Thyroid UK
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question to those currently or previously on Erfa

I have a prescription for Erfa about to expire, and before I decide not to use it, I would like to put a question to those of you currently or previously on Erfa:

The company denies any reformulation, they just admit to moving manufacturing from Belgium to Spain, which is obviously when all the problems started. From photos on the STTM, it seems the pills now look different compared to what they looked like when they were being manufactured in Belgium.

However, the pharmacy in Belgium where I order NDT told me they don't stock Armour anymore, as there is no demand for it, whereas Erfa is very popular and they have to keep reordering it constantly in order not to run out.

It seems all the Hertoghe doctors in Belgium switched to Erfa when Armour was reformulated, and are still prescribing it.

All this makes me wonder...after all, I have a valid prescription for Erfa, renewed each year, so why go through all this trouble ordering NDT from Thailand...? On the other hand, if Erfa really isn't working (or is inconsistent, as many claim), I'd prefer not to waste a fortune on it.

STTM said a while ago that, hopefully, we will not see the bad batches again in the future...implying it was just a temporary problem. But I fail to see how that could be the case...? After all, the pills are still being mfg in Spain, aren't they?

Also, the STTM seems obsessed with the ability to take NDT sublingually. If a drug cannot be taken that way, they seem to dismiss it. I don't take NDT sublingually anyway, so that is not an issue to me.

So, my question to those having taking Erfa before and after something apparently happened to it, is: did your lab results change, the way some say their FTs dropped on Armour after it was reformulated to contain more cellulose? Or did you just feel different, less good, while your FTs remained the same?

8 Replies

I had taken Armour successfully for years and years. Then the reformulation and shortage happened and a lot of us were suddenly scrambling to find any Armour or a satisfactory substitute. Thanks to the STTM site (this was back in 2010 or 2009), I found Erfa and Universal Drug. Universal Drug did require a prescription and I was so leery ordering from a Canadian pharmacy but, thankfully, it all worked out and the Erfa was almost identical to my 'old' Armour. I was a happy camper with Erfa and ordering from Canada for about 5 yrs or so.

Then Erfa changed. Again, I was scrambling to find an alternative. I tried 'em all... Thiroyd, thyroid s, WP, NP, Naturethroid etc.... Finally settled on WP and am quite happy with it. The NP was terrific also. The 'new' Erfa left me dizzy and nauseated after a week or so at my normal dosage. The Thailand NDTs also didn't do the trick.

A poster on the STTM Erfa site noted that the 'new' Erfa made him hypo again but he tried mashing up the Erfa between two spoons and it worked. He was able to take a dodgy product and find a way to make it efficacious. Maybe try a small order of the Erfa and take it whole and see how it works for you? You should know within a few days or week. If it isn't working for you, try mashing it up, making it as powdery as possible and see if it works that way for you. We are all so different and can react in different ways to the very same product. So... there is no absolute yes or no answer that suits everyone.


I know...thanks for this suggestion. I wonder why Erfa won't admit to changing the product, although there are thousands of patients all over the world reporting the same thing...?

It's a bit surprising Thai NDT did not work for you, as most online reviews are glowing...but I'm glad to hear you've found something that seems to work well for you.

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anna... I am so sensitive to things so not surprising, especially with the thiroyd (lots of fillers/additives) brand that I would react negatively to the Thailand brands. I sure wanted them to work since they are so affordable.

Frankly, I don't think the powers that be in Canada are deliberately lying about

changes to Erfa. Chemically and in a lab, I think Erfa checks out to be exactly

what it is supposed to be but... I think the pressure applied when stamping out the pills, the coating and maybe even the way the tablet is assembled may be different from the way the tablet was manufactured in Belgium. And where are the specks coming from, the specks that are readily and obviously apparent in the 'new' Erfa?

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Good suggestion.

Chewing the pills up before swallowing has been suggested for pills containing cellulose (Armour, Naturethroid). However, as far as I know, Erfa does not contain cellulose, and some claim chewing the pills up will make them work less well (just like take them sublingually will)...not sure if there is a difference between chewing the pills up before swallowing and letting them melt under the tongue?

It has also been suggested taking cellulase with pills containing cellulose (it seems the former breaks down the latter), but I doubt that would work with Erfa as it does not contain cellulose.

Anyway, what strikes me is that nobody here seems to be doing well on Erfa nowadays...or is nobody taking it anymore? A few years back, after Armour was reformulated, everyone seemed to love Erfa, and now nobody seems to want it anymore...I cannot help but wonder if the Hertoghe doctors will start prescribing another brand soon, just like they switched to Erfa after Armour's reformulation...

However, what worries me is that there are no guarantees that other manufacturers won't reformulate their products in the future, or move production to a more modern facility, etc. So even though a particular brand works great today, it may not in a year or two...that is what happened to both Armour and Erfa, after being loved by millions of thyroid patients all over the world...

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Anna... wish I had some answers for you but I don't. I don't think anyone dare project what mfgs will do in the future. And, of course, all things simple and natural are under fire from main stream medicine nowadays.

I do take my NDT sublingually and have for years and years. I think the answer to whether or not to let NDT dissolve/chew up is just to be consistent with whatever method one has for taking NDT.

If I had NO choice but the 'new' Erfa I would pulverize it to within an inch of it's in order to free the active ingredients in the product since some have reported good results with that protocol.


I know, and it was more a rhetorical question than anything.

What scares me a bit is that, when Armour was reformulated a few years back, the STTM started singing Erfa's praises. It was the best drug in the whole world, without comparison. And so on and so on...then, something happened to it as well.

Now, it seems WP Thyroid is the best world in the drug (according to STTM), along with NP Thyroid. But what if one of those manufacturers ever decided to move production to another facility or, God forbid, replace one filler with another...? I have stopped caring so much about what the so called best drug is, because that seems to change quite often...

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NDT isn't forumulated to be taken sublingually. The molecules are too large to be absorbed through the tongue, so therefore I'd imagine they'd have to take a larger dose than normal if they've to feel well. All thyroid hormone replacements have to be taken with one full glass of water and wait about an hour before eating.

If you think there's been a change in the forumula maybe try taking an anti-histamine one hour before Erfa and see if it has an effect. Some people are sensitive to something in the fillers/binders.


Been on Erfa for a yr. Ordered a yr supply beginning 2017 then reordered at end of year and is reformulated makes me feel over medicated on a lower amount 😒sent it back and now it is out of stock in Canada so hoping it will go back to pre-reformulation once back in stock we'll see, one can hope. This is so awful every brand is becoming messed up and there for we all are left sick.


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