New member, looking for alternatives to Thyroid-S - Thyroid UK

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New member, looking for alternatives to Thyroid-S

34 Replies

Dear all,

I am new to this forum but not to thyroid disease. I was diagnosed with autoimmune hypothyroidism in 1999, at age 29, and put on levothyroxine. I struggled on it for years, tried different brands, but never felt optimal. I needed 200 micrograms a day just to feel human, while doctors kept telling me I was overmedicated and had to cut back. Of course, nobody ever tested my free T3. I was only ten years later that I found a doctor who ordered a complete thyroid panel and found that, even with top range FT4 levels, FT3 levels were at the bottom of range. I was put on Armour Thyroid. This was the same year it was reformulated and it did not work any better than levo for me. I found it very chalky (I was told to chew the pills up) and difficult to swallow. I asked to try Erfa instead. This was after it too was reported problematic. And, sure enough, it did not work any better. I then thought I had nothing to lose by ordering Thai NDT. I tried Thiroyd first because it contained less fillers than Thyroid-S. It was better than Armour or Erfa, but still not optimal. I then reluctantly switched to Thyroid-S. I say reluctantly because I had seen the long list of fillers. But it worked wonders for me. All of a sudden, all remaining symptoms disappeared. I lost weight for the first time in years and lost a lot of fluid. My skin cleared up, my nails got stronger and my hair healthier. Everyone told me how much better I looked. I could not believe I had found a drug that worked so well. I took it between early 2014-late 2017 with no problems at all. I had spent a fortune on more or less useless NDT drugs, and now I was taking one at a fraction of that price with amazing results. Looking back, I think it was too good to be true:-(

Then, in early 2018, I started on a new batch and noticed I felt less well. What I had always liked about Thyroid-S was feeling stable all day long. Now, there were constant ups and downs. Various hypo symptoms started to reappear although I did not recognise them at first: weight gain, first slow, than faster, fluid retention, hair loss...

A few months later, my supplier sent out an email to his customers, explaining that there were problems with Thyroid-S, that it reportedly no longer worked the same and that he had been receiving complaints from several customers, and he recommended his customers to switch to Thiroyd or TR. I tried TR, and it was better than both Armour, Erfa and Thiroyd, but not as good as "old" Thyroid-S.

Of course, both Thiroyd and TR have since been discontinued.

Ever since, I have tried to go back on Thyroid-S, and tried different batches, only to realise it does not work the same anymore. There are many posts online complaining about it changing during or after the pandemic, but for me that problems started a lot earlier, and my supplier claims that all batches manufactured after 2017 are affected. It has also become incredibly expensive since I first started taking it. But then again, all NDT is expensive. I am not just willing to pay that much for something that does not work optimally for me.

Recently, I came across this article stating that Thyroid-S has been reformulated to include mannitol:

ibcces.org/learning/re-risk...

I have no way of knowing if this is true. As far as I know, Thai drug manufacturers are not required by law to disclose fillers. But it could explain why it stopped working for me. Many patients had to go off Euthyrox after it was reformulated a few years ago. It seems mannitol is a problem in thyroid drugs.

My NDT supplier now sells VitaliThy from Vietnam. It seems good, but I am not too crazy about the fact that the capsules are dyed (metallic blue). But I like the fact that it does not contain lactose or cellulose. Also, the gelatin capsules are said to increase absorption. It is very expensive, around the same price as prescription NDT and Thyroid-S, but if it works well then maybe it is worth it.

Has anyone here tried VitaliThy? Can anyone compare it to Thai NDT brands? I have not been able to find any reviews online.

I have also considered glandulars. But they are pretty expensive, especially considering how much you need to take if you need a pretty high dose like me (I seem to need around 4 grains or 240 mg daily of prescription-strength NDT). I have considered Metavive II since it is porcine and from organic farming, but if I need eight capsules a day I would need three bottles a month.

Or maybe a synthetic T3 and T4 combo would be the way to go? Even the Stop the Thyroid Madness site recommends that now, after saying for years that NDT is the best option. But one problem with T3 seems to be that potency varies so much from brand to brand.

I am no stranger to self-sourcing the drugs I need as I find most doctors incredibly ignorant and incompetent when it comes to autoimmune hypothyroidism.

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34 Replies
helvella profile image
helvellaAdministrator

As an excipient, mannitol very much is listed.

In the UK, way over three thousand medicines mention mannitol. (Sometimes the reason might not be because it is an excipient, but I think most in the link will actually contain it.)

products.mhra.gov.uk/search...

Afraid I am very sceptical about VitaliThy. Things like list of ingredients that does not identify the blue dye! And a previous product from Vietnam did not inspire confidence.

I don't know where that person got the information about mannitol in Thyroid S. We have never found a reliable list of ingredients in Thyroid S.

This might be of some interest:

Thyroid S Batches

A summary of known and suspected potency of Thyroid S batches.

helvella.blogspot.com/p/thy...

Last updated 2023/07/10

Alanna012 profile image
Alanna012 in reply tohelvella

I was under the impression VitalitThy was a glandular not a true NDT?

in reply toAlanna012

No, it´s marketed as an NDT, with a standardised hormone content (strangely enough, it is said to contain slightly more T3 and less T4 than Armour; 9.1 mcg of T3 and 36.9 mcg of T4 per grain. Not sure how they manage that).

Alanna012 profile image
Alanna012 in reply to

Sorry to be a pain, but a lot of glandulars market themselves as an NDT even though they're not. If it comes in capsules with powder as opposed to a tablet, I tend to put it in the glandular category.

But I am more than happy to be wrong! The world needs all the bonafide NDT's it can get after all.

in reply toAlanna012

I know what you mean. I know of some compounding pharmacies that will manufacture NDT capsules with various ingredients according to the doctor´s instructions (there a couple in Europe, one in Vienna and one in Munich from what I have read in thyroid blogs), but they don´t market their products, they only manufacture them from scratch. But I agree, thyroid capsules available OTC are usually glandulars. Personally, I also find capsules harder to split.

in reply tohelvella

I was surprised to find that information as well as I don´t think Thai drug manufacturers provide that information to patients.

VitaliThy also contains selenium and ashwagandha. They are said to support the thyroid. I simply don´t believe that. I know selenium is important for T4 to T3 conversion, but there are numerous supplements you can take for that. And I am not sure ashwagandha does anything for the thyroid...my thyroid is long gone anyway, so I doubt it would do me much good.

I am afraid they are just trying to take advantage of desperate people now that two out of three Thai brands have disappeared. I know that everything is more expensive nowadays, but $450 for 1000 pills...I simply would not pay that much for something that may not even work, or could possibly make me worse.

in reply tohelvella

Interesting blog, thank you for the link! It seems someone always has a problem with Thyroid-S, regardless of batch. My last batch was TA19047, exp. 06/22, so manufactured well before the pandemic. I found it unstable, like some pills made me hypo and others hyper, like my body absorbed them differently. But the colour looked the same. I have not had any greenish batches like some other people. There have been rumours about fake pills, but I think only from people who ordered from third parties.

in reply tohelvella

I just found this info on the website of the manufacturer of Armour Thyroid: Animal studies have shown that levothyroxine (T 4) is only partially absorbed from the gastrointestinal tract. The degree of absorption is dependent on the vehicle used for its administration and by the character of the intestinal contents, the intestinal flora, including plasma protein, and soluble dietary factors, all of which bind thyroid and thereby make it unavailable for diffusion. Only 41% is absorbed when given in a gelatin capsule as opposed to a 74% absorption when given with an albumin carrier.

What worries me is that VitaliThy is a gelatin capsule. I don´t know about drugs such as Tirosint...they come in a capsule, but is it a gelatin capsule? For some reason, it does not seem to be a good idea to take T4 as a gelatin capsule. If this is indeed true, I will stay away from VitaliThy.

helvella profile image
helvellaAdministrator in reply to

Yes - VitaliThy capsules contain gelatin! They say so on their website:

INACTIVE INGREDIENTS: Gelatin capsule shell, Dextrose, Magnesium Stearate, PVP K30, Ethanol

And I am quite happy to read that absorption of levothyroxine varies from 40 to 80%.

But I am not convinced we can take the claims from the manufacturer of Armour and just apply them to every other product in a capsule. Most particularly, it is not clear exactly what they are comparing.

in reply tohelvella

I interpret it to mean that gelatin capsules somehow interfere with absorption? But only of T4, not T3?

Even if VitaliThy does not require a prescription, it´s an NDT, not a glandular. As far as I know, only glandulars are sold as capsules, no other brand of NDT. I have no idea why they opted for capsules instead of pills.

helvella profile image
helvellaAdministrator in reply to

But I haven't found out what they put into the capsules! The underlying cause of gelatin capsules appearing to reduce absorption could be some sort of interaction between the gelatin and the specific other ingredients in whatever they used.

A different formulation might behave very differently.

in reply tohelvella

True. Tirosint is a glycerin capsule and it absorbs better than pills in many patients.

I want VitaliThy to work as there are few viable options left. If the blue colour is brilliant blue as someone suggested, that is something that is commonly used in food, drugs and supplements so should present no danger.

in reply tohelvella

Also, I am not sure adaptogens should be taken continuously. VitaliThy contains ashwagandha, although the manufacturer claims it´s a small amount. But maybe enough to lower cortisol levels? I had low cortisol a few years ago (confirmed by 24h saliva testing) and managed to rid myself of symptoms using adrenal cortex (following Dr. Myhill´s advice). But I know ashwagandha lowers cortisol and that is why it is often used in stress management supplements. Also, as far as I know, adaptogens should not be taken permanently. I remember reading that the manufacturer had to put in some ingredients to be able to sell it as a supplement, but not sure it´s a good idea to add adaptogens to a thyroid supplement, especially one known to lower cortisol (as many hypo patients have adrenal fatigue). The same company put iodine in Real Thyroid and that is also a bad idea. The explanation was the same: they needed to do it to sell it as a supplement. But not all hypothyroid patients need iodine. So I am not sure I trust this company, even though they say many of them are hypothyroid themselves and know what it means not to be able to get the treatment you need. But why add fillers known to be problematic to many thyroid patients?

helvella profile image
helvellaAdministrator in reply to

Also contains Spica Prunellae. Which clearly has lots of interesting effects. But I wouldn't want to just chuck some into another medicine for the sake of making it look good.

If you want Spica Prunellae, then choose to take Spica Prunellae in whatever form and dose you want.

europepmc.org/search?query=...

in reply tohelvella

Yes, it does sound like SP has quite a few health benefits, but I am not sure why they put it in a thyroid drug? There is no research on their website to explain why they added those very fillers to VitaliThy. I just have a hard time trusting this company since Real Thyroid turned out to be a disaster (judging from the reviews I´ve read).

helvella profile image
helvellaAdministrator in reply to

I certainly don't trust them!

That is based on what we can all see and my personal interpretation. Not hard evidence, not science.

Framboise profile image
Framboise

I hadn't heard abut mannitol being added to Thyroid-S, but I have noticed that people were complaining about batches not working back in 2017. So far it's worked for me, but I now wonder with each new batch what it will be like.

I am a member of a Facebook group where some members tried VitaliThy last year, promising to update everyone once they knew it worked. The blue colour is apparently "Brilliant Blue". I don't think any of them took it for long, and the discussion went quiet.

Alanna012 profile image
Alanna012 in reply toFramboise

Why does anyone feel the need to add colouring to any thyroid medications? Even some brands of T3 have colouring added! Thyroid S already has a lot of fillers.

Ok as I type this it just occurred to me that it might be for identification....

in reply toAlanna012

Probably, and a lot of pills and capsules contain dye, not just thyroid meds. But it does feel unnecessary. I never understood why they need 20+ fillers in Thyroid-S...

helvella profile image
helvellaAdministrator in reply toAlanna012

In general, we see countries where they have a large range of dosages being where dyes/pigments are used in thyroid medicines.

Screenshot from the USA Synthroid site showing range of colours used.
Alanna012 profile image
Alanna012 in reply tohelvella

Thank you, that makes perfect sense when you think about it.!

helvella profile image
helvellaAdministrator in reply toAlanna012

Yes - it does.

And usually one dosage has no colour - typically 50 micrograms.

Mind, even then it is not universal. Some levothyroxine products in the USA are uncoloured.

in reply toFramboise

Thank you for telling us this! VitaliThy did sound a little too good to be true. I have noticed that it is impossible to find any reviews. That is a bit surprising since it has been around for a while. Apparently, it is made by the same company that also makes/made Real Thyroid. I have no idea if Real Thyroid is still around, but I have seen some posts by people who felt horrible on it. This company is probably trying to fill the void left by Thiroyd and TR.

Margo profile image
Margo in reply toFramboise

Good morning Framboise, wondering which Facebook group you are on that are discussing Thyroid S please ?

Framboise profile image
Framboise in reply toMargo

Hello Margo, I've just sent you a PM with the details :)

gobirds1 profile image
gobirds1 in reply toFramboise

I just started taking VitaliThy and none of my capsules are colored. Maybe they changed it? (I know this is an older post, but I was wanting to chime in on the coloring recently)

serenfach profile image
serenfach

Thank you for posting this. My journey with the drugs is very much like yours - and I never felt really well. I found Nature Thyroid from the USA good for a while, until one batch did not seem to contain anything and my health went downhill fast. I moved to Thyroid-S a couple of years ago and was doing OK until recently. I upped my dose a couple of weeks ago and felt better but now my body is telling me to up it again...

I dont know what to do now, but seriously considering either adding a bit of T3 with the Thyroid-S or going back to Levo+Lio.

I missed the alarm a couple of days ago and did not wake up until the postman called at 12.00. In the afternoon I sat down for a minute and woke up two hours later, still tired.

If anyone has any suggestions as to what to try next, I would be grateful, as I suspect Hidden would be. Thanks.

in reply toserenfach

I have been doing a lot of reading lately as I realise I just accepted the "absolute truth" on many thyroid blogs that NDT is superior to T3+T4 because it contains T1, T2 and calcitonin as well. I am no longer convinced that is the case. It may or may not contain fragments of T1 and T2, but who could anyone know? And, if you cannot measure them, how do you know you are getting enough? Some sites claim that T2 helps with fat burning, but I have not found evidence of that, only speculation. It seems nobody really knows what - if anything - T1 and T2 do, or if they are simply by-products of rT3 as part of the iodine recycling process (as some claim).

I think the main advantage of NDT (and the reason many people feel better on it) is that most of the hormones are bound to thyroglobulin so not immediately available to the body.

Nature-Throid was reformulated a year or so after Armour and has been reported problematic since. According to the STTM site, there are currently no good prescription brands of NDT so even they now recommend T3+T4.

I understand that the shortage of raw material due to swine flu has caused prices to soar, but I do think that NDT is ridiculously expensive, especially since it is inconsistent and causes a lot of symptoms in many users.

in reply toserenfach

I have been wondering why so many (possibly all) brands of NDT, both prescription and OTC, have gone bad? It started with Armour in 2009 and was due to a reformulation. Then, Nature-Throid was reformulated much the same way. Erfa worked great at first and then no more. The company denied any reformulation at the time, but reviews are still mixed after over ten years. Other brands, like WP and NP, have been recalled due to potency problems but not reformulated as far as I know. They are now both said to be problematic and inconsistent. Sriprasit denies reformulating Thyroid-S; yet, many say it no longer works the same. Some speculate it´s because they had to switch raw material suppliers due to swine fever. But I am not sure I believe that...I mean, pigs are pigs no matter where they are, so why would a new supplier mean the raw material no longer works the same? Also, the first problems were reported as far back as in 2017, and the swine fever pandemic came later. Since Thiroyd and TR are no longer around, we have no way of knowing if the same thing would have happened to them eventually. But there no longer seems to be a single brand of NDT with consistently good reviews, like old Armour and Nature-Throid.

helvella profile image
helvellaAdministrator in reply to

The Armour reformulation seemed to be from changes to proportions of the excipients.

The RLC (Nature-Throid & WP Thyroid) reformulation was because Armour took over the company that had, hitherto, supplied both Armour and RLC with Thyroid USP powder. RLC then decided they had to produce it themselves (or maybe buy in some from elsewhere).

It looks like the FDA is moving to make Armour (and other USA products) fully approved - but this has meant treating them as "biologics". Might end up with the products actually becoming better and more consistent. Though very likely a reason to increase price...

Likely a good idea to remember that, despite Armour becoming the top dog because they were more consistent than many others, they too have had issues. Like bacteriological contamination. And the current (relative) consistency has been enhanced due to modern assay techniques.

in reply toserenfach

I have been wondering lately if, after years on thyroid hormone replacement, the body´s needs change when it comes to the T3:T4 ratio.

US doctor Kenneth Blanchard was a renowned endocrinologist who treated thousands of patients who finally got well. He used only tiny doses of compounded T3 (on average 1.5-2.5 mcg daily) and physiological doses levo. He claimed that no more T3 was needed. While I do think that would not be enough for me, he had one theory that I have recently been looking into: when patients on levo only switch to NDT, they feel great at first because they were T3 deficient. But, after a while, they end up with too little T4 and too much T3 on cellular level, and that causes all sorts of symptoms of both hypo- and hyperthyroidism. According to him, the symptoms are caused by an imbalance between T3 and T4 because the normal T3:T4 ratio in pigs is not normal in humans.

Compounded T3 is almost impossible to get in Europe as far as I know, but the T3 in NDT is released more slowly than synthetic T3 in my experience so is the second best thing.

Of course we don´t know what happens at cellular level as all we can measure is what is in the blood. But his theory applies to me at least partly. It no longer feels like NDT contains the right hormone ratio for me. I have tried adding synthetic T3 and felt horrible, so that is not the option. It´s all trial and error. If I don´t feel optimal on NDT, and worse when I add T3 to NDT, at least I don´t need more T3. The next logical step would then be to lower NDT and add levo. I may have needed much more T3 when I originally went on NDT in 2014, and that is why I felt so well for several years on it, but then something changed and I immediately put it down to a reformulation of Thyroid-S. But it is possible that I ended up with a T3:T4 imbalance on cellular level. A least that is an option to consider. Since there is no way of measuring that, all I can do is adjust the dosage and see what happens.

serenfach profile image
serenfach

I was on T4 + T3 for a while, and looking back, was never on a high enough dose. I was very nervous of trying NDT but fed up with the constant ignorance of my GP, and did feel a lot better once I started. I trusted the ones from the USA but this proved a false trust. And now the ones from Thailand are proving problematic.

If the GPs were trained to a high degree in such a common disease it would not be such a fight to feel well. Even reading my blood test results over time shows that low levels in vitamins and thyroid levels were ignored. The drive to get my THS above the minimum level despite my T4 and T3 being below the minimum means I cannot trust my GP to give me the right levels of drugs to make me well. My local Endo does not "believe" in prescribing or testing T3.

So I am left with either trying to find my own level with NDT and the different doses it seems to have now, or struggling with my GP who is fixated on TSH.

There is a saying that "you cannot educate pork" but pigs are easier to train than dogs. I have done it many times. It is a shame I cannot educate my GP no matter what I try.

in reply toserenfach

The problem is that most doctors are completely clueless about thyroid disease. They think that once you are on levo with a TSH anywhere in range, you are fine and any remaining symptoms have nothing to do with your thyroid. I have found endos to be the worst; they seem terrified of T3 and a suppressed TSH. I have given up on doctors and now self-medicate as that is the only way for me to get well.

I just found this comment on social media:

Introducing VitaliThy, the first Natural desiccated Thyroid designed especially for women.

How can you tell it´s designed especially for women? Most thyroid sufferers are women, of course, but I cannot see anything that makes it especially designed for women.

VitaliThy has been available for about a year now, and there are no reviews anywhere online. That is very strange indeed since there is only one Thai brand left and there should be a market for another NDT sold OTC.

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