ERFA I think my Endo's recommended starter dose is a bit too low?

[Caprice123]

Hi everyone. As my T3 (liothyronine) has been stopped, I went to see a private endocrinologist, who has prescribed Erfa or Armour. I opted for Erfa as it was the cheaper option. My endo has said 30mg a day, increasing to 60mg a day after 4 weeks. I thought this a bit low, as did the chemist who will dispense the Erfa. The chemist felt i should start at 60mg a day. I was taking 125micrograms of levothyroxine and 20micrograms of T3. I'd been taking this combination for 10 years and always felt well on it. When I was on levothyroxine only, I felt very depressed and suicidal and very tired as well. In blood tests myT4 was always so high and my T3 so low. After taking the combination dose my depression and tiredness lifted and I felt well.

So my question is, would 30mg Erfa a day be too low to begin with? I intend to see how I go. I expect some hypo symptoms returning as my body adjusts, but I have thoughts of not being able to get out of bed in the morning if the Erfa dose is too low. Any advice from you all would be very much appreciated. I am 75 years of age. Would that be an obstacle as to taking a slightly higher dose of Erfa? Thank you.

[Clutter]

Caprice123,

You will be wildly under medicated on 60mg, let alone 30mg, Erfa. An equivalent dose to 125mcg T4 and 20mcg T3 is 180mg Erfa.

I think it is a mistake to switch from your current medication if you feel well on it.

[Caprice123 in reply to Clutter]

Hi Clutter. I didn't have a choice. My doctor says it's far too expensive and took it off my prescription list without warning. He said the Society of Endocrinologists said it has been proved T3 is of no known help in treating the thyroid. He also said it was costing their budget over £3000 per year per patient. So, left me high and dry. Thank you for your advice. I'll start on 60 mg a day and increase by 30mcg after 2 weeks. I'm seeing the endo in January and since I haven't received the Erfa yet, I can afford to increase the dose slightly. The prescription is for one 30 mg by 3 months. I am surviving on some T3s I hoarded. I really can't afford Erfa, as I'm a pensioner. I'll have to cut back on heating, I think or, if the Erfa works wonders, I might look for a part time job, though who will employ me at 75 years of age? Maybe, Sainsburys?

[Clutter in reply to Caprice123]

Caprice123,

Funny how doctors weren't banging on about how useless T3 is when it was reasonably and affordably priced. I think it's shocking your GP is considering his/her drugs budget instead of your well being.

It will be a lot cheaper to buy Tiromel or Uni-Pharma T3 than switch to Erfa.

[Caprice123 in reply to Clutter]

Thank you so much, Clutter. I will immediately search the two you suggest. I'm in a dilemma at the moment. I think I would prefer T3 as I've been using it for 10 years with no problems. I've complained to the NHS about the doctor stopping my T3. I'm already not well and I feel putting me on thyroxine only, will not help matters. I get very high T4 readings and below average T3. I have a conversion problem. Thanks, again.

[puncturedbicycle]

I've sent you a pm.

[psue]

Hi Caprice, I would say you could manage 60mgs or 1 grain of ERFA Thyroid since you have already been taking both T4 and T3 in a higher dose. Increasing every 4 weeks is appropriate but I would say you could increase your initial dose for sure.

If you felt the dose was too high once you have taken it then just reduce again and your symptoms will subside within a couple of days without any major issues.

Is your Endo in the UK? Is a private prescription very expensive; since my NHS NDT prescription is being stopped too

[Caprice123 in reply to psue]

Hi Psue. Thanks for your reply. As you can see I'm going to try buying the T3 first, then if no luck I'll try the ERFA in the dose you suggest or even higher as Clutter has suggested. I had to see a private endocrinologist to get my private prescription and that set me back £100 or my husband, as he paid. I'm in the UK. I'm panicking because I know how ill I felt on thyroxine only. So I'm going to have to pay for an alternative.

I'm sorry to read that your NHS prescription is being stopped. How very callous of doctors. Some sites give you an option to get a prescription off them, but I'm not sure of the cost. I didn't know otherwise I wouldn't have paid the £100.