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Many doctors tell their patients it's "outdated," old-fashioned or "isn't even on the market anymore," and some outright refuse to prescribe it for their patients.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 drugstore.com, 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.

Quackwatch.org 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. 

More reading:
Generic drugs and patent information - Wikipedia
Thyroid Disease, Hypothyroidism and Fibromyalgia - about.com