* You are viewing Posts Tagged ‘thyroid patients’

Another interesting reply to a patient by the FDA

fdaimageAs thy­roid patients are not only in angst about a com­plete shor­tage of desic­ca­ted thy­roid in the US, we all have ques­tions and con­cerns about out future with no defi­ni­tive answer.

For exam­ple, we won­der if the FDA may be  requi­ring cli­ni­cal stu­dies from phar­ma­ceu­ti­cals who make desic­ca­ted thy­roid to prove that it’s safe and effec­tive (in spite of the fact that patients have been using it safely and effec­ti­vely for 110 years.  Nope, we don’t count. Ama­zing, isn’t it?) And we won­der: if stu­dies are requi­red, will they be able to afford the stu­dies, which are quite expen­sive? Will desic­ca­ted thy­roid con­ti­nue to be avai­la­ble while the stu­dies go on? And more uncom­for­ta­ble questions.

The FDA recently replied to a ques­tion by thy­roid patient Cathe­rine when she asked about the shor­ta­ges and here’s their reply:

Dear Cathe­rine:

Thank you for wri­ting the Divi­sion of Drug Infor­ma­tion, in the FDA’s Cen­ter for Drug Eva­lua­tion and Research.

We unders­tand your con­cerns regar­ding the avai­la­bi­lity of natu­ral desic­ca­ted thy­roid pro­ducts.  FDA has NOT taken class action against unap­pro­ved thy­roid pro­ducts resul­ting in a shor­tage.  If a com­pany dis­con­ti­nues manu­fac­tu­ring of an unap­pro­ved pro­duct, that is a busi­ness deci­sion made by the company.

Please refer to the ASHP Shor­ta­ges web­site for a lis­ting of desic­ca­ted thy­roid pro­ducts that remain avai­la­ble:
http://www.ashp.org/Import/PRACTICEANDPOLICY/PracticeResourceCenters/DrugShortages/GettingStarted/CurrentShortages/Bulletin.aspx?id=459

We have con­tac­ted the com­pa­nies and RLC (manu­fac­tu­rer of West-Throid and Nature-Throid) is in bac­kor­der for all strengths and pro­ducts for the next 90 days.

Major has the 60mg and 120mg avai­la­ble of their “gene­ric” desic­ca­ted thy­roid pro­duct.  They report inc­rea­sed demand as the rea­son for their bac­kor­der for the other strengths.

Forest reports they have the 120mg, 240mg, and 300mg strengths avai­la­ble for their Armour Thy­roid pro­ducts and they report inc­rea­sed demand as the rea­son for the bac­kor­der on their other strengths.

If you and your health­care pro­vi­der deter­mine that one of these thy­roid pro­ducts is appro­priate for you, you can pro­vide the NDC num­bers lis­ted on the ASHP web­site for these pro­ducts to your phar­ma­cist so they can order for you.

Best regards,
Drug Infor­ma­tion SH
Divi­sion of Drug Infor­ma­tion
Cen­ter for Drug Eva­lua­tion and Research
Food and Drug Administration

The inte­res­ting thing about the above is that it implies that Major Phar­ma­ceu­ti­cals is just on bac­kor­der, which goes com­ple­tely against what patients have repor­ted elsewhere.  What’s going on there? Are they using old know­ledge? And the lar­ger sizes of Armour? Is anyone fin­ding that at the phar­ma­cies right now? Very curious. Inte­res­ting the com­ment about RLC, the makers of Natu­reth­roid.  And the link to shor­ta­ges is inte­res­ting, though from the end of July.

Wha­te­ver the ans­wers are, if you need a treat­ment to get you through this dif­fi­cult time, here are options for thy­roid treat­ment. And it still may be a very good idea to inform your con­gress­per­sons of our situation…just in case. See my blog post below.

*Want to be infor­med of these blog  posts? Curious what’s on Janie’s mind? Use the Noti­fi­ca­tions on the left below the links.

*STTM t-shirts are 50% off! I love sales.


  • Want to keep track of these “fringe web­site” blog posts? ;-) Curious what’s on Janie’s mind? Use the noti­fi­ca­tion on the lower left of the links, called a News­let­ter, or an RSS Feed.
  • The extre­mely hip and sophis­ti­ca­ted STTM t-shirts are half price! Great BUMPER STICKERS, too. Spread the word – YOU may make a dif­fe­rence in someone’s life.
  • Check out the patient-to-patient book with even more detail (and which doc­tors seem to res­pect more than websites).
  • Need to unders­tand all your best options for thy­roid treat­ment? Go here.
  • Keep infor­med of each live Thy­roid Patient Com­mu­nity Call on Talkshoe by sig­ning up as a follo­wer.

The gnarly man and what we can do in the face of this crisis

ogre

There once was a gnarly, bottom-scratching and tuna-breathed man who terro­ri­zed a neigh­borhood as if he was above the law. He inti­mi­da­ted peo­ple, used threats to stop others from telling the truth about his actions, and he moo­ned his hairy but­ta­mous to anyone he didn’t like. He brought other cri­mi­nals into his large house, took bri­bes to do some of their own dirty work, and stole every sin­gle vege­ta­ble and fruit from all his neigh­bors gardens.

Finally, all the fear­ful, frus­tra­ted and hungry neigh­bors got angry, sick and tired of it all. So they sent him emails, let­ters and phone calls, asking him to stop what he was doing, and explai­ning how he was hur­ting their lives and well-being,  and spe­cu­la­ted how he was going to do this or that.

And do you think he stop­ped doing what he always did?

Finally, the neigh­bors got wise. They reached out to the police, to local radio and TV sta­tions, to the news­pa­per, and even to local poli­ti­cal lea­ders.  They sta­ted the facts as they knew them, how spe­ci­fic actions affec­ted their lives, how they had spe­cu­la­tions that they couldn’t prove but were quite uncomfortable…and they made sure ever­yone knew what was going on to get the help and sup­port they nee­ded. 

********************************

For over 100 years, thy­roid patient lives have made a huge and posi­tive turn-around on natu­ral por­cine desic­ca­ted thy­roid, a supe­rior, safe, and effec­tive medi­ca­tion as expres­sed by all our lives for over a cen­tury.  But today, we face a crisis.

The most popu­lar desic­ca­ted thy­roid brand, Armour, was refor­mu­la­ted by 2009  and most patients repor­ted a return of their hypothy­roid symp­toms. Then, the only other major phar­ma­ceu­ti­cal, RLC Labs, has their qua­lity Natu­reth­roid and Westh­roid on bac­kor­der in August of 2009. The only North Ame­ri­can makers of the desic­ca­ted pow­der, Ame­ri­can Labo­ra­to­ries, is out.

And finally, the remai­ning two gene­ric makers, Time Caps Labs and Major Phar­ma­ceu­ti­cals, are told to cease pro­duc­tion by the FDA.

We are now without desic­ca­ted thy­roid other than the remai­ning 10 tablets there, or 5 tablets here. They will all be gone soon.

The facts we know are this: because of the 1962 “Drug Effi­cacy Amend­ment”, the FDA is sud­denly deman­ding phar­ma­ceu­ti­cal drug manu­fac­tu­rers (with medi­ca­tions which have been used suc­cess­fully for 80 – 110 years) pro­vide proof of the effec­ti­ve­ness and safety of their drugs before they can receive true FDA appro­val, aka poten­tial cli­ni­cal trials and the data that results. i.e. 110 years of patient suc­cess, and a web­site like Stop the Thy­roid Mad­ness, and tes­ti­mo­nies all over the net and in patient groups with desic­ca­ted thyroid…is somehow…just…not…enough.  What is obvious, is not enough.

In other words, they want proof of effi­cacy and safety of desic­ca­ted thy­roid — a medi­ca­tion which has a safe and effec­tive track record in a huge body of patients for 110 years…in the same way they give an FDA-stamp-of-approval on a whole variety of drugs which, in 2004, killed 783,936 indi­vi­duals per year (accor­ding to the article Death by Medi­cine, co-authored by By Gary Null, PhD; Carolyn Dean MD, ND; Mar­tin Feld­man, MD; Debora Rasio, MD; and Dorothy Smith, PhD).

Does THAT make any sense to you?

And now, because there is hint that they may require RLC Labs to apply for a New Drug Application…and because we won­der if that will mean expen­sive and drawn out cli­ni­cal tes­ting to pro­vide data…and because we won­der if they will allow RLC to con­ti­nue manu­fac­tu­ring our only good supply of desic­ca­ted thy­roid which saves our lives in a com­ple­tely healthy way…we are left with a lot of uncom­for­ta­ble and unans­we­red questions.

Of course, we can admit that all the above is pure spe­cu­la­tion. We don’t know what will hap­pen until it hap­pens. But we are strongly uncom­for­ta­ble with the unk­nowns, frus­tra­ted by the pos­si­bi­li­ties, and sca­red to death we might lose the only medi­ca­tion which has remo­ved our lin­ge­ring and debi­li­ta­ting symp­toms while we were once on synthe­tic T4 – aka Synth­roid, Levoxyl, levothy­ro­xine, etc.

And by the way, synthe­tic T4 is an FDA-approved medi­ca­tion which has left most of us sick or with lin­ge­ring symp­toms to our own degree and inten­sity for YEARS. Perhaps THAT is what you need to write the FDA about.

So do we email the FDA about this situa­tion?? I am of the belief that writing/emailing the FDA is no dif­fe­rent than asking the neigh­borhood ogre to change.  I could be wrong, but it is my deep sus­pi­cion. In fact, I am sus­pi­cious that the ons­laught of com­mu­ni­ca­tion with the FDA is going to do more harm than good…if it hasn’t already…just as wri­ting and emai­ling the neigh­borhood ogre would pro­bably cause him to laugh and do even MORE harm.

So what seems the best and most logi­cal action to take with our current situa­tion? Write/email your sena­tors. Write/email your repre­sen­ta­ti­ves. Write/email news­cas­ters, talk show hosts, radio per­so­na­li­ties, news­pa­pers of merit, and anyone who has the power to spread the word. In my mind, we can­not expect to face what may be with power unless we inform the world of our plight ahead of time.

How to say what we need to say? I think, for our inte­grity in the eyes of whom we speak/email/write to, it’s impor­tant to state facts first and fore­most. For me, if I need to men­tion spe­cu­la­tion, I turn them into ques­tions: Will RLC be able to afford cli­ni­cal trials? Will the FDA stop all desic­ca­ted thy­roid? You may not agree but that’s what seems wise for me.

I have com­pi­led a list of par­ti­cu­lar con­gress­per­sons who just last year, made a reso­lu­tion against the FDA. You will see a list of those sup­por­ters at the bot­tom of the page with their con­tact info. Email them.  You will also find links to con­tact each and every other poli­ti­cal office. If I have mis­sed something, let me know and I’ll add it.

I have also com­pi­led a sim­ple tem­plate let­ter you can use, or change exactly as you need it chan­ged, for these emails.  It will not fit every sin­gle indi­vi­dual who uses it, so change it as you may. But keep it short and suc­cinct. Too much to read will turn off the reader.

I have tried hard in this post to com­mu­ni­cate my thoughts and intui­tion. I also still have some strong hope and faith that this IS going to work out, one way or the other. I’m just not into fear-mongering based on spe­cu­la­tion.  Some of you may not agree with my sen­ti­ment, but that’s okay. And some of you may agree that it’s time to strongly com­mu­ni­cate with our con­gress­per­sons, and I will hope you follow through. All of us need to follow through. I need to follow through. You need to follow through.

NEED OPTIONS FOR THYROID TREATMENT during this hard time? Go here. You’ll also find seve­ral Cana­dian Phar­ma­cies to use with a presc­rip­tion, as well, that is much easier than orde­ring directly from Erfa.

NEED A GOOD DOCTOR? Go here.

NEW TO DESICCATED THYROID? Here’s everything patients have lear­ned.

*Want to be infor­med of this blog posts? Curious what’s on Janie’s mind? Use the noti­fi­ca­tions on the left below the links.

*Spread the word! STTM T-shirts are 50% off. I love sales.


  • Want to keep track of these “fringe web­site” blog posts? ;-) Curious what’s on Janie’s mind? Use the noti­fi­ca­tion on the lower left of the links, called a News­let­ter, or an RSS Feed.
  • The extre­mely hip and sophis­ti­ca­ted STTM t-shirts are half price! Great BUMPER STICKERS, too. Spread the word – YOU may make a dif­fe­rence in someone’s life.
  • Check out the patient-to-patient book with even more detail (and which doc­tors seem to res­pect more than websites).
  • Need to unders­tand all your best options for thy­roid treat­ment? Go here.
  • Keep infor­med of each live Thy­roid Patient Com­mu­nity Call on Talkshoe by sig­ning up as a follo­wer.

An open letter to Mary Shomon

shakinghands2Hi Mary.

You know, I really don’t think this is a time for us to be sepa­rate, Mary, in our advo­ca­cies.   Seven years ago, I went a dif­fe­rent direc­tion that I felt was impor­tant, and still strongly do, as an acti­vist.  That will con­ti­nue because I believe in what I am doing. You don’t have to agree with my stance, but we can make the choice to work together in what is com­mon bet­ween us – sup­por­ting the use of desic­ca­ted thy­roid and hel­ping others with the shortage.

As I see it, Mary, we each have a won­der­ful legacy. You will always be appre­cia­ted for your work as much as many appre­ciate my work. That will never be taken away.

So why not be uni­ted in this fight, Mary, wor­king together to sup­port patients during this shor­tage.  Thy­roid patients need us.

Janie


  • Want to keep track of these “fringe web­site” blog posts? ;-) Curious what’s on Janie’s mind? Use the noti­fi­ca­tion on the lower left of the links, called a News­let­ter, or an RSS Feed.
  • The extre­mely hip and sophis­ti­ca­ted STTM t-shirts are half price! Great BUMPER STICKERS, too. Spread the word – YOU may make a dif­fe­rence in someone’s life.
  • Check out the patient-to-patient book with even more detail (and which doc­tors seem to res­pect more than websites).
  • Need to unders­tand all your best options for thy­roid treat­ment? Go here.
  • Keep infor­med of each live Thy­roid Patient Com­mu­nity Call on Talkshoe by sig­ning up as a follo­wer.

Why Forest Labs had gotten away with a “newly formulated” Armour that is causing so many problems

Armour tablets Nume­rous and ongoing com­ments to my blog posts below about the newly for­mu­la­ted Armour are shoc­king and despairing.

Addi­tio­nally, thy­roid patients are crying out about the loss of being able to do Armour sublin­gually. (Was Forest Labs not paying one hoot of atten­tion to thy­roid patients the last few years in their praise of Armour because of it’s sublin­gual effec­ti­ve­ness??) Sublin­gual admi­nis­tra­tion was a god­send for thy­roid patients who had diges­tive issues, inc­lu­ding glu­ten into­le­rance and Celiac, as well as those who nee­ded to take iron tablets (which you can’t do at the same time as you swa­llow desic­ca­ted thy­roid, but could do with taking Armour subingually)

So how in the world did Forest Labs get away with refor­mu­la­ting and pro­du­cing a pro­duct that so many patients are repor­ting to be problematic?

It’s not FDA appro­ved. As many of you may know, Armour desic­ca­ted thy­roid, even when it was pro­du­ced by a phar­ma­ceu­ti­cal other than Forest Labs, was around far before the FDA (Fede­ral Drug Admi­nis­tra­tion) came into being in 1938.  That’s why it does not have the desig­na­tion of  “FDA appro­ved” as do those drugs which were crea­ted after the FDA exis­ted. It’s called an unap­pro­ved drug, but Armour was pre­su­med to be safe and effec­tive already.

From the FDA: Under the 1938 grand­father clause (see 21 U.S.C. 321℗(1)), a drug pro­duct that was on the mar­ket prior to pas­sage of the 1938 Act and which con­tai­ned in its labe­ling the same repre­sen­ta­tions con­cer­ning the con­di­tions of use as it did prior to pas­sage of that Act was not con­si­de­red a new drug and the­re­fore was exempt from the requi­re­ment of having an appro­ved new drug application.

Because it’s not “FDA-approved”, it does not have an NDA, aka New Drug Appli­ca­tion. An NDA is used by the FDA to esta­blish if the phar­ma­ceu­ti­cal pro­duct is safe,  EFFECTIVE, more bene­fi­cial than side effects, and has in-house  “con­trols” which main­tain the qua­lity, strength and purity of the pro­duct. (Thanks to “Ben” the phar­ma­cist for remin­ding me of this.)

So…without that NDA, Forest Labs is, and has been, on their own, inc­lu­ding with the latest intro­duc­tion of a newly for­mu­la­ted Armour. So you might say, WE as patients were the gui­nea pigs.  And sadly, we’ve been squea­ling and it’s a muddy picture.

The most impor­tant fact to state: USP (Uni­ted Sta­tes Phar­ma­co­peia) desic­ca­ted thy­roid is an effec­tive and impor­tant drug which is chan­ging the lives of a huge and gro­wing body of indi­vi­duals around the world. That was evi­dent before Armour was refor­mu­la­ted, and is still evi­dent with pro­ducts like Natu­reth­roid or Westh­roid, which many patients are switching to.  See my blog post about Natu­reth­roid here, plus RLC Labs com­ment about Natu­reth­roid here.

But something has gone terribly wrong with the refor­mu­la­tion of Armour, and patients appear to be lea­ving it behind in the dust in favor of another great and effec­tive brand like Natu­reth­roid. And whether it’s the fillers are not, Forest needs to take a new look at their refor­mu­la­tion of what was once a GOOD pro­duct, and hope­fully this time, LISTEN TO PATIENTS.

*Want to be infor­med of these impor­tant blog posts? Curious what’s on Janie’s mind? Just use the Noti­fi­ca­tions to the left and below the links.

*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 (i.e. you have to request it),  you get a Cal­vin peeing on….(you’ll see) bum­per stic­ker for FREE, and it’s a hoot.


  • Want to keep track of these “fringe web­site” blog posts? ;-) Curious what’s on Janie’s mind? Use the noti­fi­ca­tion on the lower left of the links, called a News­let­ter, or an RSS Feed.
  • The extre­mely hip and sophis­ti­ca­ted STTM t-shirts are half price! Great BUMPER STICKERS, too. Spread the word – YOU may make a dif­fe­rence in someone’s life.
  • Check out the patient-to-patient book with even more detail (and which doc­tors seem to res­pect more than websites).
  • Need to unders­tand all your best options for thy­roid treat­ment? Go here.
  • Keep infor­med of each live Thy­roid Patient Com­mu­nity Call on Talkshoe by sig­ning up as a follo­wer.

Doctor questions if adrenal fatigue is real

Louis Nei­pris, M.D., a staff wri­ter who has writ­ten many fine artic­les for myOptumHealth.com, recently wrote one article tit­led Adre­nal Fati­gue: Is it for real? It appea­red on Upper Michi­gan News, TV 6 web­site on July 16th and is making the rounds on other sites. His ans­wer to his own ques­tion?  “Not really”. He adds  it’s not an accep­ted medi­cal diagnosis.”

Oops.

Dr. Nei­pris, thy­roid patients all over the world beg to dif­fer, as do a gro­wing body of collea­gues in your pro­fes­sion. Adre­nal fati­gue, aka low cor­ti­sol, has been dis­co­ve­red on the back of a huge body of thy­roid patients, wea­ring them down with  irri­ta­bi­lity, anxiety, sha­ki­ness, fee­ling dizzy or lighthea­ded­ness, sleep issues, swea­ting, salt cra­ving, nau­sea in the face of stress, and a host of other symp­toms uni­que to each indi­vi­dual with adre­nal fati­gue. My per­so­nal obser­va­tion, as a thy­roid patient acti­vist, is that up to 50% of millions of thy­roid patients all over the world, may have adre­nal fati­gue, or at the very least, a slug­gish feed­back loop.

Even worse, the wides­pread occu­rrence of adre­nal fati­gue, espe­cially in thy­roid patients, has cau­sed pro­blems when they try rai­sing a far supe­rior thy­roid medi­ca­tion called desic­ca­ted thy­roid. Because cor­ti­sol is nee­ded to faci­li­tate the move of thy­roid hor­mo­nes from the blood to the cells, the direct T3 in desic­ca­ted thy­roid pools in the blood, cau­sing low-cortisol-induced hyper symp­toms like a poun­ding hear­trate and irri­ta­bi­lity. The first-pass treat­ment then has to start with hydro­cor­ti­sone like presc­rip­tion Cor­tef from their doctors.

Why have such a large body of thy­roid patients found them­sel­ves with adre­nal fati­gue and its low cor­ti­sol? It’s clear. The TSH lab test sucks, giving one a “nor­mal” rea­ding for years in spite of obvious cli­ni­cal pre­sen­ta­tion of hypothy­roid symp­toms, and pushing one’s adre­nals into over­drive with high cor­ti­sol and adre­na­line to keep the patient going, and ulti­ma­tely lea­ding to adre­nal fati­gue.  On page 65 of the Stop the Thy­roid Mad­ness book, you’ll read about a 44 year old woman who went 15 years with a “nor­mal” TSH result, in spite of obvious cli­ni­cal pre­sen­ta­tion of hypothy­roi­dism, and which led to her own low cor­ti­sol. This is not uncommon.

Second, the risk of adre­nal fati­gue is high due to the ina­de­quate treat­ment of T4 medi­ca­tions like Synth­roid, Levoxyl, levothy­ro­xine, Eltro­xin and other T4-only meds. They all leave patients with their own brand and inten­sity of lin­ge­ring symp­toms of a poor treat­ment, for­cing the adre­nals to kick in too long for many.

Even William Mck. Jef­fries MD., who wrote the medi­cal clas­sic Safe Uses of Cor­ti­sol around 1984, unders­tood the pre­pon­de­rance of adre­nal fati­gue even without the diag­no­sis of Addison’s, and the need for phy­sio­lo­gic doses of cor­ti­sol treat­ment, or the amount nee­ded by each indi­vi­dual.  And he would cer­tainly be ama­zed by the explo­sion of adre­nal fati­gue that has occu­rred since then in thy­roid patients thanks to the lousy TSH and synthe­tic T4-only ‘affaire de coeur’ with doctors.

Adre­nal fati­gue may not be an “accep­ted diag­no­sis” by many.  But medi­cal pro­fes­sio­nals and doc­tors who think it’s not real or an accep­ta­ble diag­no­sis will have to face a huge body of patients glo­bally who DO have real live adre­nal fati­gue. And adrenally-fatigued patients can get realllllly hos­tile and angry because of low cor­ti­sol, and be very impa­tient when you deny their rea­lity.  (You’re going to see a lot of com­ments to this post which I highly sug­gest reading.)

P.S. Even desic­ca­ted thy­roid like Natu­reth­roid and the pre-reformulated Armour are not con­si­de­red to be the stan­dard of prac­tice for trea­ting hypothy­roi­dism, yet thy­roid patients all over the world are having lives CHANGED thanks to it.

***Want to be infor­med of my blog posts? Curious what’s on my mind? Use the Noti­fi­ca­tions to the left and right below the links.

***Read below why thy­roid patients are not happy with Armour and switching to brand names like Naturethroid.


  • Want to keep track of these “fringe web­site” blog posts? ;-) Curious what’s on Janie’s mind? Use the noti­fi­ca­tion on the lower left of the links, called a News­let­ter, or an RSS Feed.
  • The extre­mely hip and sophis­ti­ca­ted STTM t-shirts are half price! Great BUMPER STICKERS, too. Spread the word – YOU may make a dif­fe­rence in someone’s life.
  • Check out the patient-to-patient book with even more detail (and which doc­tors seem to res­pect more than websites).
  • Need to unders­tand all your best options for thy­roid treat­ment? Go here.
  • Keep infor­med of each live Thy­roid Patient Com­mu­nity Call on Talkshoe by sig­ning up as a follo­wer.
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