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The news this mor­ning about Oprah made me pause.

Yes, it’s being announ­ced today that there will be no more Oprah Win­frey Show on CBS after Fall of next year.  She’s saying goodbye. And the rumor is that she will move her talk show to The Oprah Win­frey Net­work, which repla­ces the Dis­co­very Health Chan­nel. We’ll see when she for­mally announ­ces it today on her show.

But the change sure does shine a bright spot­light on a colos­sal and com­plete fai­lure by Oprah and The Oprah Win­frey Show for hun­dreds of millions of thy­roid patients. Though she had her own bout with thy­roid disease (and may still be dea­ling with it when you con­si­der her weight issues), we all win­ced a year ago when she sta­ted that a month long Hawaiian vaca­tion and eating fresh foods with soy milk (a goi­tro­gen) were a great way to treat her thy­roid con­di­tion. Yikes.   We equally squir­med in our seats when Dr. Chris­tiane North­rup made the com­ment that our thy­roid pro­blems were due to an “energy bloc­kage in the throat region, the result of a life­time of ’swa­llo­wing’ words one is aching to say.” Dou­ble yikes.

And since then, we have watched nothing, zilch, zero from Oprah and The Opray Win­frey Show about a horren­dous 55-year medi­cal scan­dal of thy­roid treat­ment that has nega­ti­vely affec­ted the lives of hun­dreds of millions of thy­roid patients world­wide. T4-only meds like Synth­roid, the dar­ling medi­ca­tion of the medi­cal com­mu­nity for hypothy­roi­dism treat­ment, has left hun­dreds of millions sick.  The TSH lab test has equally sent us to hell.  Because we have been for­ced to live with con­ti­nuing symp­toms of hypothy­roi­dism, we’ve endu­red much more tes­ting and have been put on many other medi­ca­tions to ban­daid our con­ti­nuing symp­toms. And a majo­rity of us have had to deal with the addi­tio­nal bur­den of adre­nal fati­gue thanks to all the above.

It’s been hell, Oprah. But you never lis­te­ned.  So for me per­so­nally, I could care less what you do now. You’ve let millions of us down.

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On a far bet­ter note:  Last night’s Thy­roid Patient Com­mu­nity Call on Talkshoe was exce­llent. From thyroid/adrenal patient Vale­rie Tay­lor, who is abso­lu­tely one of the most know­led­gea­ble patients in the world about adre­nals and RT3, we gai­ned good infor­ma­tion how it rai­ses its ugly head when you have high or low cor­ti­sol, low B12, low ferri­tin and other untrea­ted issues, and how to treat it. You can go back to Talkshoe and lis­ten to the broad­cast, which was Epi­sode 7.  See my blog post right below this. As far as future Talkshoe Com­mu­nity Calls: they will always be announ­ced here first.

Below that, you’ll read how cellu­lose as a filler just may be a huge pro­blem in natu­ral desic­ca­ted thy­roid meds. But we are also dis­co­ve­ring that a good desic­ca­ted thy­roid like Natu­reth­roid, even with its cellu­lose, can seem even worse if we have undis­co­ve­red and untrea­ted issues like low B12, low Vit. A, low ferri­tin, low Vit. D and other con­di­tions com­mon with hypothy­roi­dism.  Make sure you have tes­ted for these.

*HO HO HO! Have a STTM book sent to someone  you care about as a CHRISTMAS or HOLIDAY pre­sent. All the work is done for you!

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 post gar­ne­red a lot of atten­tion, up to FIFTY com­ments just a few hours after it went up. Peo­ple are very inte­res­ted in sha­ring their expe­rien­ces in coping with the shor­ta­ges! See below and add your own.)

This year will go down in his­tory as shoc­kingly mise­ra­ble for enligh­te­ned thy­roid patients on natu­ral desic­ca­ted thy­roid.

First came a refor­mu­la­tion in the most popu­lar brand – Armour by Forest Labs. Patients world­wide in groups and forums repor­ted a serious return of their hypothy­roid symp­toms on this pro­duct. A huge disappointment.

Second came the pro­duc­tion shut­down of the two gene­ric makers of desic­ca­ted thy­roid: Time Caps Labs and Major Phar­ma­ceu­ti­cals. It’s the first step in the FDA’s com­pliance plan to corral all grandfathered-in drugs (drugs already in exis­tence when the the FDA was crea­ted in 1938) and make them each prove the effi­cacy and safety of their medi­ca­tion via very expen­sive cli­ni­cal trials.  i.e. over 110 years of safe and effec­tive use of desic­ca­ted thy­roid is not enough for the FDA?? We are still wai­ting to see the out­come of that plan with RLC  and Forest Labs. – the two who were actually in exis­tence before 1938.

Third came demand being grea­ter than supply and shor­ta­ges. Because of infor­ma­tive patient web­si­tes like Stop the Thy­roid Mad­ness,  Sheila’s TPA-UK, Lyn’s Thy­roi­dUK, Stephanie’s Natu­ral Thy­roid Choi­ces, some areas of about.com (and other good web­si­tes I don’t mean to miss here), plus many fine patient forums and groups,  patients found out why they had con­ti­nuing symp­toms on T4 thy­ro­xine, and demand for natu­ral desic­ca­ted thy­roid grew exponentially.

STTM then crea­ted a list of options for all thy­roid patients until the shor­ta­ges resol­ved them­sel­ves, and also crea­ted CDT (Coa­li­tion for Desic­ca­ted Thy­roid) where patients could dis­cuss alter­na­ti­ves in a sup­por­tive and fac­tual atmosphere.

And we’ve seen some inte­res­ting expe­rien­ces and comments:

The new Armour: One grain tabs star­ted to appear on some phar­macy shel­ves the past month.  Other phar­ma­cies have still been wai­ting.  Many patients appear to have switched to other alter­na­ti­ves, though. One gal still on it feels she is fin­ding suc­cess by adding T3 to the amount of new Armour she is on.  Time will tell if patients can ever find suc­cess with the newly for­mu­la­ted Armour, and most feel it’s a huge loss.

Natu­reth­roid and Westh­roid: Patients repor­ting on their switch to either of RLC Lab’s two iden­ti­cal pro­ducts report doing well, having to raise it slightly or lower it slightly, or just not liking them at all. Others have had a hard time fin­ding it on their phar­macy shel­ves, but have been seeing some appear in the last few weeks.

Erfa’s Thy­roid from Canada: When it became clear that the FDA was allo­wing this exce­llent pro­duct to be ship­ped to patients, many switched and had their presc­rip­tions faxed to a Cana­dian phar­macy. Pri­ces at many of those phar­macy web­si­tes were dou­bled after presc­rip­tions star­ted to come in from the US. Most patient who stuck with it seem to love it, repor­ting you can do it sublin­gually, as well. A few haven’t been impres­sed, but were fin­ding their for­mer suc­cess by rai­sing it.

Com­poun­ded desic­ca­ted thy­roid: In spite of being a more expen­sive option, some patients found suc­cess with this. Others lear­ned they pre­fe­rred the filler to be Aci­dophi­les.  If not the lat­ter, Mic­rocrys­ta­lline Cellu­lose was pre­fe­rred over Methyl Cellu­lose – the lat­ter which appea­red to les­sen the effec­ti­ve­ness of the com­poun­ded thyroid.

Synthe­tic T4 and Synthe­tic T3: some patients switched back to the synthe­tic com­bi­na­tion, but many report that it hasn’t been as effec­tive as desic­ca­ted thy­roid was.

Other options: Patients moved to OTC pro­ducts like Nutri-Meds, etc, which can be much wea­ker. Others sought desic­ca­ted thy­roid from other coun­tries and have found success.

So I’d like to hear from all of you.   Did you go back to synthe­tic T4?  What desic­ca­ted thy­roid did you switch to? What wor­ked and why? What didn’t work for you and why?  What pro­duct do you hope to switch to once you run out of your current meds?

I once crac­ked open an egg to find it had TWO shells.  And that oddity is equi­va­lent to fin­ding an Endoc­ri­no­lo­gist who sup­ports the use of natu­ral desic­ca­ted thy­roid. 

Voila!! ~~ you can lis­ten and talk to an Endo who does just that on this Thurs­day evening’s popu­lar THYROID PATIENT COMMUNITY CALL on TalkShoe.

His name is Dr. Gary Pep­per, Board Cer­ti­fied by the Ame­ri­can Boards of Inter­nal Medi­cine, and Endoc­ri­no­logy and Meta­bo­lism and editor-in-chief of metabolism.com.  Besi­des ser­ving many years in dis­tin­guished lea­dership posi­tions, he was selec­ted as one of the top 100 phy­si­cians in New York City by New York Maga­zine and is also a fea­tu­red expert with CNBC and ivi­llage on topics of dia­be­tes and endoc­ri­no­logy. He sta­tes:  Almost daily I reread the words of Sir William Osler: “It’s often more impor­tant to know what sort of per­son this disease has than to know what disease the per­son has.”

i.e. this is one of a rare but gro­wing breed of doc­tors who sup­ports what we as thy­roid patients already know – that desic­ca­ted thy­roid is a five-star hypothy­roid treat­ment and T4-only is about as effec­tive as a dough­nut diet for most. And lo and behold,  Dr. Pep­per is an Endoc­ri­no­lo­gist! Of course, I can give no gua­ran­tees how he is as a doc­tor in his own office, but I do appre­ciate his unders­tan­ding that T4-only treat­ment may not be the best way to treat hypo.

Join us this Thurs­day eve­ning, 6 pm Paci­fic, 7 pm Moun­tain, 8 pm Cen­tral and 9 pm Eas­tern by clic­king on the first link above tit­led Thy­roid Patient Com­mu­nity Call.  When on that page, you’ll also see the exact day and time left before the call. You’ll be able to lis­ten to the call right on your com­pu­ter, or you can dial in and lis­ten on your phone. There is also an option to talk one-on-one live with Dr. Pep­per and Janie.

And remem­ber: neither I or Dr. Pep­per can offer per­so­nal medi­cal advice or pro­vide indi­vi­dual spe­ci­fic coun­se­ling. Those are bet­ween you and your per­so­nal phy­si­cian.

***P.S.  Phar­ma­Ti­mes this month repor­ted that this quarter’s sales of  Synth­roid (levothy­ro­xine) were up 3.7% to $134 million by Abbott Labs. Sad for most of those patients. If you know of someone who has been put on a T4 med, send them here: www.stopthethyroidmadness.com/t4-only-meds-dont-work or to the audio page here: www.stopthethyroidmadness.com/audio-shorts (third one down).

On the heels of an exce­llent Thy­roid Patient STTM Com­mu­nity Call on iodine with guest Stepha­nie Buist (see below), it was just announ­ced by the Food Stan­dards Autho­rity of Aus­tra­lia and New Zea­land (FSANZ) that Aus­tra­lia will add the mic­ro­nu­trient iodine to bread. New Zea­land already star­ted that prac­tice in Sep­tem­ber of last year.

The announ­ce­ment men­tions the impor­tance of iodine to thy­roid func­tio­ning, as well as for infant brain and ner­vous sys­tem, both during and after preg­nancy.  For the lat­ter, it sta­tes “Not having enough iodine during preg­nancy and early childhood can cause deve­lop­men­tal delay and lead to reduc­tions in men­tal per­for­mance. This damage prior to 2 – 3 years of age is irreversible.”

Appa­rently, the  soils of Aus­tra­lia and New Zea­land are not too pro­li­fic in iodine, and patient levels have been revea­ling that fact for deca­des. But Stepha­nie Buist, the friendly and know­led­gea­ble owner of the yahoo group Iodine, as well as a thy­roid can­cer sur­vi­vor, sta­tes that even most US soils are beco­ming deple­ted.  It’s not just a pro­blem of the northern US “goi­ter belt”, Europe or Africa anymore.

The impor­tance of iodine goes even farther than thy­roid func­tio­ning, preg­nancy and infant brain deve­lop­ment. It has a key role in breast health, your immune sys­tem, bones, estro­gen meta­bo­lism, lung health, eyes, and can­cer pre­ven­tion. The iodine4health web­site lists many bene­fits as well as areas not unders­tood yet.

How much do we need? Experts like Abraham, Flechas and Browns­tein will empha­ti­cally state that we pro­bably need more than is recom­men­ded.  At least 50 mg of iodine may be neces­sary for awhile to bring your levels back up to healthy amounts, besi­des stop the the side effects of iodine on hashi­mo­tos disease.  i.e. thin­king you are get­ting enough iodine natu­rally from foods, or even from natu­ral desic­ca­ted thy­roid like Natu­reth­roid, Erfa’s Thy­roid, or com­poun­ded, may not be so.

How do you find out if you are iodine defi­cient? Stepha­nie sta­ted on the Com­mu­nity Call that the majo­rity of folks pro­bably are defi­cient. But if you want to be sure, you can do the Iodine Loa­ding Test.

What are good iodine sup­ple­ments? Lugols is an liquid variety, and my hus­band and I per­so­nally use it in our mor­ning juice or Emer­gen C (my hus­band uses Emer­gen C in water since he’s dia­be­tic, and it’s a good way for him to get his Vita­min C).   In pill form is Iodo­ral, deve­lo­ped by Abraham.  You can goo­gle either and find some web­site sour­ces. Also good to take with iodine sup­ple­men­ta­tion is mag­ne­sium, Vita­min C, and sele­nium, which helps with the detox effects.

You can lis­ten to the recor­ding of Stephanie’s and my con­ver­sion on iodine by going to the link below for Epi­sode 5 of the Thy­roid Patient STTM Com­mu­nity Call. (Yes, I will correct the skip­ping you hear in my voice next time.)

Read Diana’s expe­rience with iodine hel­ping her get off desic­ca­ted thy­roid. Not something we can all do, but it hap­pe­ned to her!