What is alternative to Nature Throid? You wonder after your pharmacist breaks the news these products are no longer available. Nature-Throid is used to treat hypothyroidism (underactive thyroid.) Recall of Nature Throid – and also of WP Thyroid and NP Thyroid – has created a lot of confusion and chaos among patients with hypothyroidism – underactive thyroid.
Recall of Nature Throid, WP Thyroid and NP Thyroid
- September 3, 2020 – RLC Labs voluntarily recalled Nature Throid and WP Thyroid.
- September 17, 2020 – Acella Pharmaceuticals, LLC voluntarily recalled one lot of 15-mg and one lot of 120-mg of NP Thyroid.
What is the Reason for the Recall of Nature Throid, WP Thyroid and NP Thyroid?
- Because, FDA found some samples of Nature-Throid, WP Thyroid and NP Thyroid contained slightly lower amounts – 87% than 100% – of Liothyronine (T3) or Levothyroxine(T4).
- Smaller than expected amounts of T3 and T4 may not adequately treat your hypothyroidism.
- For this reason, the manufacturers of Nature-Throid, WP Thyroid and NP Thyroid decided to voluntarily recall these products.
Update on the Recall of Nature Throid, WP Thyroid and NP Thyroid
As of April 14, 2021, there is no change in the recall of Nature Throid, WP Thyroid and NP Thyroid. There continues to be shortage of some of the doses of these various preparations of the dessicated thyroid, especially Nature-Throid and WP Thyroid. However, some strengths of NP thyroid are available.
This is what the manufacturer, RLC labs says “Although we do not yet have an exact timeframe for the reintroduction of Nature-Throid and WP Thyroid, we will continue to work with our team and FDA to ensure that the products are back on the market as soon as possible.”
So, what is the replacement for Nature Throid – or WP thyroid or NP Thyroid? Here are your choices:
Choice No 1: Armour Thyroid
Armour thyroid is a good substitute for Nature Throid (or WP Thyroid or NP thyroid.) However, it is more expensive than Nature Throid, WP Thyroid and NP Thyroid.
The active ingredient of Armour Thyroid is dessicated Thyroid. which is the same ingredient in Nature Throid – or WP Thyroid or NP Thyroid.
Over the years, I have used dessicated Thyroid in most of my hypothyroid patients. Dessicated Thyroid comes with various brand names (Nature Throid, WP Thyroid, Armour Thyroid, NP Thyroid). I have found all these brands of dessicated Thyroid to work well, although there is a marked difference in their prices – Armour Thyroid being the most expensive one.
Is Nature Throid the same as Armour Thyroid?
The active ingredient is the same in Nature Throid and Armour thyroid. It is called dessicated Thyroid, which comes from pigs and cattle. However, there are differences in the inactive ingredients between Nature Throid and Armour Thyroid. For this reason, some patients may not do as well when switched from Nature-Throid to Armour Thyroid.
What is equivalent to Nature Throid?
65 mg of Nature Throid is equal to 60 mg of Armour Thyroid, 32.5 mg of Nature Throid equals 30 mg of Armour thyroid…..
What is equivalent to NP Thyroid?
60 mg of NP Thyroid is equal to 60 mg of Armour Thyroid, 30 mg of NP Thyroid equals 30 mg of Armour thyroid…..
Huge difference in the Price of NP Thyroid at various pharmacies
There can be a huge difference in the price of a medication. Remember to check GoodRx.com for price comparison if you pay out of pocket. For example, a patient shared this info today.
Price for NP Thyroid 120 mg for 90 day supply – with GoodRx.com coupon – at various pharmacies on March 1, 2021 in Sothern California:
Walgreen = $51.38
Walmart = $ 113.09
CVS = $51.88
Rite Aid = $ 44.69
Costco = $ 102.41
Vons = $95.40
Target = $51.88
Ralphs = $ 44.06
Safeway = $95.40
Choice No 2 : Switch to a Compounding Pharmacy
You can also switch to a compounding pharmacy to substitute for Nature-Throid or NP Thyroid or WP Thyroid. 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, 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 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 out. Then, the physician and the patient think that the combination of T4 and T3 does not work.
Conversion from Nature Throid to Levothyroxine and Cytomel combination?
The ratio of T4:T3 is approximately 4:1 in Nature-Throid, NP Thyroid, WP Thyroid and Armour Thyroid.
For example, if you were on 65 mg per day of Nature- Throid, you were getting 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 dessicated Thyroid product such as Armour Thyroid in place of levothyroxine. But there is a difference between dessiacted 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 atom in its molecule. That is why it is also called Triiodothyronine. But 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 of T3.
In normal individuals, about 80% of the daily production of T3 comes from the conversion of T4 to T3 and 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 the 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, 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, the SNEVM.
Please refer to my book, “Hypothyroidism And Hashimoto’s Thyroiditis” for more details.
Vitamins For Hypothyroidism:
I recommend the following vitamins for hypothyroid patients.