When You Can't Find Your Thyroid Medication, Alternatives Exist

If you take desiccated Thyroid — whether it's Armour Thyroid, NP Thyroid, Nature-Throid, or another brand — and you've hit a wall trying to fill your prescription, you're facing a stressful situation. Going without thyroid medication isn't an option for most patients. The symptoms of untreated hypothyroidism — crushing fatigue, brain fog, weight gain, depression, and sensitivity to cold — can set in within days.

The good news is that effective alternatives exist. None of them are identical to desiccated Thyroid, but they can keep your thyroid levels stable while supply issues get resolved. Here's what you need to know about your options.

What Is Desiccated Thyroid and How Does It Work?

Desiccated Thyroid (Natural Desiccated Thyroid, or NDT) is derived from porcine (pig) thyroid glands. It's unique because it contains both thyroid hormones:

• T4 (Levothyroxine) — the "storage" hormone that your body converts to T3
• T3 (Liothyronine) — the "active" hormone that directly affects your cells

Each 60 mg grain provides approximately 38 mcg of T4 and 9 mcg of T3. This combination is why many patients prefer it — it more closely mirrors what a healthy human thyroid produces. For a deeper dive, read our post on how Thyroid works.

Alternative #1: Levothyroxine (Synthroid, Levoxyl, Tirosint)

Levothyroxine is the most commonly prescribed thyroid medication in the world and is considered the standard of care for hypothyroidism by most endocrinology guidelines. It contains synthetic T4 only.

Why it's a good alternative:

• FDA-approved and widely available at virtually every pharmacy
• Consistent potency from tablet to tablet — no batch variability
• Covered by nearly all insurance plans, including Medicare
• Very affordable: generic Levothyroxine costs as little as $4-$15 for a 30-day supply
• Multiple brand options: Synthroid, Levoxyl, Tirosint (gel cap), Euthyrox

What to know:

• Contains only T4, not T3. Your body must convert T4 to T3 on its own.
• Some patients report that they don't feel as well on Levothyroxine alone compared to desiccated Thyroid, possibly because of incomplete T4-to-T3 conversion.
• Dose conversion is not 1:1. Your doctor will calculate the appropriate Levothyroxine dose based on the T4 content in your current desiccated Thyroid dose.

Alternative #2: Liothyronine (Cytomel)

Liothyronine is synthetic T3 — the active thyroid hormone. It's sometimes prescribed alongside Levothyroxine to replicate the T4/T3 combination found in desiccated Thyroid.

Why it's a good alternative:

• Provides the T3 component that Levothyroxine alone doesn't
• Fast-acting — effects are noticeable within hours to days
• Available as a generic at most pharmacies
• Costs approximately $15-$40 for a 30-day supply with a discount card

What to know:

• T3 has a shorter half-life than T4, which means blood levels can fluctuate more. Some doctors prescribe it twice daily to maintain steady levels.
• Requires careful dose monitoring — too much T3 can cause heart palpitations, anxiety, and insomnia.
• Not all endocrinologists routinely prescribe T3, though this is changing.

Alternative #3: Levothyroxine + Liothyronine Combination

For patients who want both T4 and T3 — similar to what desiccated Thyroid provides — doctors can prescribe Levothyroxine and Liothyronine together as separate pills.

Why it's a good alternative:

• Provides both hormones, mimicking the composition of desiccated Thyroid
• Allows precise, independent dosing of each hormone
• Both medications are widely available and affordable
• Combined cost is typically $20-$50/month with discount cards

What to know:

• Requires taking two pills (or more, if Liothyronine is split into twice-daily dosing)
• The T4:T3 ratio can be customized to your needs, which some patients actually prefer over the fixed ratio in desiccated Thyroid
• Your doctor will need to monitor your labs closely during the transition period

Alternative #4: Compounded Thyroid

If you strongly prefer a natural T4/T3 combination, a compounding pharmacy can prepare a custom thyroid formulation using pharmaceutical-grade ingredients. This can include desiccated thyroid powder or a synthetic T4/T3 combination in your specific dose.

Why it's a good alternative:

• Can be customized to match your exact dose
• Available when commercial brands are not
• Some compounding pharmacies use porcine thyroid powder similar to brand products

What to know:

• Not FDA-approved (compounded products generally aren't)
• May not be covered by insurance — typical cost is $30-$80/month
• Quality can vary between compounding pharmacies — choose one accredited by PCAB or PCCA

How to Switch Safely

Switching thyroid medications is not something to do on your own. Here's what your doctor will consider:

• Dose conversion: 1 grain (60 mg) of desiccated Thyroid is roughly equivalent to 88-100 mcg of Levothyroxine, but individual response varies.
• Lab monitoring: Expect blood work (TSH, free T4, free T3) 4-6 weeks after switching to confirm proper dosing.
• Symptom tracking: Keep a log of how you feel during the transition — energy, mood, weight, temperature sensitivity.

For help finding a doctor who can manage this transition, read our guide on how to find a doctor who can prescribe Thyroid.

Final Thoughts

Losing access to your desiccated Thyroid medication is scary, but you have real alternatives. Levothyroxine is widely available and affordable, Liothyronine adds the T3 component many patients want, and compounding pharmacies can fill the gap when commercial products are scarce.

Before making any changes, talk to your doctor. And in the meantime, check Medfinder to see if your current medication is available at a pharmacy near you — you may not need to switch at all. See our tips for finding Thyroid in stock for more strategies.