Alternatives to Westhroid If You Can't Fill Your Prescription

If your pharmacy can't fill your Westhroid prescription, you have real options. Several effective alternatives exist—some are nearly identical to Westhroid, and others take a different approach to thyroid hormone replacement. Here's what you need to know about each.

Why Westhroid Is Currently Unavailable

Westhroid is manufactured by RLC Labs, which recalled all lots of its desiccated thyroid products in August 2020 due to sub-potency concerns. As of 2026, RLC Labs has not fully resumed distribution. Read the full shortage explanation here. The good news: several high-quality alternatives are available.

Option 1: Armour Thyroid (Most Widely Available NDT)

Armour Thyroid is the oldest and most widely available natural desiccated thyroid brand on the market. Like Westhroid, it is made from porcine thyroid glands and contains both T4 and T3 in the same standard ratio (38 mcg T4 and 9 mcg T3 per grain).

Armour Thyroid is manufactured by AbbVie and is available at most major pharmacies, including CVS, Walgreens, Walmart, and Costco. It comes in more strengths than Westhroid, including 15 mg, 30 mg, 60 mg, 90 mg, 120 mg, 180 mg, 240 mg, and 300 mg.

The inactive ingredients differ from Westhroid, so some patients who were sensitive to a specific brand may notice differences. Always recheck your TSH 4–6 weeks after any brand switch.

Option 2: NP Thyroid (Budget-Friendly NDT)

NP Thyroid by Acella Pharmaceuticals is another widely available desiccated thyroid option. It contains the same active hormones as Westhroid (T3 + T4 per USP standards) and tends to be less expensive than Armour Thyroid. NP Thyroid is available in multiple strengths and is stocked at most major pharmacy chains.

Note: In 2020, Acella also recalled some lots of NP Thyroid for potency issues, but the product returned to market and has been widely available since. As with Armour, your doctor should recheck labs after switching.

Option 3: Compounded Desiccated Thyroid

Compounding pharmacies can prepare custom desiccated thyroid capsules or tablets using Thyroid USP powder. This is an excellent option for patients who:

Need a strength not commercially available (e.g., an odd dose between standard tablet sizes)

Are sensitive to specific inactive ingredients in commercial brands

Prefer a specific T3:T4 ratio that differs from the standard USP ratio

Compounded NDT tends to cost more than commercial brands (typically $50–$100+ per month depending on dose and pharmacy), and it is generally not covered by insurance. However, the flexibility can be worth it for patients who have struggled to tolerate standard brands.

Option 4: Levothyroxine (T4-Only Therapy)

Levothyroxine (brand names Synthroid, Levoxyl, Tirosint) is by far the most widely prescribed thyroid medication in the United States. It provides synthetic T4 only, which your body is supposed to convert to T3 as needed.

Many patients do well on levothyroxine alone, but some—particularly those with poor T4-to-T3 conversion—feel better on a combined T3/T4 therapy. Levothyroxine is the most affordable option, widely covered by insurance, and universally available at pharmacies. Generic levothyroxine typically costs $10–$30 per month without insurance.

Option 5: Combination T4 + T3 Therapy

For patients who need both T3 and T4 but can't access NDT, synthetic combination therapy is an alternative. This involves taking:

Levothyroxine (T4) — to supply the majority of thyroid hormone

Liothyronine / Cytomel (T3) — to supplement the T3 portion

Each grain of Westhroid contains 38 mcg T4 and 9 mcg T3. Your doctor can approximate this ratio using synthetic medications. This approach provides flexibility in dosing and is entirely pharmacy-available. Liothyronine adds some cost (typically $30–$70/month), but both medications are widely in stock.

How to Talk to Your Doctor About Switching

When switching thyroid brands or formulations, keep these points in mind:

Never stop or change your thyroid medication without your doctor's guidance

A TSH test should be done 4–6 weeks after any change in thyroid medication

Different brands may require different doses to achieve the same effect — don't assume a 1:1 substitution

Track your symptoms during the transition — fatigue, weight changes, hair loss, and mood changes are important data points

If you want to try to find Westhroid before switching, medfinder can search pharmacies near you to find which ones can fill your prescription—saving you hours of phone calls.