Your Patients Can't Find Their Thyroid Medication — Here's How to Help

Your front desk is fielding daily calls from anxious patients who can't fill their desiccated Thyroid prescriptions. Your clinical staff is spending hours calling pharmacies. Your patients are running out of medication and developing symptoms. The desiccated Thyroid shortage is consuming practice resources and affecting patient outcomes.

This guide provides a practical, step-by-step approach to helping your patients find desiccated Thyroid in stock — or safely transition to alternatives when it's unavailable.

Current Availability Landscape

As of early 2026, the availability of desiccated Thyroid products varies significantly:

• Armour Thyroid: Intermittent availability — some pharmacies maintain stock while others report indefinite backorders
• NP Thyroid: Limited supply following 2020-2021 recalls and ongoing manufacturing constraints
• Nature-Throid / WP Thyroid: Minimal availability in most markets
• Compounded NDT: Generally available through accredited compounding pharmacies

The August 2025 FDA enforcement actions against unapproved desiccated thyroid products remain the primary driver of the current supply disruption. For the full regulatory context, see our provider shortage briefing.

Why Your Patients Can't Find It

Understanding the bottlenecks helps you counsel patients more effectively:

1. Regulatory disruption: The FDA's enforcement actions have reduced the number of products legally available on the market
2. Concentrated manufacturing: Only 2-3 companies produce commercial NDT, so any disruption cascades quickly
3. Pharmacy ordering limits: Wholesalers may restrict quantities during shortages, meaning pharmacies can't stock up even when product is available
4. Insurance barriers: Many plans don't cover NDT, pushing patients to fewer pharmacies and creating bottlenecks
5. Geographic variation: Supply is not evenly distributed — pharmacies in some regions have stock while nearby areas are completely dry

What Providers Can Do: 5 Practical Steps

Step 1: Use Medfinder to Locate Stock

Medfinder for Providers tracks real-time pharmacy inventory, allowing you or your staff to quickly identify pharmacies that currently have desiccated Thyroid in stock in your patient's area.

Instead of having staff call pharmacies individually — which can take 30-60 minutes per patient — a Medfinder search takes seconds. You can share results directly with patients or use them to direct prescription transfers.

Step 2: Build Relationships with Independent and Compounding Pharmacies

Independent pharmacies often have different wholesaler networks than large chains, giving them access to different supply channels. Identify 2-3 independent pharmacies in your area that reliably stock desiccated Thyroid and build referral relationships with them.

Similarly, establish relationships with accredited compounding pharmacies (PCAB or PCCA-affiliated) that can prepare custom thyroid formulations. Having these connections in place means you can quickly redirect patients when commercial products are unavailable.

Step 3: Prepare Transition Protocols

Have a documented protocol ready for transitioning patients from NDT to synthetic alternatives. This should include:

• Dose conversion guidelines: 1 grain (60 mg) NDT ≈ 88-100 mcg Levothyroxine
• T3 supplementation criteria: When to add Liothyronine (Cytomel) — typically for patients who had suboptimal response to T4-only therapy or who specifically need T3 support
• Lab monitoring schedule: Baseline, 4-6 weeks post-transition, and 3 months
• Patient education materials: Explain why the switch is happening and what to expect

For detailed alternative information to share with patients, direct them to our alternatives to Thyroid guide.

Step 4: Proactively Communicate with Affected Patients

Don't wait for patients to call in crisis. Identify all patients in your panel who are on desiccated Thyroid and proactively reach out to:

• Assess their current medication supply
• Discuss contingency plans
• Document preferred alternatives in their chart
• Set up advance prescriptions for alternatives if appropriate

A simple EHR query for active prescriptions of Armour Thyroid, NP Thyroid, Nature-Throid, WP Thyroid, or desiccated thyroid can generate your patient list.

Step 5: Advocate for Prior Authorization Exceptions

For patients whose insurance plans require prior authorization for alternative thyroid medications (particularly Liothyronine or brand-name products like Tirosint), be prepared to submit PA requests that cite the shortage as medical necessity. Document:

• The specific NDT product the patient was taking and the dose
• The shortage status (reference FDA enforcement actions)
• Why the requested alternative is medically necessary
• Prior trial and failure of other covered options, if applicable

Alternative Medications at a Glance

Quick reference for the most common transition options:

• Levothyroxine (generic): $4-$15/month — universal availability, universal coverage. T4 only.
• Synthroid (brand Levothyroxine): $30-$50/month — consistent formulation. T4 only.
• Tirosint (Levothyroxine gelcap): $30-$90/month — minimal excipients, good for absorption issues. T4 only.
• Liothyronine/Cytomel (T3): $15-$40/month — add to Levothyroxine for combination therapy.
• Compounded T4/T3: $30-$80/month — customizable doses, not covered by insurance.

For the comprehensive cost breakdown and savings strategies your patients can use, see the Thyroid savings guide and the provider's guide to helping patients save on Thyroid.

Workflow Tips for Your Practice

Designate a Shortage Point Person

Assign one staff member to be the practice's shortage coordinator. This person monitors supply updates, maintains relationships with pharmacy contacts, and fields patient calls about medication availability. Concentrating this knowledge saves time across your entire team.

Create Template Responses

Develop template messages (for patient portal, email, or phone scripts) that address the shortage situation, outline available options, and direct patients to resources like Medfinder. This reduces the time staff spend on repetitive calls.

Batch Transition Appointments

For patients who need to switch medications, consider scheduling dedicated "thyroid transition" appointment blocks. This allows you to efficiently manage labs, dosing calculations, and patient education for multiple patients in sequence.

Document Everything

Ensure that the reason for any medication transition is clearly documented in the patient chart — including the shortage as the driving factor and the patient's preferred NDT product for future resumption. This is important for continuity of care and potential insurance appeals.

Final Thoughts

The desiccated Thyroid shortage is placing significant burden on both patients and practices. By leveraging tools like Medfinder for Providers, building pharmacy relationships, preparing transition protocols, and communicating proactively, you can protect your patients' health while managing the operational impact on your practice.

The shortage will eventually improve, but in the meantime, a systematic approach will serve your patients far better than reactive, one-off solutions. Your patients trust you to help them navigate this — and with the right tools and plans, you can.