New member, question about Thyroid-S

[HashimotosSucks]

I notice that my newest batch of Thyroid-S 24T01005 has a different label compare to my previous batch TA20091. It used to say on the label: ”Dosage 30-240 mg daily or as directed by physician”. Now it reads: ”Please refer to package insert for further information.”

In the package insert it says:

”Initial dose for hypothyroidism 30-300 mg daily. Usual maintenance dose is 30-125 mg daily. Thyroid extract 60 mg is usually considered equivalent to thyroglobulin 60 mg, Levothyroxine sodium 0.1 mg or liothytonine sodium 25 micrograms.”

So now, they distinguish between an initial dose and a maintenance dose, and the recommended maintenance dose is only half of what they used to recommend (125 mg vs 240 mg).

Others here on Thyroid-S who know what is going on?

[pennyannie]

Hello Hashimotossucks and welcome to the forum -

I am on batch 23T01005 of Thyroid S - ( just wondered if there was a typo there ) and have no leaflet -

but having just checked another bottle from a later batch find there is now a leaflet within the box -

I have been taking Thyroid S since 2018 and take the same dose every day.

[HashimotosSucks in reply to pennyannie]

Ok, thanks! I am not sure how you are supposed to take 125 mg as each pill is 60 mg…I see that my new batch has a different colour (slightly greenish pills compared to the batch manufactured in 2020), but I have not noticed any difference in potency,

[CreakingGate47 in reply to HashimotosSucks]

Unlike Armour NDT, Thyroid S have never made a 30 mg tablet. Each tablet (or grain) is 60 mg and contains 38 mcg T4 and 9 mcg T3.

Your dose should be determined by blood results and symptoms

[HashimotosSucks in reply to CreakingGate47]

Yes, but how do you take 125 mg of Thyroid-S? 2 pills = 120 mg. It would be impossible to get 5 mg out of a 60 mg pill. They should simply have said 120 mg instead.

[CreakingGate47 in reply to HashimotosSucks]

I think they’re using instructions based on Armour’s packaging.

drugs.com/pro/armour-thyroi...

Armour is marketed in many different strengths.

Obviously 30 mg is half a grain and 15 mg a quarter of a grain.

I hadn’t noticed this because I’ve been taking same dose for 7 years. If I wanted to adjust dose I would be looking at T4/T3 content of my dose - not tablet size but the hormones in that tablet (grain)

Don’t know why they’ve done this.

I would say just stick to your usual dosage unless bloods and/or symptoms indicate a change is needed

[pennyannie in reply to HashimotosSucks]

Well that's all that matters really - isn't it :

There were some issues a year or two ago and we were told Thyroid S had been reformulated - all I know is that I threw away some bottles pre-fixed ' 22 ' batches and now ok again on much later batches from ' 23 ' onwards.

If wanting to update Helvella's blog on all things Thyroid S - please use this link below -

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

[Hypopotamus]

All I can say is that my current batch is 24TO1002, and I don't notice any difference to the previous batches, ie it still works OK for me.

I must admit that I don't recall ever having seen any suggestion of taking a higher dose of thyroid medication initially, but if it works with something like B12 injections, then may be there is something in it.

[HashimotosSucks in reply to Hypopotamus]

But hormones are not vitamins, and we need a steady supply each day. I have never heard of diabetics starting on higher doses of insulin, or people with Addison’s disease starting on higher doses of hydrocortisone, and then needing less. Our medication simply replaces the hormones we no longer make, so why would we need much less after a while?

[CreakingGate47 in reply to HashimotosSucks]

I wouldn’t overthink the new ‘instructions’. Terms like ‘maintenance doses’ are crazy. We increase or decrease as necessary.

Sometimes factors such as taking HRT or weight loss / gain can make it necessary to lower or increase dose - but bloods and symptoms would still be the determining factors.

[HashimotosSucks in reply to CreakingGate47]

Yes, hormone needs are not static!

[CreakingGate47 in reply to HashimotosSucks]

Indeed not.

In the real world our hormone needs change throughout the day, in different weather etc.

[CreakingGate47 in reply to HashimotosSucks]

Shows instructions for using Armour.

Find it hard to believe that 15 mg (1/4 grain) would ever be sufficient ……

I’m more curious about why Thyroid S have started to package like this - and apparently to use Armour as their model.

Armour NDT

[HashimotosSucks in reply to CreakingGate47]

I would like to know as well, especially why - from one batch to the next - they recommend going from 240 to 125 mg daily? Could it be related to the fact that NDT is now a licenced drug in Thailand (I read the cost of this is why Thiroyd and TR stopped production)?

[CreakingGate47 in reply to HashimotosSucks]

I don’t think the inclusion of leaflets changed their dosing recommendations. 240 mg is 4 grains a day and some people (not many) take that much.

As for licensing … it’s complicated and I’m not going there.

[RockyPath]

I have a friend who was raised in Thailand. Yes, they speak English as a second language. Do they compose technical instructions in English? The average technical writer in Thailand can explain in Thai, but English is a very tangly tongue. The Thai manager would say in Thai to the worker whose native langue is Thai, "Copy what it says on this box. Don't worry if it makes any sense."

Writing in English is hard.

[CreakingGate47 in reply to RockyPath]

Yes. That is indeed the case.