Thyroid UK
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Armour/Erfa confusion

I have been trying both Armour and Erfa in the past year and a half. I started out on Armour and did great for the first six months. I lost 5 kilograms of water weight in the first few weeks. I chewed the pills up according to my doctor's instructions. They were not sweet, but did not taste bad either.

Then I suddenly did not feel so great anymore (I went from 120, 90, 60 and 30 mg pills to 240 and 300 mg pills). The new pills tasted terrible, plus symptoms returned, so I asked the pharmacy if they could give me Erfa even if the prescription was for Armour (those are the only two NDT drugs available where I live).

I have been doing fine on Erfa, although I am beginning to wonder if I'm allergic to it? On Armour, I was on 300 mg daily; on Erfa, I started feeling seriously hyper on that dose, so I cut back to 270 mg, but I still feel hyper. Or rather, I think I am both hyper and hypo at the same time. I feel warm most of the time, I wake up in the middle of the night drenched in sweat, I lose a lot of hair (did not happen on Armour), but I have not lost any weight on Erfa (and did not gain any on Armour either). But I've been having problmes with eczema lately, and I don't know if that could be related to Erfa?

So I recently decided to go back to Armour again, and ordered a 120 mg bottle with my last prescription. This time around, even those pills tasted awful. They taste so awful that there is no way I can chew them up, but I understand they don't work if simply swallowed? The only way I could stand to take it would be to crush the pills and mix with honey. I have noticed, though, that the 30 mg pills do not taste as disgusting as the 120 mg pills.

I conclude that I must have been given batches of the old Armour the first time around, although that was in late 2011 and they expired in 2012, so after the reformulation? The first pills I got were not nearly as sweet as Erfa (I don't remember them being sweet at all), but they were very effective - and they were definitely not as disgusting as the pills I have now (they expire in early 2014).

I feel totally confused. Is Erfa so much stronger than Armour; could that explain why I need to lower the dose? I have to admit that I felt calmer on the first batch of Armour I got; Erfa seems to be stressing my body more. I don't know if more of Erfa is better absorbed compared to Armour, as it does not contain any cellulose?

I have seen posts here by people on Armour. My question to you is: how to you take it? I think that swallowing the pills would also be a problem as the bigger pills are really big, and would need to be split. But, given how the last batch of 2 grains pills tasted, I don't understand how anyone can chew them up.

I have been wondering, though, if the way they taste really affect their effectiveness? Is sugar necessary for maximal absorption, as some seem to think?

I'd appreciate any input on this.


23 Replies

To try to solve your problem. It is very disappointing when things start to slide again when initially it seemed promising. If you cursor to the question dated January 30, 2002 you will find it informative.

I have always swallowed NDT with a glass of water. They are not made as sublingual. They are made to dissolve in our stomachs. Dr Lowe's patients always took their dose in one daily dose as the T3 can then saturate the cells.

This is from Armour Thyroid and personally, I would start again with a much lower dose as your symptoms appear overstimulated.


Therapy is usually instituted using low doses, with increments which depend

on the cardiovascular status of the patient. The usual starting dose is 30 mg Armour Thyroid,with increments of 15 mg every 2 to 3 weeks. A lower starting dosage, 15 mg/day, is recommended in patients with long-standing myxedema, particularly if cardiovascular

impairment is suspected, in which case extreme caution is recommended. The appearance of angina is an indication for a reduction in dosage.

Most patients require 60 to 120 mg/day. Failure to respond to doses of 180 mg suggests lack of compliance or malabsorption. Maintenance dosages 60 to 120 mg/day usually result in normal serum T4 and T3 levels. Adequate results in normal TSH and T4 levels after 2 to 3 weeks of therapy.

Readjustment of thyroid hormone dosage should be made within the first four weeks of therapy,after proper clinical and laboratory evaluations, including serum levels of T4, bound and free,and TSH.


......I have been doing fine on Erfa, although I am beginning to wonder if I'm allergic to it? On Armour, I was on 300 mg daily; on Erfa, I started feeling seriously hyper on that dose, so I cut back to 470 mg.........

Did you mean you cut back to 270 mg?

As you will see below, Erfa 1 grain (60mg) has 3mcg less of T4 & 1mcg less of T3 than Armour. I began my NDT journey on Armour: when this was unavailable I switched to Erfa and consequently after a few months downward slide, had to up my Erfa dose.

Armour Thyroid

(Forest Pharmaceuticals)

1 grain = 60mg

38 mcg

9 mcg


(Erfa Canada Inc)

1 grain = 60mg

35 mcg

8 mcg


Yes, of course I mean 270 mg, I'll try to correct it in the post!

Does swallowing Armour work? The STTM webpage does not seem to think so; that's where I learned to chew the pills up, until I could not stand the taste any's logical that if they are meant to be swallowed they don't have to taste nice...


All I can tell you Anna69, is that I always swallow my NDT, both Armour when I took that and now Erfa. Perhaps someone else has info on the pro's & con's?


I'd be very interested to know, because so many claim that you should chew Armour up and take Erfa sublingually...whereas the manufacturers claim they were made to be swallowed and digested by the GI tract. I even read somewhere that Forest reformulated Armour to make it easier to absorb from the GI tract...kind of ironic, since most seem to agree that the reformulation made Armour work less well.

Aprilthorn, did you switch to Erfa because you did no longer do as well on Armour, or what was the reason? Just curious.



Hello Anna,

I switched to Erfa when it was almost impossible to get hold of Armour. I certainly improved on Arnour and after adjusting my Erfa dose seem to do well on that also.

I am sure I read somewhere that if you take your NDT on an empty stomach and leave a wee while before eating, it is adsorbed just fine :-)

1 like

I have the STTM book and it says can be taken with food and patients have found it better if chewed. I posted about this a few days ago and decided to change how i dosed myself from the advice of the ladies here. I now take it half an hour before eating and chew and swallow with a glass of water. The difference is brilliant. I feel better in myself (lighter) and ive been weeing so much its unbelievable (im losing water weight yay!), i also have a period something i havent had for 2 years because im on the POP pill. Weird but its all good as far as i can tell. Im on 2.5 grains which is 150mg. So very different to you. I dont mind the taste at all in fact i dont notice it which was something i was meant to ask people cos everywhere i read that it smells and tastes vile. But I am on amytriptyline and if you leave that too long in your mouth it burns your tongue so maybe thats why i dont mind the armour!

maybe you are getting too much T3 at one go? Did you say you take them with food or not? maybe with food is better for you personally? I think Shaws is right it might be good to start again, annoying i know but could help. I get the sweats when im underdosed. though ive never woken up sweatin, just when im out and about. hope this helps xo


Thank you so much!!! You might be right, and I could be getting too much T3, or maybe I should take it with food instead of on an empty stomach...back in my thyroxine days, I was always careful not to eat or drink anything besides water for at least half an hour after taking my meds, but maybe that does not apply any longer...

When I had my T3 and T4 levels tested in 24 hour urine, on 200 mcg of thyroxine, it turned out that my T4 levels were midrange, but my T3 levels below range...which caused my doctor to conclude that I probably needed a lot of additional T3.

Your post has given me new hope. Thank you.



Im glad! I guess you have to experiment to see what works for you. I think as i got used to the dose of 2.5 grains to "pep" it up for me i had to start taking it without food. Another lady on here takes all her NDT at night before bed. Its not supposed to work like that! So don't lose hope you'll find whats right for you. good luck xx

quick note. my armour is in half grain pill form so maybe thats why they don't taste so bad(?)


Hi BexyLS

Do you take all your 2.5 grains at once or split?


I split them. 1 grain in the morn before breakfast, 1 grain before lunch and the 1/2 grain i used to take at 7 but dropped that to 5pm


Yes, I also noticed a difference between the 15, 30 and 60 mg pills on the one hand, and the 90 and 120 mg pills on the other...I could learn to live with the taste, though, as long as I knew that the pills worked!


Hi I am taking Armour at the moment and have not heard of ERFA before is this available in the U.K. on prescription, or are you in the states


Information about many thyroid hormone products, including Erfa and Nature-Throid, is here:

Erfa comes from Canada.


I am in Belgium, where Armour and Erfa are available, although some pharmacies no longer carry Armour, only Erfa...


Hi I started on ERFA in October and I get it from a practice in Winchester I've been unable to find anywhere in the U.K. to get Armour


Hi sorry I can't help answer your question but could any of you in this thread pm me how you get your ndt is it named patient basis private script or on the net?


There is NO need for it to be in a Private Message if it is about properly prescribed desiccated thyroid. Nor even if it is in the most general terms (e.g. "I get mine on the Internet"). But as soon as identifiable sources are being mentioned, please abide by the guidelines and keep that to PMs.



Warning, I took Erfa (T3) sublingually for almost two years and delt with speach stuttering. I always thought this developed as part of my thyroid problems. I just recently started swallowing the T3 and it's a world of difference. My stutter disappeared and I feel way better overall.

I don't understand the science behind this but I do understand the simple direct effect. And because of this I highly advise against it.

By the way this didn't happen because my dose was too high. It's just the effect of taking sublingually.


This is very interesting! I have never liked taking NDT sublingually (synthetic drugs simply taste too bad to take that way IMHO). I could never explain why, it just made me feel uncomfortable...reading what you say, I think "jittery" is the best word to describe the effect it had on me. I also do much better simply swallowing NDT, one hour before breakfast.

Taking NDT sublingually is recommended by the STTM, a forum I have recently started to question as it seems they don't accept any other opinions than the "official party line".

I recently read an article by a US doctor prescribing NDT, and she said NDT (unlike synthetic T3) contains thyroglobulin which slows down its absorption by the body, enabling you to take it once a day instead of multi dosing. I have never liked multi dosing, and feel fine taking NDT once a day (in the morning). This is also what the late Dr. Lowe recommended. I know some like or need splitting the dose which just proves we are all different, but it's interesting to see theories about why some methods work better for you than others...


Steve, very interesting! Just to be sure I understand you correctly: when you say T3, do you mean T3 products only, or NDT/synthetic combo drugs which contain both T3 and T4?


Interesting! It seems you never had any problems with Armour, after it was reformulated a few years ago...?

Some claim Armour went downhill after Actavis bought Forest (last year, I think), but complaints actually started in 2009 already, after Armour was reformulated, but was still manufactured by I don't know if Actavis changed it again....?


Hey im on erfa and doing great! Yes its seems to be stronger than armour, I was very hyper when I first started it and im now only taking 90mg! Armour didnt work for me dont know why! A question for you where do you get your erfa? Are you living in uk? Im live in Belgium and now the price has gone up 3 times and they cant say why?! Can I order from Canada?

Kind regards Stephanie


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