA, and in order for their desiccated thyroid to cross the US border, you have to fill out and sign the FDA patient study form which is mentioned below.

Erfa’s Thyroid is made in Europe with the raw materials, and they bought an excess of it. So there will be no problem getting it and they expect no shortages the rest of the year.

One canadian pharmacy you can use (and is not associated with Erfa) is the Canada Pharmacy Online.

Good news! You can get good desiccated thyroid from Canada.

erfathyroid

NOTE: when this blog post was written in 2009, it was good news to mention the Canadian brand of NDT, made by the company called Erfa. But sadly beginning in 2014, it seemed to change in a negative way, as reported by numerous patients, even if some still used it. Complaints about symptoms returning fell on deaf ears. There have also been shortages. 

Unfortunately, patients who want to switch to desiccated thyroid from T4-only meds like Synthroid et al, or those already on desiccated thyroid who want to fill their next prescription, are going to find it difficult. There are widespread shortages in desiccated thyroid like Armour, Naturethroid and Westhroid. (see my posts below).

But there’s good news, and it comes in the form of “Thyroid”  by Erfa.

Erfa’s “Thyroid”  is an excellent natural desiccated thyroid product according to the experience of patients who use it. It contains:

  • Dried Thyroid
  • Mag­ne­sium Stearate
  • Corns­tarch
  • Talc
  • Sugar

**Note the “sugar”. Patients also report they are able to do this brand of medication sublingually! That is good news.

The Erfa website states you can obtain their desiccated thyroid medication outside of Canada via a special access program and follow their steps:

For patients outside Canada and the US:

1. Get a prescription from your local doctor (mention hypothyroidism on it).
2. Your doctor should fill in this simple document (not required for the UK)
3. Fax or e-mail us the documents at 1-514-931-7330 or info@ERFA.net

For patients in the US:

1. get a valid prescription of Thyroid from your local doctor
2. your doctor has to fill FDA form 1572 (e-mail us a request at info@ERFA.net
3. Fax or e-mail us the documents at 1-514-931-7330 or info@ERFA.net

Thank you Erfa from Stop the Thyroid Madness and thyroid patients all over the world who KNOW what a superior treatment desiccated thyroid really is!

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The only North American maker of desiccated porcine thyroid is working hard

Screen Shot 2015-09-21 at 11.27.57 AM(This page was originally written in 2009 but it has been updated to the present day and time.)

We always talk about pharmaceuticals which produce our desiccated thyroid medication pills like Forest Labs (Armour) and RLC Labs (Naturethroid and Westhroid).

These are also the pharmaceuticals who provide these pills to the local pharmacies we use.

But there is another important link in the chain that proceeds them–the laboratory that makes the actual porcine powder!

American Laboratories, Inc. (ALI)

ALI is a small and family-owned processing company located in Omaha, Nebraska which was established in 1967 by Mr. Jack Jackson and Mr. William Phalen.  They have been making desiccated Porcine Thyroid Powder (which is an Active Pharmaceutical Ingredient, API) for over 47 years, as well as 200 natural biologically derived products such as Pancreatin and Pepsin, both digestive enzymes. Their mantra is “Building trust through quality products and service.”

Pertaining to their raw porcine powder, they state:

American Laboratories staff has been dedicated to the manufacture of active Pharmaceutical products for over 47 years, and currently follow all FDA cGMP (21 CFR) requirements or the safe and effective manufacturing of drug products or human consumption. Our stringent raw material quality requirements and highly defined manufacturing process control have aided us in providing category leading status for the drug products that we manufacture.

ALI, as a leading manufacture and supplier of enzyme and natural dried products, is also probably the only North American company to make desiccated thyroid powder. And they will explain that it’s a long and difficult product to make, but they are committed to it. ALI sells product to over 50 countries around the world, as stated below from them!!

Their website underscores:

American Laboratories, Inc. is a family-owned business founded nearly 50 years ago based on our knowledge of providing enzymes, proteins and flavors to various industries. Today, American Laboratories is proud to offer an extensive listing of over 300 products to the Food Processing, Pharmaceutical, Veterinary Health, Nutritional and Diagnostic industries in the United States and over 50 countries around the world. Through our high quality products and customer service, American Laboratories has become an industry-recognized supplier for the products we manufacture.

In August of 2009, I spoke with Kenny Soejoto, the Chief Operating Officer. He explained that supply and demand has been a critical issue, and ALI will be doing everything they can to provide the quality desiccated thyroid powder to pharmaceuticals that they always have. You’ll also see a Press Release come out later today from Kenny and ALI about the issue. I’ll add it below.

The supply and demand issue is outright due to the current patient revolution, represented by STTM and other fine groups and websites,  against the sole treatment of hypothyroidism with T4 meds like Synthroid by too many doctors….and in favor of desiccated thyroid as a far better treatment. Demand has grown, and perhaps it caught them by surprise. (That is my comment, by the way, NOT ALI’s.)

Even RLC Labs states that demand for Naturethroid (due to problems with the newly formulated Armour) has quadrupled in the past few weeks. And rightly so!  Thyroid patients around the world KNOW FIRSTHAND how much better desiccated thyroid treatment is over T4-only. And word is spreading.

So as we,  thyroid patients on desiccated thyroid, face a shortage in 2009, take heart that everyone is working hard to bring supply back to us.  🙂 Also see my post below concerning the bigger issue with Medco, and potential alternatives.

*************************************

Here’s the Press Release below, and it should calm any fears or panic:

August 19, 2009

To our knowledge, American Laboratories, Inc. is the only manufacturer in North America of Thyroid Products for use in Human Pharmaceuticals as an Active Pharmaceutical Ingredient. We have manufactured our Thyroid products for over forty years, and we understand the importance they have to our customers and ultimately the consumer patients. Today, as well as in the future, our Thyroid products will continue to be a strategic part of our business.

Through the years, the world-wide demand for our Thyroid products, as well as our human nutritional enzyme products has increased dramatically. Through careful planning and strict adherence to regulations set forth by the FDA, USDA and other government agencies, we have implemented plans to increase our production capacities. In addition, American Laboratories’ is working closely with our suppliers to help ensure a consistent supply of quality raw materials. We hope that you understand that the process to manufacture the active ingredient takes several months to complete.

Please be assured that we have placed our Thyroid production as our number one priority so that we can meet the demands of our customers.

American Laboratories, Inc
Omaha, Nebraska, USA

JanieSignature SEIZE THE WISDOM

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I am very concerned for those on Naturethroid with a month-to-month supply

shortageWord has trickled down to me from a few patients and emails that even Naturethroid is getting harder to come by at pharmacies because of the extreme demand on RLC Labs.

No, they are not ceasing to make desiccated thyroid. They just weren’t prepared for the high demand due to the reformulation of Armour and problems it caused.  And they aren’t keeping up and won’t for several months.

So, if you can’t last with your current prescription for several months, you will probably need to talk to your doc about getting a generic version by Major Pharmacy, or get some over-the-counter like NutriMeds, or even the “Hypo Support Formula” made by RLC Labs, but expect to take much more of either.  Many patients are also mentioning Thyroid-S by Greater Pharma as a backup until RLC catches up.  But it’s by mail order and will take a few weeks to arrive.  Google any of the above. Finally, you can move a slight step backwards and talk to your doc about doing synthetic T4 and synthetic T3.  It’s not going to be quite a good as being on desiccated thyroid, but it’s certainly better than being on T4 alone, don’t you agree?? Keep connected to your doc.  And hang in there. This will pass.

Janie

P.S. I’ll be adding more information to this post tomorrow. Check back.

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Below is the actual release by RLC Labs:

For any patients experiencing difficulties in attaining either Nature-ThroidTM or WesthroidTM through their pharmacy, RLC Labs, Inc, asks these individuals to have their pharmacy contact us directly at 877-797-7997 to place an order, or have their pharmacy request a drop-shipment through their wholesale supplier.

RLC Labs’ products are only available through wholesalers, pharmacies and or their doctors; thus all confirmations and/or tracking information will only be available through the wholesaler, pharmacy, or doctor’s office that placed the order.

RLC Labs is experiencing a substantial increase in orders for Nature-ThroidTM and WesthroidTM. The recent unexpected influx has inundated our customer service and shipping departments, thus causing delays and depleting our current stock. We are working around the clock to fulfill all current orders; however, we cannot guarantee that
any future orders will be fulfilled until our stock is replenished.

RLC Labs will continue to accept orders from our customers, however as of Friday August 14th, we are backordered on all strengths of Nature-ThroidTM and WesthroidTM. Shipment is expected to resume within 90 days.

We regret to inform you of this situation; however, we can assure you that we are working diligently to replenish our stock and will resume shipping as soon as possible. Please accept our sincerest apology for any inconvenience.

We do understand how much of an impact this has as most of us employed @ RLC Labs, are hypothyroid and take our own product. Thus, we know and understand how important it is to get product back into the market place. We are grateful for your continued patience, patronage and support!

Feel free to contact our customer service department with any questions concerning this matter @ 877-797-7997.

Thank you from all of us @ RLC Labs, Inc.