Immediate change over from Levo to ERFA - Thyroid UK

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Immediate change over from Levo to ERFA

Cecilbenhard profile image
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I have just, 5 days ago, done an immediate change from 25 mg of levothyroxine to 30 mg ERFA. I am waking with bad headaches - any thoughts or advice? I have been very sensitive to doses of both levo and lio in the past.

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Cecilbenhard profile image
Cecilbenhard
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helvella profile image
helvellaAdministratorThyroid UK

The dosing of thyroid hormones is usually in micrograms (mcg) - not milligrams (mg). :-)

But the dosing of desiccated thyroid is usually milligrams (mg) or grains.

The document linked below says it all, I hope:

dropbox.com/s/q00vyt5703f4u...

Harlech profile image
Harlech

Hi. I don't think I will be able to give you advice as my gp has been sending me in circles long story. I first started on 25 every other day 5 months later seen endro, he said take every day, & just few days ago had phone conversation with another endro & with some insistence I was give the ok to increase to 50. My first levo was "mercury pharma" but after 3months suffered severe joint pain so changed to "teva brand" so now I have to wait & see if the increase helps, & have more bloods done around the new year hopefully.

If possible could you PM me reference to ndt.

pennyannie profile image
pennyannie

Hello Cecilbenhard

I swopped overnight from 125 T4 t- Levothyroxine to NDT at 1/2 grain :

I read that it's recommended that you start with 1/4 grain for one week, but I had trialled T3 with my T4 successfully, and being with thyroid ablation was confident to start at 1/2 grain :

As I understand things, you start low and slow, and initially need to run a blood test for T3 and T4 so you have bench mark figures to compare to :

You will need to monitor your blood pressure and temperature daily and you should ensure that your ferritin, folate, B12 and vitamin D are all at good optimal levels in the ranges, as no thyroid hormone replacement works well if your core strength isn't strong and solid.

Slowly, over a period of weeks increase your dose of NDT by just a 1/4 grain weekly :

When and if you reach 2 grains you hold that dose for 6-8 weeks and then take a blood test.

Your TSH will be low/suppressed your T4 probably lower but your T3 should be higher than the bench mark numbers you started with, and if your T3 hasn't risen this treatment option may not be the best option for you.

There should be some relief of symptoms and if happy with your progress you continue raising in 1/4 grain increases weekly until a week arrives when you feel different, maybe nervous, anxious, just not you, so drop back down to the your previous dose and this is your dose on NDT at this juncture.

However with NDT you dose to the relief of symptoms and not a blood test result.

NDT was the successful treatment for hypothyroidism for over 100 years prior to blood tests. The blood tests and guidelines were introduced to be used alongside the new thyroid hormone replacement Levothyroxine launched by Big Pharma in around the 1970s.

I read you have Hashimoto's so this does throw a bit of a spanner into the works.

When your immune system attacks your gland, your thyroid goes a bit haywire and you may well experience symptoms of " hyper " at this time but it is transient and then your thyroid calms down and the symptoms reduce. However with every attack your thyroid becomes a little more damaged and it's production erratic - so you may well find that over time you'll need to increase your thyroid hormone replacement to compensate for your own thyroid's declining production.

I read that some people can sense a " hyper " phase coming on, so drop down on their replacement dose a little, so this " hyper swing " isn't as full on and off set a little and the symptoms experienced not so acute.

I hope that's helped explain things a bit for you, I'm with Graves post RAI thyroid ablation and now manage lingering Graves, thyroid eye disease and hypothyroidism, and take NDT.

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