NO, NDT hasn’t gone bad. That is the short answer. I take NDT myself, and it works just fine.
I see people claiming, NDT is no good anymore. That it is better to take synthetic T4/T3 now. I think this is very serious, that this incorrect, untrue info is being spread in the Facebook groups. It stems from STTM, Stop the Thyroid Madness, and its Facebook group, Adrenal Fatigue and Thyroid Care. STTM is a site that has contributed so much, and I am sad to see, there is such black and white thinking going on. This issue isn’t black and white.
I wrote to the woman behind STTM about this, Janie A. Bowthrope. I told her, we are lots of people who do great on NDT here in Scandinavia. She said, most of those who still “believe” they are ok on NDT, only experiences adrenalin! I find that to be a strange claim. What does it mean? Adrenalin? We don’t have good thyroid levels? We just think we do? A female admin in the Facebook group, told me in a comment, we here in Scandinavia probably took our meds right before labs! None of us know how to do our labs? I am a member of thyroid groups in many countries. The members in the Norwegian groups are among the better informed in the world, as far as I am concerned. I am aware that many thyroid patients don’t know how to do labs correctly. Norwegians on NDT are not among those.
It’s a little difficult to take this seriously. Yes, absolutly, there were some bad batches of Nature Troid in 18. It didn’t take long before there were good batches again. STTM claims, that NP Acella is bad now. We don’t have NP here in Scandinavia, I don’t know if they have it in other European countries. But I see lots of people saying it is fine for them in the US groups. We use a lot of Armour, Erfa and nature Throid over here. Just now, May 2020, I see people here in Scandinavia saying, there is something wrong with Erfa. With the smelly product Erfa themselves have made a statement about it. Erfa says, they contain the proper amount of hormone. But some experience it differently.
Update: I wrote this last year. I have just checked back with people on NP now in August 2021. They are doing fine on it still. Despite STTM claiming, it does not work at all. So maybe it works for some, and not for others. Keep in mind as well, we fluctuate a lot in our levels. We use a lot of Armour, Erfa and Na
I am not saying, there are no issues. But to say, all NDT has gone bad, and to accuse the producers of being callous and indifferent to us patients and only out to make money, as Janie Bowthrope does here, https://stopthethyroidmadness.com/2019/09/23/the-sad-saga-of-where-we-are-today-as-hypothyroid-patients/ That is a sad saga.
In the US they talk a lot about “Big pharma”. It’s apparently the Devil himself. One thing is for sure, most of the NDT producers are NOT “Big Pharma”. Allergan making Armour is a big company. But Erfa is small. Also RLC labs producing Nature Troid and WP. Acella making NP is a small firm with 76 employees. So small companies. They all want to make good products people will want to buy. Of course. Anything else would be bizzare. If they want to make money.
The reality is, there are issues with all kinds of thyroid hormones from time to time. It’s not like synthetic T4 is consistent. It is not. Euthyrox came about as a result of Frensh authorities demanding, Merck start making a more consistent product than the Levothyrox they made at the time, https://www.sciencemag.org/news/2017/09/france-brings-back-phased-out-drug-after-patients-rebel-against-its-replacement . Where there was a problem with fluctuating hormone content. Patients were reacting very badly to the new Levothyroxine, hypo symptoms returned. So French authorities demanded, Merck reintroduce the old Levothyroxine. They did, under the new name, Euthyrox. There has been a lot of controvercy over this. A woman even died due to the medication. The patients were not believed by the courts. But now there is a study, showing that the fillers impact absorption greatly, https://www.connexionfrance.com/French-news/New-France-UK-study-finds-controversial-new-formula-of-Levothyrox-not-equivalent-for-all-patients .
This is something patients knew already. There are always issues when producers change the formulas. For some it will work better, for others it will not work anymore. The study on fillers
Now, in August 2021, there is a new study on Levothyroxine, Levothyroxine sodium pentahydrate tablets – formulation considerations . I haven’t been able to read the full study yet. And there are some chemical stuff here that I don’t fully understand. But the point is, that the authors think Levothyroxine should be put to bed. They address the inconsistency of the hormone content. The authors, N. Kaur and R.Suryanarayanan say this is due to two things:
hygroscopicity and microenvironmental acidity, appeared to be responsible for inducing drug instability.
Apparently this means, that ” the pentahydrate can dehydrate to highly reactive levothyroxine sodium monohydrate, or undergo salt disproportionation to the free acid form of the drug.”
I wonder if this is the reason why so many, myself included, get such serious symptoms from levothyroxine. I mean, there are fillers in NDT as well, and I don’t get side effects on THEM. They write further, that the FDA tests do not pick up on these things.
I am not on a campaign against T4 meds, far from it. But if you believe that synthetic thyroid medication is stable and consistent, and that NDT is the only thyroid medicine that has issues, you are mistaken.
Plus, if you are worried about “Big Pharma”, don’t take synthetic T4. THAT is “Big Pharma”. For sure.
Is making thyroid meds difficult?
Maybe it’s difficult to make thyroid medications. I know it is a complicated, chemical process to produce the synthetic hormones. And with the fillers impacting absorption to such a degree. NDT must follow the USP standard, that is there, must be a certain ratio between T4:T3. I don’t know all the things that can go wrong in the production process. When it comes to NDT, it’s an organic material. There is a shortage of product.
There is so much we as patients don’t know about this. And it is hard to find out. I have tried to find out where the different producers get their thyroid. I know a lot of it used to come from China. But they have had the African swine fever, and half their pigs have died. None of the producers answer my questions. I don’t understand the secrecy. I think it is a bad strategy. It breeds mistrust. But I don’t see the NDT producers as our enemies. Bashing them isn’t conducive to the relationship between them and us. I wish they would be more open with us though. And respond when there are issues. Plus if there are problems with particular batches, we should be refunded. NDT is expencive. Very expencive. Too expencive.
I know it’s very expencive to test NDT. I guess that is the reason producers test too little. Testing a single batch with liquid chromatography can cost 3000 US dollars. You can read more about how NDT is made here
And you can read more about the recall of Nature Throid in 2020, and what are the USP standards for hormone content in NDT here Quality of NDT.
All thyroid meds are actually allowed to fluctuate quite a bit. I believe many don’t know this.
Patients react very badly to this smelly thyroid we have seen this past year. In the US they believe it comes from Europe. I don’t know. I have been speculating, can this be thyroid tissue from male pigs that have not been gelded? Ungelded pigs impart a terrible smell to the meat when slaughtered. In Norway, we even have a word for it, “rånelukt”. It’s just a thought.
There has always been variations in smell in the 13 years I have been on NDT. I have taken Armour, Erfa, Glostrup (a Danish NDT), Thiroyd and TR Man. At times they have smelled more. But this smell people complain of at present is something else. They say it smells of cat pee.
Why do I engage in this issue?
Yes, why? As someone in a Norwegian group wrote, why, it’s great they are dropping NDT over there. It will be more for us. And that makes sense. There is a shortage of NDT.
But seriously, I find this important, and serious. Because a lot of people only do well on NDT. I am one of those people. I feel bad adding only 25 mcg Levaxin to my NDT dose. I get a rheumatic aching in my upper back, neck and shoulders. And become tired. And I see a lot of people having similar side effects. From Levaxin, Euthyrox, Eltroxin, Levo, Synthoid. Maybe Tirosint is better. I might tolerate that, I don’t know. But I believe very many get side effects from these T4 meds, without knowing.
So I find it serious if people abstain from testing NDT, or discontinue it because of group think or group pressure. Many are insecure. Especially those who are new to this. In the very short time I was in Adrenal fatigue and thyroid care, and it didn’t take long before I was thrown out, ha ha. I saw people saying things like, maybe I better quit NDT then, if it is no good. And admins concurring, yes, you better. It’s a big responsibility to take on, advising against taking NDT. Could be that person can only feel good on the organic medicine.
I see so much ignorance when it comes to what one can expect when starting NDT in US groups. I see people writing after a few weeks, it’s not working! And they don’t even have optimal levels as yet! It can take time to tweak the dose, plus one has to figure out what is optimal for ME. We don’t feel ok on the same levels. All this usually takes some time.
Another issue I see often, is that people expect to find a dose, and then stay on that dose for the rest of their lives. It might be like that for some. For most people it is not like that. There are so many things affecting our thyroid levels. How much we are producing ourselves, the state of our thyroid, what is going on in our immune system, winter, summer, oral intake of estrogen, gluten, lots of medicines,our individual uptake. And probably other things as well. I have always had to tweak my dose. Don’t waste your energy being frustrated over this. Just test often, take your body temperature and pulse. And adjust your dose. What’s important is to figure out your individual optimal levels and to get the medicine that can get you there.
I hope all who feel so inclined will try NDT. It’s the only meds for me, at least. Yes, there has been issues with some batches. That doesn’t mean all NDT has gone bad. I have never had an inferior NDT in the 13 years I have been taking it. There are issues with bad batches of synthetic thyroid meds as well. There are MANY examples of that. And there are quite often supply issues. And there are much more side effects on the synthetics. Patients hardly ever report side effects on NDT. They do on T4 meds. I know this from looking at the public side effects complaints in Denmark and Norway.
Hoangs study from 2013 showed, that when people didn’t know what meds they were given, 48% preferred NDT, 29% preferred T4 medicine, https://pubmed.ncbi.nlm.nih.gov/23539727/ . All participants were given both NDT and T4, for a few week each. But no one in this study were optimal, they were all under dosed. As patients are in most studies.
If you don’t feel good on the synthetics, try NDT. Don’t get scared off. We are in the hundreds of thousands, maybe millions, doing very well on NDT. To get tips on how to get started, see SYNTHETIC T4 TO NDT CONVERSION. All the best!