Please read...food for thought...

[Guest guest]

In a message dated 5/23/2004 4:30:14 PM Eastern Standard Time,

nnichols@... writes:

> Would any of you who are now on Armour, and who have been through $inthoid

> or not, be willing to write a letter to the board if it might help? I will

> know more about this in a few days. I don't know if letters to the board will

> help or not, (especially since you're not her patients) but it sounds like

> someone is trying to get between us and our Armour...that's fighting words for

> me!!

>

These are definitely fighting words for me too. My first doc, and ENT,

mentioned that he was all the time fighting the medical board on this

issue...because as you said Armour is not the " standard of care " .I think it

ought to be and

we need to stomp on Synthyroid. I think it's time we let our voices be

heard. If it takes a letter writing campaign from us...with a letter to every

state medical board....I'm willing to do it. Thoughts?

Cindi

[Guest guest]

First I want to apologize if some of you get this more than once...I know some

of us are on more than 1 list.

My endo informed me that she is being investigated by the state board for using

human growth hormone in adults and Armour thyroid. Another endo told the board

that Armour thyroid was not " standard of care " . I don't know yet what the

complaint was about her using HGH in adults. I know that she said that she took

a gentleman who had been in an auto accident and was expected to be a vegetable,

and treated him with HGH over a period of time, and now he is well enough to go

back to being a productive individual. I volunteered myself and my husband (who

are both being treated by her with Armour) to stand up for her if necessary.

Would any of you who are now on Armour, and who have been through $inthoid or

not, be willing to write a letter to the board if it might help? I will know

more about this in a few days. I don't know if letters to the board will help or

not, (especially since you're not her patients) but it sounds like someone is

trying to get between us and our Armour...that's fighting words for me!!

She is an awesome Doctor and the most caring physician I have even known.

Dusty

Olathe, Ks.

[Guest guest]

Do a search on about.com. Here is a link and a letter they have that

might help: http://thyroid.about.com/cs/thyroiddrugs/l/blletter.htm

Dear Doctor

Why Do You Insist on Synthroid Instead of Armour? -- A Patient's

Letter

Thanks to Shirley Grose, a thyroid patient, for sharing with us the

following powerful letter she wrote to her doctor, after he insisted

on prescribing Synthroid (a brand name synthetic levothyroxine

sodium/T4 thyroid hormone replacement drug) instead of the Armour

Thyroid (a brand name naturally derived T4/T3 drug) she'd been

taking. (See " A Quick Look at Thyroid Hormone Replacement " for more

about these different drugs.) Shirley's letter is strong and clearly

asks many excellent questions many people want answered. She's

generously agreed to allow her letter to be posted for other thyroid

patients to read or modify for their use, in the hopes that it might

help empower her fellow thyroid sufferers who are having the same

problems with their doctors. (Note: Shirley's doctor never

responded...)

Dear Doctor ______________:

I would like for you to clarify several points which came up during

our recent discussion. You said Armour Natural Thyroid, my thyroid

replacement preference, was impure, not predictably the same strength

and old fashioned. I am concerned about this information because I

have uncovered some research which indicates flaws in this reasoning.

Would you clarify your statements on Armour Natural Thyroid product?

If you feel those statements were valid, can you provide

documentation to confirm your opinion that Armour Thyroid is an

inferior product to Synthroid? Is Synthroid really a " new " product

or was it " grandfathered-in " around 1930? I would like to know, why,

when I changed to Armour Natural Thyroid, you didn't consider the

definite improvement in my health important? I would like to know why

you felt I was unqualified to say how my own body felt? Why would you

insist upon prescribing a drug that I have tried and does not work

well with my body?

Why do you prescribe one drug for all patients? According to Dr.

E. Langer's book Solved, The Riddle of Illness, " It is

possible, because of the liver's role in the T-4 and T-3 conversion,

to have an over-or under-conversion as a result of liver function. "

For some patients, Armour Thyroid, because it contains both T-3 and T-

4, may provide the extra energy they need to stay employed, continue

relationships, or feel good. Synthroid does not contain both,

Synthroid has to convert to T3 from T4. Furthermore, author Dr. Ray

Peat states, " Unfortunately, our physicians often fail to understand

or explain the benefits of natural (marketed under the name 'Armour')

over synthetic thyroid medication. " Though the formula has changed

somewhat in recent years, Dr. Peat calls the natural {thyroid} " the

most generally effective, " since " many people whose thyroids are

suppressed by stress cannot respond to synthetic thyroxine, T4. "

Finally, is it possible that those impurities or unknowns you

mentioned might possibly be as yet undiscovered substances which

assist thyroid function, a substance or substances which cannot

possibly exist in a synthetic product?

Your first statement during my consultation as a new patient was that

the Armour Natural Thyroid should be discarded, it was full of

impurities, it was of inconsistent strength and it " went out in the

70s. " Synthroid was the drug of choice. Armour was clearly inferior.

I explained that I felt better on the Armour Thyroid. You ordered me

to throw the Armour Natural Thyroid away and take the Synthroid

dosage you prescribed. You said that a TSH test would not be valid if

taken while on Armour Natural Thyroid. Can you document this last

statement? I understand the TSH is considered one objective

measurement for thyroid supplementation; however, I question the

inference that a patient's subjective opinion is unimportant. You

seem to disregard how your patients feel. Have there been any major

published studies indicating which product the health consumer

preferred? Customers have apparently had no choice in thyroid

medication in most instances. Therefore, sales volume is not

indicative of customer preference. Also, does the Synthroid company

fund or in any way contribute to organizations which you belong or to

the university, itself? If so, does this influence your decision to

singularly prescribe Synthroid?

At the end of my appointment, when you began to write my prescription

for Synthroid, I indicated that would not be necessary. You

asked, " Why? " I said I was continuing with the Armour Thyroid at the

dosage my family physician had prescribed. Your response was, " You

don't need to return do you? " I said, " No, I don't. " You further

explained you did not use the Armour Natural Thyroid, and you would

not treat me if I continued taking it.

Do you refuse to treat thyroid cancer patients who refuse to take

Synthroid? Should I develop thyroid cancer at some point in the

future, would you refuse treatment to me on the basis that I chose

not to take Synthroid? Can you legally refuse to treat a patient who

has thyroid cancer because the patient takes Armour Natural Thyroid?

Why should I or any patient be intimidated into taking what they feel

is an inferior product. Why should I or any patient suffer a lesser

quality of life because of physician bias for a particular brand name?

I called Forest Pharmaceuticals, Inc. the manufacturer's of Armour

Natural Thyroid, and spoke to Neal Sailer, the Product Manager,

Thyroid Products. He is sending a packet of documentation supporting

the consistency of Armour Natural Thyroid.

He took exception that Armour Natural Thyroid is of " unpredictable

variability. " He explained that desiccated Thyroid powder is a U.S.P.

product which means potency content is consistent and he added that

the active drug product is constantly assayed during the entire

manufacturing process, the FDA insists on this for all products. In

addition, Mr. Sailer explained that samples from every batch are

retained and periodically assayed for potency. I understand that the

limit for T3 and T4 for U.S.P. Thyroid powder is 90% to 110% and

natural thyroid is a more stable product than the synthetics. Mr.

Sailer would like to know how you came to a determination of Armour

being an " impure " or sub-potent drug substance, and would like to see

your data. Are you suggesting that Armour Natural Thyroid be recalled?

Additionally, Mr. Sailer informed me of a study recently published in

the Journal of the American Medical Association (JAMA), entitled

Bioequivalence of Generic and Brand-name Levothyroxine Products in

the Treatment of Hypothyroidism, by Betty J. Dong, PharmD; et. al.

Are you familiar with the study? Why are you prescribing a product

that is 50% more expensive than Levoxyl and Levothroid? Are you

assured of the potency of Synthroid? I also understand that Synthroid

was reformulated in 1982 because the potency of Synthroid was not

near its stated content. In fact, in a letter from Dr. Betty Dong, to

the editor of The Journal of Clinical Pharmacy, Dr. Dong assayed

several 200 mg tablets of levothyroxine from several brands and

generic and found Levothroid had 99% of it s stated potency content

and Synthroid had only 78%. I understand that it was this information

that prompted the reformulation of Synthroid. I also understand that

patients were not informed of this change in formulation, which was

clearly dangerous. Which now leads me back to the U.S.P. standard and

something else I have learned about Synthroid.

Mr. Sailer informed me that Synthroid is failing the original U.S.P.

standard for dissolution for levothyroxine preparations. It is also

my understanding that they requested and were given a separate

standard for dissolution by the U.S.P. which Mr. Sailer said was most

unusual. If this separate dissolution standard for Synthroid is

successfully challenged, Synthroid may have to once again

reformulate. Will you or the public be informed if this happens? I

understand also that there are several class action lawsuits pending

against the makers of Synthroid probably initiated as a result of the

several articles that appeared in the Wall Street Journal and news

stories that were carried on NBC Nightly News. After all of the

above, why did you insist on prescribing Synthroid? Could _________

University provide me with any information regarding support from the

makers of Synthroid, whether it is Knoll or Boots or Flint?

I would sincerely appreciate an answer with documentation, in writing

about the statements you have made about Synthroid and Armour

Thyroid. I feel these are important questions, not only for me, but

for the future physicians _______________ University educates. These

future doctors, including the student who took my thyroid history,

have not been given complete information which would allow them and

their patients to make educated decisions about their health and

their lives.

Sincerely,

Shirley E. Grose

Synthroid and other Levothyroxine Sodium Preparations Found to Have

Significant Stability and Potency Problems

When Shirley Grose wrote in this letter to her doctor, " Are you

assured of the potency of Synthroid? " she was asking a question whose

answer is just now now coming to light. On August 14, 1997, the U.S.

Food and Drug Administration filed notice in the Federal Register

that drugs containing levothyroxine sodium (such as Synthroid and

other brand name and generic thyroid hormone preparations) are " new

drugs. " This means that these drugs will for the first time be

required to submit new drug applications that formally document the

drug's safety, effectiveness, and consistent potency.

This notice is in response to new information found by the government

that shows significant stability and potency problems with orally

administered levothyroxine sodium products. Also, these products do

not remain potent through the expiration date, and tablets of the

same dosage strength from the same manufacturer have been shown to

vary from lot to lot in the amount of active ingredient present. The

government found that this lack of stability and consistent potency

has the potential to cause serious health consequences to the public.

You can read more about this in an article here at the website.

> In a message dated 5/23/2004 4:30:14 PM Eastern Standard Time,

> nnichols@s... writes:

>

> > Would any of you who are now on Armour, and who have been through

$inthoid

> > or not, be willing to write a letter to the board if it might

help? I will

> > know more about this in a few days. I don't know if letters to

the board will

> > help or not, (especially since you're not her patients) but it

sounds like

> > someone is trying to get between us and our Armour...that's

fighting words for

> > me!!

> >

>

[Guest guest]

> Dear Doctor

> Why Do You Insist on Synthroid Instead of Armour? -- A Patient's

> Letter

EXCELLENT letter. It's also already in our FILES in case folks want

to see it again for future reference.

Janie