What are the alternatives to Nature- Throid or NP Thyroid? You might wonder this after your pharmacist breaks the news these products are no longer available. Nature-Throid and NP Thyroid are used to treat hypothyroidism (underactive thyroid.) A recall of Nature Throid – and also of NP Thyroid – has created a lot of confusion among patients with hypothyroidism – underactive thyroid.
Availability of Nature -Throid and NP Thyroid
As of July 10, 2021, many doses of Nature-Throid and NP thyroid continue to be unavailable.
So, what is the replacement for Nature Throid – NP Thyroid? Here are your choices:
Choice No 1: Armour Thyroid
Armour thyroid is a good substitute for Nature Throid or NP thyroid. The active ingredient of Armour Thyroid is dessicated Thyroid, which is the same ingredient in Nature Throid and NP Thyroid. In other words, Nature Throid, Armour Thyroid, and NP Thyroid are various brand names of dessicated Thyroid.
Over the years, I have used dessicated Thyroid in most of my hypothyroid patients. I have found all the brands of dessicated Thyroid to work well, although there is a marked difference in their prices – Armour Thyroid being the most expensive one.
Nature Throid vs Armour Thyroid vs NP Thyroid
As mentioned above, the active ingredient is the same in Nature Throid, NP Thyroid and Armour thyroid. It is called dessicated Thyroid, which comes from pigs and cattle. However, there are differences in the inactive ingredients between Armour Thyroid, Nature Throid and NP Thyroid. For this reason, some patients may not do as well when switched from Nature-Throid or NP Thyroid to Armour Thyroid.
Conversion from Nature Throid to Armour thyroid
65 mg of Nature Throid = 60 mg of Armour Thyroid.
32.5 mg of Nature Throid = 30 mg of Armour Thyroid.
16.25 mg of Nature Throid = 15 mg of Armour Tyroid.
How to Convert from NP Thyroid to Armour Thyroid?
It is 1:1 conversion.
60 mg of NP Thyroid = 60 mg of Armour Thyroid
30 mg of NP Thyroid = 30 mg of Armour thyroid
15 mg of NP Thyroid = 15 mg to Armour Thyroid
Huge Difference in the Price of Thyroid Medications at Various Pharmacies
There can be a huge difference in the price of a medication. Remember to check GoodRx.com for price comparison especially if you pay out of pocket.
Choice No 2: Switch to a Compounding Pharmacy
You can also switch to a compounding pharmacy to substitute for Nature-Throid or NP Thyroid.
Thyroid USP from a compounding pharmacy is an excellent alternative to Nature-Throid. It has the same high quality active pharmaceutical ingredient (API) found in Nature-Throid, according to RLC – the manufacturer of Nature Throid. Also, it is made in the USA.
Click here to find a Thyroid Compounding Pharmacy in your area
You can ask your physician to write you a prescription of T4+T3 per capsule.
The conversion from Dessicated Thyroid to Compounding pharmacy requires in-depth thyroid knowledge on the part of the physician. One grain (65 mg) of Nature-Throid, WP Thyroid and NP Thyroid (60 mg) contains approximately 38 mcg of T4 (Levothyroxine) and 9 mcg of T3 (Liothyronine).
Over the years, I have prescribed T4, T3 combination through compounding pharmacies. In general, it works out well.
The good side is that it gives your physician a lot of room to tailor the amount of T4 and T3 to your individual needs.
The downside is that compounding pharmacies are expensive. In addition, you need to find a reputable compounding pharmacy in your area.
Choice No 3: Switch to Levothyroxine (T4) and Cytomel (T3)
Some patients prefer synthetic thyroid hormones. Synthetic T4 is available as Levothyroxine with the brand names of Synthroid, Levoxyl or Unithroid.
Synthetic T3 is available as Liothyronine with the brand name of Cytomel.
A combination of Levothyroxine and Liothyronine can be used as an alternative to Nature Throid – or NP Thyroid or WP Thyroid.
The combination of Levothyroxine and Liothyronine works well to substitute for Nature-Throid or NP Thyroid or WP Thyroid – as long as the physician prescribes the correct amounts of these medications.
Often physicians prescribe too little of T3 (Liothyronine) and too much of T4 (Levothyroxine) and it does not work well for the patient. Then, the physician and the patient think that the combination of T4 and T3 does not work for them.
Conversion from Nature Throid or NP Thyroid to Levothyroxine and Cytomel combination
The ratio of T4:T3 is approximately 4:1 in Nature-Throid, NP Thyroid, and Armour Thyroid.
For example, if you were on 65 mg per day of Nature- Throid – or 60 mg of NP Thyroid – you were getting about 38 mcg of T4 and 9 mcg of T3. Unfortunately, Levothyroxine and Cytomel are not available in these doses. The closest dose of Levothyroxine would be 25 mcg, which you may take as 1-1/2 tablet a day which will give you 37.5 mcg of T4.
Cytomel is available as 5 mcg tablet. You may take two tablets of Cytomel a day which will give you 10 mcg of T3.
Monitoring T4 and T3 while on an Alternative to Nature Throid, WP Thyroid or NP Thyroid
Caution: Monitor your symptoms as well as blood test for free T3 and free T4, while you switch from Nature Throid, WP Thyroid or NP Thyroid to one of the alternatives. You may need some tweaking in the dosage with the guidance of your healthcare provider.
Armour Thyroid vs. Levothyroxine
Armour thyroid is a natural thyroid product. It contains both of the thyroid hormones – T3 and T4. In contrast, Levothyroxine is synthetic and contains only T4.
What Can I Take Instead of Levothyroxine?
You can take a dessicated Thyroid product such as Armour Thyroid in place of Levothyroxine, but there is a difference between dessicated Thyroid preparations and Levothyroxine. Dessicated Thyroid products contain T3 and T4 thyroid hormones. In contrast, Levothyroxine contains only T4 thyroid hormone.
What is the Difference Between T3 and T4?
T3 has three iodine atoms in its molecule. That is why it is also called Triiodothyronine. T4 has four iodine atoms. That why it is also called tetraiodothyronine or thyroxine.
T3 is the active thyroid hormone that actually binds to the Thyroid Hormone Receptor inside the nucleus of a cell. In this way, it is T3 that sets in motion the actions of the thyroid hormone in our body.
On the other hand T4 is inactive by itself as it does not bind to the Thyroid Hormone Receptor, but it converts to T3 inside the cell. As such, it serves as a reservoir for T3.
In normal individuals, about 80% of the daily production of T3 comes from the conversion of T4 to T3 and the remaining 20% from the Thyroid gland itself.
Conversion of T4 to T3
The conversion of T4 to T3 takes place under the direction of an enzyme called Deiodinase. There are two types of this enzyme – one inside the brain which is called Type 2 Deiodinase and one inside the rest of the body is called Type 1 Deiodinase.
The conversion to T3 gets easily disrupted due to a variety of conditions, such as Hashimoto’s thyroiditis, stress, obesity, aging, diabetes, nutritional deficiencies and certain medications including beta-blockers and steroids.
Why Levothyroxine may not Adequately Treat your Hypothyroidism
Many hypothyroid patients do not feel well on Levothyroxine and continue to experience the symptoms of underactive thyroid. Why? Levothyroxine contains only T4 which has to convert to T3 inside the body to be effective. As mentioned above, the conversion of T4 to T3 is interrupted by Hashimoto’s thyroiditis, stress, obesity, aging, diabetes, nutritional issues, beta-blockers and steroids. That’s why many patients do not have optimal levels of T3 in their body and continue to suffer from hypothyroidism.
Beyond Nature Throid, Armour Thyroid, WP Thyroid or NP Thyroid
Treating hypothyroidism is not just replacing T4 and T3. The comprehensive treatment of hypothyroidism should go beyond medication. My treatment approach consists of 5-steps: Stress management, proper Nutrition, proper Exercise, appropriate Vitamins, in addition to the correct Medication.
Please refer to my book, “Hypothyroidism And Hashimoto’s Thyroiditis” for more details.
Vitamins For Hypothyroidism:
I recommend the following vitamins for hypothyroid patients.