Sunday, April 28, 2013

Medications May Contain Hidden Gluten: Cytomel "Very Likely Contains Gluten"

Many people assume that medications are free from major allergens like wheat. People who follow a medically prescribed gluten free diet are told (by doctors and in support groups) to look up online whether a particular medication is gluten free. When I was first prescribed Cytomel, I confirmed it was gluten free by looking it up on the website and speaking with my pharmacist. It was on the list and the pharmacist confirmed it being gluten free.

When a friend, who has celiac disease and the same low thyroid issue as I do, called me to tell me how upset she was when she discovered that this brand name thyroid medication called Cytomel contained gluten, I really didn't know what to think.  Lisa pointed out "I am just so upset--every can of soup has to be labelled with ingredients and you can see if it contains wheat. But prescription medicine doesn't have to be labelled? How is this possible?"

To get more information about whether Cytomel contained gluten, I spoke to Christine with customer service at Pfizer 1-800-438-1985, the pharmaceutical company that manufactures Cytomel. Christine looked at database and checked with someone else and reported back that: "it lists as an inactive ingredient "starch" which would be wheat based and likely to be a potential source of gluten"

I was actually shocked to hear that it contains wheat starch. I have been on this medicine for a few years. (A few years, I will add, that I have been doing so-so and thought that my thyroid problems were causing me problems--never thinking it might be from gluten in my doctor prescribed thyroid medication.) After hearing that Cytomel contains wheat starch, my doctor replied "I am stunned and speechless."

In an informative article titled 3 Steps to Choosing the Right Thyroid Hormone, Chris Kesser confirms
"Cytomel, which is a popular synthetic T3 hormone, has modified food starch – which contains gluten – as a filler."
Because thyroid problems and celiac disease/gluten intolerance go together it is disappointing that Pfizer is not using a different type of starch that is not a major allergen. It's not like Cytomel is a bagel or croissant that needs to contain wheat/gluten to be chewy and yummy. There is no reason to not use corn starch or another non-allergenic starch in the inactive ingredients.

But, the bigger issue,  is WHY AREN'T PHARMACEUTICALS REQUIRED TO LIST INGREDIENTS AND MAJOR ALLERGENS like food companies? How can a company like Pfizer get away with listing "starch" as an ingredient and not tell consumers the source of the starch? And how many of their other medications also contain "starch" which is actually wheat?

Unfortunately, the Gluten in Medicine Identification Act of 2012 (House of Representatives 4972 Bill) never passed. Until there is better disclosure, the safest thing to do is to call the pharmaceutical companies directly and ask if there is gluten in the medication.



I confirmed the generic my pharmacy carries of Cytomel, called Liothyronine Sodium,  from Paddock Laboratories is gluten free by speaking directly to customer service at Paddock Laboratories (800) 328-5113. Because formulas change, it is best to check DIRECTLY with the manufacturer about whether a medication contains gluten. (You can look at the back of your prescription label to find the name of the manufacturer--but you might need your glasses because the print is so tiny.)

Paddock Laboratories, who makes the generic my pharmacy sells, is much more transparent with their ingredients (inactive ingredients: Calcium Sulfate, Cellulose, microcrystalline, hypromellose, talc and silicon dioxide) which are listed at the National Library of Medicines Daily Med site page for the liothyronine sodium. The same Daily Meds page for Cytomel does not mention any inactive ingredients so it is harder to know exactly what it contains.

I am happy to report if you switch to a gluten free starch--and if you ever certify your medication to be gluten free!


The Healthy Apple said...

Such a great post. It upsets me SO much that no one puts labels on these prescriptions!

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Anonymous said...

I was wondering where your generic cytomel was made? I recently switched to the brand name because the generic made me itch. I found the company Mylan made the generic and it is manufactured in China and India. Another thing to check.

I still don't understand the labeling issue though. I don't think the healthcare industry and insurance companies care at all about the health of the people.

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@monicabuck said...

Thanks GFCFMOM for the info about Liothyronine Sodium being gluten free. I sit here with the prescription bottle in hand as I look up the needed information. My pharmacist was unable to answer the question!! Thanks to you doing your homework, I now have the answer AND the number to reach the manufacturer. Very helpful information and much appreciated!

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Anonymous said...

I'm so thankful that you posted this information. The internet is full of different information about the gluten free status of Cytomel. After reading your article, I decided to switch to the generic made by Paddock labs. and am hoping the results will be as good or better than brand. Have you noticed any improvement or difference since switching?

I too called Pfizer (today) and was told that the ingredient list says "starch" and doesn't specify the source- therefore to assume it does contain gluten.

I'm wondering if all of the confusion is because prior to King Labs. being bought out by Pfizer, Cytomel could have indeed been gluten free. What do you think?


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Dale Almond said...

I just found your post on Cytomel. Just today I called Pfizer - after a month on Cytomel and feeling horrid - and the customer service person transferred me to a Pfizer pharmacist. When I asked her if the starch was wheat starch, she said it was "not Pfizer's policy" to reveal the source of the starch, but that I should "absolutely assume that it comes from wheat". I think that's a pretty definitive answer, which still allows Pfizer to sidestep the issue. I'm disgusted, but at least I know the truth. My doctor will order a custom T3 from a compounding pharmacy.

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Anonymous said...

Unfortunately, if coeliac or very sensitive to gluten, it's not enough just to avoid gluten. There are a number of other foods, assumed to be gluten-free friendly, that cross-react in the body as if you have consumed gluten. Corn, rice and potatoes are some of these. There is an excellent blog article by Paleo Mom about this. So even if tablets contain corn starch, you're not necessarily safe. Fortunately, Paddock Labs is corn-free too.

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Petru Speaks said...

It is sad . I am experiencing the same situation. King pharmaceuticals have switched manufacturing plants from Bristol, Tn to Austria. The medication does not work well for me anymore. I called Pfizer, pharmacists, and also my insurance. They act as if they are clueless about the whole thing.

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