When Forest Labs reformulated Armour earlier this year, they stated they increased the filler Microcrystalline Cellulose, and decreased the Sucrose (sugar). The tablets became impossible to do sublingually, and you have to wonder why they would change a quality that patients praised so heavily. Positive opinion among patients for Forest Labs slipped several notches.
But the real cuckoo’s nest for many thyroid patients, who knew firsthand the life-changing benefits of natural desiccated thyroid, was a maddening return of serious hypo symptoms on the new Armour 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: Naturethroid and Westhroid by RLC Labs…then when the desiccated thyroid shortages hit in the Fall of 2009, Erfa’s Thyroid, Compounded desiccated thyroid, and others. And there have been problems for some patients on most everything they switched to. The LEAST problematic has been Erfa’s Thyroid, and the most problematic was Compounded.
So what has been the common thread in the most problematic desiccated thyroid products? 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 before it became scarce. And Naturethroid uses cellulose as a filler.
Is this problem true with T3-only products? Yup. Patients have noted that generic T3 is far less effective than the brand name Cytomel (both Liothyronine Sodium) And what filler it up to 70% in the generic T3? CELLULOSE. See the percentages here for Paddock’s generic T3.
Why have less problems been reported with Erfa’s Thyroid? Perhaps because it has no cellulose as a filler! See this list of ingredients, which STTM has been working on lovingly for a few years.
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.
Cellulose can clearly be a problem, especially when it’s ratio is too high as compared to the desiccated thyroid. So what can you do?
If you are using a compounded medication, strongly 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). See what other fillers your compounder can offer.
Another possibility is Cellulase, an enzyme which helps the splitting and breakdown of cellulose, and which was proposed to me by Naturopathic student Stephanie Buist. Google “cellulase” and find supplements that contain it. If it looks promising to you, I’ll be curious to read your experience with swallowing a cellulase supplement, then swallowing your problematic desiccated thyroid.
And leaning towards Erfa’s Thyroid can be a plus.
Have other ideas or comments about Cellulose in our desiccated thyroid? Use the COMMENT function below and let’s talk!
This entry was posted on Wednesday, November 11th, 2009 and is filed under desiccated thyroid, shortages of desiccated thyroid. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
Marie Poling said:
Nov 11, 09 at 4:47 pmHi. I am getting Armour thyroid from a compounding pharmacy without fillers. They simply put the powder into a gelatin capsule. So that’s also an option.
Paula said:
Nov 11, 09 at 4:56 pmI’d been on Armour since 2002. I didn’t think I was having an increase in symptoms until I switched to compounded thyroid capsules. My symptoms were subtle: increased hair loss, but not tons, an increase in fatigue, but my hours aren’t the most regular so I wasn’t sure. After taking the capsules for a couple of weeks, it was obvious I was having a return of symptoms. My pharmacist uses microcrystalline cellulose, but I don’t appear to be having a problem with it. Perhaps it’s the quantity of cellulose or a difference between tablet vs capsule…???
Julie said:
Nov 11, 09 at 5:00 pmVery interesting. I feel the best on Erfa and now this makes sense. Being hypo we already have absorption issues so this really does explain a lot. I do believe you are on to something big here.
nutralady2001 said:
Nov 11, 09 at 5:09 pmMakes sense to me.….…. that batch of Armour starting April really did me in.Am still struggling to get back to where I was (including a 12 kilo weight gain which I’ve just managed to lose.…yeah)
They could rap Armour in gold leaf, stud the bottle with diamonds and I still wouldn’t touch it again
Hardasnails1973 said:
Nov 11, 09 at 5:32 pmI have been dealing with thyroid issues for over 8 months because of the nonsense that has been going on with armour. I have tried Natural throid,west throid, compounded armour, t-4, t-3, and still no resolution. I just ordered from canada erfa as all patients are being switched over to this to see if there is any resolution to the absorption issues. My system can only take it sublingually. I have lost over 20 lbs of muscle when all this circus started and some times left me feeling disabled as well as help to end my past relationship because of the irregular mood swings. When research the symptoms began right after starting the new batch of armour in april. Even on 4 grains of new armour i tested below reference range. T-3 give some relief but not like I felt on the old armour. As many of you I have been through the ringer. If it was not for me going through it patients would not have a clue what was going on resulting in potential unneeded trips to the head shrinkers. I warned every one starting new armour if they feel a drop in 2 weeks please let me know. My phone was ringing off the hook and the lab test reflected this change. I hope erfa will be the missing link to finally put people back on the road to recovery which has already taken many years to achieve then to have it all taken away because of the FDA change in formulation. Wish we could some how get compensation for this error.
ESPRESSO said:
Nov 11, 09 at 5:38 pmI was wondering if you have to have a doctor’s prescription to order Armour thyroid.
(From Janie: Yes. Even some of the Canadian pharmacies are now carrying Armour. http://www.stopthethyroidmadness.com/options-for-thyroid-treatment )
gigilaroux said:
Nov 11, 09 at 6:01 pmYes its all about the filler. I had problems with Armour this year it sometimes would be great then it would reak havoc with my TSH levels. I would take 60mg & 90mg alternating days. When I found out 2 months ago about this issue I started dissolving it under my tongue so it would bypass my stomach– it takes about a half an hour before its all dissolved. I could feel it though start working again because my jitteryness came back a bit. And for those who don’t know one of the biggest arteries is under your tongue so if you ever need meds to work right away that the way to get in your system quickly it is absorbed thru your arterial wall there. I got my new levels 2 days ago and my TSH was back down to 1.5 from the 2 previous tests 6 & 9 months ago of 5.5 and 4.5. And I have just been taking the 60mg, the 90 makes me really jittery now its too strong under the tongue. Also I could tell it was working because I am seeing more baby hair sprouting up around my temples, and my eyebrows. Also all my other levels were totally in balance including reverse t3. Other than that I’m kindof excited to try the Erfa though, my doctor was indifferent of my ordering it from Canada, its sitting the closet waiting to be used. Armour though it just doesn’t work if its swallowed, If you have any left just let it dissolve under tongue just try it for a month see what happens you’ll see it working. It’ll take about a half an hour though to dissolve.
Traci said:
Nov 11, 09 at 9:53 pmIt makes sense to me that the cellulose is probably causing problems. I have noticed that I seem to be doing so much better on ERFA than even old Armour.… I did okay on Armour before they changed the formula, but I haven’t had ANY problems with ERFA, even when I take it late in the day or miss a dose. I haven’t had heart palps in a long time, and I feel fine. I’m planning on staying with ERFA even if they fix what’s wrong with Armour.
Nell said:
Nov 12, 09 at 8:34 amHi all,
I don’t know how this will equate to theories already suggested but I really crashed on the new armour and I did what gigilaroux has suggested — well almost, I put it in my cheek. It made no difference to me despite my having it in my mouth for at least 1/2 an hour. When I changed to Westhroid (did thryoid-s in between times) I continued letting it absorb in the mouth and that worked. I’m almost back to where I was before the placebo-like armour arrived but I’m mystified as to why it didn’t work.
Does anyone have any feedback about thiroyd please. This is the thyroid from Greata Pharma which I got from Canada. I can’t find details of the filler it contains and few people have given their experiences of how it’s worked for them.
Nan said:
Nov 12, 09 at 1:19 pmHearing the feedback about ERFA excites me as I just faxed my prescription.
The cellulose in the new Armour caused SERIOUS problems for me. Lucky for you I’m too tired to recant my tale of woe.
I switched to NatureThroid 3 months ago and improved in some ways but not in others. It too has cellulose although not as much. I suspect I’m getting more uptake but not quite as much as my body needs. Would ask my Dr. if I can boost the dose a little but am afraid of increasing the cellulose.
Am counting the days until the ERFA arrives and will hold onto the info about acidophiles as a filler.
Thanks!
nutralady2001 said:
Nov 12, 09 at 1:40 pmDissolving it under my tongue made absolutely no difference to me, it was how I had always taken it. I thought I was going mad and emailed Janie and the other NTH mods because I didn’t want to raise it on the list at that time (still thought it was me) and within a week the other complaints started coming in.
Lynn Dunning said:
Nov 12, 09 at 7:32 pmNell– I have been using thiroyd for 10 months and it is great. I am celiac and it does not afect me in any bad way. I emailed them and got this:
“Thank you for your inquiry.
The product contains a minimal quantity of corn starch, and contains T3 at 8.31 microgram; T4 at 35 microgram, which is 0.013% and 0.058% respectively”.
shae said:
Nov 13, 09 at 8:48 amAgain, I experienced no problems whatsoever. I take 45 mg and my TSH levels are at my norm with that does (somewhere around 1.0). The only problems that I have is that I am out and using Levothyroxine. Now THAT is a problem!
Sandy said:
Nov 13, 09 at 10:02 amWHY can’t we just have the old Armour back?? It’s bad enough dealing with this stupid disease — no we all have to be chemists to get the right meds?? INSANE!!
valerie said:
Nov 13, 09 at 11:57 amlm sure the cellulose is a problem…l was chewing my armour b4 all of this happened.…but chewing the new didnt work and it was gross with NT…but b4 l chewed my dessicated l had bought a pill crusher and was crushing my meds cause swallowing armour had not worked for me and l found great improvement with that method…l have been on NT since June and it hasnt worked that great..just been swallowing the pills…l forgot about my pill crusher…but l remembered the other day…my results again are good…l warm up…my ears stop ringing and my energy level is way better…l have been taking t4 along with NT since l started it and l will probably continue with that as l feel it really makes a difference for me…l just feel more stable..no ups and downs.…l crush the NT into a fine powder and swallow with a big glass of water.…working good.…l recommend it…Val
Shantygirl said:
Nov 14, 09 at 10:37 amI have been taking Erfa sublinqaly for three days. I have done nothing else and lost 2 pounds. A friend who is also taking Erfa has noticed her depression lifting already. To me, the flavour and aroma is even stronger than the Armour before it was reformulated.
Linda said:
Nov 15, 09 at 1:21 pmI did really terrible on the new Armour, but wonder if cellulose is the only problem with it. I did better on Naturethroid when I could get it, but still had symptoms. A few weeks ago, though, I got some thyroid-s and feel really great! But looking at the ingredients on this site, I see it also has cellulose. So if that is the problem with new Armour, why am I feeling so good on thyroid-s?
Nell said:
Nov 16, 09 at 4:43 pmLynn, thanks for the feedback, that’s very reassuring. I’m tempted to switch over to thiroyd now rather than wait for the westhroid to run out.
angela elser said:
Nov 16, 09 at 5:18 pmJust diagnosed in July (after 10 yrs of misery). Tried just T4 generic, had relief of most of my symptoms immediately although hair loss accelerated. Doc switched me to Armour in August — in 2 weeks I was a mess again — all symptoms returned. Switched to Synthroid. Then doc suggested to try Armour again but “up” the dose. (same bottle) Got worse AGAIN! Back on Synthroid. But heart palps and now heart pain are making me NOT want to take it. Afraid of switching back to Armour. I never got a chance to try the original formula. Any suggestions? In the dark here. Not too many Docs are willing to even discuss thyroid alternatives like Elfa…
Jessica Williams said:
Nov 18, 09 at 5:03 pmI personally feel better on my compounding pharmacist’s Dessicated Thyroid USP, using porcine material from New Zealand. Avicel is the filler (Microcrystalline Cellulose). Besides the question of Methyl Cellulose as filler, the conditions for pig farming in the US are criminal, causing untold misery and damage to the smart little creatures before we ever get our medication from them. They’re penned so tightly that they chew each others tails off, they are left in pens standing on the corpses of dead pigs, they actually eat swill that is produced containing the feces of other livestock… it’s evil and totally uncalled for. I gather that the pigs in New Zealand are treated and fed well.
The new CODEX (international food law) is almost in place, and we’re all hoping that the compounding pharmacies aren’t shut down as the new law goes into effect. We live in a nation now that isn’t very sympathetic to our health and welfare unless we are very very rich.
I want to commend all of the people here for doing such a great job of researching for their own welfare and realizing that our doctors know very little. I have been lucky to have a PCP who listens to and trusts me. I would be long dead from myxedema coma otherwise.
And yes, a class-action suit against Armour (and the FDA) seems appropriate. Lawyers, step forward!
angela elser said:
Nov 18, 09 at 7:22 pmDearest Jessica Williams — Where on the planet are you. And would you be willing to share your Docs name with me. I’ll travel. I’m sick and getting sicker.
I live in Minneapolis — you? angela@greatskinmn.com
Leah Schmaman said:
Nov 19, 09 at 6:48 amReading all this about ERFA, what is the best way to get hold of some? I could get a scrip from my Dr. Whom do I contact to get it?
Thanks
(From Janie: http://www.stopthethyroidmadness.com/options-for-thyroid-treatment )
Jessica Williams said:
Nov 20, 09 at 12:10 amTo Leah, re ERFA and “Thyroid from Canada”:
http://thyroid.erfa.net/
and
http://www.erfa-sa.com/thyroid_en.htm
And please, we all need to stock up and keep the meds cool, dry, and stored in different containers from the ones we open and close daily. My research says no to refrigeration, but if anyone knows otherwise, let me know.
jessica@jessicawilliams.com
Tom @ Wheat Fiber said:
Nov 26, 09 at 11:57 pmI know it’s a sad thing when a company doesn’t listen to it’s customers, but the reason is most likely to increase profits, as cellulose fiber can be cheaper than sugars to add for companies.
Andy said:
Nov 27, 09 at 7:05 amBeen having digestive issues on the Nutri-meds Thyroid (but…I am awake!) Because of this article I started taking it with yogurt, no more stomach problems! Thank-you much!
Sue McGuire said:
Nov 27, 09 at 1:35 pm(From Janie: For clarification: not all facilities mistreat their pigs.)
I am new to this blog. I was just diagnosed and today ordered my pills called ERFA’s “Thyroid” from canadadrugs.com. Shipping is free whereas it is more expensive to order directly from ERFA. Genevieve the rep from ERFA said that the pig material in “Thyroid” is from American pigs…(I agree they are not treated well and we need to stop animal abusers!) and the problem that Armour was reformulated was because some people had an adverse reaction to the fillers. She said the pills are actually made in Belgium and sent back to Canada. ERFA’s fillers are different from the reformulated Armour.
Kelly said:
Dec 01, 09 at 4:34 pmI don’t think Cellulose was the issue for me with Armour. I had two great months and then two really awful months when the formula changed (worse than before medication). I had my levels checked and they were almost the same as prior tests, even though I felt terrible. I then switched to Nature Thyroid and felt better within 2 days. Of course, now this is in short supply as well so I have been on the compounded capsules, rather than tablets, for nearly three months and I have never felt better.
MH said:
Dec 01, 09 at 8:56 pmI have a question for you Janie, and anyone else who want to reply.
What filler(s) would you recommend in capsules? I guess there has to be something?
I plan to open them and take the medication sublingually.
(From Janie: if compounded, acidophiles.)
Judith said:
Dec 09, 09 at 7:04 pmJessica Williams – Could you share where your compounding pharmacy is that gets porcine material from New Zealand? Thanks!
Judith said:
Dec 09, 09 at 7:06 pmAlternative filler material – I was confused by the spelling, “acidophiles.” It might be good to change it to “acidophilus,” although the link spells it correctly. Seems like a great idea. Are there other filler materials in addition to this and ginger?
KK said:
Dec 10, 09 at 9:29 pmHas anyone experimented with opening their compounded thyroid (with microcrystalline cellulose as filler) capsule and letting it absorb sublingually?
Alixe said:
Feb 25, 10 at 11:15 amMarie Poling — or anyone else who reads this — what pharmacies can compound without any fillers?
Denice said:
Jun 21, 10 at 1:04 pmI was on the new Nature-throid for the last 3 months and it seemed to cause my heart to go crazy. I added levothyroxine and that helped — but now I think I need to get off Nature-throid — I am sorry to say.
Anyone else having heard issues on the new Nature-throid?
(From Janie: Denice, you need to either chew the Naturethroid up before swallowing it, or pulverize it with a mortar and pestle and add a touch of honey or sugar. Doing either breaks down the cellulose and makes Naturethroid work better. Or use this page: http://www.stopthethyroidmadness.com/options-for-thyroid-treatment )