Patients using thyroid replacement medication have been through a lot of suspense the last few years. Starting in 2017, there was an international backorder of porcine-derived thyroid that affected both commercially available thyroid as well as compounded thyroid medications.
Now, over the course of the last ten days, RLC Labs have begun recalling all active lots (non-expired stock) of Nature-Throid® and WP Thyroid.® After recalling just a few lots, RLC started working with the FDA, and after some testing, they made a joint decision to recall everything. At this point, 483 total lots are being recalled at the consumer level. Because the recall was expanded from very specific batches to all stock, we want to go over what we know, and how to move forward.
What's the reason for the recall?
Nature-Throid and WP Thyroid are being recalled because of of sub-potency, not contamination. From the FDA, "The product may have as low as 87% of the labeled amount of Liothyronine (T3) or Levothyroxine (T4)." RLC representatives have said that only five lots have sub-potency, but they are not releasing information on which lots.
What will happen if I only get 87% of my thyroid?
If you have a batch that has lower than advertised potency, you could experience symptoms of hypothyroidism. This can include fatigue, increased sensitivity to cold, constipation, dry skin, puffy face, hair loss, slow heart rate, depression, swelling of the thyroid gland and/or unexplained weight gain or difficulty losing weight.
There is greater risk to pregnant patients, so we urge you to talk to your doctor and report any symptoms of hypothyroidism. Long term effects may be experienced by the patient and their child.
What should patients do?
You should talk to your healthcare provider as soon as you can. However, RLC Labs haven't received reports of serious adverse health events from these using these lots, so they advise patients to continue their therapy until a they have a replacement thyroid medication.
What are the alternatives?
Patients have a few options to move forward with their thyroid therapy. There are, of course, other commercially-available thyroid medications. Your pharmacy can tell you what they have available, and any potential price differences. Some commercially-available thyroid strengths still have not reached pre-shortage prices.
There are also custom-made options! You can get the same strength (grain) and same ratio of T4:T3 that you're currently using either as porcine or synthetic, human-identical thyroid compounded just for you. If you start using human-identical thyroid, the strength can later be altered to meet your exact needs, instead of only measuring in 1/4 grains. That's because porcine thyroid always has the same ratio of levothyroxine (T4) to liothyronine (T3), but compounded human-identical thyroid can be any strength or grain that each individual patient needs. You can read more about compounded thyroid here
At Folsom Medical Pharmacy, many of our patients use thyroid-replacement therapy. Because we're a compounding pharmacy, we're able to offer more options for patients and their physicians. If you have questions about how to get a prescription, or about our competitive pricing, give us a call at 916-983-4900.