Archive | February, 2012

Why I Hate Generics

22 Feb

I was a pharmaceutical rep for seven years. My closest friend is still a pharmaceutical rep, and we talked today about her struggles selling a branded drug against the onslaught of generics. As a salesperson, I fought the good fight against generics every day. As a disclaimer to everything I am about to say, I am still pro-pharmaceutical industry. But now that I take a daily chronic medication, I feel the need to advocate from the patient perspective.

There are several reasons I refuse generic medication, but here are the most important reasons:

  1. Generic drugs are only required to have between 75% and 125% bioavailability (active drug in the bloodstream). Branded medications are required to have 100% bioavailability at all times. I currently take 125 mcg of Synthroid. That’s less than 1 mg. A variability of 25% either way could absolutely affect my daily life. Read more here.
  2. Generic drugs must have the same ACTIVE drug as the branded medication, but God only knows what they use for inactive ingredients. My guess is that they use whatever is the absolute cheapest. Inactive ingredients affect absorption, and also contribute a great deal to the side effect profile of a medication. Patients also often have allergies to these additives. Read more here.
  3. A large portion of generic medications are manufactured in India and China, where quality control standards are far below that of the U.S. Read more here.
  4. Generic levothyroxine has been PROVEN to be inferior to branded Synthroid in multiple clinical studies. Ironically, I used Synthroid as an example for why doctors shouldn’t switch their Actonel patients to generic Fosamax. Little did I know I would live and breathe that study just four years later. Read more here. 

So you might think this doesn’t matter, because your doctor doesn’t prescribe generic drugs. But guess what? Unless the doctor specifically writes D.A.W. -DISPENSE AS WRITTEN on your prescription, a pharmacist can switch it out with a generic. And you might get a different generic manufacturer every single time you refill…different bioavailability, different inactive ingredients and different quality on a month-to-month basis.

I went into this experience as a very educated patient. I specifically asked for a D.A.W. prescription from the moment I woke up from surgery. Yet on FIVE different occasions over the past six months, I have been harassed at the pharmacy to switch to a generic.

“Sarah – we didn’t fill your prescription because your co-pay is $30. Are you okay with that?”

“We don’t have any Synthroid, but we have levothyroxine, which is the same thing.”

I just want to scream every time. It is NOT the same thing! Pharmacists do this to patients because the profit margin on generic drugs is HUGE compared to their branded counterparts, and inventory costs are much lower. Therefore retail stores incentivize pharmacists to convert to generic drugs. I am all about Capitalism…I really, really am…but at least give me the opportunity to get what I pay for. At least be truthful and say there is a cheaper option, but it might be less effective.

So, fellow thyroid warriors, be educated. Ask questions. And be prepared for one more battle in the war for optimal treatment.

Still Bargaining…

21 Feb

Finally! Something to celebrate!

I just got a call from U of M, so I thought I would do a lunch hour post to share some news.

First, my ultrasound showed no abnormalities and my thyroglobulin (cancer tumor marker in the bloodstream) level is still undetectable.

The rest of my numbers are as follows:

  • B12: 490 (normal, and way better than before)
  • Vitamin D: 31 (normal, but could be higher)
  • TSH: 1.55 (I think that’s high – Dr. E likes it)
  • T4: 0.97 (I think that’s low – Dr. E likes it)
  • T3: 2.4 (that’s just about perfect, and that is while taking Cytomel)

So what does all this mean? It means I FINALLY get to go back on 125 mcg of Synthroid. Dr. E wants me to drop the Cytomel, but I begged to stay on it. We’ll see what she says.


  • I continue to live flour-free, and I think I am happy with the choice. I feel healthier overall, so it’s worth it. I never thought I could win the battle over bread, but I did! I don’t even crave it anymore.
  • I added back my iodine supplement (Iodoral) and started taking Selenium. It’s been 4 days, and I have lost 3 pounds. It’s hard to attribute the weight loss to any one thing, but whatever, I’ll take it. I am researching and closely monitoring my response to iodine, and will post separately about my findings.
  • I am feeling really good. I always forget to reflect on the improvements in my health. My energy level is almost normal, my hair totally stopped falling out and looks normal, my skin is not as dry, and I don’t feel as depressed as I did before. What’s changed? Cytomel? Flour elimination? Added estrogen? The fact that I have been exercising a little bit more? There’s no way to know, so I will just keep doing what I’m doing!

Cheers to being cancer-free, and to a higher dose of Synthroid!


 I get to stay on 5 mcg of Cytomel with the new increased dose of 125 mcg Synthroid. It’s what I have been pulling for all along! I am seriously jumping for joy!

The Flourless Experiment

15 Feb

I made it through 21 days of no flour. I incorporated Ezekiel bread into my breakfast. I ate more fruit, vegetables and lean meat. I skipped the quick airport and meeting snacks when I traveled to Florida last week. I even ordered salad at Disneyland. And what were the final results?

-0.8 pounds

That’s right, my initial weight loss kinda rebounded back, and I basically have nothing to show for my suffering. It’s true, I didn’t gain anything over the past three weeks, which is positive. And my digestion, brain fog and energy level have maintained their improvements. But what’s the use if I am still overweight? Today at lunch I ate 4 croutons in my salad and I had some vegetable dumplings. And boy, did I regret it. My stomach ballooned out and I almost fell asleep at my desk at 2:00 p.m. I have ruined my favorite food forever, and I am still fat!

So, here we are in My Journey…

DENIAL: I will be fine. This is the best cancer to get!

ANGER: I am NOT going to be one of those people who get really fat and have permanently hoarse voices!

BARGAINING: Okay, maybe if I try Armour. Or adding Cytomel to my Synthroid. Or giving up flour. Maybe then I can have my old life back.

DEPRESSION: Why do I even bother? Now the best I can hope for is never eating white bread or noodles again and still being overweight! Why did this have to happen to me??

I guess the next step is ACCEPTANCE. But can I go there after I have one more round of bloodwork this Friday? After all, I did start on birth control pills. Maybe the added estrogen is interfering with the thyroid meds. Maybe a magical dose increase will make me normal again?

Oh wait, now I’m back to bargaining.

9 Down…12 To Go?

4 Feb

I have been officially “flourless” for 9 whole days. And as I sit here in my recliner, enjoying a glass of Pinot Noir from Oregon, I gotta tell you…it ain’t that bad!

For the first 3 days, I had an awful headache and felt like I was coming off of drugs. Then in the last few days the fog began to clear. My watch and my rings got a little looser. I’ve started thinking clearly. The only way I could describe it is like putting your glasses on in the morning…the world is suddenly in focus. I can think straight. Oh yeah…now I remember! I used to be smart! I used to be able to get through my work day without feeling confused and overwhelmed! I used to be able to work out and still walk the next day!

I feel pretty good. Some of this might be attributed to the Cytomel finally kicking in. Whatever it is – I’ll take it. The biggest change I have made is the elimination of flour. I replaced my sugary morning cereal with a slice of Ezekiel flourless toast. I still eat rice with my stir fry. I still eat sugar…it’s in my salad dressing and my occasional handful of Hershey’s Kisses.  I don’t even feel that deprived anymore. And believe me, I would tell you if I did.

I was listening to Coldplay’s new album this morning – Mylo Xyloto. Those of you who know me know that Coldplay is my all-time favorite band. And there is nothing I love more than one of their live shows. As I cranked up “Charlie Brown,” I imagined myself at the concert, singing, screaming, jumping around. And in my head, I am my normal-sized, cancer-free self.

Coldplay releases butterfly confetti during In My Place. How thyroid-appropriate!

Tickets go one sale tomorrow for the August 1 concert. And mark my words…I am going to make that vision come true. And if I have to pass on the bread basket for the rest of my life, I’ll do it.

Week 1 Results Recap:

  • Pounds lost – 2
  • Energy level – Good
  • Digestion – MUCH improved! I would even call myself normal!
  • Brain fog – Gone

Stay tuned!