Posts Tagged 'armour thyroid'

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 Madness? Apparently so.

Those of us in the pharmacy world have certainly noticed the sporadic availability of Armour Thyroid and Nature-throid, but to those who rely on this form of thyroid supplementation (derived from desiccated porcine thyroid gland), the shortage is nothing less than a threat to their very well-being.

Hypothyroidism is a very common endocrine problem, affecting approximately 11 million people worldwide, and twice as many women as men. Symptoms of hypothyroidism include low energy, fatigue, cold in the extremities and constipation. For a comprehensive symptom checklist for hormone imbalance go to As a compounding pharmacist, the thyroid issue has been the number one concern expressed by my patients. I am glad to report that at my pharmacy we have been able to make high-quality desiccated porcine thyroid capsules with great success (patient feedback has been very positive). The thyroid powder has to be mixed with an inactive ingredient in order to properly fill the capsule and ensure that each capsule has the proper amount of active ingredient. We are able to use different inactive ingredients in addition to the standard microcrystalline cellulose (Avicel). These include acidophilus powder, and ginger root powder which have their own therapeutic benefits.

There are a couple of good discussion boards and blogs about the thyroid, namely and Both of these sites do a good job of expressing the importance of proper thyroid testing and supplementation and hope to answer some of the questions about the current controversy surrounding Armour Thyroid and Nature-throid. Although I don’t have any answers to explain the thyroid shortage, it may be partly due to the FDA’s recent tightening of its definition of Thyroid USP, the active ingredient in these products.

As an experienced compounding pharmacist, I figure it is time to put my own two cents out there on this subject. The standard of care for hypothyroidism taught by the medical schools (and pharmacy schools) is to start a patient with levothyroxine or T4 (aka Synthroid, Levoxyl, etc.). For many patients, this is an effective treatment, but it assumes that the patient efficiently converts the levothyroxine to liothyroinine (T3), the active form of the hormone. Levothyroxine also provides no additional constituents to support the healthy functioning of the thyroid gland itself. For patients who do not respond well to levothyroxine, desiccated porcine thyroid is a viable option, and many patients do significantly better on this supplement rather than levothyroxine. One explanation as to why some patients respond better is that it contains T3 and T4 roughly in physiological doses. It also has many of other byproducts of the thyroid gland that may support healthy thyroid functioning, like T1, T2, iodine, calcitonin, and other glandular fragments. This kind of treatment harkens back to the earlier part of the 20th Century when glandulars were often used to treat many ailments, often with great success. The rise of the pharmaceutical industry in the 1950s and the marketing of single pharmacologic agents greatly diminished the use of many glandular treatments.

For patients worried about obtaining the desiccated porcine thyroid, the good news is that compounding pharmacies have been able to fill in the gap left by the manufacturers of Armour Thyroid and Nature-throid. It is important to choose a compounding pharmacy that is using a high quality form of the Thyorid USP. The FDA states that for Thyroid powder to be considered USP grade (or pharmaceutical grade), it must have between 90 and 110% of the allowed amount amount of T3 and T4. This is a very wide potency range and could potentially account for therapeutic differences between two thyroid products that are labeled as the same strength. For information about selecting a high-quality, professional compounding pharmacy see my blog post, How to evaluate a compounding pharmacy.

I also want to mention another compounded thyroid product that may be useful for some patients and has been largely been left out of the current thyroid discussion. This is a compounded capsule that has the thyroid hormones 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 2 distinct advantages. The first is that the T3 and T4 can be combined into a single dose and customized to a strength that perfectly suites a patient’s needs. The second advantage is that by making these capsules sustained-release, the hormones are absorbed more steadily minimizing the potential of having any low thyroid symptoms hours after taking the tablets. Since the thyroid gland produces both T3 and T4 in a steady release, this product more closely mimics natural thyroid production.

The thyroid controversy is undoubtedly going to continue for the foreseeable future. Patients educating themselves about this issue are in a good position to advocate for their health and demand relief from hypothyroid symptoms, especially if their current medications are not meeting their needs. At Koshland Pharm: Custom Compounding Pharmacy, we want to be a resource for patients and providers, as well, helping facilitate optimal health and well-being of our patients. Don’t hesitate to call us at the pharmacy if you have any questions (415-344-0600).

Live well.

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