Armour or Erfa - would like input from others

I have been considering going back on either Erfa or Armour which I have a prescription for. The reason is that I feel that Thyroid-S has been weaker and more inconsistent lately, but that could be due to other things such as cortisol deficiency.

Also, more generally, I'm worried about what's happening to Thai NDT - one brand has already been discontinued, Thiroyd seems unavailable ATM as well, and I don't like relying on one single brand that may or may not continue to be available.

I have not been on prescription NDT since 2014. I took Armour from 2011-13, then it became unavailable and I switched to Erfa which I never found great. That was right after the STTM reported problems with it.

As far as I recall, I did OK on Armour, but probably never worked myself up to the dose I need for complete symptom-relief. I remember chewing the pills up to break down the cellulose (as recommended by STTM) and that may have helped as well. Anyway, I don't remember it being so disastrous as reported by STTM...to me, Erfa was worse. But that could be due to the fact that switching brands can mess you up, so not entirely sure that was all Erfa's fault...

I have been in touch with two Belgian pharmacies and they carry both brands.

My doctor claimed that Erfa has been reformulated to have lactose removed, and that's the reason the pills now look different. There are photos on the STTM showing two different pills, one (the "reformulated" one) looking more blotchy than the other ("old" Erfa), but removing lactose would make it work better, rather than worse...so not sure my doctor is right about that. She claimed the lactose is what made "old" Erfa white, and removing it made the pills more grayish.

Anyway, I'd be interested in input from those of you on either or Armour or Erfa (no other brand of NDT is available in Belgium). Is Armour working better now than right after the unappreciated 2009 reformulation (there is some anecdotal evidence it is although I don't understand why)? Is Erfa still problematic? I don't trust everything the STTM says (according to them, there seems to be a global conspiracy against NDT going on) but, given the price of prescription NDT, I'd like to hear about other patients' more recent experiences before I decide to try it again.

[Valeriu]

This may not be helpful to you but I was happy with NP by Acella; Now taking Thyroid-S and have a pounding heart (which may be due to an increase of T3 from 5mcg to 10mcg) - still experimenting; Good Luck ! I also was prescribed Erfa ....heard that Armour is still one of the best however....

[Hidden in reply to Valeriu]

Yes, I have not been able to find many critical reviews of Armour in the past few years...they seem to have disappeared a year or so after it was reformulated. Many people still seem happy with it.

I remember the STTM being upset about the increased cellulose content making it impossible to take sublingually, but I have never taken NDT that way so that is not a problem for me. Cellulose is a common filler in drugs so not sure how accurate the STTM claims are that it inhibits absorption of thyroid hormone.

Unfortunately, no other NDT drugs than Armour and Erfa are available in Belgium, and all US suppliers of NP or WP that I've been in touch with require a prescription for that very brand which I cannot get from my doctor.

Now that you mention it...I have also noticed my heart beating faster lately. At the doctor's office the other day, 88 bpm which is a bit fast...not sure why. I read recently that Thyroid-S has allegedly been reformulated somehow and that some users are less happy with it since, but there are always rumours like that floating around so idea if they are true...besides, low cortisol can cause your heart to race when on thyroid hormone, especially NDT or T3, so not sure it's related to Thyroid-S. But it's interesting that you experienced the same thing!

[Valeriu in reply to Hidden]

I don't have a prescription for NP but manage to still buy it from a US Pharmacy (not allowed to mention here so PM if you like, but is expensive). I had Propranalol at hand but manage to fall asleep without it; As I wear earplugs at bedtime the heart pounding bothers me at night as I hear it better....I didn't dare take my 4 Flu Benylin as it has a decongestant and know it'd have made my heart beat faster too....it's been like that since increasing the T3 to 10mcg (2x 5mcg per day) (I stopped the Adrenavive II cortex that raises the cortisol levels because even that affected me a little so didn't want to make matters worse...maybe I should restart it . I'm also taking LDN at night and they gave me the liquid instead of the sublingual drops so it might be that too....I will see if it is as from tonight I have the sublingual LDN drops....only the pounding happens during the day so it's more likely that it's the T3....Good luck to us all here !

[Hidden in reply to Valeriu]

However, I just checked with the pharmacy, and although all NDT is expensive, Armour is much more expensive than Erfa...I'd end up paying almost 700€ more for it than for Erfa (the prescription is for a year's supply at my current dose - 4 grains daily). I simply cannot believe it's worth that much more...!

[Valeriu in reply to Hidden]

Yes my private Dr suggested Erfa too but I kept buying NP by Acella from US...However you can still get NP from US if you wish....Good Luck with whatever you decide

[Hidden in reply to Valeriu]

Thx

[C70rol in reply to Hidden]

Hi, Ive been on Armour since 2015 ( after it was reformulated), and it's been fine for me !!!!

However I do get it prescribed for me by my G.P, who was recommended to give it to me by the endo.....so I don't have to pay for it YET!

But my GP fears that it may be blacklisted in the not too distant future by NICE ! So I will have to pay for it, when that happens !.....

Good luck with your decision !!!

[Hidden in reply to C70rol]

Well, I checked with two Belgian pharmacies carrying NDT, and they quoted the same price: at my current dose, a year's supply of Armour will cost me 2200€, Erfa "only" 1500€...I cannot imagine Armour is that much better...!

I don't understand why Armour has ended up being far more expensive than other NDT drugs. After all, they all contain the same raw material, and only the fillers differ.

My health insurance does not cover NDT as it's considered organ therapy. That was the main reason I switched to Thai NDT five years ago. However, my latest batch of Thyroid-S has not worked as well, and I've seen several hypo symptoms return since starting on it. That's why I thought of giving either Armour or Erfa a try.

A member provided a link to a seller of other NDT brands such as NP and WP, shipping from the US: However, when I looked up the country restrictions, I saw that in most countries except the UK, prior approval by the Ministry of Health is required to import NDT, and I don't have that. When Belgian doctors prescribe NDT they give you a medical declaration form stating that you cannot be adequately treated with levothyroxine, but that is hardly the same as an approval by the Ministry of Health so maybe it would be safer to stick to Armour and Erfa which I can buy legally in Belgium...

[Howard39 in reply to Hidden]

Hi

I switched to thyroid s due to the cost. I’d say armour is ever so slightly better but I found thyroid s fine. That said I’ve not used the latest two bottles as I have enough for 2 years. Hopefully I’ll not encounter any in due course 😩( sigh!).

If money was no object I’d definitely have the armour though.

My adrenals are under control.

My specialist stocks nature throid which I found v weak. For me 5 grains of that equals 3 of armour of thyroid s.

It’s a pity we can’t all have it on the nhs in the UK.

It’s good you can legally buy two types of ndt though.

[Hidden in reply to Howard39]

OK, thanks! It's really difficult...Armour is much more expensive than other drugs so not sure it's worth it TBH...but at least it seems to work. I'll just have to decide if I want to pay 700€ more for it...

Out of curiosity: how did you take Armour; did you swallow it or crush it first?

Has anyone had success with Erfa?

[Howard39 in reply to Hidden]

Hi

Oh I chew everything whether or not you are supposed to lol. I find it gets into my system faster.

Thinking about it a year back I noticed a slightly different taste to the thyroid s ( sweeter) but no difference in how effective it was.

I tried metavive, thyroid, nature throid, TR man( that was good but now discontinued) then armour but returned to thyroid s as my supply of armour ran out.

Sorry I’ve not tried Erfa only because I did not know where to obtain it from.

I must say my initial t3 when first tested was nil and my free t4 7( 12-28). My thyroxine dose was 300 with 25 liothyronine. ( the max my gp would allow me.) After the liothyronine was removed due to cost I was v pleased to be well on three/3.25 grains as it’s a huge reduction in amount.

I’d say it’s worth a try of the Erfa. You can always swap back. I fully understand about the reliance on one ndt. I am definitely never going back to thyroxine though, no more nasal infections.

Good luck.

[Hidden in reply to Howard39]

Thanks! At least it's good to know that some do well on Armour after all the negative things that have been said about it since the reformulation.

[C70rol in reply to Hidden]

I have to say that I'm one those people who had no 'negativeIf problems' since Armour's reformulations and if it's any help Dr Peatfield once said to me that In his opinion Armour is still the best in the world .

[Hidden in reply to C70rol]

Ok, thanks, good to know! Most of the criticism comes from the STTM where they more or less encouraged people to boycott Armour after it was reformulated...the main problem IMO is the cost, but maybe it's worth it...

[Hidden in reply to Hidden]

PS. This is strange; please remember I have been on Thai NDT for five years so not sure how it works, but I just looked at the prices of Armour (Belgium):

4 bottles of A 30 mg 500€

4 bottles of A 120 mg 920€

4 bottles of A 60 mg 560€

Sorry if this sounds like a very stupid question, but would it not be better to order the larger pills and split them if need be, rather than ordering bottles of 30 mg pills...?! The latter seem disproportionately more expensive.

[C70rol in reply to Hidden]

Well yes, the idea is a good one, and I have cut Armour pills quite successfully, but I've only cut them in half , I haven't tried cutting them into quarters, if you happen to need that at any time !!

[C70rol in reply to Hidden]

Oh, I do appreciate that, and I think that if my GP suddenly tells me that he can't prescribe Armour for me anymore, I would still buy it, as it's been good for me....And I have a very sensitive system , it's not happy being messed about !!!!

[Hidden in reply to C70rol]

True! The pharmacy offered me to mix Armour and Erfa as Erfa 125 is currently out of stock worldwide, but I prefer to try one brand at a time rather than mixing brands...