by Gary Pepper M.D. | Mar 8, 2013 | health insurance, hormones, Hypothyroidism, T3, thyroid
The 2013 guidelines issued by the American Association of Clinical Endocrinologists and the American Thyroid Association reiterated their long standing opinion that only a single hormone, T4 (Synthroid, levothyroxine) is advised for treatment of hypothyroidism. These key organizations
(more…)
by Dr. G. Pepper | Mar 7, 2011 | general health & nutrition, health, hormones, metabolism, thyroid
A few weeks ago a new patient arrived at my office to discuss treatment for her thyroid disease. She was diagnosed with an under active thyroid several years prior but treatment with Synthroid was unsuccessful. She stopped using the medication on her own, at least a year ago. Blood tests obtained by another doctor a month before her visit with me, were diagnostic of hypothyroidism (low thyroid levels with elevated TSH) . During our session she described typical symptoms of hypothyroidism including fatigue, feeling unusually cold, dryness of the skin, brittle nails and puffiness around the eyes. On exam her thyroid was enlarged and had a gritty texture typical of Hashimoto’s Thyroiditis. Her sister and mother also had thyroid disease, increasing the likelihood of the diagnosis of Hashimoto’s. Since her latest thyroid blood tests were only a few weeks old I felt comfortable beginning her on thyroid hormone replacement, in this case, Armour Thyroid, which I prefer due to its excellent clinical effectiveness.
My new patient was also on a number of supplements and vitamins including a non-prescription “metabolic complex†given to her recently by her chiropractor. By law in the U.S. supplements like these do not possess thyroid hormone and, in my experience, have no impact on thyroid hormone levels, either to increase or decrease them. As a precaution, we obtained a new set of thyroid hormone levels along with the test for Hashimoto’s Thyroiditis (anti-thyroid antibody panel).
Several days later, the patient called complaining she was “allergic†to the Armour Thyroid, developing jitteriness, anxiety, feeling flushed and a rapid heart rate. My first thought was she received the wrong dose of medication but a quick check of her records indicated this was not the issue. I called the lab and was surprised to learn the TSH at the time of her visit was already low, indicating excess thyroid levels or hyperthyroidism. What could have caused the sudden switch from hypo to hyper thyroidism? Rarely, patients with Hashimoto’s Thyroiditis can convert to hyperthyroidism, an event I call the Zombie Thyroid because the thyroid comes back from the dead. More likely was that one of her supplements contained actual thyroid hormone, so I asked the patient to get me the labels from these products. In the meantime, I instructed her to stop the Armour Thyroid and the supplements until I could figure out what was happening. Her allergic symptoms resolved in a few days.
Examination of the supplements’ labels indicated that one manufactured in New Zealand did in fact have thyroid extract in it. It had so much thyroid hormone in it that the patient was already becoming hyperthyroid at the time she first came to the office. Signs and symptoms of hyperthyroidism didn’t develop until she started taking Armour Thyroid along with the supplement. The mystery was solved but I am left feeling much less secure that my patients will not injure themselves with products obtained from outside the country either via the internet or from practitioners who provide it, perhaps unwittingly.
As I have in the past, I urge everyone to avoid medications and supplements produced outside the country which can contain active ingredients with potential health hazards. Always check with a physician before beginning a supplement which is obtained from the internet or mail order.
Gary Pepper, M.D.
Editor-in-Chief, metabolism.com
This information is for educational purposes only and is not intended as medical advice or treatment. Some details of this case have been altered to protect the patient’s identity.
by Dr. G. Pepper | Jan 24, 2011 | diet and weight loss, fitness, general health & nutrition, health, hormones, metabolism, thyroid, weight gain
Every so often I like to bring attention to someone who has struggled to get properly treated for hypothyroidism. Not everyone shares the same dilemma regarding treatment of hypothyroidism because T4 by itself may be sufficient in many instances. But for those who continue to experience symptoms of hypothyroidism despite T4 treatment, adding T3 can be a life changing experience.
Here is Sarah’s story:
I was diagnosed with hypothyroidism in my early twenties and Synthroid did not help. I did not know at the time that many of my symptoms were due to hypothyroidism. After changing to my long time physician, I told her of my original diagnosis some years back. She did only the TSH and told me I was no longer hypothyroid! So for some 15 years after being in her care and continuing to feel crummy, then for the last 8 steadily gaining weight and feeling worse, I was not on any medication. I begged her for Cytomel several years back and was denied…she said she didn’t treat with that. When I finally was deemed hypo by her, she put me on the smallest dose of levothyroxine. It did not help. I finally went to see a shrink and he put me on 25 mcg of Cytomel. For the first time in my post pubescent life, I feel like living. My dose was upped to 50, and I felt even better but my thyroid levels were off, so we are now working on that and I am back to 25 mcg per day. If you can’t get Cytomel from your regular physician, you might get a psychiatrist to prescribe it. It changed my life and I finally feel alive. I’ve since switched primary physician because she wouldn’t listen to me, and she didn’t like that I was on Cytomel. I don’t know what it is about this medication that regular physicians don’t like and make them refuse to treat with it, especially when so many can benefit from it. I’ve lost only 12 lbs since being on it, but I gained nearly 35 unnecessarily while not being properly treated and was told to eat less and exercise more…I only ate about 1500 calories a day and walked my dog 2 miles each day, so I don’t feel it had anything to do with my diet!
by Dr. G. Pepper | Jan 30, 2010 | diet and weight loss, general health & nutrition, health, hormones, metabolism, weight gain, weight loss
Maya Sarkisyan, a consultant with metabolism.com, shares her life experiences with smoking, gaining weight and hypothyroidism. If you want to ask Maya questions about her methods please do not hesitate to make use of our forum page. Once on the forum look for the “Latest Discussions” column and then click on Topic “Add New”. Then you are ready to post questions or your own opinions and comments.
Here is what Maya writes about her own life:
I replied some time ago to this thread and would like to add something. Everybody here posted a personal story of dealing with weight gain after quitting smoking. I went through that too. I smoked since I was 15, quit to have a child, picked up just that one cigarette a year after…, and than quit again 7 years ago for good. I did start gaining weight and was diagnosed with hypothyroid condition right prior to quitting. However what was effective for me is to modify almost all my life habits, not only eating and exercising. I did go to gym every day (and worked out hard) , ate small portions, meditated, made peace with few people in my life, looked at the bright side of things, etc. I even got certified as a fitness trainer! By no means it was easy but it was worthwhile doing. I wrote down all my life patterns and changed them all – even good ones modified slightly. I did it to reset my system completely. All the women in my family are very overweight and I’m not – only due to the discipline and frame of mind I choose to keep.
I started helping people to quit smoking with customized individual hypnosis sessions, because it is the best thing you can do – quit smoking forever. All it takes is a firm decision and sometimes some help.
I know that you can do anything when you make a decision to do it. Real firm once-and-for-all decision. I came to Dr. Pepper four years ago as a mess on Synthroid, and now with Armour, Selenium, meditation, and holistic medicine even my antibodies levels are going down. I decided to get healthier and did everything it took that is healthy for me. We all are not getting younger so I choose to take care of my body and eliminate unhealthy habits on daily basis, and help my patients do the same.
Good luck to you all, congratulations on quitting, and I wish you health.
by Dr. G. Pepper | Dec 23, 2009 | diet and weight loss, general health & nutrition, health, hormones, metabolism, thyroid
Hank Frier has been involved with the pharma industry for a long time and helps us see through the news blackout in regards to the FDA actions on Armour. He is also suffering the same fate as many others in the U.S., having been successfully treated with Armour for many years, now forced to switch to other alternatives.
Hank writes:
I too have been switched back to Synthroid after several successful years of being on Armour. At this juncture it is too early to tell how this will impact me. Luckily, my physician had the foresight to also put me on Cytomel after I suggested this from my readings. The combination of Armour and Cytomel seemed to work quite well for me without any adverse events.
This next is my opinion so take it as such. I believe the makers of Synthroid (Abbott Ross) in an attempt to increase their sales of Synthroid put pressure on the FDA to require the makers of Armour to submit an NDA. It is a devastatingly poor tactic by Abbott Ross but typical of this industry.
It is unfortunate that the FDA is caught in the middle of this since by statute and law drugs must pass regulatory muster. Where the FDA has failed is in their lack of looking at the long past history of Armour, its lack of adverse events and its benefit/risk for those individuals that have been using this drug. As opposed to demanding an NDA from Forest Pharma they should have sat with them and reviewed the long history of this drug, the number of scripts written for this drug and even contacting those physicians/endocrinologists that have been prescribing it for their patients.
The only safety question in my mind is does Armour ingestion, a foreign protein, cause an immune response. This would have been reported by the medical profession if that were the case. Secondly, historically, large segments of the population have been eating pig and pig organ meats for generations without ill affects. The ingestion of a purified material from pig (Armour thyroid a protein) is probably benign. The FDA scientists should know this and counsel their legal staff as to the benign nature of the drug.
Hank
I too have been switched back to Synthroid after several successful years of being on Armour. At this juncture it is too early to tell how this will impact me. Luckily, my physician had the foresight to also put me on Cytomel after I suggested this from my readings. The combination of Armour and Cytomel seemed to work quite well for me without any adverse events.
This next is my opinion so take it as such. I believe the makers of Synthroid (Abbott Ross) in an attempt to increase their sales of Synthroid put pressure on the FDA to require the makers of Armour to submit an NDA. It is a devastatingly poor tactic by Abbott Ross but typical of this industry.
It is unfortunate that the FDA is caught in the middle of this since by statute and law drugs must pass regulatory muster. Where the FDA has failed is in their lack of looking at the long past history of Armour, its lack of adverse events and its benefit/risk for those individuals that have been using this drug. As opposed to demanding an NDA from Forest Pharma they should have sat with them and reviewed the long history of this drug, the number of scripts written for this drug and even contacting those physicians/endocrinologists that have been prescribing it for their patients.
The only safety question in my mind is does Armour ingestion, a foreign protein, cause an immune response. This would have been reported by the medical profession if that were the case. Secondly, historically, large segments of the population have been eating pig and pig organ meats for generations without ill affects. The ingestion of a purified material from pig (Armour thyroid a protein) is probably benign. The FDA scientists should know this and counsel their legal staff as to the benign nature of the drug.
Hank
hfrier@comcast.net
Hank Frier
1
