Update on Desiccated Thyroid
Dr. Friedman frequently prescribes Natural Desiccated Thyroid (NDT), also called desiccated thyroid extract (DTE) to patients with hypothyroidism, especially to the 20% of hypothyroid patients on synthetic thyroid hormone replacement who still have hypothyroid symptoms, despite normal TSH values. Of the NDT products, Dr. Friedman prescribes either NP Thyroid or Armour Thyroid to his patients. NDT has other substances not found in synthetic thyroid preparations, and contrary to misinformation, are well-formulated products with excellent quality control. No NDT product is currently U.S. Food and Drug Administration (FDA)-approved, although Acella Pharmaceuticals, the manufacturer of NP Thyroid is completing a study that will be the basis for their FDA application. Synthroid and other L-T4 products were on the market for over 50 years before FDA-approval.
FDA Announcement
While on August 6, 2025, the FDA announced that it plans to remove all DTE, on March 11, 2026, the FDA issued a follow-up statement to DTE manufacturers. In this follow-up announcement, the FDA stated that it would “continue applying its risk-based enforcement approach to ‘unapproved’ animal-derived medications …,” while reiterating that it may “take action against a manufacturer that is not meeting quality standards and putting patients at risk.” This follow-up memo stated that the FDA will continue to allow DTE products to remain on the market beyond August 2026, while manufacturers pursue full approval of their DTE products as biologics.
We thank Dr. Makary and the FDA for their leadership in protecting access to DTEs for the 1.5 million Americans who depend on this vital medication to treat hypothyroidism. Acella Pharmaceuticals has been collaborating with the FDA since 2018 to pursue formal approval of a new DTE product. They remain committed to delivering a quality treatment that meets all current good manufacturing practices and FDA requirements.
CVS Caremark Announcement
However, starting April 1, 2026, CVS Caremark, a pharmacy benefit manager (PBM) that manages the prescription benefits for many health plans (including some Aetna plans), notified its members that they are removing DTE medications from its standard list of covered drugs. They did not give a reason for this decision, but Dr. Friedman suspects that CVS Caremark is pushing patients toward synthetic thyroid medicines instead of DTE products. This is not the first instance of CVS Caremark putting profits over patient care, as in 2019, they claimed that all doses of NP thyroid were on backorder, even though they were not.
Dr. Friedman encourages his patients to make their voices heard. If you are upset or concerned about losing coverage for NDT, you can tell CVS Caremark directly:
o Phone: 1-888-217-4161
o Email: customerservice@caremark.com
Alternatives for DTE
Fortunately, there are alternatives for DTE that may even be lower cost than insurance coverage. Dr. Friedman recommends you explore these options before suggesting Dr. Friedman change your thyroid medication, especially if you are doing well. Dr. Friedman recommends patients taking DTE and other T3-containing preparations twice a day.
Acella Pharmaceuticals offers a program called Vytal, with reasonable cash pricing. The following doses of NP thyroid are available at $69 for a 90-day supply including free shipping: 15 mg, 30 mg, 60 mg, 90 mg, 120 mg, 45 mg (15 mg + 30 mg), 75 mg (15 mg + 60 mg). Dr. Friedman frequently prescribes the 45 mg dose, so this is an excellent option.
The following are other options for obtaining NP thyroid:
Glendale Pharmacy
There are also coupons at GoodRx, WellRx or Optum PerksFor more information In case you missed it, Dr. Friedman’s webinar with Dr. Henderson entitled Dueling Academic-Based Endocrinologists discussing state of the art hypothyroidism diagnosis and treatment, September 14, 2025 is available at https://www.youtube.com/watch?v=hNx3ekkc0-Q or https://www.goodhormonehealth.com/webinars/ or https://www.facebook.com/goodhormonehealth
This webinar discussed the advantages of DTE and Drs. Friedman and Henderson’s view on why the FDA should not ban these products
Please contact our office at mail@goodhormonehealth.com or go to our website, www.goodhormonehealth.com for more information or to schedule an appointment.