Has NDT gone bad?

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!


  1. Penny

    Good feature on NDT. I was really dismayed by Janie Bowthorpe’s carry-on. She advised people to take a link/levo combination instead. I for one cannot take the synthetics and there are plenty like me

    • L S-L


      Thank you. Yes, I am upset about it as well. She must be unaware that people have side effects from Levo. It’s really not uncommon. I have been thinking a lot about WHY, as NDT contain as much fillers as synthetic T4. But last year this study came out, saying that the levothyroxine maybe converts to a highly reactive chemical under storage. I comment on it here odds-and-ends

      I actually wrote her and told her that, and said, I don’t think it is a good idea to attack the NDT producers like you do. She was very angry with me. I was apparantly without respect for all the patients who reported to her, that their NDT didn’t work anylonger. I am not sure she knows that NDT is allowed to vary between 90 and 110%. And in her FB group too, that Jamie Dolan does not love me, that’s for sure. I think their behaviour is very short sighted. Not helping thyroid patients. We are so many who have to have NDT. And actually millions more would do better on NDT. The truth is, that all thyroid meds vary in hormone content.

      It’s very worrying. When we look at Nature Throid, it has disappeared. The FDA asked them to recall 4 lots. They withdrew all lots from all over the world. Did they do this out of fear? Fear of criticism? Has it destroyed them? I mean, I think it was a stupid thing to do. Not even the 4 lots should have been recalled. They COULD be at 87%, that is 3 % under the allowed. With the lack of raw material, it should not have been thrown out. NT was a good, affordable NDT. Many loved it in Norway. Maybe it comes back, but it will certainly not be at the same price.

      TPAUK is a good internet forum for people on NDT, or who wants to be.

      Blessings, Liv

  2. Helen

    For the last 2 years I have been sourcing my Thyroid S direct from Sriprasat the manufacturers, they were very helpful during the pandemic when there were no supplies to be had from anywhere to Europe via post from Thailand. However, I just opened my new bottle and took the first tablet and UGH it tastes disgusting, just like cat pee. I have been taking Thyroid S for over 8 years now, and I am completely aware of how it should taste, and this is nothing like the original formulation. I just hope and pray the efficacy of the tablet isn’t different, as I have been reading from other NDT users when other brands started to smell this way.

    • L S-L

      Hi Helen!

      I am sorry to hear that, but it does not have to mean anything in terms of strength. I have written elsewhere, I wonder if it is ungelded pigs that makes for this awful smell. One cannot eat the meat from ungelded pigs, as the smell pervades the whole pig. I have used NDT for many years now, since 2007. I have had many batches that have smelled more, but this might be worse than that. You are very welcome to report back, how it works. Just keep in mind, that the NDT can vary with 20%, so it must be dramatically weaker or stronger for there to be something wrong according to USP standard.

      There are many compounding pharmacies in Europe, if you can get a doctor to prescribe it. I am currently trying out NDT from Weltapotheke in Vienna. It was a very simple process. They say, they are never short of product. I write about it Our thyroid medicines

      Be well, Liv

  3. Melior Elynas

    There isn’t any NDT due to the African Swine Flu outbreak the summer before Covid-19, that decimated the pork industry. Heparin which is also made from porcine byproduct isn’t available either. Amour and NP Thyroid even before the NDT shortage didn’t work very well according to my blood tests when I was put on amour and then np. I was suffering and my test results proved it. Thiroyd by Greater Pharma and T-Man have gone out of business. I don’t know about Thyroid-S by Sriprasit but none is available to purchase.

    • Liv

      Hi Melior!
      I agree that the situation is serious, I am writing about the current situation in this post, Quality of NDT. But there is still NDT to be had, and new NDT is seeing the light. You can read about various Thai NDT, Our thyroid medicines They are starting to source raw material from Thailand now, which has no swine fewer so far. I know of someone who still has Thyroid S, but it is too expencive. I find the new Tru from PimPom very good. But these things are very individual. I don’t think Sriprasit is stopping production. They lack raw material. I believe they are finding new suppliers. As Thiroyd and TR did not get their licence renewed from Thai authorities, everybody wants Thyroid S. So I guess, demand has been very great.

      When you say neither Armour and NP did work for you, I cannot but wonder if your levels were optimal. If you weren’t under dosed. I see this a lot, people saying, NDT is no good. And then they have a low FT3! You might know what ARE optimal levels. But if you don’t, I have a post on that too, Optimal thyroid levels. I know a lot of people doing very good on both Armour and NP. But like I said, it’s very individual how we absorb the various meds.

      I follow my temperature and pulse a lot, to see if I am ok with my thyroid levels. I need it to be 37 C in the evening. And my pulse needs to be in mid or late 60ties in the morning and the 70ies during the day. I tweak my dose according to my vitals.

      Blessings, Liv

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