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Monday, January 23, 2012

Synthroid vs. Armour: Squashing the competition

When it comes to treating thyroid problems, your physician will probably prescribe one drug: synthetic thyroid hormone, either Synthroid or a generic equivalent. Generic levothyroxine is one of the most popularly prescribed drugs in the United States. And in 2010, profits of Synthroid rose over 18 percent and made Abbott Pharmaceuticals $123 million dollars richer. 

There are alternatives to Synthroid, but you'd never know it based on some of the information from doctors and major thyroid advocacy websites. In some of the research I've done on thyroid treatment natural desiccated thyroid (NDT) isn't even mentioned at all.

Many doctors tell their patients it's "outdated," old-fashioned or "isn't even on the market anymore," and some outright refuse to prescribe it for their patients. Some patients give it a bad rap because it caused problems for them, when really it's probably the prescribing physician who is not dosing them properly. Basically, many thyroid groups and physicians are detracting patients from using NDT and funneling them towards Synthroid - perhaps because of financial incentives, pervasive myths and incorrect information about the product.

One theory is because desiccated thyroid comes from an animal source, it cannot be patented. While cost can vary, Armour Thyroid is roughly half the cost I used to pay for Synthroid, and Armour has both T3 and T4 in it - whereas synthetic is T4 only. (Each hormone level is essential in the thyroid's production, basically, to give your body energy, but the mainstay of thyroid treatment these days only includes one hormone rather than a little of each.) 

There are synthetic T3 meds like Cytomel, but guess what that means: you have to have two prescriptions filled, instead of just one with natural desiccated thyroid. More prescriptions to fill means you spend more money. Name-brand Cytomel runs around $40 per 30-day prescription on, and generic is about $30 for a 30-day supply. Add that to a month's worth of Synthroid and two prescription T3-T4 meds will cost around $70 a month versus $14.99 for Armour (depending on the dose, of course).

Before the advent of blood tests that were supposed to be the magic answer to every problem, doctors paid more attention to symptoms. Before synthetic versions were introduced to the market, thyroid patients were treated with natural desiccated thyroid and many did very well. Some adjustments were accounted for, because every patient was different. Many criticize it as being "unregulated," although I'm sure science has improved since then, but natural thyroid is a prescription medication and therefore has to go through the same regulatory process as any other drug. 

While some people do wonderfully on Synthroid, not all do - even though many medical professionals tell them it's their only option. Not only that, but many people believe - and know to be true, based on personal experience - that there is wide variation in effectiveness between brands of synthetic hormone, as well as between name-brand and generic. As a pharmacy technician, the pharmacist told me this when filling prescriptions for patients, and I still hear these same stories from thyroid patients all over the web. When I got my prescription filled for the first time, the pharmacist herself reiterated the same thing: that many (many!) patients believe name-brand to be superior, and it's not just psychological as some would have us to believe. 

Not long ago generic levothyroxine came under fire because its strength was not as potent as it should be. The medication was recalled and brought to light problems people were having with a return to symptoms while being medicated. As far as synthetic versus name-brand, I've heard that the FDA considers the potency of synthetic hormones to be between "90 to 110 percent," which can mean a huge difference for some people. But, because it's sanctioned by the FDA and considered "true," drugs like Armor are considered poorly regulated and should be avoided. Gee, I wonder why they'd say that? It seems that the synthetic hormone drugs have the same problems that doctors are criticizing Armour for. 

Some websites wage an all-out attack on natural desiccated thyroid and label it "do not use" because it's
  • not adequately guaranteed to provide appropriate blood levels of thyroid hormone and reliable alternatives are available.
Seriously? Tell that to all the patients who are doing well on natural thyroid medications! Curiously, the same website - "Worst Pills, Best Pills" - mentions a lawsuit brought to the manufacturers of Synthroid because they suppressed information that supposedly proved they were wrongly influencing patients to believe their medication was superior to generics, even though "scientific" evidence had shown it was the same. While many people complain of a return to symptoms if their medication was switched, medical professionals often pass this off as "psychological." (So that irregular bleeding that my neighbor complained of when her insurance company switched her meds without asking was all in her mind, right?)

The site goes on to say that it should not be taken except by those who have found successful results from it "for years" - meaning, they want a whole new generation of thyroid sufferers to be dependent on crappy, subpar medication and not realize that many of their symptoms still prevail and are not normal. Perhaps the most frustrating problem is the medical community's tendency to "fix it and forget it" when it comes to thyroid problems, as if one dosage is going to solve everything. In reality, for many people it's a complicated, often tedious process that is well worth it if you can find relief. tries very hard to completely discredit Armour Thyroid and the doctors who prescribe it by telling you to be "wary" of anyone who dispenses it. Funny, but I bet there are lots of people who have been totally let down by synthetic hormones who would love to find a competent doctor to prescribe them desiccated thyroid. Again, all those people who manage to do well on it must be crazy. They try to paint a dismal picture about the effectiveness and potency of Armour, while synthetic hormones have had exactly the same problems.

(Ironically, I googled the guy's name who runs Quackwatch and found that he was misrepresenting himself as a licensed psychiatrist during court proceedings he was asked to participate in as an "expert." He also apparently has ties to the FDA, which explains his distrust of physicians who will prescribe Armour.)

Depending on the nature of your remaining symptoms - say, depression is one of them - it's often perceived that you're "fine" because your TSH is "normal" and you're taking meds. So let's treat your depression. Or any of the other slew of problems you have that are unknowingly caused by your thyroid and the crappy management of it. That will require a few more scripts, some of which are astronomically expensive. High blood pressure and cholesterol levels? Hey, there's a drug for those. Instead of taking one thyroid medication to address the root cause, let's put you on a number of meds that address each symptom, until your medicine cabinet looks like a mini pharmacy. 

When you consider how pervasive hypothyroidism is, and yet how under-treated (or improperly treated) it is, it makes you wonder. It seems like more of a scam to get you to spend lots of money on unnecessary prescriptions. More and more people are feeling lied to, like our doctors want - and expect - us to completely, blindly trust them and just suffer the consequences when they are wrong. Considering there are other treatments out there, they should let that decision ultimately be made by the patient - and counsel you accordingly - instead of distort or hide information. 


The Deranged Housewife said...

I also failed to mention this site for lots more information about dosing, differences in medication and just about everything else!

Anonymous said...

How do you get a prescription for ARmour without all the worthless blood tests?

EveOfDestruction said...

WONDERFLY WRITTEN!! Thank you I have just recently heard of Armour and was reading up on things before I go to my DR. Thank you for taking your time & energy to write a blog about it :)

Anonymous said...

I'm leaving a message and it's not appearing....what am I NOT doing here...

Years ago back in 2002, my D.O. called in for Armour no labs, nadda and the rest is find a good old time doc is GOLD...

Before labs, docs treated with Armour by symptoms, today people are NUMBERS.... Crime and tons more
money for medical world...

Anonymous said...

Got it to post..I see only integrative MD's and will NEVER see
a conventional Syn pushing doc....

the conventional's will push MOSTLY Syn if they believe you need thyroid support at all.

Anonymous said...

I just asked my dr to change me from levothyroxine to armour and he is not wanting to do it. I have so many side effects that ii am barely functioning. Headaches, fatigue, bloating and weight gain and suspecting some depression/moodiness. It may be time to change dr's because I really want to try this drug. Synthroid is too expensive now with my cost just going up over 400% per month! I refuse to pay higher cost when there are other options.

The Deranged Housewife said...

Anonymous, one suggestion I've heard is to ask the pharmacist for a list of doctors who appear to prescribe Armour instead of Synthroid. It's a perfectly viable option that works for many, and you're right - it is cheaper. At no point in the time I've been taking thyroid meds has my insurance EVER paid for it, unless I go on generic Synthroid. Apparently they are under the impression that even though it works well for some and not others, that it doesn't matter. :/

It's interesting how the American Thyroid ASsociation has ties to Abbott, the manufacturer of Synthroid. Well, of course! *eyeroll* How can they offer objective information at that rate?

I definitely suggest changing doctors - although know that it might be an uphill battle. You can try supplementing (check out the Stop the Thyroid Madness website for info, because I'm not as well-versed in doing that as I probably should be). Hope you can find some relief.

Carol said...

I was put on Armour by an integrative med doctor in 08, he called it Hashimoto, I lower my intake of gluten. No real symptoms, but interruptive sleep I thought due to menopause.
By 2011, I noticed brittle nails, later dramatic hair loss. I had 2 surgeries in that time frame 09-2011, plus relocation to Fl and stressful house sale!

New MD in fl, changed me to Levothyroxine .05.

It's only 10 days, but night sweats are a pain, so bad....loss of sleep, today I took an Armour 30 mg instead.
I'm totally confused!

The Deranged Housewife said...

Sorry I have been missing all these comments!

Anonymous - as far as blood tests - I don't necessarily consider them worthless. I would suggest a thyroid panel, not something that just looks at one thing (like the TSH and nothing else). I consider it important to have a baseline for knowing where to start, because you can definitely make yourself hyperT with too many meds. I don't know that any doctor would give you an Rx without doing bloodwork, but I could be wrong. *wink wink nudge nudge* O.o

The Deranged Housewife said...

Carol, do you mean 50 mcg? That is usually the starting dose. I know it's important to raise continually after several weeks once you start out but not to wait too long or you just experience a "crash." What dose of Armour were you on before? Hope you check back. :)

Sharri said...

I was diagnosed with hypo almost 20 yrs. ago and when I first when on synthroid life had a whole new meaning to me I felt so much better. It didn't take long when my levels were high then low, high then low. For years this was what I lived with. I never had a Dr. tell me I needed an endo so last year I took it upon myself and set up an appt. First visit was encouraging I felt he really wanted to get to the bottom of it. Before my next appt. my elderly mother became sick, Daddy confined to a wheel chair depended on her to help him. I had no choice but to pack them both up and bring them home with me, (different towns)so if there was ever a time I needed energy and my wits about me was now and I had neither. The endro is a 3 1/2 hrs. drive from me and I couldn't make any more appts. with him. (no way I could leave my folks for that long. After weeks on the couch not even caring what the house looked like I trot off to the Doc. He's seeing a pattern of the highs and lows. He calls me up and told me to quit taking my levothroxine (sp?), and made an appt. with a surgeon in town. (that appt. is this coming Tues.) First thot was oh boy off my med and trying to take care of them was really going to be a challenge! By the 3rd day I was feeling so much better I had the will to get up and do things, my mind was clearing up and I could actually think again. It's been 2 weeks now and I will not get back on the stuff!!! I'm keeping the appt. to see what this one has to say. My thots are that that stuff was killing me. I've done more around this house in 2 weeks than possibly all year.

Anonymous said...

T4 and T3 together does not equate to DTE...that is a misconception and some use it to "disprove" a recent study showing DTE > T4 only in a double-blinded crossover study...but claiming DTE = Synthetic T3 + T4.

The other thyroid hormones all probably matter to some degree, but published literature proves outright that T2 does and you can't even be tested for T2 levels. Equating 2 hormones to 5 hormones is ludicrous.

Anonymous said...

hi fdr me ihave hashimoto symptoms and that was for years i never knew that ai m ill i couldn t understand why i was so innactive in doing my housework i felt guilty about that thanks for makung me aware of it .my dr didn t say that to me the problem is that i have mre serious problems the loss of weight only in the lower part so im becoming the more and more manly and that embarrassed my ex and me divorced for my spoilt shape my auestion is how can i gain mre weight in the lower part by the way i m under levothyrox 50mg i m so grateful to you

Russ said...

In 1976 I was diagnosed with graves dieses and had radioactive iodine to kill my thyroid, and was put on Amour thyroid.
My health was never the same after the radioactive iodine. For years I suffered from a long list of health and mental problems.
Every time I went to a new DR they wanted to put me on Synthroid after about three or 4 months started feeling bad again
So I switch myself back to Armor and got better, but still not back to healthy. I am 65 now and just went to a Endoconoligest
He started me on levothyroxine 137mg, and Hydrocortisone 15mg a day. Because my cordisol levels were low. Well in about a month
My world went crazy; I had more symptoms than I could write down. Talked to DR and he wanted to up my levothyroxine? I
Told him no it is the Hydrocortisone that is causing the problem. So he dropped my levothyroxine from 137mg to 120. That didn't
Help so I started lowering my Hydrocortisone, to get weaned off of it. I feel somewhat better but still lots of bad symptoms.
So for 37 years I have used just about as many DR's and still no relief, so I am going back on Armour thyroid that I have been
On for most of the 37 years, it just disappoints me in the DR's I have seen. All but one wanted me on synthetic so I think its
Time to stay with him.

Anonymous said...

I was diagnosed Hypo and started at a 28 or something around there,I had gained 100 pounds in a year was very depressed and always sleepy no matter how much sleep I was getting. (like 18 hours a day and still tired) Over the next 2 years my levels went down but not by very much and not fast at all, but not feeling any better and continued to pack on weight and cry all of the time Dr. didn't really care and pushes my emotions to the side and told me it was a head problem. By this point I was weighing 376 lbs. and still my thyroid was barely functioning along with the rest of my body. At best my level got to a 14 I think it was so I just quit taking it! I felt very sick and strange in the week after but then it seemed like I felt the same as when I was on it. A week ago I started a medical diet and the doctor I saw immediately put me on Armour and I am hoping it will work and the diet too, of course my insurance will not pay but I think it is going to be worth it. Lord knows I couldn't be any worse off. Thanks for letting me know that it is not all in my head and that I am not the only one suffering from these very REAL symptoms.

Anonymous said...

Did the armour help you? I was just put on it

Anonymous said...

I just can't understand why - in 2014 - people are still trusting quacks and drug companies.

You all know, don't you, that big pharma is under serious investigation globally, right? (Google it)

You know that this investigation has so far shown that no less than "90%" of big pharma's drugs are nothing more than placebo scams, right?

So surely you'd also know that an increasing number of all the quacks they use as their drug pushers are also now being put under the microscope for accepting kickbacks and bribes.

Two things are about to fall completely apart: the drug world and the medical world. Let's hope we're all smart enough to replace them with Nature, truth, compassion and transparency.

Oh and while you're googling, you might also want to look into the fact that drug companies are also under the microscope for Alzheimer's fraud.

There's been nothing those insidious leeches wouldn't do to make a profit, but now the wheels of justice are slowly but surely catching up with all of them, one at a time.

Nature provides a cure for everything under the sun. The problem is, people pander to their taste buds and turn their noses up at Nature's potent remedies - or they're too bone lazy to do anything other than pop pills, in which case, I'm not so sure that they don't deserve what they get.

Anonymous said...

Even reducing the maximum allowed dosage of potassium iodide seems to be aimed at screwing up peoples thyroid. Potassium iodide has an LD50(lethal dose 50% the amount required to kill half of the population with a certain dosage) in rats higher than table salt, and I've been able to find an old study in israel where they were giving a gram or two a day for an extended time to children as young as 3(note that it shouldn't be taken in high doses by anyone with autoimmune, nodules or tumors). There was also a recent study in Uruguay where they had great results treating staph skin infections with around 4-5 grams per day for an extended period of time.

The Deranged Housewife said...

Anonymous (from Sept 11) - don't worry, I have posts planned about that. Stay tuned!

Mary Chamberlain said...
This comment has been removed by the author.
Mary Chamberlain said...

I switched from levothyroxin to armour thyroid and within the first 4 days I lost a lot of the water retention that I had. The tightness I had in my back from the bloating went away. Weight gain ceased. Ievothyroxin also cause muscle & joint pain; It made my arms feel like they were being pulled in opposite directions at the same time.

Anonymous said...

I'd like to know if anyone is or has been on Levothyroxine who is underweight. I have been extremely thin all my life, and after radioactive Iodide to remove my thyroid over ten years ago, I thought hypothyroidism would cause me to gain. Though many say they wish they had my problem, I still eat like crazy now at age 42, always have, and I can't seem to gain. I stopped taking Levo here recently due to back pain - (I read that it may lead to osteoporosis) and became severely constipated. Seven days with no bowel movement has made me very sluggish, but I started a natural vegetarian thyroid supplement and I'm hoping something will give. Any advice or suggestions???

Anonymous said...

I was wondering how you feel about generic synthroid? I buy generic synthroid online, thru a Canadian pharmacy. I would like to know if this is any different than the other medications you use? I have a half off code (50%off), which is why I use this brand. Here is the link Any advice is appreciated!

Donna Marie said...

I'm pretty sure the reason why NDT can't be patented anymore is because it was invented in 1891. Way, way, way off-patent, as they say.

Anonymous said...

I have been on Armour for any years I recently saw a new Endocrinologist who spent my first visit chewing me out for being on Armour. It was really upsetting to me I go to doctors for help not for a lecture and I didn't prescribe it to myself. I asked if after all the lip service did he want to change my meds and he said no your blood work is perfect.
Also if Armour is so bad why is Hilary Clinton on it should could be on any medicine and that is what she takes...enough said.

Jaimie said...

After being on synthroid since 2003, almsot dying when my tsh hit 312 and never in 13 years getting out of severe hypo status I now have a terminal stage of toxic encephalopathy due to hypothyroidism.
I was misdiagnosised too many years and in January I asked my dr (at Georgetown University) if we can try Armor he said sure. I kid you not the next day I could tell! My awful headaches are GONE and my labs came back and I am just on the side of hyper now! So a lil tweaking and in 6 weeks time my tsh is good and 3/4 I am looking into a new lawsuit

Jaimie said...

After being on synthroid since 2003, almsot dying when my tsh hit 312 and never in 13 years getting out of severe hypo status I now have a terminal stage of toxic encephalopathy due to hypothyroidism.
I was misdiagnosised too many years and in January I asked my dr (at Georgetown University) if we can try Armor he said sure. I kid you not the next day I could tell! My awful headaches are GONE and my labs came back and I am just on the side of hyper now! So a lil tweaking and in 6 weeks time my tsh is good and 3/4 I am looking into a new lawsuit

Sarah Hall said...

The article is in sooth useful! However, Synthroid is not an optimal treatment for hypothyroidism and, respectively, it should not be used as a first-line treatment. Here is an article prepared by a qualified specialist - it's accessible at You're welcome to read it!

Geri Burgener said...

I've been taking Armour for several years. A couple of months ago my pharmacist gave me a generic Armour and within a month I was feeling like I was useless. All I wanted to do was sleep. I had no ambition to do a thing. I went back and told him I didn't do well on the generic even though it was a lot cheaper and I wanted my Armour back. He told me he couldn't refund any money and I told him I didn't care. In about three days I was feeling so much more ambitious and told the drugest to put "No Substitutions" on my Armour medication. It is certainly not cheaper (It cost me close to $70. for a month's supply but it is well worth it. Years of synthroid and generic Synthroid and I never felt any change. Geri Burgener