Armour Thyroid            Similar dosing amounts

1/4 Grain 15mg             T4  9.5mcg       T3  2.25mcg

1/2Grain 30mg              T4  19mcg        T3  4.5mcg

1Grain 60mg                 T4 38mcg         T3  9mcg

1.5Grain 90mg              T4 57mcg         T3  13.5mcg

2Grain 120mg               T4 76mcg         T3 18mcg

T3= Liothyronine    T4 = Levothyroxine

The Compounder will compound a capsule that is similar to Armour Thyroid.

Options:

1. Thyroid USP compounded can be ordered in any strength or same dosage strengths as Armour Thyroid.
2. T3/T4 compound can be ordered in any combination of strengths or the dosing amounts noted above.

Example Thyroid Supplement Order

Rx

  Date: ____/_____/_____

  Patient Name: _______________________________________________

  Patient Address: _____________________________________________

  Patient City / State / ZIP: _______________________________________

  Patient Phone: ______________________________________________

Please check options below

_____   Compounded Thyroid, USP _______ mg (any strength)

_____   Compounded T3/T4 with      _______mcg T3   _______mcg T4

_____   Regular Filler         _____ Slow Release Filler

_____  Other Filler (describe:___________________________________)

Quantity: # 100 Capsules                    Refills: _____

Sig: _______________________________________________________

Prescriber's Signature: ________________________________________________

Prescriber's Name (printed): ___________________________________________

DEA# _________________________ Phone # (_____)______________________