The sudden disappearance of Armour Thyroid from pharmacies in the United States about a year ago had all the makings of a mystery novel. Armour Thyroid had been available since the 1950’s with a long history of being safe and effective. No one could produce a good reason for what was happening, not even the company, Forest Laboratories, which manufacturers the drug. After weeks of puzzling back then, I recognized key wording in an FDA brief on the subject alerting me to the political nature of the Armour shortage.

Now I have confirmation that political and economic, not medical, forces were responsible for Armour Thyroid’s sudden disappearance. A recent letter from the President and Chief Operating Officer of Forest Labs, Lawrence Olanoff, M.D, Ph.D., reveals that Forest Labs just entered into an agreement with the federal government to accept fines and other penalties in a settlement of misdemeanour and felony charges related to the companies marketing practices of its Celexa and Levothroid products. It is clear to me that in the midst of negotiations with the FDA on these issues, Forest Labs needed to be ultra cautious in its handling of Armour Thyroid, which was separately being scrutinized by the FDA for formulation issues. Was it a coincidence back then that Medicare removed Armour from its list of recognized drugs or was it a warning by the government that Armour was on the “hit” list. The executives at Forest undoubtedly were required to remain silent as they dealt with the government on these issues.

The good news is that the Armour shortage appears all but over, coinciding with the settlement between Forest and the FDA. It was a difficult time for many people who needed Armour and for the doctors who depended on it for adequate treatment of hypothyroidism. If I am correct, this should be the end of this painful episode.

Gary Pepper, M.D.,

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