Welcome to Episode 42. Thanks for joining me. We have a listener question today. I may have covered this in the past but we are going to discuss her question anyway.
Before we do that I want to talk about your reviews on iTunes. I want to thank all of you who have left a review. It helps me help more people and it helps me know what I am doing well and what I can improve on. So, someone left me a 1 star review but didn’t leave any comments. Can you all help me out? If you think there is something I can do better, something to improve the podcast, please let me know. Send me an email at email@example.com or fill out the contact form on my website. Thanks so much.
Okay, let’s get started. The question from a listener today is:
What is Armour Thyroid? I have never heard of it before. I take levothyroxine and been on it for years and I still feel awful... I'm curious if Armour is the best for Hashimoto’s.
Thanks for writing in Shirley. I appreciate you!
Most doctors are going to prescribe Generic Levothyroxine or Synthroid which are T4 only medications. There are others but the only other one you are likely to hear about is Tirosint which is kind of considered a hypoallergenic medication because the ingredients are levothyroixine (T4), gelatin, glycerin and water in a gel cap.
Synthroid ingredients are long but they start with:
the synthetic or man made T4 along with
acacia (binder, emulsifying agent, and a suspending or viscosity increasing agent)
confectioner’s sugar with corn starch
lactose monohydrate (used to keep the tablet formed)
magnesium stearate (a water insoluble powder used as a release agent and as a lubricant or part of the production of pharmaceutical drugs and cosmetics. Hydrogenated cottonseed or palm oils are a common source for it)
povidone (a synthetic polymer vehicle for dispersing and suspending drugs. It also acts as a binder) and
talc (used as a binding agent). There are also a number of artificial colorings depending on the strength of your medication all of which contain aluminum and are produced from coal tar or petroleum.
So nice for a medication you might have to take the rest of your life.
These synthetic forms started making their way in to our lives around the 1950’s and the natural stuff was said to be unreliable and not as effective. So most doctors stopped prescribing it and started prescribing these synthetic forms.
Synthetic means it is made in a lab. Doctors often have to go along with what their medical association says is best or face penalties. So don’t blame your doctor 100%. Do be proactive in your own care and fight for what makes you feel best.
Armour Thyroid seems to be the only widely available Natural Desiccated Thyroid hormone these days.
All natural desiccated thyroid hormone pills come from a pig thyroid gland. This was the original thyroid hormone replacement back in the 1800’s. It has been around a long time and made a whole lot of us feel so much better than a synthetic T4 only medication like Synthroid or Levothyroxine. Some people do fine on the synthetics but it sure seems like most of us do better on NDT.
These “natural” thyroid hormones are called natural because they come from a an animal rather than a lab. They also contain all of the thyroid hormones that are available in our own tissue.
You mostly only hear about T4 and T3 but there is also a T2, T1 and T0. There is not as much research on exactly what the other ones do for us but if they are there it must mean we need them.
The word desiccated means that the thyroid gland removed from the pig, who is bred just for this purpose, in a special way. The pigs thyroid gland is frozen, minced, dried and turned into a powder. The fat is removed with chemicals and then many batches of thyroid powder are combined to keep the ratios of T4 to T3 more consistent.
This means you are getting ratios more consistent with what your own body would produce.
NDT has a naturally occurring hormone called calcitonin which is also produced by the thyroid gland and is used by the body to maintain bone health as well as blood levels of calcium.
NDT products are often referred to in grains rather than micrograms or milligrams. This is becoming less so now but was quite common even just five or ten years ago.
What is a thyroid grain?
One grain of NDT is 60mg in Armour Thyroid. It has 38mcg T4 and 9mcg of T3. Not all medications are the same. Every manufacturer will be different and your body will probably respond differently to each one so it is a bit of trial and error to find the one that is just right.
Thyroid medication is often called the Goldilocks medication for this reason.
The ingredients in Armour besides the thyroid hormones are:
calcium stearate (a white waxy powder in lubricants, soaps and in some food products)
dextrose (a form of sugar)
microcrystalline cellulose ( refined wood pulp used as a texturizer, anti-caking agent, fat substitute, emulsifier, extender and bulking agent in food production most commonly used in supplements or tablets)
sodium starch glycolate (used in pharmaceuticals to cause the tablet to disintegrate quickly or as a suspending agent)
and lastly opadry white ( polyvinyl-alcohol film-forming polymer used to keep the pill from absorbing moisture).
I did really well on WP Thyroid which is another NDT but it is tough to get. I cannot get it locally here in Minnesota. I also did really really well on compounded NDT which was just thyroid powder and cellulose. The one pharmacy I found her that could make it for me can no longer get the thyroid powder.
Nature-Throid and WP Thyroid have an info page on their website about how you may be able to obtain their products through mail order pharmacies. That link is in the blog post for this episode at helpforhashimotos.com.
Why is Natural Desiccated Thyroid Hormone better for so many people?
Let’s take a look at what this medication is doing for us.
There are two kinds of T4 in our body- a levo and a dextro and synthetic T4 has only the levo type. I’m not going to get deep in to science and will just leave it at that.
Around 80-90% of T4 is made by the thyroid gland as thyroxine (so levothyroxine is from the levo type which is a left rotating isomer of the thyroxine molecule).
T4 is converted to T3 in the thyroid a bit and in other tissues much more. About 40% of T4 is converted to T3 in the body and some is converted to reverse T3.
T3 is more bioavailable or bioactive and is about 10% or so of thyroid hormone and most is made in tissues in the body by converting T4.
Now Free T3 is what our cells are using and works better than free T4 according to some. We do know that Free T3 can get to our brain by crossing the blood brain barrier better than Free T4. So Free T3 gets to the brain easier and could be why so many find that our cognitive abilities and general brain function are so much better on NDT.
What can help brain fog?
Being on NDT is a good place to start. Often synthetic T4 medications don’t convert as well to T3 in many people OR you just are not getting an adequate dose of your medication.
I said earlier that there isn’t a lot known about the T2, T1 and T0 but what we do know is that T2 may be involved in enzyme production that helps us make T3 from T4.
It is thought that T1 helps the thyroid function and play a role in heart health.
I also mentioned calcitonin which helps our body regulate calcium levels in our body and particularly in our bones. It plays a role in prevention and reversal of osteoporosis. It also helps us reabsorb calcium from bone storage and helps the gut absorb calcium from our diet.
So gut health is pretty important for that.
In order for our body to convert thyroid hormone we need to have this enzyme called a deiodinase. When someone is taking synthetic synthroid (T4 only) you must rely on your body (which is not functioning well if you have the need for thyroid medication) to make enough of these enzymes so your body can convert T4 to T3.
With a NDT like Armour or one of the other brands, your body doesn’t have to do this because the medication contains the much needed T3.
T3 is also absorbed in the small intestine much better than T4. T3 is bound by the thyroid binding globulin (TBG) which is a protein that transports the hormone through the blood. When they are no longer bound to the TBG, they are free hormones.
Synthetic T4 does not have this type of protein bringing it through the blood and can be more affected by stomach acid, digestive enzymes or gut flora making absorption more difficult.
The Wall Street Journal published an article bringing to light a scandal with Synthroid in 1996. The then owner of Synthroid paid a researcher to study the medication proving it was a better product than NDT. The research did not come out in their favor and the company tried to discredit the author and threatened to sue her if she published her findings.
Synthroid has been has been recalled a couple of times by the FDA due to problems with doses and strength. It was actually sold in the US for years without FDA approval and in 2001 a new drug application for Synthroid had to be made.
So why does your doctor or endocrinologist typically only prescribe synthetic thyroid hormone?
Could be financial incentives due to financial ties between manufacturers and the American Association of Clinical Endocrinologists who create the guidelines under which your doctor may practice.
A NDT like Armour or WP or Naturethroid have helped many thyroid patients feel better in a plethora of ways from fixing brain fog as mentioned earlier to being able to lose weight, better sleep, more energy and so much more. All because we are getting that missing component in something that is more biologically available to our body in its full form.
When you take a NDT medication it can be helpful to take it in divided doses such as 2x a day with a dose in the morning and one in the afternoon. Personally when I switched to Armour I got heart palpitations (this did not happen on the compounded medication or WP thyroid for me) so I started with half a dose dissolved under my tongue in the morning then the other half a couple hours later and the second pill in the afternoon. I have to do this for a week or so until my body gets used to the medication and then I can take a whole pill in the morning without getting palpitations.
Another recommendation is to do ⅔ of your total dose in the morning and ⅓ in the afternoon. T3 has a shorter half life and so taking that second dose in the afternoon can help keep you from feeling sluggish. Some people get too stimulated by a T3 medication and cannot take it at night, others have no problem. You just have to play around with dosing until you find what works for you.
You also don’t want to take too much, remember I said this is a goldilocks drug and hopefully you have a doctor that will work with you on treating symptoms. You can end up with heart issues, osteoporosis, insomnia, and intolerance to heat, hyperthyroidism, tremors, too many bowel movements in one day and thinning hair.
You will want to make sure your doctor orders a Free T3, Free T4, Reverse T3 test as well as TSH when taking NDT. TSH can be below normal but if Free T3 is in normal range and you feel great, it should not be a problem. My doctor does not prescribe to this idea but she is very good about supporting me in checking my symptoms first.
Thanks for listening. Send my your questions at firstname.lastname@example.org or fill out the contact form on my website.
Please leave me a rating and review on iTunes, the more reviews the more people will be able to find the podcast and get help. I appreciate your help!
You can find me at helpforhashimotos.com and you can join the facebook support group help for hashimoto’s. I’m avoiding social media still but will be checking for people who want to join the group. You can also get my ebook Five Things Your Doctor Won’t Tell You About Hypothyroidism on my website by signing up for my newsletter.
Need help figuring out how to navigate your thyroid health? I’m here for you and am taking new clients. I can’t wait to help you!
That is it until next week. Take care!