Thyroid UK
85,603 members100,536 posts

Starting Erfa NDT today


So FINALLY I have got a prescription for NDT (not NHS I hasten to add)

Can I just swop straight over?

I was on 100mcgs of Levo now 60mg of Erfa.

Are there any side effects, headaches etc?...

Excited but nervous as so don't want to feel worse!


13 Replies

Can you double check, please. Erfa is NDT (Natural Dessicated Thyroid). T3 is liothyronine. They aren't the same thing.


Yes it's NDT sorry my mistake!


At the bottom of your original post is a v. Click on that and several options come up, including Edit. You can edit the title and the content of your post. Don't forget to Submit or Save changes or whatever the words used are.


I am assuming your T3 is 25mcg (UK T3 is 20mcg). If it is 25mcg you can take that once daily as you would levo or NDT. 25mcg is around 100mcg of levo.

If you wish you can start on half T3 for a couple of days, taking note of your pulse/temp before beginning and then gradually increasing dose till you feel well. If you either get a fast heartbeat or high temp, drop dose down to previous dose.

Any side effects I had on levothyroxine all disappeared with T3 and had no side effects. Excerpt:

Dr. Lowe: The physician should call a pharmacy and request the leaflet given to patients when they pick up a Cytomel (T3) prescription. The physician would learn, as the patient leaflet on Cytomel explains, "POSSIBLE SIDE EFFECTS: NO COMMON SIDE EFFECTS HAVE BEEN REPORTED with proper use of this medication." Other than Nystatin, he probably will find that no other drug he might prescribe is as free from adverse effects as T3.


Stupidly I put T3 rather than NDT

So it's NDT I'm starting. I know that has T4 and T3 in hence my confusion.



Not at all Katepots - I think when we are learning all of these 'hormones' run through our brains.

NDT contains T3, T4, T2, T1 and calitonin so you're getting all of the hormones not just one or two :)

1 like

Some links for you to read on the subject of dosing :

As you can see, the protocols for starting to take NDT are not all the same. If you are relatively healthy (other than thyroid issues) - no heart problems, for example - then I would follow the protocol in the first link. If you are elderly or suffering severe health issues I would go with the more conservative protocols in the 2nd or 3rd link.

Some comments :

You will often see people referring to "grains" when talking about dosage of NDT. Depending on brand this is usually either 60mg or 65mg of NDT. So you have been prescribed 1 grain of NDT per day.

60mg Erfa is roughly equivalent to 75mcg - 100mcg T4, depending on who you read. Personally, I believe it is closer to 75mcg rather than 100mcg. So even when you take all your Erfa you may be quite under-dosed.

Different people do well on different brands of NDT, so if Erfa doesn't suit you don't despair, there are others to try.

Don't forget as well, that there are other options open to you - a combination of T4 and T3, or T3 only, or any other combo of NDT, levo, and T3.

1 like

Great, thanks for all that.


To be honest I stopped my levo for 2 weeks before starting NDT. It was easier to start on a low dose (1/4 grain) and build up over a few weeks.

1 like

Hi Katepots, just wondered how you're getting on with Erfa. I have recently seen a private Endo in London who recommended 2 lines of treatment for me (I'm 61) and I have opted initially for the NDT option and he prescribes Erfa. It will be arriving in the post on Tuesday this week, so I'm kind of excited and a little nervous at the same time. I've been taking Levo 75mcg for some years, tried increasing to 100mcg recently (and once some years ago) but can't tolerate it.


Georgina (Bedfordshire UK)


I really liked it as my hair stopped falling out, I eyelashes grew back and generally I felt much better BUT sadly I was allergic to the filler and gave me horrendous itching and rashes. I've bought Thyroid S from Thailand now but it doesn't seem quite as good although no itching.

Erfa should be great for you as long as you're not sensitive to the filler.

NDT definitely the way to go.

Good luck.


Hi Kate

Many thanks for your reply. Strange about the filler causing a problem. I have already looked at the ingredient list and think I should be OK with it, but you never know. But Thyroid S has quite a lot of additives / colours? I'm more concerned with how I react to the introduction of the T3 within the NDT. Currently Im taking 75mcg Levo and have been for a while, but last blood test taken when I was at the Endo clinic showed my T3 is pretty much at the bottom of the range and T4 at the top, so there's obviously a conversion problem going on with Levo. And I feel its a positive step to at least be doing something about it, rather than keep making GP appointments where you tell them you still feel unwell and they pretty much tell you none of its thyroid related. But they've never actually tested T3 at the surgery!


T3 for me is the answer I'm sure once I find the right brand. Felt better almost immediately so such a shame I was allergic to Erfa. The first few days I had a few palpitations but soon settled. Really hope you adjust quickly too.


You may also like...