There is so much talk of issues with NDT. And I have already written one post about it. I hope to be a sobering voice. I see a lot of stress and worry created, especially in the US. We take it more easy here in Europe. 

Is there any need for worry? No, you don’t need to worry. Only people who do not know anything about their optimal levels, or how to monitor them, need to worry. You will learn how to do these things, if you don’t already know it. I will teach you.  Follow your temperature and pulse, guide below. Then you just adjust your dose as needed. 

Because thyroid meds will continue to fluctuate also in  the future. And not only NDT, synthetic meds differ in their hormone levels as well. There is just now, August 2021, a new study on Levothyroxine. Where the authors think the medicine is so inconsistent, it should be put to bed. You can read more about that  here.  

USP standard for NDT

Synthetic T4 meds like Synthroid and Levo, are legally allowed to vary between 95 and 105 % of the given amount.  So your current batch can be 10 % stronger or weaker than your previous batch. NDT and synthetic T3 medicine is allowed to vary between 90 and 110 %, US pharmacopia.

Recall of NT and WP 2020 and NP Acella nov 2020

The recall of Nature Throid and Westhroid in 2020 was NDT that might contain 87 % of the given amount. That is 3 % less than what is allowed. OMG! In hormone content, that would be hardly anything. The same with the NP recall in November 2020. That was also a sub potency at 87%. 

The FDA asked RCL labs to recall 6 lots . They tested 10 lots and found 6 to be subpotent, and writes that “some may be subpotent at 87%”, link to FDA recall . And criticized RCL for lack of procedures. 

 But RCL labs recalled all 483 lots from all over the world. I said at the time, now Nature Throid will no longer be an affordable option. And we see now, that I was unfortunately right.  It’s us patients who will pay the price of course. That was a very bad judgement call on behalf of RCL labs. I am thinking, with all the negativity going around in the US, originating from the STTM, they are maybe nervous. Why not just go out and say, all of these lots may be a little sub potent, please check your levels and adjust dose? There is a real shortage of NDT raw material in the world, due to the African swine fever. Can we afford to destroy large amounts of NDT? The NDT  certainly becomes more and more expensive as a result.

NP Acella recall summer 2020

 

And last summer (2020), NP Acella recalled product due to what they called “super potency”, it could contain 115 % T3 of given amount. That is 5 % over the allowed amount. Super potent? It would make for 1 to 1,5 mcg more T3 pr 60 mg, which normally contains 9 mcg T3. Most people would hardly notice such an increase. NP Acella warns, this could be dangerous to pregnant women. BS, is all I can say. 

It becomes a big drama. I know people who took NT from the recalled lots. They noticed no difference. 

This is the world we live in, all thyroid meds vary in hormone content. I am not saying this is good, and that we should just accept it. But I don’t know how easy it is to rectify it. Not even for the synthetic meds. If you have a look at the study on Levo that I link to over, you see, that the authors highlight detoriation that takes place in Levo that the FDA tests cannot detect. And that make it inconsistent, and even reactive. Maybe this is why so many of us have serious side effects on Levo?

And I believe, making and testing NDT is even more difficult. And keep in mind, each liquid chromatography can cost 3000 US dollars. WE will be the ones paying for increased testing. You can read more about how NDT is made and tested here

But, of course, the manufactures must have quality procedures in place. No doubt about that. Both RCL labs and Acella need to do better. Both synthetic and organic thyroid meds need to be more consistent.

Do all pigs have the same thyroid levels?

No they don’t. They are like us humans. Their levels vary with age, gender and even breed. I don’t know how this reflects in the actual NDT powder. But we do know the different NDT brands vary in hormone content. 

These graphs are from this study by Petkov

Table 1. Age- and gender-related variations in blood thyroid hormones in HCS Shoumen

Shoumen is a big pig company in Bulgaria. There are even variations between breeds:

Table 2. Breed- and gender related variations in blood thyroid hormones in Duroc (DD), Landrace (DL) and Yourshire (DY) pigs; HCS Shoumen.

What are the consequenses of these recalls?

The consequences are very serious. Patients are becoming scared and worried. This fear goes directly to our adrenals, which are often weak already. Sites like STTM and their corresponding FB groups also stirs up a lot of anger and conspiration theories. Which creates even more turmoil in many people. I don’t think most patients go very deep into this themselves, really look at the numbers and think.  I hope my post will make you do that.

Our NDT will become more expencive. When so much product goes to waste, there is only one person who will pay for that, YOU. 

Patients will have to change meds, which is very scary to many. Last year, Nature Throid was not to be had.  It can become expencive to change meds. It could entail a visit to the doctor, having to apply for a new license, having to buy a  more expensive brand. Maybe even being without NDT for a period. Or maybe even switching back to synthetic for good, and doing less well.

STTM rages against the NDT producers. I am becoming more and more pissed at the FDA. I find it very irresponsible what they are doing. I see in US groups, people talking about Big Pharma in this situation. Don’t you see, you are palying into the hands of Big Pharma? NDT producers are not Big Pharma, synthetic T4 producers are Big Pharma. 

FDA, I hope you are scrutinizing synthetic thyroid meds as well. I suspect not.

What can WE do?

We can monitor our levels when starting on a new batch. If you follow your pulse and temperature, you will know when to adjust dose. And keep in mind, there are many other reasons for our levels fluctuating besides variations in our meds. 

 

How to take the temperature

Measure before getting up and again in the afternoon. Preferably with a glass thermometer. Measure rectally or vaginally. Should be 98,6 F or 37 C in the afternoon, a little lower in the morning. 


How to take the pulse

Pulse is more individual than temp. What I have done, it taking my pulse when my temp is 37 C and I feel good, and go by that. For me that is a pulse around 72 in the morning and 80 in the afternoon. A very low pulse is never good.

 

Let us take things down a notch. If it is possible to raise the quality of our NDT, I hope it will be done. But if it is difficult to avoid variations, talk to us, inform us, work with us. We all want the same thing, good and consistent  NDT