Thyroid Health

Thyroid Health

College Pharmacy: Commercial & Compounded Thyroid Formulations

The pituitary gland at the base of the brain produces thyroid stimulating hormone (TSH). TSH travels to the thyroid gland and stimulates it to produce T4 (thyroxine) and a smaller amount of T3 (liothyronine). Eighty percent of what the thyroid gland produces is T4, most of which is changed into T3 in the liver or kidneys.

The thyroid hormone system affects every bodily function by regulating energy and heat production, growth, tissue repair, and development; stimulating protein synthesis; modulating carbohydrates, protein, and fat metabolism as well as digestion; modulating muscle and nerve action; and helping to regulate hormone excretion and oxygen utilization.

For those patients that choose to switch to a compounded natural thyroid formula, or for those that chose to make the switch to a synthetic formula, we offer comprehensive services backed by over 40 years of compounding experience.

Compounded Thyroid Formulations

  • Compounded Thyroid USP (Natural, Porcine, SR capsules): For those patients that have traditionally taken a commercially available Natural Thyroid product, this is the most requested compounded alternative.
  • Compounded Thyroid Synthetic USP Grade T3/T4 Combinations (Synthetic, SR capsules)
  • L-Thyroxine (T4)
  • Liothyronine (T3)

Commercially Available Thyroid Formulations

(Please call for availability of Natural Thyroid products.)

  • Armour Thyroid® (Natural, Thyroid USP, Porcine, T3/T4)
  • Nature-Throid™ (Natural, Thyroid USP, Porcine, T3/T4)
  • WesThroid™ (Natural, Thyroid USP, Porcine, T3/T4)
  • Cytomel® (Synthetic, T3)
  • Levothroid® (Synthetic, T4)
  • Levoxyl® (Synthetic, T4)
  • Synthroid® (Synthetic, T4)

Making the Switch: Considering a Compounded Natural Thyroid USP Formula?

Although many patients and practitioners have weathered the storm of unpredictable availability of popular commercial thyroid products in the past couple of years, we also regularly receive calls from practitioners and patients alike about making the switch to a compounded Natural Thyroid USP formula rather than relying on unpredictable commercial product availability.

Making the Switch, Made Easy.

Our experience compounding both natural and synthetic thyroid formulations has enabled us to provide you with the answers you need. College Pharmacy can adjust T3 and/or T4 dosing for custom strength, individualized prescriptions.

Our highly trained compounding pharmacists are available to discuss individualized prescriptions, thyroid conversions, considerations in therapy options, and pricing.


Thyroid Disease: The Numbers

How Common Is Thyroid Disease?

Information Provided By: The American Association of Clinical Endocrinologists: Annual Thyroid Awareness Campaign

When the AACE established new TSH Guidelines (0.3 - 3.0 vs. 0.5 - 5.0) the number of people estimated to be affected by abnormal thyroid function doubled.

According to the AACE, the number of people affected by Thyroid Disease now surpasses the number of people diagnosed with Diabetes or Heart Disease.

  • 27 Million: The number of Americans estimated to suffer from Thyroid Disease.
  • 13 Million: The number of Americans estimated to suffer from Thyroid Disease…but remain undiagnosed.
  • 14 Million: Estimated number of Americans affected by Hashimoto’s Thyroiditis (Autoimmune Thyroiditis / Hypothyroidism).
  • 8 out of 10: Patients with Thyroid Disease are women.
  • 5x - 8x: Women are 5 to 8 times more likely to suffer from Hypothyroidism than men.
  • 25%: Approximate number of women that will develop permanent Hypothyroidism.

AACE TSH Guidelines: Click To Download

For additional information provided by the American Association of Clinical Endocrinologists, please visit: http://www.aace.com.


What Does the Thyroid Do?

The thyroid system affects every bodily function by regulating energy and heat production, growth, and tissue repair and development; stimulating protein synthesis; modulating carbohydrates, protein, fat metabolism, and digestion; modulating muscle and nerve action; and helping regulate hormone excretion and oxygen utilization.

How Does Thyroid Work?

The pituitary gland at the base of the brain produces thyroid-stimulating hormone (TSH). TSH travels to the thyroid gland and stimulates it to produce T4 (thyroxine) and a smaller amount of T3 (liothyronine), in an approximate ratio of 80:20.

Thyroid Disorders and Symptoms

Hypothyroidism is when the body produces too much TSH, and too little T3 and T4. Common symptoms are tiredness, depression, forgetfulness, dry, coarse hair, loss of lateral eyebrow hair, puffy face and eyes, goiter (a non-cancerous enlargement of the thyroid gland), slow heartbeat, dry skin, cold intolerance, weight gain, heavy menstrual periods, constipation, and brittle nails.

Hyperthyroidism is when the body produces too little TSH, and too much T3 and T4. Common symptoms are nervousness, irritability, difficulty sleeping, bulging eyes, unblinking stare, goiter, rapid heartbeat, increased sweating, heat intolerance, unexplained weight loss, scant menstrual periods, frequent bowel movements, warm, moist palms, and fine tremor of fingers.

Wilson’s Syndrome is an impairment in the conversion of T4 to T3 which causes a maladaptively slow metabolism rate, resulting in a cluster of seemingly unrelated symptoms. This is often caused by significant physical, mental, or emotional stress (often persisting after the stress has passed), and characterized by routine thyroid blood tests in the normal range with a body temperature pattern that runs below normal.

The main indicator of Wilson’s Syndrome is a pattern of low body temperatures. Additional common symptoms include fatigue, headaches, irritability, mood swings, dry hair or hair loss, decreased memory and concentration, insomnia and daytime sleepiness, anxiety or panic attacks, heat or cold intolerance, depression, fluid retention, inappropriate weight gain, constipation or irritable bowel syndrome, dry skin, allergies and asthma, itchiness, unhealthy nails, acid indigestion, increased post-prandial response, elevated cholesterol levels, recurrent infections, musculoskeletal strains, tinnitus, abnormal throat and swallowing sensations, sweating abnormalities, lack of coordination, and food intolerances.

Hashimoto’s Disease is a condition occurring when your immune system does not properly identify your thyroid and begins bombarding it with protector cells. Common symptoms include intolerance to cold, weight gain – mild, fatigue, constipation, enlarged neck or presence of goiter, small or atrophic thyroid gland (late in the disease), dry skin, hair loss, heavy and irregular menses, and difficulty concentrating or thinking.

Treatments and Therapies

There are many treatments and therapies for hyper- and hypothyroidism. College Pharmacy is able to compound thyroid treatments to virtually any specification, including T3, which tends to have a short life once ingested, into time-release capsules. Also available is T4 and T3 compounded together in physiologic doses tailored to each individual patient, or desiccated pork thyroid.


Thyroid Health Resources & Research

Hypothyroidism: Optimizing Medication with Slow-Release Compounded Thyroid Replacement

In observing patients taking either Levothyroxine (L-thyroxine) USP (eg, Synthroid, Levoxyl) or Dessicated Thyroid USP (eg, Armour Thyroid, WesThroid, Nature-throid), it has become apparent that a significant percentage continue to suffer from thyroid-related symptoms in spite of optimal blood levels of thyroid hormones. Click Here To Access Article

The Colorado Thyroid Disease Prevalence Study

Among patients taking thyroid medication, only 60% were within the normal range of TSH. Click Here To Access Article

Diagnosis & Management of Hypothyroidism in Women

Thyroid disorders are common in women. These disorders involve either functional impairment, such as hypothyroidism, or structural abnormalities such as thyroid nodules and thyroid cancer. In the present discussion I will focus on functional abnormalities, with an emphasis on conditions that alter their frequency, clinical presentation or treatment. Click Here To Access Article

Townsend Letter:

The Townsend Letter has many articles discussing Thyroid health. Of special interest are the February/March 2007 and the December 2008 Issues. You can access these articles through their website. Click Here To Visit Their Website