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To all doctors and pharmacies: cellulose IS a problem with desiccated thyroid

(Though this post was originally written in 2010, it’s been updated to the current day and time, because it still applies!)

A patient reported on Facebook that a particular large and well-known health center in Texas decided to make their own compounded natural desiccated thyroid for their hypothyroid patients…with cellulose.

Having read my blog posts about certain negative patient experience with cellulose, she told the pharmacy that many of us have noticed distinct problems with the addition of cellulose in our desiccated thyroid medications–exactly why the newly formulated Armour in 2009 caused too many patients to see a return of their hypothyroid symptoms. Naturethroid has not escaped the same fate for some.

(There is also wonder if, after Activas bought out Forest in 2014 and patients then reported that Armour wasn’t working as well for them in 2015, if added cellulose was the problem. We’re not sure.(

When she asked if they could remove the cellulose, she received a firm and condescending “No” from the pharmacist, referring to cellulose as “a common ingredient in many medications and not a problem.”

Not a problem? Once again, patients are dismissed as if we couldn’t possibly know what works, and what doesn’t work, in our treatment and in our own bodies. A shameful reality. She left disappointed. 

What is cellulose?

Cellulose is the most common organic substance found on our planet–a fiber abundantly found in plants and trees, and most especially in cotton.

Where is cellulose used?

You wear it and you write on it! You eat it when you consume celery, potatoes, or mushrooms. It’s used to stabilize and thicken processed foods, and may be found in many cheeses, dry milk, puddings, and more. And since it’s difficult to find anyone allergic to wood, it’s been a common ingredient in medications, used as a filler.

So where’s the problem for thyroid patients?

  1. Unlike the happy cows in their pastures chewing their cuds, human stomachs  have a limited ability to break cellulose down. Cellulose is a fiber. And what does fiber do? It “binds”. It binds to the desiccated thyroid that has gone down with it.  i.e. the life-changing effects of desiccated thyroid are clearly dampened by the presence of cellulose. In 2009, after Armour was reformulated with an increase of cellulose in the mix, a great deal of patients started to report problems, and to some degree, on Naturethroid, whether the latter switched to microcrystalline cellulose or not (as compared to the larger celled methylcellulose).
  2. Hypothyroid patients do not digest well. As one of many complications of hypothyroidism,  especially due to the inadequate treatment of T4-only medications and poor diagnosis from the TSH lab test,  low stomach acid and poor digestion is COMMON in hypothyroid patients.  So when you add cellulose to the mix, you are further damning thyroid patients.
  3. Though not specific to just thyroid patients, we are not too comfortable with finding out that cellulose can collect in our lungs, as revealed in pubmed articles here and here.  (Thanks to thyroid patient Danny for alerting me to this.)

Bottom line, desiccated thyroid is a quality and superior treatment medication which has changed the lives ten-fold for thyroid patients around the world. But cellulose and desiccated thyroid DO NOT MIX for certain patients, it appears. And BRAVO to those compounding pharmacies who have listened and have used the beneficial probiotic acidophilus as a filler. We appreciate you.

JanieSignature SEIZE THE WISDOM

 

 

 

 

 

 

 

Want to know your options for better thyroid treatment?? Go here.

Need help finding a good doctor? Go here.

Think desiccated thyroid didn’t work for you?? Go here.

See common Questions and Answers here.

49 replies

Here’s the skinny about the “new” Naturethroid: the good, the bad, and the curious

(A lot has gone on since this post below was first put up in 2010. So after reading the below, see what happened in 2017 here.)

As the one grain tabs of Naturethroid desiccated thyroid by RLC Labs are hitting pharmacy shelves again all across the nation here and there after the recent shortages and the sad reformulation of Armour,  and patients are starting to use the new Naturethroid, we are gathering some good information, both anecdotal and factual:

  • The typical smell of desiccated porcine is less intense with the new tablets. We have no idea why.
  • The tablets are now stamped with RLC on one side, and N over 1 on the other, whereas before you’d see just NT1 or a reference to the fact that Time Caps Labs (TCL) used to make Naturethroid for RLC Labs
  • The package insert is no longer inside the bottle but stuck on top of the cap
  • Lot number info used to be on the edge of the label running vertically, whereas now, it runs along the bottom of the label  under the ingredients.

One grain is still 65 mg, with the T3 content being at 9 mcg and the T4 content being at 38 mcg.  The T2, T1 and calcitonin still unmeasured.

There are filler/inactive ingredients which have changed:

  • Calcium filler has moved up from 16 mg to 17 mg (calcium binds thyroid, but you just take more. Don’t swallow it with milk, please.)
  • The old contained Magnesium, Potassium, and Sodium (each at less than 1 mg), whereas in the new, potassium is now removed
  • And here’s the best part: the old NT had Hydropropyl Methylcellulose–that’s the larger size cellulose structure which we know binds some of the thyroid hormones. Now, the new NT has Microcrystaline Cellulose, the smaller size. (Too bad we can’t see all cellulose removed!)

Below are the new NT fillers, which are identical to the old except for the cellulose change:

Carnaba Wax, Colloidal Silicon Dioxide, Dicalcium Phosphate, Hypromellose, Lactose Monohydrate, Magnesium Stearate, Microcrystaline Cellulose, Polyethylene Glycol (PEG)-400, Sodium Starch Glycolate, Stearic Acid.

Most all the above comes courtesy of Stephanie Buist, owner of the Iodine group on Yahoo and thyroid and adrenal patient and advocate.  Thank you, Steph!  You can read about the fillers here by scrolling down.

Oh and by the way, the new tablets are now scored. A helpful addition!

In patient groups, we are seeing a variety of experiences with the new Naturethroid.  Most folks seem happy with it so far, and even some report it seems a tad stronger than the old (the cellulose change may have caused that). Occasionally, someone will report problems, but they appear to be from underdosing or a potential RT3 problem which has arisen and needs treatment with T3-only.  Changing brands can also bring different reactions, so you have to wiggle the dosage around sometimes to find your sweet spot once again.

All in all, it looks good.

P.S. If you are reading this via the Newsletter Notification, just click on the above link to put yourself right on the actual blog post if you want to comment. Let’s gather all our experiences with the new Naturethroid.

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If you missed the last internet radio Thyroid Patient Community Call with Dr. Kent Holtorf, you missed a VERY good one. Thank you Dr. Holtorf for excellent information. But good news! All the shows are recorded.  Just go to the following link, scroll down, and you can click on any past interviews, including two with Dr.  John C. Lowe and a great one with Endocrinologist Dr Pepper–one of a rare breed of open-minded Endos.  (I’ve also stopped doing my long intro’s about me in the last two, figuring if someone wants to know, they can go to the About Me page, or read the Introduction in the book which has even more detail. lol.)

http://www.talkshoe.com/talkshoe/web/talkCast.jsp?masterId=62603&cmd=tc

159 replies

Is Cellulose the real problem in desiccated thyroid meds for many?

Screen Shot 2015-08-05 at 12.53.55 PM(This blog post is updated to the current day and time. Enjoy!)

When Forest Labs reformulated Armour desiccated thyroid in early 2009, they stated they increased the filler Microcrystalline Cellulose, and decreased the Sucrose (sugar). And all of sudden, the tablets became impossible to do sublingually–a method so many of us loved and which seemed to give even more of a punch.

And we were left wondering in 2009 why they would change a particular quality (being able to do the tablets sublingually) that thyroid patients praised so heavily?  Positive opinion among patients for Forest Labs back then slipped several notches. (Forest Labs was bought out by Actavis in 2014)

But the real cuckoo’s nest for many thyroid patients still on Armour in 2009, who knew firsthand the life-changing benefits of natural desiccated thyroid, was a maddening return of serious hypo symptoms on the 2009 Armour with its increase in cellulose, and subsequent new stress on their adrenals, sooner…or later! You can read several horror stories in the comments of the post below, or go here.

So patients turned to other alternatives, which at the time was Naturethroid and Westhroid by RLC Labs. (Naturethroid stopped working as well in 2018)

So what has been the common thread in the most problematic desiccated thyroid products?

It has always been CELLULOSE, a plant fiber, and more commonly known by the trade name Avicel. And what does fiber do in your stomach? Inhibits absorption. Armour’s cellulose was raised, and bamm…problems.  Compounded desiccated thyroid, with cellulose as a filler, has been problematic for many patients with a return of hypo symptoms, especially if it was Methyl Cellulose, a larger particle size product. But some have even had problems with compounded containing Microcrystalline Cellulose, the smaller cellular product. And a certain body of patients even had problems with Naturethroid back then before it became scarce for awhile. And Naturethroid used cellulose as a filler.

Note: With all the complaints, Forest Labs did change something about Armour by mid–to-late 2010. Though it never returned to what it was before 2009, it did become a softer tablet and patients did better on it. But we certainly learned a big lesson about cellulose in our NDT pills..

Is this problem true with T3-only products?

Yes. Patients noted that generic T3 was far less effective than the brand name Cytomel (both Liothyronine Sodium)  And what filler is up to 70% in the generic T3?  CELLULOSE.  

What does literature say about the use of Cellulose as a filler in medications?

Plenty. Cellulose is from wood. Wood is fiber. And fiber in your gut affects absorption. From http://www.umm.edu/altmed/articles/fiber-000303.htm we get this:

* Dietary fiber has been reported to lower the blood levels and effectiveness of tricyclic antidepressant medications…Reduced dietary fiber intake increased the blood levels and improved symptoms in these patients.

* While fiber supplements may help to regulate blood sugar levels, they may also interfere with the absorption of anti-diabetic medications….Therefore, fiber supplements should not be taken at the same time as these medications.

* Taking soluble fiber such as psyllium with carbamazepine (Tegretol), a medication used to treat seizure disorders, may decrease the absorption and effectiveness of carbamazepine.

* Fiber in the form of pectin (from fruit) and oat bran reportedly reduces the body’s ability to absorb cholesterol-lowering medications known as “statins,”… and could lead to decreased effectiveness of these medications.

* Fiber supplements may reduce the body’s ability to absorb digoxin (Lanoxin), a medication used to regulate heart function.

* Clinical reports suggest that psyllium or other soluble fibers may lower lithium levels in the blood, reducing the effectiveness of this medication.

* In one clinical study, the fiber supplement guar gum reduced blood levels of penicillin.

Fast forward to the present

If you are using a compounded desiccated thyroid medication, it’s strongly recommended to request powdered acidophiles, also spelled acidophilus, as your filler.  One gal states her compounding pharmacy uses powdered Ginger (but beware of too much Ginger if you have Mitral Valve Prolapse. It can cause palps if you take too much–my experience).  Others might use powdered Vitamin C.  See what other fillers your compounder can offer.

Another possibility is Cellulase, an enzyme which helps the splitting and breakdown of cellulose, It’s found on most supplement websites.

JanieSignature SEIZE THE WISDOM

*Join the STTM Facebook page for information, tips and inspiration!

* Become an informed thyroid patient! //www.laughinggrapepublishing.com

74 replies

How are YOU doing with the current desiccated thyroid shortages?

Pills Spilled Shortages

(This post garnered a lot of attention, up to FIFTY comments just a few hours after it went up. People are very interested in sharing their experiences in coping with the shortages! See below and add your own.)

This year will go down in history as shockingly miserable for enlightened thyroid patients on natural desiccated thyroid.

First came a reformulation in the most popular brand–Armour by Forest Labs. Patients worldwide in groups and forums reported a serious return of their hypothyroid symptoms on this product. A huge disappointment.

Second came the production shutdown of the two generic makers of desiccated thyroid: Time Caps Labs and Major Pharmaceuticals. It’s the first step in the FDA’s compliance plan to corral all grandfathered-in drugs (drugs already in existence when the the FDA was created in 1938) and make them each prove the efficacy and safety of their medication via very expensive clinical trials.  i.e. over 110 years of safe and effective use of desiccated thyroid is not enough for the FDA?? We are still waiting to see the outcome of that plan with RLC  and Forest Labs.–the two who were actually in existence before 1938.

Third came demand being greater than supply and shortages. Because of informative patient websites like Stop the Thyroid Madness,  Sheila’s TPA-UK, Lyn’s ThyroidUK, Stephanie’s Natural Thyroid Choices, some areas of about.com (and other good websites I don’t mean to miss here), plus many fine patient forums and groups,  patients found out why they had continuing symptoms on T4 thyroxine, and demand for natural desiccated thyroid grew exponentially.

STTM then created a list of options for all thyroid patients until the shortages resolved themselves, and also created CDT (Coalition for Desiccated Thyroid) where patients could discuss alternatives in a supportive and factual atmosphere.

And we’ve seen some interesting experiences and comments:

The new Armour: One grain tabs started to appear on some pharmacy shelves the past month.  Other pharmacies have still been waiting.  Many patients appear to have switched to other alternatives, though. One gal still on it feels she is finding success by adding T3 to the amount of new Armour she is on.  Time will tell if patients can ever find success with the newly formulated Armour, and most feel it’s a huge loss.

Naturethroid and Westhroid: Patients reporting on their switch to either of RLC Lab’s two identical products report doing well, having to raise it slightly or lower it slightly, or just not liking them at all. Others have had a hard time finding it on their pharmacy shelves, but have been seeing some appear in the last few weeks.

Erfa’s Thyroid from Canada: When it became clear that the FDA was allowing this excellent product to be shipped to patients, many switched and had their prescriptions faxed to a Canadian pharmacy. Prices at many of those pharmacy websites were doubled after prescriptions started to come in from the US. Most patient who stuck with it seem to love it, reporting you can do it sublingually, as well. A few haven’t been impressed, but were finding their former success by raising it.

Compounded desiccated thyroid: In spite of being a more expensive option, some patients found success with this. Others learned they preferred the filler to be Acidophiles.  If not the latter, Microcrystalline Cellulose was preferred over Methyl Cellulose–the latter which appeared to lessen the effectiveness of the compounded thyroid.

Synthetic T4 and Synthetic T3: some patients switched back to the synthetic combination, but many report that it hasn’t been as effective as desiccated thyroid was.

Other options: Patients moved to OTC products like Nutri-Meds, etc, which can be much weaker. Others sought desiccated thyroid from other countries and have found success.

So I’d like to hear from all of you.   Did you go back to synthetic T4?  What desiccated thyroid did you switch to? What worked and why? What didn’t work for you and why?  What product do you hope to switch to once you run out of your current meds?

107 replies

Are you switching to Nature-throid? Here’s 10 good things to know!

Screen Shot 2015-09-27 at 1.33.08 PM(This page has been updated to the current day and time. Enjoy!)

In 2009, there were many folks reporting problems with the newly-formulated Armour (and that has been true for 2015, sadly), just as there was a growing body of individuals stating they are switching to Naturethroid by RLC Labs (formerly Western Research), another prescription brand of desiccated thyroid which also makes WP Thyroid.  

Today, there are even more quality brands to consider. And when a brand like Armour disappoints, many are also switching to NP Thyroid by Acella.

But if you are considering Naturethroid, here is info to carry with you if you switch:

  1. Naturethroid has a coating on the outside, and some patients state they bite on the pill to remove the coating, and still try to do it sublingually. No sugar, but some are determined.
  2. One grain of Naturethroid is 65 mg rather than the 60 mg that Armour users have been used to. Two grains are 130 mgs, etc. (One grain is actually 64.8 but it’s easier to round it up). Strengths are 1/4, 1/2, one grain, two grains, three grains.
  3. The makers of Naturethroid started making 1 1/2 grain tablets by 2010.
  4. Ingredients are
    • Porcine Thyroid Powder, U.S. Pharmacopeia
    • Microcrystalline Cellulose
    • Dicalcium Phosphate
    • Sodium Starch Glycolate
    • Magnesium Stearate
    • Hydroxypropyl Methylcellulose
    • Stearic Acid
    • Carnauba Wax
    • Polyethylene Glycol
  5. Naturethroid uses the same USP thyroid powder as any good desiccated thyroid product—it “adheres to full pharmaceutical purity and standardization on the consistency of the hormones along with full pre-and-post testing procedures associated with quality prescription products.”
  6. RLC Labs is a small and friendly pharmaceutical company.
  7. Twitter has a Nature Throid website.
  8. RLC labs also used to distribute Westhroid more than it does today (simlar), but that has largely been replaced by WP Thyroid–an NDT with very few fillers.
  9. When switching, you will have to figure out if you need to be on a similar amount as before, or a different amount, according to symptoms.
  10. And finally, it’s been around since the 1930’s–another tried and true desiccated thyroid product!

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654 replies