The earliest forms of natural thyroid came from the thyroid glands of cows, but early in the 1900s, the Armour meat company got into the thyroid medication arena, marketing its own natural desiccated thyroid from pigs, known as Armour Thyroid. All commercial DTE now comes from pig thyroids.
DTE contains both thyroxine (T4) and triiodothyronine (T3), as well as a hormone called calcitonin and other compounds. A normal human thyroid gland produces T4, T3, and calcitonin as well.
When synthetic T4 (levothyroxine) was first available in the 1950s, healthcare providers were reluctant to prescribe it because they were afraid that since it didn’t have T3 as DTE does, it might cause people to end up with T3 deficiencies. It was also considerably more expensive than DTE.
Around the same time, there were starting to be serious concerns about the potency of DTE. With a limited shelf life and major variability in the amount of active hormones found in the medication (it could contain anywhere from twice the amount needed to none at all), DTE began to get a bad reputation from which it hasn’t totally recovered, despite the fact that in 1985, revised U.S. Pharmacopeia content standards made the potency stable.
In 1970, scientists discovered that T4 converts to T3, alleviating the previous worry that levothyroxine as a standalone treatment could lead to T3 deficiency. In addition, the specific lab test to check thyroid stimulating hormone (TSH) levels was developed in 1971, giving healthcare providers a way to better monitor the effects of hormone replacement medication.
New awareness of T4’s conversion to T3 and the advent of the TSH test sparked the trend toward increasing numbers of healthcare providers prescribing levothyroxine as the sole treatment for hypothyroidism. By 1974, the treatment recommendations proclaimed levothyroxine “the agent of choice.”
Despite the preference toward levothyroxine, DTE started to make a resurgence in the 1990s as interest in natural medicine increased. At that time, patients who weren’t feeling well on levothyroxine were also becoming more empowered and aware of treatment options—like Armour Thyroid, Nature-Throid, and other desiccated thyroid drugs—thanks in part to the internet.
Many Patients Prefer It
A 2018 online survey of 12,146 patients being treated for hypothyroidism with levothyroxine, levothyroxine with liothyronine (T3), or DTE, found that the people taking DTE were happier with their treatment and their healthcare providers than people on the other two types of therapy. The DTE group also reported fewer problems with memory, weight, fatigue, and energy than the other two groups.
You May Be More Likely to Lose Weight
A 2013 study compared DTE to levothyroxine, evaluating 70 patients ages 18 to 65 who had primary hypothyroidism. The patients were randomly assigned to either natural desiccated thyroid or levothyroxine for 16 weeks, and then switched to the opposite for 16 weeks. Neither the researchers nor the patients knew who was taking what.
At the end of the study, there were no remarkable differences between DTE and levothyroxine in terms of heart rate, blood pressure, or thyroid hormone levels, but HDL cholesterol (“good” cholesterol) was reduced.
In this study, patients on DTE lost an average of 3 pounds during their DTE treatment.
When asked whether they preferred the first or the second regimen, nearly 49 percent of the participants preferred DTE, almost 19 percent preferred levothyroxine, and about 33 percent had no preference.
Some Report an Improvement in Symptoms
In the 2013 study, some of the patients who preferred DTE said their mood and mental symptoms, such as happiness, memory, concentration, sleep, and energy level, were greatly improved while taking DTE. However, overall the study measured no significant differences in general health, or in neuropsychological testing, during treatment with DTE vs. T4.
Furthermore, a 2006 meta-analysis of 11 randomized trials with a total of 1216 patients, in which treatment with T4 was compared to combination treatment with T4 and T3 found no improvement in body pain, depression, anxiety, quality of life, or body weight with combination treatment.
Cost Is Similar
Armour Thyroid is the most expensive brand of desiccated thyroid extract, but other DTE brands like Nature-Throid, NP Thyroid, and WP Thyroid are comparable or cost less than brand names of levothyroxine.
Potential Shortages
Sometimes there are shortages of DTE, as there was in 2009 to 2010. When this happens, you may have to switch to another brand or order your DTE from Canada (brand name: ERFA Thyroid).
Market Fluctuations
DTE is vulnerable to the market conditions affecting pork. For instance, in 2013 to 2014, an epidemic of porcine epidemic diarrhea virus wiped out an estimated 8 million pigs in the United States. The virus killed as many as 10 percent of the country’s pig population, driving up prices for pork products, including DTE.
Hormonal Concerns
There are slightly varying amounts of T4 and T3 in DTE, making them a less precise treatment option and potentially creating more difficulty in finding the correct dosage. As an example, Armour Thyroid states that the active ingredients in their medication are “similar” from tablet to tablet.
Animals have different balances of hormones than humans. DTE contains a 4:1 ratio of T4 to T3; humans have a ratio of 14:1. This can translate into high T3 levels in people taking DTE.
Thyrotoxicosis is a condition that occurs when you have too much thyroid hormone in your body. In order to combat this, if you’re taking DTE or synthetic T4/T3 therapy, your free T4 and free T3 levels should be tested right away in the morning to make sure that even when they’re at their peak, they’re still within normal ranges.
Pregnancy
The fetus through the first 18 weeks of gestation depends on T4 for normal neurological development, and higher-than-normal levels of T3 have been associated with impaired neurological development. Because the ratio of T4:T3 are much lower with desiccated thyroid (4:1 in pigs vs 14:1 in humans), desiccated thyroid generally should not be used in women of childbearing age.
Improper Use
Whether synthetic or natural, thyroid hormones shouldn’t be used to treat obesity or to help with weight loss. Taking a thyroid hormone won’t help someone with normal thyroid function lose weight. Another concern is that taking too much thyroid hormone or using it along with other weight loss drugs can result in serious and potentially life-threatening complications.
Contraindications
You shouldn’t use DTE if you’re allergic to any of the ingredients it contains, such as pork, or if you have an overactive thyroid or untreated adrenal issues. You also should not take DTE if you are a woman of childbearing age.
Other Serious Health Conditions
If you have other medical conditions like diabetes, heart disease, adrenal problems, or issues with your pituitary gland, your medications for these may need to be adjusted when you’re taking DTE.
Medication Interactions
Be sure to tell your healthcare provider about all prescription or over-the-counter medications, vitamins, supplements, and herbal products you’re taking, as DTE can have interactions with many of these.
Pregnancy
If you’re pregnant, nursing, or plan to become pregnant, talk to your healthcare provider about taking DTE. Let your healthcare provider know if you become pregnant while you’re taking DTE as well.
Once experts realized that T4 naturally converts to T3, there was a great deal of excitement about how modern levothyroxine was compared to DTE, which was considered old-fashioned. At that time, many healthcare providers switched patients over to the synthetic medication and never looked back.
Still, some of these patients complained after being switched to levothyroxine that their symptoms had worsened or couldn’t be resolved. This led to a number of the healthcare providers who had previously prescribed DTE for their patients putting some of them back on it.
DTE is prescribed far less often than levothyroxine. But frustrated patients who don’t feel well who are doing their research and talking to other people. As a result, they’re becoming increasingly aware that there are options beyond levothyroxine and that some people feel better on DTE.
Along with that, many healthcare providers aren’t aware that DTE is still available or that it can be used safely to treat some hypothyroid patients. Some believe that prescribing DTE is difficult. These ideas are unfortunately reinforced by negative opinions from levothyroxine sales representatives, unfounded rumors that DTE is going off the market, and other anecdotal information.
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Let your healthcare provider know that you’ve done your homework on DTE and that recent studies have shown that it can be very beneficial for people who aren’t doing well on levothyroxine. Though, in 2012, the American Thyroid Association said that DTE should not be used to treat hypothyroidism, it conceded in its 2014 recommendations that some people respond well to DTE or a combination of synthetic T4/T3 therapy.
