A fellow thyroid patient wrote in and asked a GREAT Thyroid Question.  Cynthia asked what is the difference between compounded thyroid medication that has T3/T4 in it and tablets of natural desiccated thyroid.  Tablets of natural desiccated thyroid would be things like Naturethroid, Armour thyroid,  Efra, or the new Generic Thyroid made by Acella.

And the answer to this question is……

It depends!    That’s why this is such a great question. I will explain.  The active ingredients are the same in either compounded natural thyroid or the tablets that contain natural desiccated  thyroid hormone, but there are some differences.

Here are the differences between Natural Desiccated Thyroid Tablets, Versus Getting  a compounded thyroid medication from a compounding pharmacy

Medicine bottle.Compounded Natural Thyroid

*  Consists of  Natural Desiccated Thyroid Hormone

* A Compounding Pharmacy Makes the tablets according to your thyroid prescription and your health care provider’s instructions

*  Has Both T3 and T4 In it

*  Your doctor can specify if desired, the amount of T3 or T4 that they want added to the compound. This means that your T3/T4 levels that you would receive in your thyroid medication may be customized to your needs.

*  Note: Some doctors however, do not specify a “different’” amount of T3/T4, and simply go with one of the standard formulations of T3/T4 that would come in one of the tablet preparations of natural desiccated thyroid hormone which would be 38 mcgs of T4 and 9 mcgs of T3 for a one grain or 65 mg dose.

* The fillers will vary by compounding pharmacy ** This is important, so ASK your compounding pharmacy if you don’t know what fillers they are using

* If you are paying extra for the compounded natural thyroid please do not get yours compounded using cellulose as a filler (*A  much better alternative is either olive oil, or acidophilus) and your compounding pharmacy can use either of these instead of cellulose in the compound.    Do not assume your compounding pharmacy will use olive oil or acidophilus—– ASK and write down the answer and then make sure that you get one of the better fillers, like the olive oil or acidophilus in your medication.

* The Cost : Compounded Natural Thyroid Is More Expensive. Because each capsule must be made one by one, there is a labor cost involved, and patients will pay extra for this. When I checked pricing, the cost to fill my own prescription for natural thyroid that was compounded was 10 times the cost compared to what I  paid for Naturethroid at the time. So, do take this into consideration as it is important for some people and compounded thyroid medication can be expensive.

* Lack of flexibility to change dosing:   The other big drawback, in my opinion, with using compounded natural thyroid medication vs getting a tablet, is that with compounded you don’t have the ability to easily adjust your dose. And since dosing changes are quite common, and can even occur with changes in season. Wintertime, for example, may require that thyroid patients take a larger dose of thyroid hormones, and not having the ability to use a pill splitter to adjust the does with a compounded medication makes a difference as well.

Now, let’s compare Compounded Thyroid to Natural Desiccated Thyroid Tablets.

Natural Desiccated Thyroid Hormone Tablets
For example, Natural Desiccated Thyroid Tablets (Naturethroid, Armour Thyroid, Generic Thyroid and others)

* Also consists of Natural Desiccated Thyroid Hormone

* Is available generally through any pharmacy with a prescription, and is already manufactured, does not have to be custom made

* And Has T3 and T4 in it

* Has a specific amount of T3/T4 in the medication.  Some brands vary slightly, but Naturethroid and Armour Thyroid both have 38mgs of T4 and 9 mcgs of T3 per one grain tablet.  Naturethroid comes in 65 mg tablets, and Armour’s tablets are 60mg tablets, however, both have the same amount of T3 and T4 in them.

* Less expensive than compounded natural thyroid hormone.  Your exact costs may vary per pharmacy and if you have insurance, but generally the tablets are much less expensive than having compounded natural thyroid medication customized for you.

* Perhaps even more important, in my opinion, is that using a tablet gives the patient much more flexibility in terms of working with their doctor with regards to changing one’s dose. Most thyroid patients will have adjustments in their medication strength that is needed, and having the tablet gives the patient the ability to split the tablet into 1/2’s or even 1/4th’s with their doctor’s permission as needed during their treatment if dosing changes are required.  Patients may also benefit by having their doctor’s prescribe 2x the dose that they will take per day for example, a 2 grain tablet it they are on a one grain dose, and then splitting the tablet. This can save the patient 1/2 off their costs of their medication and can be a very easy way of reducing medication costs over time.  Medications are usually priced per tablet, not per mg, so in theory some tablets will cost the same regardless if you are purchasing a one or a two grain tablet. Thus, sometimes splitting the dose for those patients who can do so and who wish or need to do so to reduce costs can be a way of making thyroid medication much more affordable. Being able to use a tablet splitter when taking thyroid medication also allows the patient and doctor to collaborate on changing or adjusting doses of thyroid medication much more easily than having to have a new prescription compounded.

Note: Very important safety information about tablet splitting.

If anyone ever adjusts their medication with the approval of your physician,  and you are taking a different amount than what is listed on your prescription bottle, it is very, very important to carry a medication card with you with the names and doses of all medications including over the counter and prescriptions in your wallet.  It is also important to make sure that the person who would be designated as the person making your health care decisions in the event that you become unable to speak for yourself, has a a current list of your medications and dose.  Your doctor should also have a list of your medications and the dose you are currently on in your medical chart, but it is always good to have a copy with you at all times for safety reasons.  There are some medic-alert bracelets you can get which can be linked to an online record of your medications. This, can also be an important safety feature to make sure that in the event of an emergency, you are not overdosed.

As you can see there are certain situations where having a compounded thyroid medication could be helpful, although other times where using a natural desiccated thyroid tablet may be the best decision for you. Knowing the differences in thyroid medications is important for you to know, so that you can advocate for yourself in discussions with doctors and pharmacists about which thyroid medication is best for you.