The continuing supply problems for Armour thyroid make this an ideal time to discuss the customized options for patients with thyroid disorders.

Low thyroid disorders can be classified into 3 major categories: hypothyroidism, functional hypothyroidism, and functional hypometabolism. Several factors can contribute to low thyroid function, including: inadequate production of T4, poor conversion from T4 to T3 (remembering the T4 is a pro hormone), problems with the cells' ability to take up T3, problems with receptor function, and problems with intracellular transport.

Thyroid USP, Cytomel, and Levothyroxine are the principle replacement products available commercially. None of these products completely address thyroid care needs. Cytomel has a very short half life necessitating several daily doses. Levothyroxine is a prohormone that depends on proper conversion in the body for action (rT3 is inactive in the body). Thyroid USP (Armour) is animal derived and more than 99.9% of the product is not T3 or T4.Furthermore, the Thyroid USP ratio of T4 to T3 is 4.2 to 1, not a physiologic ratio. A 60mg dose of Armour thyroid contains 38mcg of T4, and 9mcg of T3.

It has been our recommendation for those who have inquired to consider 2 possible dosing scenarios for replacing thyroid that is unavailable, and for those that just don't feel right on Levothyroxine alone. The first regimen involves using an equivalent AM dose of commercial T4, and splitting the T3 dose into a customized modified release capsule in the early morning and early afternoon. The second, more simple dose would be to combine the T4 and T3 into a modified release capsule for morning administration. Each regimen should be supported with a quality thyroid support vitamin or regimen that contains selenium, zinc, chromium, iodine, vitamins A, B2 and E, among others.

In addition, we have an easy to use visual tool available that will help the prescriber to determine appropriate body conversion.