Acella NP Thyroid Problems

I went through a difficult couple of months because Acella changed its NP Thyroid pills.  So much for the company's claim that the medication did not change at all... I now have proof that it did aside from the obvious change in appearance.

I had an appointment on Monday.  The NP Thyroid pill contains two thyroid hormones, T3 and T4.  My T3 level dropped somewhat, and my T4 level dropped significantly.  My levels are back to where they were back in the spring before my medication increase of earlier this year.  Whatever Acella did to the pill reduced the pill's efficacy by 50%.  I can now see why I've struggled for two months.  My levels were dropping precipitously during that time.

I also take a second thyroid medication, Tirosint, that gives me extra T4.  My Tirosint has been doubled to make up for the reduction in efficacy of the NP Thyroid.  This means that I have now begun yet another difficult medication adjustment period which will last for 2 to 2 1/2 months.  This is the third medication adjustment I have had this year.

I am four days in and feel better than I did on Monday; however, I can tell that how I feel has just started to deteriorate.  I always feel better for most of the first week, then the drop begins.  I can feel the very beginning of the drop coming on.

This happens because the hypothalamus detects the sudden increase in thyroid hormone in the body due to the medication increase.  The hypothalamus then secretes a hormone that tells the pituitary gland to shut down the thyroid, which then makes the patient feel sick for two to five weeks or possibly even longer.  The lengthy adjustment period is caused by the long half-life of T4.  It takes weeks for the hormone to stabilize, which is why many thyroid patients feel bad for a lengthy period of time after any medication change.

I will bottom out at around four to five weeks after the medication increase, which will fortunately be during my winter break.  The third week is also usually a bit difficult, so semester tests will be a chore, but I will manage.  I always do.

The New Changed NP Thyroid

In September, the NP Thyroid pills changed in color, size, and shape.  The 60 mg pill changed from solid tan to gray with speckles.  The size and shape also changed slightly.  According to Acella, the company changed suppliers for the raw ingredient used in the medication.  The company states that the medication has the same formulation.

I respectfully disagree.  While the company may consider the "formulation" to be the same, the ingredients cannot be identical when the color and size of the pills have changed.  Many patients reported adverse effects as they began taking the new pills in August and September.

It was in late August that I became aware that the pills had changed.  I sorted my pills by old and new.  I took all of the old pills until I ran out of those.  I switched over to the new pills in late September.  By the middle of October, I was sick with hyperthyroid symptoms.  I suspect that the new pills temporarily resulted in a spike in thyroid hormone.  Having too much thyroid hormone in the blood is far worse than not having enough, in my experience.  I am very sensitive to the thyroid hormones. 

I also believe that my body is not absorbing the new pills as well as it did the old pills.  This matches other patients' reports.  The coating on the new pill is apparently harder than the coating on the old pill.  This would be the cause of the poor absorption.

While my thyroid hormone levels temporarily spiked in October, ultimately they decreased.  By early November, I felt okay again for around two weeks.  I believe that my levels were steadily dropping during that time, and for a brief period in early November, my levels were about right.  By November 15, I felt like my thyroid hormone levels were a little low.

Beginning Thursday, November 21, I felt a significant decrease in wellness each successful day up to Monday, November 25.  In addition to unpleasant hypothyroid symptoms, my blood pressure spiked by around 20 points.  I felt worse day by day, with the reappearance of more symptoms each day.  Fortunately, my three-month checkup was on November 25.

My thyroid hormone levels, both T3 and T4, had dropped due to the change in the NP Thyroid pill.  The T4 level had dropped a lot.

I do take another thyroid medication, Tirosint, in addition to NP Thyroid.  Tirosint is T4 only while NP Thyroid is a combination of T4 and T3.  My Tirosint dosage was doubled to make up for the T4 deficit caused by the change in the NP Thyroid pills.

Just a few hours after I took the new Tirosint dosage, my blood pressure dropped by 20 points and stayed down.  I felt warmer, although other symptoms will take longer to diminish.

Unfortunately, this means that I am at the beginning of yet another difficult medication adjustment period.  I probably will continue to feel better for around the next week.  After that, I will begin to feel sick.  This happens because the pituitary gland senses the sudden increase in T4 in the body due to the medication increase.  The pituitary gland then temporarily shuts down the thyroid, which then makes the patient feel sick for two to five weeks, or possibly even longer.

The lengthy adjustment period is caused by the long half-life of T4.  It takes weeks for the hormone to build up in the body.

I always go through a 2 to 2 1/2 month adjustment period before the levels completely sort out.

So if you take NP Thyroid and are no longer well, you are not imagining it.

Excerpt from Blog Post of November 15, 2019

I have autoimmune thyroid disease, known as Hashimoto’s thyroiditis.  The autoimmune aspect causes the trouble.  My body even launches attacks on the medication sometimes.  When that happens, I feel like I have the flu.  By the way, if you search online for information about the condition, the websites say how easy it is to treat. Clearly, the writers don’t have the condition, or they’d know better.

In early August, I finally was near optimal for the first time in five years.  It was great. Unfortunately, Acella Pharmaceuticals changed to a different supplier for one medication I take, NP Thyroid.  While Acella claims that the pills did not change, they actually did.  The pills are a different size and color.  Just know that any change in thyroid medication is the kiss of death for me.  My body goes through a hard adjustment that takes 2 to 2 1/2 months.  This doesn't mean that I feel awful all of the time, but I do have a lot of bad side effects and can feel sick for parts of each day.

Understand that my life is not horrible.  I am actually doing okay and often fine, in spite of what I just mentioned.  However, I often feel bad for part of each day.  I can actually feel fine one moment, awful a minute later which can last for just a few minutes or for 30 minutes up to a few hours, then instantly feel fine again.  On some days, I feel fine all day.  Unfortunately, I usually pay for it by feeling awful the entire next day.

I am nearing the end of my body's current hard adjustment to the change in medication.  I bottomed out right about on Wednesday, October 16, which coincided with the events described in this post.  It’s really unfortunate to be in a position where I must limit stress, and then I have people going off on me because they aren’t getting what they want.  I don’t think much of people who throw fits online in an attempt to bully others.

I also want to point out that my medication dosage has to be changed fairly frequently and that I typically go through at least one hard adjustment per year, sometimes two of them.  If I ever seem off, then you know why.  I cannot always cover the symptoms, even though I try hard to do so.