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All about Drug Recalls and what happened to Westminster’s Natural Desiccated Thyroid

Probably most people have heard about “drug recalls”, but may not know the ins and outs about recalls.

What is a recall?

I personally think the best definition of a drug recall comes from the Saunders Comprehensive Veterinary Dictionary1:  a voluntary action of removing a product from retail or distribution by a manufacturer or distributor to protect the public from products that may cause health problems.”

Note the word “may” cause. Recalls can also be about risk, not just about definite adverse consequences.

So a recall is voluntary by a pharmaceutical?

It definitely can be. And it can also be at the request of the FDA.  Either.  From the FDA2: Drug recalls may be conducted on a company’s own initiative or by FDA request. FDA’s role in a recall is to oversee a company’s strategy, assess the adequacy of the recall and classify the recall.

What are reasons for a recall?

WebMD3 defines five potential reasons:

1) it’s a hazard to your health
2) it’s mislabeled or poorly packaged
3) it’s potentially contaminated during production or distribution
4) it’s not what it says it is
5) It’s poorly made, effecting it’s quality, purity, and/or potency

For #3 above, note that the potential contamination may be harmful OR non-harmful.

Are recalls common?

Believe it or not, yes! A 2017 article in the Journal of the American Medical Association4 stated that 1/3 of all prescription meds have been recalled due to “safety events”.

If something I take has a recall, what do I do? Can I get my money back?

Yes. But you do need to call the pharmacy from which you got it, first. They have to get official notification of the recall before giving that refund.

Shouldn’t I get a replacement for my prescription medication before taking it back?

Call your doctor so he or she can prescribe a different one before you return your recalled medication. That way, you can pick it up at the same time you return your recalled medication, say experts.

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Now let’s move to a recent recall of one particular natural desiccated thyroid medication by Westminster Pharmaceuticals.

Westminster came out with its own natural desiccated thyroid (NDT) product, considered a generic version, in late 2017.  You can read more about their NDT product on Stop the Thyroid Madness’s page which lists brands and ingredients, here.

Westminster voluntarily issued a recall of their NDT in August 2018 due to “risk of adulteration”. See below.

Why did Westminster voluntarily issue a recall?

The recall states it was done “as a precaution because they were manufactured using active pharmaceutical ingredients that were sourced prior to the FDA’s Import Alert of Sichuan Friendly Pharmaceutical Co., Ltd., which as a result of a 2017 inspection were found to have deficiencies with Current Good Manufacturing Practices (cGMP). Substandard cGMP practices could represent the possibility of risk being introduced into the manufacturing process.”

It’s important to point out the words “possibility of risk”. That is different than a definite negative outcome as having occurred. But time will tell.

And if you really want to get into detail about why the FDA issued an alert about Sishuan Friendly Pharmaceutical, the maker of desiccated thyroid powder that Westminster was using, it’s all here.

How do I know if my particular bottle of Westminster’s NDT is part of this recall?

The recall notice lists many lots. You’ll need to call your pharmacist to see which lot your bottle came from. But it does appear that most of Westminster’s NDT has been recalled by the long list of lot numbers.

Has anyone been harmed by their use of Westminster’s NDT?

In the 2009 recall wording, it was stated “To date, Westminster Pharmaceuticals has not received any reports of adverse events related to this product.”

Is this the first time that any thyroid medication has been recalled?

Nope. For example, Levoxyl, a T4-only medication, was recalled in April 2013.  Synthroid, another T4-only medication, has been recalled numerous times due to issues like subpotency and the same failure to follow good manufacturing practices.

Is 2018 a year of Natural Desiccated Thyroid mishaps??

Boy oh boy, it sure has been.

First, RLC’s Naturethroid and WP Thyroid ceased production in 2017, and Naturethroid only started creeping back in 2018. But sadly in 2018, there seem to be quite a few patients reporting it to be far weaker than it used to be and finding that out the hard way with the return of major hypothyroid symptoms. Some are trying to raise it to see if they can regain their former feel-goods; others have been switching to other brands.

Then comes this with Westminster’s NDT. What a mess.

Is there a conspiracy at foot to take our NDT away?

No, it does not appear to be conspiracy.

My doctor claims these recent issues prove that desiccated thyroid is unreliable and I should use Synthroid. What do I say?

You say “What is proven by millions over the years is that T4-only like Synthroid is the unreliable way to treat hypothyroidism”.

So where do I turn now?

People have been moving over to NP Thyroid by Acella, or Armour. You can also choose to have your NDT compounded. Or move to synthetic T3 with synthetic T4. But the goals are the same, which for years includes seeking a free T3 towards the top part of the range, and a free T4 midrange. Both. And to achieve the latter, it’s still important to have the right amount of cortisol and iron, we’ve learned repeatedly, because if you don’t, you can see problems. Too often, people blame their problems on NDT, when in reality, it’s what NDT or T3 reveals that is the problem.

 

 

 

 

 

 

 

 

Footnotes:

1. Saunders Comprehensive Veterinary Dictionary, 3 ed. © 2007 Elsevier, Inc.

2. https://www.fda.gov/Drugs/DrugSafety/DrugRecalls/ucm612550.htm

3. https://www.webmd.com/a-to-z-guides/what-is-a-drug-recall#1

4. http://jamanetwork.com/journals/jama/fullarticle/2625319

The Makers of Naturethroid & WP Thyroid have contacted Janie Bowthorpe

An update from Janie after this original 2018 post below

Sadly, since I posted the below, there have been a large and growing body of patients who have found that the “new” Naturethroid (in the same amount that once removed their hypothyroid symptoms) has left them with with major symptoms, plus free T3 and free T4 very low in the range and a high TSH. Those who have tried raising state it has done nothing to return them to their former state. Something pretty bad is going on now with Naturethroid.

There are a very few who report feeling fine…but, we notice that the longer someone is on the new Naturethroid, the more the hypo symptoms creep up.  i.e. it can be the adrenaline being released that fools people into feeling better…until they crash. 

So below, which I wrote before writing what I am now, seems to counter the comment that RLC has a commitment to quality, say many patients in groups.

2nd update from Janie as of August 2020

It turns out that Naturethroid was recalled in 2020 due to sub-potency.

And now the original blog post from 2018, below.

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Here is a May 16th, 2018 update directly from RLC Labs to me via email (and perhaps on their site)–the maker of Naturethroid and WP Thyroid, both natural desiccated thyroid brands. Comments from me, Janie Bowthorpe, below that. 

Since we went back into production, there have been a lot of questions–understandably so– around what caused the backorder, why certain strengths have been released ahead of others, and why available strengths are not yet at some pharmacies. We have done our best to communicate updates throughout the delay but deeply apologize if they did not reach you or answer your questions. It is not our intention to keep anyone in the dark or hide anything, and we hope this letter helps clear things up a bit more.

After expanding our operations to better accommodate growing demand and overcoming hurdles in obtaining raw material–the primary factor behind the backorder–we are happy to say that everything needed to ensure ongoing, full-scale production is in place. We are actively shipping and are focused on filling backorders.

We are far from being a “big pharma” company, however, and do not have the scale of one, but we are maximizing our working capacity and mean it when we say every effort is being made to expedite things. We are a small but dedicated team, many of whom take Nature-Throid® and WP Thyroid®, that has been and continues to be committed to keeping patients, not profits, the top priority. We also have very strict quality standards. Every batch of Nature-Throid and WP Thyroid is rigorously tested to ensure it meets or exceeds United States Pharmacopeia (USP) monographs for potency and consistency.

Our commitment to quality has been a huge factor in why no RLC Labs® medication has ever being recalled for inconsistent hormones and we do our due diligence to keep it that way. Working through our existing orders at our size and with our strict quality standards takes time, but progress is being made–including with WP Thyroid, which we will share updates on as soon as they become available.

We remain committed to staying as transparent as possible throughout this process, but just like any other company, some of our information–such as our processes and sources–is strictly internal-only. This has been understandably frustrating in some instances, but please know that we are sharing what information we can when we can. We will continue to do so, just as we have from the start, until all strengths are fully stocked and available again.

In that spirit, here are the real facts of some rumors you may have heard along the way:

● RLC Labs is not going out of business, nor have we been acquired by any other company.
● There are no issues with our licensing and the backorder is completely unrelated to any governmental or FDA-related rumors.
● Neither of our medications, nor any strengths of them, are being discontinued.
● We stay committed to maintaining the affordability of our medications. Pharmacies set their own prices, but ours have not changed.
● Our strict quality standards apply to every part of our operation–from our guaranteed hormone levels to our materials and manufacturing–which is why we carefully source our thyroid from the U.S. and Canada and are only in production in the continental U.S.

It has been difficult not being able to serve our patients at the level you have come to know and expect from us, but we know that what we are dealing with is a far cry from the challenges our patients are facing and for that we are truly sorry. Our teams are working around the clock to get us back on track, but below are some suggestions if your doctor or pharmacy is having trouble obtaining available strengths, or if you are having trouble locating them. Your continued understanding, patience, and support are greatly appreciated as we work to make things right.

ORDERING AND LOCATING AVAILABLE STRENGTHS

Please check the availability statement on our website (getrealthyroid.com) for a list of actively shipping strengths. If your doctor or pharmacy is having trouble obtaining available strengths, they can contact us directly for assistance via the ‘Provider’ tab on our contact page. Any pharmacy of your choice that is not required to order through a wholesaler can also contact us through our website for a direct account–this applies for many healthcare providers as well. Please note that most pharmacies do not order directly from RLC Labs but through third party suppliers, and many large chains are required to order through a wholesaler. Once product is out our doors, we have no control over how it is prioritized or distributed among pharmacies, nor do we have any insight into a specific location’s inventory. If you are having trouble getting an available strength from your local pharmacies, we recommend checking any of the mail-order pharmacies listed on our website. The states shown only indicate where they are located; please check the pharmacy’s website or contact them to see where they ship. When getting your prescription filled through any pharmacy–brick & mortar or mail-order–we also recommend asking for both the cash price and insurance price (pending coverage) as all pharmacies set their own prices.

Comments and summary from Janie Bowthorpe

As long as I’ve been doing this, I’ve always been amazed at the false information patients receive from Pharmacists especially, then from each other, which spreads like wildfire in groups.

For example, note above that RLC has not been bought out by another company, and they have their tablets produced in the continental US, i.e. NOT in Puerto Rico. Both rumors were rampant and widespread. I even approved a few comments on the STTM blog posts that stated the Puerto Rico comment, and had massive doubts. But the rest of their comment was too good to reject the post.

Also note that RLC labs is working on getting WP Thyroid back as well i.e., no, it has not been discontinued–another rumor. The lesson is: don’t believe everything you hear!!

Also note that the reason this all happened, says RLC Labs, is because of increased difficulty in obtaining their Thyroid USP–that means the desiccated porcine powder. Costs were getting higher, as well. So they state they are now sourcing their thyroid powder from both the US and Canada…they wouldn’t state from whom. The latter is also on top of “some infrastructural upgrades (bigger facility, updated technology, refined processes) not too long ago”, stated RLC, to better meet the growing demand for their medications.

Finally, I think it was a good recommendation to ask for both the cash price and insurance price at your pharmacy. There may be a savings there.

In the meantime….

There are other good Natural Desiccated Thyroid products like NP Thyroid made by Acella–many good reports on that one. Even the less popular Armour has been working for some, even if not all. Here is a summary of your choices for a much better treatment of your hypothyroid state.

Also please note: if you switch and don’t feel you aren’t doing well, consider two things:

  1. The amount that did you well on Naturethroid or WP may be a different amount with another brand. REDO YOUR FREE T3 and FREE T4 and see how you stand after being on the different brand a few weeks, because you may need to tweak. Optimal puts the free T3 toward the top along with a free T4 mid-range.
  2. Some people have developed either a cortisol problem and/or iron issue, and it’s being revealed on the different brand. Find out by doing all four iron labs and cortisol saliva testing. Too many people are blaming brands, and it’s most likely either 1 or 2 are the real problems.

Don’t hesitate to comment below! Could RLC Labs have done all this better than they did?  Does the above give you peace of mind? Have YOU been able to acquire the latest Naturethroid? How are you doing??

  • Need a good discussion group with integrity? Go here.
  • STUDY the Natural Thyroid 101 page on how patients have learned to use Natural Desiccated Thyroid–it’s important, as too many patients under dose themselves!
  • STAND UP AGAINST A DOCTOR who tries to dose you by the TSH. Be educated to counter his or lack of education!!
  • READ the STTM books! YOU have to become informed and confident to stand up to bad doctoring. 

Warning!! STTM is about bat-guano crazy conspiracy theorists…and more Thyroid Tidbits!

ANNOUNCINGACELLA’S NP THYROID IS ON BACKORDER  

It’s a back-handed compliment. i.e. Acella‘s brand of Natural Desiccated Thyroid has been in great demand! But…success can equal problems, because they weren’t keeping up…or that’s how we understand it. So when you go back to get a refill, the pharmacist may try to put you another brand if they are already out. So hang tight. Acella states that they will be back into better production by the end of April.

DO YOU REALLY NEED COMPOUNDED DESICCATED THYROID?

Progressive doctors have been having a love-affair with compounded medications for several years. And for some medications, as well as for patients who are sensitive or allergic to certain fillers, it makes complete sense! (Compounded means that the pharmacist “combines, mixes, or alters ingredients in response to a prescription to create a medication tailored to the medical needs of an individual patient”).

But…most thyroid patients are discovering that they really do NOT need compounded NDT and that is especially true for “slow release” compounded NDT.  First, compounded NDT is far more expensive than the prescription brands. Second, the T4 in desiccated thyroid is your “natural slow release” of T3 throughout your day. So it makes financial sense to go with the prescription brands if you have no sensitivities or problems with fillers. And even if you go with compounded….you don’t need slow-release!

YES, THE STTM WEBSITE HAS BEEN UPDATED, plus more pages!

In case you didn’t notice, there’s a new look to STTM. Part of it is because we needed STTM to be far more user-friendly on your cell phones. I think you’ll like what you see. You’ll also find links at the TOP of each page instead of to the left.

There are also new pages from the last several weeks: one on parathyroid issues, especially hyperparathyroidism (i.e. if you have high calcium levels, you need to read this page); another is an issues related to hypo landing page showing you several conditions which can outright be related to your hypothyroidism and you may not even realize it (like fibromyalgia); another about problems that can occur if you overeat high oxalate foods (as happened to ME!); how hypothyroid patients can have low stomach acid and its consequences (like acid reflux and poor absorption issues)….and you can always keep up with What’s New on STTM.

ALL THE BUZZ ABOUT MTHFR

If you haven’t heard about it, you probably will. Because lots of thyroid patients are finding themselves with a defect in a particular gene called the MTHFR, which is the acronym for “methylenetetrahydrofolate reductase” gene (methyl-ene-tetra-hydro-folate-re-duc-tase). This gene is supposed to make the MTHFR enzyme. But if there’s a defect, the enzyme doesn’t work right and you can be left with a multitude of health issues (or see them in your ancestors) including heart disease (and high homocysteine levels), breast cancer, other cancers, addictions, miscarriages, chemical sensitivities, IBS, strokes and so much more. Those with this defect can also find themselves with high levels of mercury, or iron, or other toxins. Go here to read what it’s all about.

BERBERINE. INSULIN RESISTANCE, and THYROID CANCER

Since it’s pretty obvious to me that I have insulin resistance (i.e. it takes twice as much insulin to do the job, which means more fat storage), I was pretty excited when I learned about Berberine. It’s a natural alkaloid salt found in a variety of different plants and it’s stated to make your insulin more effective, thus your blood sugar levels can come down. I notice that some folks are using it in place of Metformin, as well, and reporting better glucose levels. It’s supposedly been used for centuries in Ayurvedic and Chinese medicine.

***But there’s another interesting possibility about Berberine: studies have shown it to be effective in reducing thyroid cancer cells, here. Talk to your doctor about it before assuming you can use it for cancer in lieu of other treatments, please.

AND ABOUT THE TITLE OF THIS BLOG POST...

Bet ya didn’t know that STTM is bat-guano crazy, did ya?? lol. This misinformed comment was found as a comment of a random blog post, and tells me that some still don’t get that this isn’t about conspiracy or theory. This is about patients worldwide who have either found that T4-only meds weren’t doing the job in their own degree and kind, or….patients were getting bit in the behind years later thanks to the inadequacy of thyroxine. Even worse, doctor who have been diagnosing or treating by the TSH pituitary hormone were leaving patients sick!

So what you have on STTM is more than ten years of GOOD patient experiences, the good and the bad. LEARN from it, and expect to take it into your doctor’s office to help them catch up with us!

STTM BOOK IS COMING SOON IN SPANISH  

First there was English, then came Swedish, then came German….and later, you’ll see Spanish! I’ll announce it when it’s out. I also plan on updating a few parts of the current revised STTM English book by Fall–just some corrections here or there. For example, the current one states that the percent saturation should be 25 – 45% for women, but we know that most women, when optimal, fall somewhere around 35% and definitely not 25%. So I’ll correct that, because somehow, it didn’t get in Addendum C of the current revised edition! Get your book here…and consider two or three, because your shipping rate is much better. Give the extras to a friend or loved one.

The Good, the Bad and the Ugly: 2012 in perspective for thyroid patients worldwide

2012 represented my tenth year as an activist, which has given me great perspective of where we are today as to compared to where we were ten years ago. And it’s huge. We had NO Stop the Thyroid Madness compilation of successful patient experiences to learn from and very few patient groups. We’ve come a long way, baby and the fight for better thyroid treatment and wisdom continues!

To summarize, Clint Eastwood couldn’t have said it better as to the mix of what 2012 gave us as informed thyroid patients!

THE GOOD: 

  • Armour returns to a softer tablet  After Forest Labs disastrous reformulation of Armour natural desiccated thyroid in 2009, which made the tablets harder and caused a return of our hypothyroid symptoms, we started to see Armour tablets becoming softer again in mid-2012. And that meant we could choose to do Armour sublingually once again. In the meantime, this disaster allowed many patients to discover NP Thyroid by Acella, which has turned out to be a great product.
  • More doctors are getting it! I probably see this in a more widespread way than individual patients do thanks to all the emails I get, but it’s clear that a growing body of doctors are finally understanding the efficacy of natural desiccated thyroid and the idiocy of the TSH lab test in diagnosing and dosing NDT. Sure, the field of Endocrinology is still as backwards as it gets, as are many other doctors, but others are listening here or there. (But do note that even the best doctors aren’t caught up in other areas, so become informed and expect to guide them as to patient experience! STTM book helps you do that.)
  • STTM book now in German and Swedish  I was proud and excited to offer these two translations to help spread the word to those who may not speak English.
  • Study being done comparing NDT with Synthroid Walter Reed National Military Medical Center in Bethesda, Maryland is doing a study, and seeking participants from the military, to compare the results of natural desiccated thyroid (which they call Natural Desiccated Extract or NDE, and will be Armour) and T4-only aka levothyroxine (and will be the infamous Synthroid). But there is a clear bad…..see below 
  • Wichita, Kansas says no to Fluoride in their waterConsidering that many of us suspect that the fluoride we are constantly exposed to could explain the huge influx of thyroid disease, this is extremely good news and we can only hope that other cities get this smart.
  • Thyroid Change In an attempt to unite all thyroid websites, leaders and focuses came this new website, Thyroid Change.

THE BAD:

  •  John C. Lowe dies  It was a terrible shock to lose this helpful medical professional in January due to the effects of a head injury the previous year. And his websites went with him for awhile due to probate. He will be sorely missed, as he was a champion for the use of NDT and understood SO much about better thyroid care.
  • The passing of Edna Kyrie  Edna of the UK worked hard on the website Thyroid History, aka Thyroid Research, compiling everything she could find pertaining to thyroid research and science, even while dealing with the effects of MS (multiple sclerosis).
  • US now confiscates medications if they come into the country  In July, Obama passed a bill called the FDA Safety and Innovation Act (S. 3187) which allows the government to destroy a package of personally imported drugs at their point of entry to the United States…even if some patients feel they need them when they can’t find any doctor wise enough to prescribe NDT, or enough NDT thanks to the poor use of the TSH lab test. And several patients have already had this happen to them.
  • Walter Reed National Military Medical Center study will sadly be using the TSH  i.e. though it looks exciting to see a study comparing NDT to Synthroid, they are going “to keep TSH in normal range” (which for the majority can mean they are still hypothyroid) and aren’t even testing the FREE T3, just using the total T3, total T4, free T4, T3 resin uptake, sex hormone binding globulin (SHBG), and a lipid panel.  Give me a break….
THE UGLY:

Good thyroid patient discussion groups here.

Things we have learned here.

What’s new on STTM here.

What your Road to Recovery can look like here.

The revised STTM book here.

Who has the vision and courage of Dr. Lowe…and a message from Acella about delays

Each day, when I think about the passing of Dr. Lowe (which you can read about here), I reel in shock at this huge loss in our fight for better thyroid treatment and SANITY.

And now we have to ask: who will fill those shoes when it comes to the continuation of thyroidscience.org and the courageous message of Dr. Lowe?? Even the front page contains an important article  titled “TSH is Not the Answer,” a report Dr. Carol Rowsemitt and Dr. Thomas Najarian: Their explanation and verification  i.e. Dr. Lowe fought for what PATIENTS ALREADY KNOW TO BE TRUE about the lousy TSH lab test!

And Lowe announced that he was next coming out with an article concerning ” false statements of fact online about T3-containing thyroid products including Armour Thyroid” by The British Thyroid Association and UK Royal College of Physicians.  He continued: ” The scientific facts patently show the falsehood of the two organizations’ statements. Is this a failure of responsibility to study scientific issues before making public pronouncements on them? Or do the statements constitute science fraud?”    Unless it was already written, we might never see this article. But we all know the truth.

The loss of Dr. Lowe propels me to ask: Who do YOU see as a medical professional who has the following qualities:

  • high intelligence
  • an interest in true science rather than blindly following research with outcomes based on who paid for certain studies
  • the courage to speak the truth, even if it goes against the grain of staid medical opinion
  • compassion for thyroid patients and the willingness to listen to their experiences

Who, as a medical professional, can patients give a vote of confidence to as someone who can continue the legacy of Dr. Lowe?  Propose some names by commenting on this blog post below. (If you are reading this via the Email Notification, click on the title of this post, which will bring you directly to the blog post where you can leave a comment).

A MESSAGE FROM ELLEN GETTENBERG of ACELLA (THE MAKERS OF GENERIC DESICCATED THYROID CALLED N.P. THYROID)

Over the past several weeks, Acella has experienced production planning issues associated with NP Thyroid.  We sincerely apologize for this and want to inform our valued customers that we are putting measures in place now to prevent any further limited supply.  We anticipate improved availability by the end of January.  Please check back here on our website for further updates.  If you need additional information, please email us through the “Contact Us” page on NPThyroid.com.

Ellen Gettenberg
Director, Marketing| Acella Pharmaceuticals
9005 Westside Parkway | Alpharetta, GA 30009
www.acellapharma.com

WANT TO PAY IT FORWARD AS TO WHAT STTM HAS GIVEN YOU?

Out of my own savings last Fall, I paid for three months in hiring a publicist for the message of Stop the Thyroid Madness…i.e. through the end of December. My goal is to reach far more who may not understand WHY they have problems thanks to the lousy TSH lab test or T4-only meds like Synthroid, Levothyroxine, etc. And she has done a fabulous job in getting interviews and articles out there–you can see what she has done on the donation page mentioned below.

After December, patients donations completely paid for January. Now we are working on February, and nearly half way there. But this will end sooner than later if more donations don’t come in. Go here to read about it and Pay It Forward.

HAVE YOU CONSIDERED YOU MAY NOT NEED HC TO HEAL YOUR ADRENALS? OR IF ON HC, YOU CAN DO THIS A LOT FASTER?

UK thyroid and adrenal patient Paul Robinson made a VERY interesting discovery–that he could heal his adrenals with his unique use of T3. Yup, and he SUCCEEDED. And it’s quite exciting news for adrenal fatigue patients.  Additionally, if you are on T3, his  T3 titration process alone is vastly superior to most other recommendations in the use of T3, and means you can use less!!

Take the time to find out for yourself!!  There’s a good summary of what he discovered in the new STTM Facebook Adrenals group (and please note this group is for PATIENTS ONLY, not medical professionals. And for approval to the group, you canNOT have a hidden info and friends. We have to be this way to keep out spammers, and to see that you are who you say you are).  You can also order his book from this Recommended books page on STTM. To order the patient-to-patient STTM book, go here.