Archive for the 'Thyroid Health' Category

An Interview with Peter Koshland, PharmD, and Sonia Rafeh, Outreach Director at Koshland Pharm

Pharmacist Peter

Check out Dr. Richard Shames’ recent interview with pharmacist Peter Koshland and Outreach Director Sonia Rafeh of Koshland Pharm about how compounded medications can make a difference in your health and healing. They also cover current topics such as the “me too” movement and how it’s relevant to women’s health.


Healing Thyroid Imbalance Presentation with Dr. Shiroko Sokitch

What is thyroid disfunction? What are the symptoms? How is it tested? How can it be treated on an individual basis?

Dr. Shiroko Sokitch of Santa Rosa, CA addressed these questions, and shared her unique approach to healing using both Western and Eastern medicine, in a presentation at Koshland Pharm last fall. We are pleased to share that presentation here in its recorded form.

For more about Dr. Shiroko Sokitch, see her website at

We welcome your comments, questions and feedback. All our best,

Krista Shaffer, Outreach Director at Koshland Pharm, and Peter Koshland, PharmD

Thyroid Health

Thyroid Health - CopyI get a lot of questions as a  pharmacist about thyroid medications.  This is not surprising, considering that an estimated 11 million people worldwide are affected by hypothyroidism.  Common symptoms include low energy, fatigue, cold in the extremities, and constipation.  Hypothyroidism means that the body’s thyroid gland is producing too little thyroid hormone.

The body’s thyroid gland produces two types of peptide hormones.  Liothyronine (T3) is the active thyroid molecule, the form that exerts its effects on the body’s cells. The body also produces levothyroxine (T4) and converts it to T3 in the blood vessels.

The conventional treatment of hypothyroidism starts a patient off on T4 alone (i.e. Synthroid, Levoxyl). For many patients, this is an effective treatment, but it assumes that they efficiently convert T4 to T3.  For patients who do not respond well to T4, desiccated porcine thyroid (i.e. Armour Thyroid, Nature-throid), which contains T3 and T4 in roughly physiological doses, can be a viable option.

Another option is a compounded, or customized, thyroid capsule that has T3 and T4 in a sustained-release form. This product is similar to the off-the-shelf products like Synthroid (T4) and Cytomel (T3) with two distinct advantages. First, T3 and T4 can be combined into a single dose and customized to a strength that perfectly suites a patient’s profile. Secondly, by making these capsules sustained-release, it prolongs the activity of the T3, which has a short half-life.  This allows the T3/T4 capsule to be taken once daily for most patients.

For patients taking any thyroid medication, it is important to know that this type of medication interacts with most foods, drugs, and supplements.  Therefore, it is important to take the capsule one hour before any food or drug, and four hours before any supplement containing minerals like iron, calcium, or zinc.

To see a thyroid symptom rating form that helps to screen for thyroid imbalance, see Koshland Pharm’s new webpage about thyroid treatments.  The webpage also addresses quality considerations for compounded thyroid medications.


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