www.drlowe.com--Desiccated Thyroid--Fibromyalgia, Hypothyroidism, Thyroid Hormone Resistance

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The Metabolic Treatment
of Fibromyalgia
by Dr. John C. Lowe
Readers' Comments

Desiccated Thyroid
[Q&As are placed in reverse chronological order. In other words,
the latest Q&As come first. Earlier ones are further down the page.]

Latest Updates to drlowe.com

November 8, 2004

Question: I have had hypothyroid symptoms for years, but they’ve been diagnosed as fibromyalgia and chronic fatigue. I don’t have health insurance, I have very little money, and can’t pay your fees or those of other doctors either. I would like to know how to obtain desiccated thyroid that doesn't require a prescription. Please let me know. Thank You.

Dr. Lowe: I sincerely regret that you've suffered so long from hypothyroid symptoms. I am also sorry that you’re in a compromised financial circumstance; I understand and sympathize.

Over-the-counter (OTC) desiccated thyroid is available through many websites on the Internet. All you have to do is type into any search engine the words "desiccated thyroid." Many sites that sell products will come up.

If you're going to use an OTC desiccated thyroid product, you should first read my Q&A page on desiccated thyroid. You should also get a copy of our book for patients titled Your Guide to Metabolic Health. The publisher's webpage address for ordering the book is http://www.McDowellPublishing.com/ygmh.htm.

The book is a by-the-numbers guide to self treatment, and it includes important educational information on using thyroid hormone safely and effectively. We wrote the book partly for patients such you, whose personal finances don’t allow them to pay for professional services.

I also recommend that you get a copy of Dr. Barry Durrant-Peatfield’s book, The Great Thyroid Scandal and How to Survive It. In the book, Dr. Durrant-Peatfield gives a great deal of practical information that's important to patients guiding themselves through metabolic treatment with desiccated thyroid. The publisher’s website for the book is http://www.baronsdownpublishing.com/ordercc.htm.

These books will give you more accurate and advanced information about thyroid hormone therapy than most conventional doctors have in their heads. With the information, you’ll stand a far better chance of recovering than you would under those doctors’ care. If you run into obstacles along the way, we'll be happy to help you through brief long-distance consulting. Many patients get themselves well through self treatment, and I sincerely hope you're soon one of them.

October 6, 2004

Question: I am a 40-year-old hypothyroid woman who can’t get any relief. I live in a rural part of Kansas, and our only doctor travels from town-to-town and is here only once a month. He prescribed 0.025 mg of Synthroid, which I’ve learned is a very low dose, and he refuses to raise it or prescribe anything else. It’s not helping me. I still am always tired, weak, depressed, have dry skin, hair loss, weight gain, and my memory is terrible. I’m simply miserable. Since I read your book Your Guide to Metabolic Health last year, I’ve been exercising and taking nutritional supplements. These have helped enough that I’ll keep on with them, but I know I need more thyroid hormone because of my awful symptoms. I can’t afford to come to your clinic in Colorado, so I feel trapped in this misery. Is there anyway out of this for somebody like me?

Dr. Lowe: I am sincerely sorry you’re presently trapped in misery. I understand your circumstance because we’ve communicated with other patients in rural areas who don’t have cooperative doctors and don't have the means to travel for effective treatment.

We recommend that patients in your circumstance treat themselves with over-the-counter (OTC) desiccated thyroid. It is available through the Internet, and most brands are less expensive than Synthroid.

We know of one downside to using OTC desiccated thyroid products: Patients occasionally find themselves with "weak" (subpotent) tablets or capsules. These tablets or capsules apparently don’t contain the amount of thyroid hormone the products typically do. A week or two after the patient starts using a new bottle that contains weak tablets or capsules, her hypothyroid symptoms reappear, and her TSH level rises.

Occasional weaker-than-usual tablets or capsules, however, aren’t unique to OTC desiccated thyroid. As Mary Shomon has documented, for various reasons, the FDA often recalls prescription thyroid hormone products. Fairly often, the FDA recalls a prescription product because it contains less thyroid hormone than its label states.

The upside of OTC products is that patients can take control of their own health and raise it to the level they prefer. Patients who avail themselves of OTC products are free to use them as they see fit—and they aren’t kept miserable with symptoms sustained by uncooperative doctors. We’ve worked with patients who’ve treated themselves with OTC products and fully recovered their health. We act as educational counselors for such patients, teaching them how to tweak their treatment to get optimal results. Once they learn, they’re equipped with knowledge to keep themselves well over the long-haul.

Your most accessible and affordable way out of your misery may be an OTC desiccated thyroid product. By using one, you’ll certainly have control over your own well being—something you haven’t had with the itinerant doctor who’s kept your dosage too low to get you well.

November 25, 2003

Question: For many years, I was on T4 for my hypothyroidism. It kept my TSH level at about 2.0, which my doctors consider normal. Unfortunately, I had hypothyroid symptoms the whole time. Based on one of your newsletters, I went out on the Internet and purchased an over-the-counter [OTC] natural desiccated thyroid product. The company I bought it from advertises that you recommend their product. The product claims to have 130 mg of dissected thyroid hormone in each capsule. After four weeks on the product, my TSH level went up from 2.0 to 96! My conclusion is that there are no hormones in this product!

When my doctor saw how high my TSH went up, he put me on 60 mg. of Armour Thyroid. He prescribed Armour because I refused to take another T4 product. After four weeks, my TSH went down from 96 to 2.29! I'm doing very well on the Armour. In fact, I haven't felt this well in many years, even though I was taking T4 all that time!

I don't know whether the OTC product I took really contains 130 mg of desiccated thyroid. But no one should have to experience what happened to me! I really want to hear what you think about this. What, if anything, do you intend to do about it?

Dr. Lowe: You're not the first person who has written to us about this issue, and it certainly deserves comment.

Your increased TSH level while you were using the OTC product indicates one of two things: (1) you were taking too few of the capsules, or (2) the capsules had little or no thyroid hormone in them.

You didn't tell me how many of the capsules you were taking each day; because of that, I don't know whether you were taking too little to keep your TSH down.

Assuming for the moment that you were taking enough, the capsules may have contained too little thyroid hormone. The thyroid hormone in all brands—both prescription and OTC—is highly susceptible to degrading. Because of this, all thyroid hormone products are subject to losing some or all of their potency. When they do, we say the products are "subpotent." Subpotent batches of Synthroid and Levoxyl have often been recalled by the FDA. And over the years, an occasional patient of ours has found that the Armour, Cytomel, Cynomel, or other brand of thyroid hormone she was taking was subpotent.

In our experience, only a small percentage of prescription products are subpotent, and a higher percentage of OTC products are subpotent. Unfortunately, we don't know exactly what percentage of OTC products are subpotent.

We find that prescription thyroid hormone products generally—but certainly not always—provide more predictable clinical results. Still, though, we’ve found that most patients who use OTC thyroid hormone have had satisfactory results. Many patients we know have fully relieved their hypothyroid symptoms with OTC products after doctor-regulated therapy with prescription products failed to do so.

July 8, 2003

Question: I read yours and your wife’s new book Your Guide to Metabolic Health, and I’m truly impressed. I learned many things to try to get into a healthy routine. But I bought the book for my mother. She’s hypothyroid and has fibromyalgia symptoms. I was so glad that in the book, you support every issue I’ve brought up to Mom, especially that she should be using a thyroid hormone product that contains both T4 and T3. She’s taken Synthroid for many years and it hasn’t helped her. I explained that Synthroid has only T4 in it, and now she’s willing to ask her family doctor for a product that contains T4 and T3.

Family doctors are oblivious to how to correctly treat hypothyroidism, but maybe hers will listen if she tells him what to prescribe instead of Synthroid. Can you give me the name of some prescription products that contain T4 and T3? Knowing what to ask for is a step in the right direction. Hopefully he’ll cooperate, and then my prayers may be answered and she’ll finally get well.

Dr. Lowe: Thanks for your kind estimate of Your Guide to Metabolic Health. It sounds like you plan to improve your own metabolic health with the methods we describe in the book, and perhaps your mother will, too.

Doctors have a choice of prescribing any of several brands of thyroid hormone that contain T4 and T3. Armour Thyroid is the most commonly prescribed brand. Armour is desiccated (dried) thyroid taken from pigs. Thyrolar is a synthetic brand that contains the same ratio of T4 to T3 as Armour.

Many of our hypothyroid patients use Armour. Most of them fully recover from their hypothyroid symptoms when they reach a high enough daily dose. It's noteworthy that the patients recover with Armour after having failed to improve enough—if at all!—with the use of Synthroid, Levoxyl, or other brands that contain only T4. A small percentage of patients do well with brands that contain only T4. But many years of clinical experience have compelled us to a firm conclusion: Brands containing T4 alone provide most hypothyroid patients with distinctly inferior treatment results. Because of this, none of our patients use such brands anymore.

I hope your mother’s doctor will cooperate and switch her to a more effective thyroid hormone product than Synthroid. If he does, you’re likely to see her undergo a rapid and full recovery—assuming, of course, that she uses the other metabolism-regulating therapies and lifestyle practices I describe in Your Guide to Metabolic Health. Please give your mother my best wishes.

February 15, 1998

Question: Four years ago I was diagnosed with fibromyalgia. I have had my thyroid level tested and my doctor tells me it comes back "normal". She has, at my request, prescribed Armour Natural Thyroid at 60 mg daily. Is this enough?

Dr. Lowe: Whether 60 mg of Armour is enough for you must be determined by you and your physician. In general, however, 60 mg is not enough for improvement or recovery from fibromyalgia. It should help to put this dosage of Armour (desiccated thyroid) into proper perspective. To do so, I'll convert your dosage of Armour into the equivalent dosage of T4 (thyroxine) required for most hypothyroid fibromyalgia patients to improve or recover.

Most hypothyroid fibromyalgia patients respond only to 200-to-400 micrograms of T4 (0.2-to-0.4 milligrams). Few patients benefit from the 100-to-200 micrograms of T4 that most clinicians unjustifiably restrict them to. Some writers state that your dosage, one grain (65 mg), of desiccated thyroid provides the equivalent of 80 micrograms of T4. [Actually, desiccated thyroid contains both T4 and T3. For example, one grain of Johnson's desiccated thyroid contains 38 micrograms of T4 and 9 micrograms of T3. T3 is often reported to be four times more potent than T4. Thus, in terms of potency, the 9 micrograms of T3 is roughly equivalent to 36 micrograms of T4 (9 x 4=36). So it could be argued that the total potency of the thyroid hormone in one grain of Johnson's desiccated thyroid is equivalent to about 74 micrograms of T4 (38 micrograms from T4 + 36 micrograms from T3 = the potency equivalent of 74 micrograms of T4).]

From this consideration, one might assume that to benefit from Armour thyroid, a patient must take enough to equal the potency of 200-to-400 micrograms of T4. If this were true, it would be necessary to take between 2½ to 5 tablets of Armour per day. (2½ tablets would have a potency roughly equivalent to 200 micrograms of T4; 5 tablets would have a potency roughly equivalent to 400 micrograms of T4.) But this assumption would be incorrect. Most hypothyroid fibromyalgia patients improve on lower dosages of Armour than this. The likely explanation is that the potency of the T3 in the Amour is actually equivalent to more than four times the potency of T4. Some recent publications suggest that T3 may be 10 times more potent than T4.

The bottom line is this: While mathematical conversions can be fun, they don't help us determine how much Armour a patient will need to improve. A patient's effective dosage must be determined on an individual basis, with the patient and physician closely cooperating. To find that dosage, the patient's fibromyalgia status should be objectively measured repeatedly (as with the five fibromyalgia measures we use in our research studies). So should certain physical measures, such as the Achilles reflex and pulse rate. A comparison of the repeated measures as time passes will show whether the patient is benefiting from a particular dosage. If not, the physician may need to gradually increase the dosage until the repeated measures indicate improvement or recovery. In most cases, the patient's subjective assessment of his or her improvement corresponds closely with the changes in the objective measures. And it's important to remember that the patient's TSH level is of no value in determining the proper dosage.

The response to desiccated thyroid is difficult to predict simply through mathematical conversions. However, many patients benefit from it after they've failed to benefit from T4 alone.