Thyroid Hormone Replacements

The original thyroid hormone replacement was Armour Thyroid, a natural thyroid hormone taken from pigs, but this is now not licenced in this country but many of the practitioners use this because they say it is more akin to our own thyroid hormone. Armour contains approximately 38mcg T4 and 9mcg T3 plus an X factor (something not yet understood). The original synthetic hormone replacement is Eltroxin and the others are called generics. There is a train of thought that the generics are not as good as Eltroxin and certainly, I know of many people who have tried them but feel better on Eltroxin. Some people feel better on one of the generics but not the others. I personally feel better on Norton.

If you have found that you feel better on one particular brand, ask your pharmacist to order it for you, if they don’t already have it in stock. Boots tell us that although it sometimes costs more for a particular brand, they will order it for you if you tell them that you are ill on anything else. Stand your ground and insist on them ordering for you.

Thyroid hormone replacements have different half-lives ie they act on your body in different amounts of time. The half-life of T4 in the blood is about 7 days. The half-life of T3 is 1-2 days, so you would get the maximum benefit of this after 2-3 days and the duration of effectiveness is up to 3 days after stopping T3. Although this means that the hormones are benefiting you within this time, don’t forget that the body then has to slowly repair itself and this can take many months.

TEVA (www.tevauk.com) - The 50mcg and 100 mcg tablet ingredients are: Levothyroxine Sodium BP, Lactose, Dextrin, Maize Starch, Magnesium Stearate

Teva also distribute 25mcg tablets under the Teva name, but these are actually manufactured by Custom Pharmaceuticals under the marketing authorisation of Goldshield Pharmaceuticals Ltd. The ingredients in these 25mcg tablets as stated on the PIL are: Anhydrous Levothyroxine Sodium, Sodium Citrate, Lactose, Maize Starch, Acacia Powder, Magnesium Stearate.

ACTAVIS (www.actavis.co.uk) - The 50mcg and 100mcg tablet ingredients are listed as: Levothyroxine Sodium, Lactose, Magnesium Stearate, Maize Starch, Stearic Acid

IVAX (Distributer name) - The 50 mcg tablets distributed by IVAX are manufactured by Custom Pharmaceuticals for Goldshield Pharmaceuticals Ltd. Ingredients are: Levothyroxine Sodium BP, Sodium Citrate, Lactose, Maize starch, Powdered Acacia, Magnesium Stearate, Purified water.

ELTROXIN (Goldshield) - (Brand) Thyroxine Sodium BP, Sodium Citrate, Lactose, Maize starch, Powdered Acacia, Magnesium Stearate, Purified water.

APS (Approved Prescription Services) - (Generic) Active ingredient: Thyroxine Sodium BP, lactose, dextrin, maize starch and magnesium stearate.

CP PHARMACEUTICALS Ltd. - (Generic) Thyroxine Sodium BP, lactose, sucrose (find powder), maize starch, and magnesium stearate.

COX PHARMACEUTICALS - (Generic) Thyroxine Sodium Lactose, magnesium stearate, maize starch, stearic acid.
Note: I have received a thyroxine tablet insert for a company called "Alpharma". This is from their website: Welcome to the UK section of Alpharma's website, http://www.accessiblemedicine.co.uk. Alpharma has been established in the UK market through the ownership of Dumex™ and the acquisition of Cox Pharmaceuticals™ in 1998. Both Dumex™ and Cox Pharmaceuticals™ are now known as Alpharma Limited. Be aware - if the Cox brand did not suit you, then probably the Alpharma brand won't either.

The generic name is liothyronine. It is also called triiodothyronine.

The only brand available in the UK is: TERTROXIN (Goldshield) - Ingredients: Liothyronine sodium; lactose, maize starch, powdered acacia, sodium chloride, magnesium stearate, industrial methylated spirit , and purified water. This only comes in 20mcg tablets, which generally need to be cut in half or quartered for use with thyroxine.

CYTOMEL (King Pharmaceuticals) - (Brand) Is also a synthetic T3 which is only available from America. It comes in 5mcg tablets, which is much easier.
http://www.kingpharm.com/kingpharm/Products/product_details.asp?id_product=36

These are not available on the NHS in the UK but may be available from a private doctor (although they usually prefer the natural thyroid). May be a good idea for people who are allergic to pork.

THYROLAR (Forest Pharmaceuticals) - (Brand) - Available from America.
http://www.thyrolar.com

(These contain 38mcg T4 and 9mcg T3) - natural desiccated thyroid from pigs. There are some made from bovine source, I believe, but I haven't been able to track them down yet.

ARMOUR THYROID (Forest Pharmaceuticals) - (Brand) Thyroid Powder, USP (active ingredient), Dextrose, Anhydrous (inactive ingredient) Microcrystalline Cellulose, NF (inactive ingredient) Sodium Starch Glycolate, NF (inactive ingredient), Calcium Stearate, NF (inactive ingredient) and Opadry White (titanium dioxide used as a whitening agent (inactive ingredient).

WESTHROID (Western Research Laboratories) - (Brand) Cornstarch bound.

NATURE-THROID (Western Research Laboratories) - (Brand) Bound with microcrystalline cellulose, which makes this tablet hypoallergenic, dicalcium phosphate, colloidal silicon dioxide, sodium starch Glycolate, stearic acid, magnesium stearate, hydroxypropyl methylcellulose, and other ingredients. Lactose free.

BIO-THROID (Bio-Tech) - (Brand) Dye free, corn free, preservative free, wax free.

THYROID URL (Time-Caps Labs Inc) - (Brand) Thyroid Powder, USP provides 38 mcg levothyroxine (T4), 9mcg liothyronine (T3), for each 65mg of labelled product, micro-coated, easy to swallow. Inactive ingredients: Microcrystalline Cellulose, dicalcium phosphate, colloidal silicon dioxide, sodium starch glycolate, stearic acid, magnesium stearate, hydroxypropyl methylcellulose, and other ingredients.

According to the MHRA, in the UK a GP is allowed to prescribe any of the natural thyroids on a "named patient basis" on the NHS or privately. Your doctor can give you a normal green prescription (FP10) and write Armour Thyroid on it, (or any of the others) then your local chemist can contact: Idis World Medicines, Millbank House, 171-185 Ewell Road, Surbiton, Surrey KT6 6AX. Tel: 020 8410 0700/ Fax: 020 8410 0800. Email: prodinfo@idis.co.uk or idis@idis.co.uk for orders. Website: http://www.idis.co.uk. If your doctor or pharmacist needs information from them, they must set up an account first, but they are not obliged to purchase anything. You just need to persuade your doctor that you need Armour because the synthetic hormone does not suit you. Ask him for a trial, at least. This company import Armour and add a very small administration charge.

Forest Pharmaceuticals Inc in America make Armour and they are very helpful. They will send your doctor any information he requires or we have an information pack on Armour. If you would like your doctor to have a copy, please send us your doctor's details and we will send one free of charge". Alternatively, if you would like to order a copy for yourself please go to the Thyroid UK Order Form.

This hormone replacement is made in Grains. 1 grain is equal to 100mcg of thyroxine. If you cannot get this on the NHS you will have to pay for this and the cost would depend on how many grains you were on each day.

Amour can also be obtained by your doctor/pharmacist direct from the Broda Barnes Foundation. Again, they need to set up an account with them and we have all the paperwork here if your GP or pharmacist wants to do this. It may be cheaper this way. Once an account has been set up, the Armour can be ordered via fax, telephone or in writing. Orders for less than £250 dollars are not accepted, though. As an example, at the moment the cost of 1000 x 1grain tablets is $115.06, plus freight and collection charges. These prices vary according to the cost from Broda Barnes Foundation.

For those of you who are able to obtain prescriptions for Armour, here is a list of chemists who can obtain it for you:

Be careful!
Check the ingredients of the tablets before you take them.
They may not agree with you!

If you are allergic to pork, be aware that Armour comes from pig's thyroid gland. Those of you who are lactose intolerant need to be aware that some of the replacements contain lactose. Lactose free thyroxine is available. Contact us if you need information on this.

If you have adrenal insufficiency or low adrenal reserve you may be given a steroid to replace what your body is not making. There are different types but the most common are:

Deltacortril (prednisolone)

Ingredients: (two strengths) 2.5 milligrams or 5 milligrams prednisolone. Calcium carbonate, lactose, magnesium stearate, maize starch, polyvinyl alcohol, titanium dioxide, purified talc, lecithin, xanthan gum, polyvinyl acetate phthalate, polyethylene glycol, sodium hydrogen carbonate, triethyl citrate, purified stearic acid, sodium alginate, colloidal silicon dioxide, beeswax, carnauba wax, polysorbate 20, sorbic acid, shellac, propyulene glycol, indigo carmine aluminium lake. Additionally, the 5mg tablet contains methylcellulose, sodium carboxymethyl cellulose, carmine and the 2.5 tablet contains methycellulose, sodium carboxymethyl cellulose and iron oxide.

Deltacortril ‘Enteric’ is used to make up the difference when the body’s production of cortisone is too low to maintain good health.

Hydrocortone (hydrocortisone)

Ingredients: (two strengths 10mg and 20mg hydrocortisone Ph Eur, Lactose Ph Eur, magnesium stearate Ph Eur, and maize starch Ph Eur.