Splitting EFRA Thyroid?

[GarryB]

Yesterday my doctor prescribed 60mg (1 grain) of EFRA Thyroid as a starting dose. I read I am supposed to raise this by 30mg (1/2 grain) after two weeks.

I assumed I could just split the 60mg pill but my Dr. told me the pill can only be split if it has a score line. The pill doesn't have that line.

But the first pill I took today - by melting it in my mouth - felt the same all the way through so I assume it's structure is homogeneous and surely it can be split reliably?

Can anyone comment please? Thank you.

[silverfox7]

May be he means can only be split accurately. I take Thyroid S which is pretty hard to split but with a good pill cutter and a little practice it's not too bad. Ok not spot on but not noticed any different between one day and the next. As I kept forgetting my afternoon dose and I wasused to the T3 I tried taking mine all in one go as that's how I took my NDT a lifetime away. It doesn't suit every one but it works for me.

[phoenix23002]

I am in the US and you certainly can split your Erfa. I took Erfa for 3 - 4 yrs (from Canada) when Armour went nuts a few years back. As silverfox noted, get yourself a good pill splitter and you should be okay.

[stoneym]

I cut my Erfa into 4 using a pair of good quality scissors and I cut my T3 into 6 pieces - as I slowly built up my dose. They cut easily .. maybe not totally accurately but it's not made any noticeable difference.

[GarryB]

Thank you each. This is good advice. I'm sure I will be able to split the pill very close to half with my splitter. I have had good success splitting other pills.

The only problem I can see is when the pill has been split the interior will be exposed. The intact pill has a smooth shiny exterior. Hopefully the split pill won't degrade or off-gas through the exposed part. I am doubtful the remaining bit would deteriorate in one day.

[fixit]

I have been on Erfa for 3 years & I split my pills.

[GarryB]

I am really impressed with EFRA. I wrote to them asking about splitting pills and received a response. I guess they are not so big that they can't respond to customers.

"Thyroid tablets are not scored and we do not have data to support splitting them. This means that we cannot guarantee that you would have exactly half of the dose in both halves. However, despite this, some patients use a pill cutter and split them in half."

This is exactly what I would have expected them to say. Their concern is they cannot guarantee the same dose in the split parts.

But I have no worries about splitting now.

[phoenix23002 in reply to GarryB]

You will be fine, GarryB. Some of us have stock-piled NDT meds, as much as a year ahead and there is usually no degradation or weakening of dosage as long as they are kept cool and dry. (Some of us keep extra in the freezer divided into small packets.)

[GarryB in reply to phoenix23002]

Thank you! To be clear freezer means freezing them rather than refrigerating them? Freezing them might cause frost build-up or freezer burn long term? Dividing them into small packets is for convenience? Sometimes my office reaches 30C - would this temperature bother them? My other room where I would keep them doesn't reach that temperature. Thanks!

[phoenix23002 in reply to GarryB]

We are farenheit here in the states so.... not sure what 30C is??? A 3 - 6 month supply can be left out at comfortable room temperatures with no problem.

Yes... freezing. If you freeze NDT, always package in multiple freezer baggies and thaw them out slowly. Haven't had a frost bite or freezer burn problem yet. The small packets are so you can remove one small pack at a time and leave the bulk of the packets undisturbed in the freezer.

[helvella in reply to phoenix23002]

Type 30 c in f into a search engine (works with at least Google) - will convert instantly.

Answer: 86 F.

[GarryB in reply to phoenix23002]

30C is 86F. Is that too hot?

Freezing. Got it. Packing in multiple Baggies. Got it. That makes sense. So I think I would thaw it by taking from the freezer and putting it into the refrigerator? And then the room?

Sorry for so many questions. I want to maximize the success I have with this medication.

Thank you!

[helvella in reply to GarryB]

There is a big difference between have a few tablets in your office and storing your whole year supply there. A few days at 30 C is unlikely to have much impact. A few months might...

If you are considering freezing, it is vital that the packaging is absolutely and completely moisture-proof. Not just liquid water but vapour.

[GarryB in reply to helvella]

Thank you. In Canada we have something called ZipLock bags and while they surely are water proof I have no way of saying they are vapor proof. I would assume they would be but will look into that.

To clarify, we are trying to keep moisture from entering the bag and degrading the NDT or we are trying to prevent the NDT from off-gassing and losing efficacy?

[helvella in reply to GarryB]

Thyroid hormone degrades due to oxygen humidity and light. So you are also trying to keep oxygen and water molecules out. But you also do not want whatever its current water content to change.

The low temperature and the darkness (I assume!) will help but only if well sealed.

There is little published on the details of desiccated thyroid storage.

[GarryB in reply to helvella]

This is super information. Thank you. I'm going to look up long term medicine storage solutions. I bet there are solutions made or described. But I'm not planning storing past a year so maybe I don't need to get too intense over this. Thank you again.

[phoenix23002]

Garry... I store my NDT in the freezer in the manufacturer's original packaging.. usually 100# tabs per bottle and they are factory sealed. I wrap each one individually in several of the 'freezer' labeled quality ziplock or handy bags, sqeezing as much air out as possible. I bet one of those seal-a-meal machines would work great. lol. I then remove one bottle at a time as I need them. I think I just leave them out at room temp but don't try to rush the thawing process (like microwaving... bad !!!).

I think storing in the fridge for a short time (a few months if tightly sealed up) would be okay but most fridges remove excess moisture, right? And you don't want the NDT to get dehydrated and stale I would think.

Here is a post from the STTM (Stop the Thyroid Madness) site re: NDT storage...

"Any other tips?

Many patients are keen to having an emergency backup of desiccated natural thyroid just for that–emergencies! Desiccated thyroid has a long shelf life, but you can also wrap it securely to avoid damaging moisture and place it in the freezer or refrigerator door.

"

stopthethyroidmadness.com/n...

Oh.. and your 30C should be fine (thank you, helvella... I'm lazy today? ..lol).