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QUESTION: I have 57 apples. How many do I have to give away to have 88 left? If you don't know, ask a doctor.

I received a note today from a woman whose doctor has switched her from 88 mcg of Levothroid to 90 mg of Armour Thyroid. In itself that isn’t a bad move (I prefer the combination of thyroid hormone over T3 alone). Sadly, though, the doctor is confused about the difference between levothyroxine (T3) and natural thyroid. The Armour product is sold in milligrams and 90 mg delivers 57 micrograms of T3, which is 31 micrograms (35%) LESS than she had been taking (88-57=31).

Maybe the doctor was lowering her dose? Nope. The prescriber also told the woman to “shave off a little of each of the Armour tablets to get the dose down to the 88 she had been using.

Those are the people – the doctors – we are supposed to trust with our health. I am certainly not willing to trust someone who doesn't know the difference between milligrams and micrograms and makes a 35% mistake on a prescription.

I explained this error to the customer with the hope that she passes it along to her doctor. I wonder how that will work out?

Larry J. Frieders, R.Ph.
The Compounder Pharmacy
340 Marshall, Unit 100 ~ Aurora, IL 60506 Tel: 630.859.0333 FAX: 630.859.0114


AKA Larry J. Frieders
Grandpa's Arms, Inc.
340 Marshall Ave #100 | Aurora, IL 60506 |
Monday through Friday, 9am to 5pm |
Office: 630.859.0333 Cell: 630.992.7513 FAX: 630.859.0114
 

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Larry, do you know what they call the guy who graduates last in his class at Med School? ........Doctor!
 

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Probably won't work out too well for you Larry. This physician may have other reasons for switching to the more natural product. As you should know, there may be significant bioavailability differences in these two medications. He may be experimenting with her therapeutic regimen to solve a problem you are unfamiliar with. She may have misunderstood what was communicated to her. There are a myriad of possibilities...none of which will be improved by you driving a wedge between patient and physician.
 

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If you were concerned a prescription was in error why in heaven's name did you not immediately contact the doctor?
 

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Don't hesitate to talk to the Pharmacist. He spent his entire education studying pharmacology, for MD's it is really a side class. The Pharmacist does not have the authority to change the medicine, but they can help you know the right questions to speak to the Dr. about. I have gotten good advice from the Pharmacy while trying to stablize my heart meds and in one instance, I was warned about serious reactions if I took two drugs at the same time. The Dr. had made a mistake and made an immediate change when I brought it to his attention.
 

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Discussion Starter #6
I'm not professionally involved (didn't get the order) and have no contact with the doctor. I cannot randomly contact someone's doctor if I have no direct interest in the prescription (interest in a legal sense, not in the sense of being interested)

A significant number of people contact me for consultation when they have concerns about their drugs (My motto has long been "Too many people take too many drugs"). They contact me because their doctors are often too busy to devote time to their concerns (very common today and WILL get worse in the near future - and no reasonable hope it will improve). In a similar manner the local pharmacist - or the preferred mail order facility staff - are too busy to do what we'd like them to do. Often their pay is partially determined by how many "scripts" they process in a shift. Like it or not, medicine is a numbers game.

I am a licensed pharmacist and I decided to not sell commercial prescription drugs in my store; compounding only. We do not accept any form of third party payment (Medicare, Medicaid, or any insurance). This allows significant freedom to advise and consult - provided we never advise a person to do anything that contradicts their prescription orders. Only another doctor can make those kinds of changes. Our advice is always to discuss your concerns with your doctor - WITH the information we provide as a resource for your discussion. Sometime the customer is successful. Usually not. The vast majority of drug prescribers seemed convinced of their infallibility and their superiority over their patients.

The lady in my story feels just awful and has already talked to her doctor - who seems convinced that 90 MILLIGRAMS of the natural thyroid product is a little more than 88 MICROGRAMS of T4 (levothyroxine). As I mentioned above, a 90mg tablet of the natural product delivers 57mcg of the T4 she had been using. It is not an experiment. He changed the prescription FROM T4 TO the natural substance at the request of his patient and has refused to discuss the matter further until her next appointment (the one he can schedule in a few weeks and for which his group can submit billing). The prescription is not a mistake. He is delivering 35% LESS material and believes he is offering a little more - that's why he suggested the patient shave a little off the new dosage.

The good thing about ignorance is that it is 100% curable. I'm certain the doctor can make adjustments if he takes the time to learn the difference between milligrams and micrograms - and takes a few minutes to learn what is in the products he orders.
 

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omgb,

You mean like McCain who graduated last in his class at Annapolis? Imagine having that schmuck as President!

Birdogs
 

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John McCain DID NOT graduate last in his class...he graduated fifth from the bottom.

John McCain finished 894th out of 899 at the Naval Academy and lost five jets in Vietnam.

Watch the video at the above Website URL...
 
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