NOTE: they would be Lot #: 1077413 with an expiration of  9/30/2011  This is what your pharmacist would need to know.

PRODUCT

Armour Thyroid (thyroid tablets, USP), 1/2 grain (30 mg) , each tablet contains 19 mcg levothyroxine (T4) and 4.5 mcg liothyronine (T3), 100-count bottle, NDC 0456-0458-01. Recall # D-231-2011
CODE
Lot #: 1077413, Exp. 9/30/2011
RECALLING FIRM/MANUFACTURER
Recalling Firm: Forest Pharmaceuticals Inc., Earth City, MO, by telephone and letters on October 6, 2010. 
Manufacturer: Forest Pharmaceuticals Inc., Cincinnati, OH. Firm initiated recall is ongoing.
REASON
Labeling: Label error on declared strength; some bottles are mislabeled as containing 1/2-grain tablets but actually contain 1-grain tablets. The entire lot is being recalled even though some bottles are labeled correctly because bottles of 1/2-grain and 1-grain could be shrink-wrapped together.
VOLUME OF PRODUCT IN COMMERCE
31,172 bottles approx.
DISTRIBUTION
Nationwide, PR, Belgium and the United Kingdom

http://www.fda.gov/Safety/Recalls/EnforcementReports/ucm242808.htm

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Now I’m making no guarantees nor saying this is absolute fact…but because of emails I’m getting and other information, I’m seeing little drops of potential evidence that we may be seeing the beginning of a return of natural desiccated thyroid in our pharmacies. Are we?

For one, a patient called the Forest Hotline today (866) 927-3260, and it said that the 4 and 5 grain is available. Is that an old recording, or could that be a possibility at some pharmacy here or there? Granted, Forest states that the problem of backorders has been found in the “complicated steps in the supply line”, and “one factor is the supplier”.  But if the 4 or 5 grain tablet is available, is something getting through here or there?

Then comes an email from a gal stating she was told by her large national pharmacy that Armour would be in stock by the middle of October.  That is similar to a comment on another blog post below.

Also, American Laboratories, the producer and supplier of desiccated powder, has always stated that they continue to make it–just not enough to meet the demands of larger pharmaceuticals all at once. i.e. perhaps some is getting through.

Little positive rain drops of clues? Maybe. I’m not sure what the near future holds. And there are unanswered questions, such as will Armour still be ineffective for so many in its reformulated state?  In what way, and when, will the FDA follow through on the 1960′s Drug Efficacy Study Implementation (DESI) to prove that desiccated thyroid is safe and effective (which still makes most of us want to ask  “Aren’t 110 years enough evidence?”)

In the meantime, there are options you can use for good thyroid treatment here. Just work with a good doctor if you use any of these options. But a caveat–a few Canadian pharmacies have doubled their prices!! Ouch. I find that very nasty and unethical. So check their prices on the website as compared to what was listed on this page. And GOOD NEWS: a German pharmacy will ship out its own brand of desiccated thyroid.  See it on the Options page.

There continues to be good feedback from patients that most compounding pharmacies have plenty of desiccated thyroid powder in stock.  The above link gives information on how to find a compounding pharmacy. I have used one before that mailed my order to me after my doc faxed the prescription.

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We have never had any mandatory or voluntary recall of any of our thyroid medications due to inconsistency in dosages. Our formulation and preparation is able to stabilize the T3 and T4 hormones through its entire expiry period (3 years from manufacturing) providing additional assurance to both physician and patient alike in quality and consistency of our strengths.

Kudos for RLC Labs and Naturethroid! Patients whose lives have changed ten-fold thanks to desiccated thyroid need a good product. (And we’re going to hope down the line that “someone” will create desiccated thyroid in a sublingual form.)

P.S. If you don’t know what has happened to Armour and patient experiences with it, scroll down.

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*SALE! Stop the Thyroid Madness T-shirts are now 50% off just because I like sales. A great way to spread the word about our patient revolution for the superiority of desiccated thyroid over T4-only meds. You’ll also see funny bumper stickers. Also…when you order the STTM book and request it,  you get a Calvin peeing on….(you’ll see) bumper sticker for FREE, and it’s a hoot.

And you see it happening all over thyroid patient groups on the net.  Many folks are done with Armour.

It’s too chalky. It tastes terrible.  It doesn’t break into smaller pieces well anymore.  It’s lost the ability to be done sublingually. And even worse, it has caused a return of symptoms.

In case you are wondering what this is all about, read the 40 current comments attached to the June 2nd post Trying the Newly Formulated Armour? Before that, you can read my May 7th post Why the party is over with Forest Pharmaceuticals and the current 37 comments.  And especially powerful is the April 28th post Patients say PHOOEY to new Armour formulation and Forest Pharmaceuticals with a current 57 posts.

So what’s their next step?

Right now, doctors of patients on Armour on being asked for a prescription for Naturethroid. Many report it working wonderfully; some state they need a little more to be as optimal as Armour. A small minority aren’t sure about it yet. But overall, the majority are happy.

So let’s get an update of those who have switched: what product did you move to? Is the same amount giving you the same results? Did you have to more to a slightlyl higher amount, or lower amount? Was your pharmacy cooperative for a different brand?  Did you have to explain to your pharmacy that Naturethroid can be drop-shipped directly to them?

P.S. Thyroid patient Cheryl emailed me and said she is sending the above posts about Armour’s problems to practically everyone on her email list, hoping they in turn will send it to their friends, and the word will get out.  If you want to do the same, this post is the most updated, and includes the links to the former posts.

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*Have depression and you are on a T4 med like Synthroid, Levoxyl, levothyroxine, Eltroxin, etc?? Read the blog post below.

Armour desiccated thyroid by Forest Pharmaceuticals used to be easy to do sublingually, even if the official line was they didn’t make it that way.

And patients liked that sublingual ability with Armour.  It allowed them to work around the problem of swallowing desiccated thyroid several hours from having swallowed iron, estrogen or calcium–all which can bind some of the thyroid hormones in your stomach.

It also helped those with digestive issues, gluten intolerance or Celiac (a common problem for some hypothyroid patients) by bypassing the stomach.

But with the newly formulated Armour in 2009, it became difficult. The pill is harder with less dextrose and more cellulose.  It now fell into the ranks of all other desiccated thyroid pills, including Naturethroid and other good brands, as a more dense tablet.

But no matter what brand you use (especially the growing group of patients who are having their doctors switch them to Naturethroid), below are tips from patients on how to continue doing your desiccated thyroid sublingually. Let your doc know, too.

1) Try adding a touch of the contents of a Pixie Stix under your tongue. It’s flavored sugar in a straw, and the sugar seems to help the tablet dissolve sublingually through tissues under the tongue.

2) If you are using sublingual B12 lonzenges to treat low B12, try adding it under the tongue with your desiccated thyroid. The action of the sublingual lozenge seems to move over to the thyroid tablet.

3) Swish warm water in your mouth before you place the tablet under your tongue.

4) Crunch up the desiccated thyroid tablet before any of the above and before placing it all under your tongue.

Also note that you can swallow your desiccated thyroid. You’ll just have to make sure you don’t also have a stomach full of iron rich foods or calcium, or estrogen. Generally, it’s best to take your tablet 4 hours from any of the former. P.S. See comments below on the newly formulated Armour, and farther down, a post on Naturethroid.

*Have more sublingual ideas or experiences? Share it in the Comments section.

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My fondness for Armour did not take away my praises for other prescription brands, though, including Naturethroid or Westhroid by RLC Labs.  I simply made a doe-eyed commitment to Armour for my personal treatment because you could do it sublingually. I have also used the name “Armour” interchangeably to represent all good desiccated thyroid products.

But because of a succession of three events, I think it’s time to give back my going-steady ring.

The first blow to my romance with Armour centered around the extreme tight-lipped secrecy from Forest when the reformulation of Armour began. We can surmise the trouble begin in 2007 when patients were finding Armour in the larger sizes to be suddenly ineffective.  For the entire year of 2008, supplies were extremely limited and only the one grain size or lower could be found, if at all.  Patients were worried and unhappy.  I even supported Forest in my blog posts, assuring patients that everything would be fine.  But Forest said practically nothing. Why was and is Forest mum about why this was happening ?

The second blow to our courtship was the change to the “reformulated” Armour. Suddenly, patients find that doing Armour sublingually was a thing of the past. Now all we get is a never-ending chalky pasty residue.  Additionally, many patients have been reporting that the amount of Armour that once removed all symptoms, was now bringing them back.  Huh?? In spite of an apparent drawback in some batches in 2007, why would Forest take an effective product and change it?

And the third and final straw to my affair of the heart? I made a phone call to Forest using the same 800 number you all can use. That was Tuesday, May 5th. My intent was to ask about the word anhydrous which is now after the ingredient dextrose in the Armour ingredients listing. (It means that all moisture has been withdrawn, but I wanted to confirm the details for the brands page.)  When I reached the representative for Forest, and after she asked my name and I gave it (oops),  the tune of the conversation changed.  She said she could not answer my question since I own a public website, and would have to inform the “Media group” from Forest, and they would call me back. When I asked when, the answer was a vague as Synthroid is in treating hypothyroidism i.e. she didn’t know. I even called back the next day to get the same dribble.   Why have representatives on the Forest hotline been instructed not to answer a simple question from someone like myself,  and I still have not received a phone call from Forest?

Sob.  Yup, breaking up is hard to do, but a gal can only take so much strange betrayal, tight-lipped silence…and ignoring a simple question from someone who has done a LOT to put money in their pockets out of extreme gratitude. Besides, there’s another pharmaceutical courting me at my door:  RLC Labs. Thank goodness there are other fish in the sea.

As the “newly” formulated Armour desiccated thyroid pills, made by Forest Pharmaceuticals/Laboratories, have been hitting the market, so are comments coming out from some thyroid patients…and they are not in the least complimentary.

The reason that Armour had been favored by so many thyroid patients among all the desiccated thyroid brands is the ability to take it sublingually.  Sure, Armour was never officially made to be taken sublingually, but it worked.

Sublingual refers to the administration of a medication via the millions of tiny capillaries that line your mouth and mucous membrane. The pill was placed under the tongue and allowed to dissolve–most of it entering the body directly via your sublingual glands, and only a small amount swallowed.

Some patients who switched from swallowing to sublingual noticed the difference, too.

But the beauty of sublingual has gone even farther than noticing anything different. First, it was always a known “baddy” to swallow any pills that might contain iron, estrogen or calcium at the same time we swallowed Armour or any other desiccated thyroid brand. Why? All three interfere with and bind a certain percentage of the thyroid hormones in our stomachs.  We were forced to take any of those hours apart from swallowing our pill. So doing the Armour sublingually allowed us to swallow the above pills, or drink milk, or eat high iron foods, at our own timing and not hours away.

Second, the old formula was usually gone in our mouths within 30 minutes give or take. Now, patients who take their newly formulated pills sublingually (which now has less dextrose and more cellulose) despise the “chalky, pasty, gritty residue” left in one’s mouth.  It also results in Armour taking far too long to be properly absorbed.

Third, those with adrenal fatigue can find themselves waking up with nausea due to the morning low cortisol. And being able to take Armour sublingually bypassed the need to swallow a liquid to take a pill and promote more nausea.

Fourth, those with Celiac disease, and even those with standard low thyroid digestive issues, found sublingual administration to help their absorption of what desiccated thyroid offers, which they didn’t get well if they swallowed the pill.

All in all, the buzz around patient groups or on comments here  about the newly formulated Armour is not complimentary.  It doesn’t work well sublingually. It’s too chalky. It leaves a gritty paste in your mouth.  And patients are highly disappointed.  Let’s hope that one of the pharmaceuticals takes the ball and runs to create a sublingual desiccated thyroid.

What is your experience with the new formulation? Are you still trying to do it sublingually?  Have you found doing Naturethroid sublingually works? Are you switching to Naturethroid or Westhroid out of principal, as many are stating they are doing? Use the comment section and let’s talk.

*Express your opinion to Forest here: 1-800-678-1605, ext. 66297.

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I can remember a few people the past year who proclaimed fervently that Armour was being discontinued because of the shortage.  And I chuckle about it.  Hopefully, my previous posts helped calm that fear.

But in case you haven’t heard, those larger sizes are back!  And you can keep track of what’s going via the Forest Pharmaceuticals customer product availability hotline: 1-866-927-3260  As of today, April 19, they state that the one grain tabs (60 mg) and 1 1/2 grains tabs (90 mg) are on backorder, and will catch up with production on April 20th, tomorrow as I am writing this.  We’ll see.

Unfortunately, the new formulation has made Armour lacking in sweetness, and it’s almost impossible to do it sublingually.  Sad. Maybe another pharmaceutical will get the hint. In the meantime, if you swallow your desiccated thyroid, make sure to avoid calcium, iron and estrogen at the same time. And if you’ve been doing it sublingually, and have to switch to swallowing, you may need a tad more.

Remember: if you have any issues with natural Armour desiccated thyroid in the treatment of your hypothyroidism, you can always ask your doctor for a prescription switch to Naturethroid or Westthroid, both fine FDA-approved, US Pharmacopeia standard prescription desiccated thyroid.

Janie

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P.S. If you haven’t bought the Stop the Thyroid Madness book yet, wanted to tell you that numerous patients are emailing me, stating they find the book even easier to refer to than this vast website (plus it has more details and information).  So if you want the ease of referral, the book may be the way to go.

1) 15 mg. (1/4 grain)
2) 30 mg. (1/2 grain)
3) 60 mg. (one grain)
4) 120 mg. (2 grains)
5) 180 mg. (3 grains)
6) 240 mg. (4 grains)
7) 300 mg. (5 grains)

Yessiree, the above represent the different size and strength tablets of natural desiccated thyroid via the Armour brand, most of which had been unavailable for quite awhile. The 90 mgs is still on backorder.

Rejoice!

P.S. And we thank RLC Labs for their continued availability of Naturethroid and Westhroid, plus Sriprasit Pharma Co., Ltd. in Thailand for their Thyroid-S.   Because no matter how hard any pharmaceutical company, Endocrinologist, certain hospitals,  or group of physicians (see below) tries to sing the praises of T4 treatment with Synthroid, Levoxyl, Levothyroxine, Eltroxin, Norton for thyroid disorders or hypothyroid….WE KNOW BETTER.

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