Switching to NDT (Efra) - good idea?

[Beachcombe]

I’ve been in levothyroxine since 2008 and never felt great - bad days outnumbered good, one illness after another, etc etc. I’ve heard that people can feel better from taking NDT so I’ve found an Endo who will prescribe me Efra. He’s a very established Endo so I feel confident in his expertise. I’m wondering what other people have experienced switching to NDT as I’m a bit nervous now. I want it to work so much and I’m paying for it out of my savings it feels a bit scary. Any advice very welcome 🙏

[pennyannie]

Hello Beachcombe

Natural Desiccated Thyroid was successfully used for over 100 years to treat hypothyroidism prior to the introduction of the blood tests, ranges, and guidelines introduced alongside the launch of Levothyroxine, by Big Pharma , as a better, more improved thyroid hormone replacement in the middle if the last century.

NDT is pig thyroid dried and ground down into tablets referred to as grains with each grain containing all the same known thyroid hormones of that of the human gland : viz : trace elements of T1. T2. and calcitonin plus a measure of both T3 and T4 :

In order for any thyroid hormone replacement to work well it is essential that you maintain your ferritin, folate, B12 and vitamin D at optimal levels, so this might be an area to check out before switching.

T4 - Levothyroxine is a storage hormone and needs to be converted by your body into T3 which is the active hormone that the body runs on. T3 is said to be about 4 times more powerful than T4 with the average person utilising about 50 T3 daily, just to function.

Some people simply need a little T3 to kick start their metabolism and use a T3/T4 combo dosing both Liothyronine and Levothyroxine independently to find their " sweet spot " :

NDT has a fixed ratio of T3 and T4 in each grain, generally on a 1/4 ratio T3/ T4 with most grains having a T3 of around 9 mcg and a T4 of around 38 mcg.

You dose NDT to the relief of symptoms and in my experience your TSH will go low suppressed, your T4 low in the range with your T3 higher in the range than when on T4 Levothyroxine alone.

Yes, it is more expensive but once you feel confidant, happy and settled you can try sourcing product yourself with many of us on here buying from Thailand - though currently there is no quality stock NDT in Thailand but this situation should resolve in early 2021.

There is NDT in the USA but understand here too, brand availability somewhat restricted.

I switched from 125mcg T4 one day to 1/2 grain NDT the following day and slowly, weekly increased my dose by 1/4 grains : monitoring daily blood pressure and temperature.

I had also tried a combo of synthetic T3/ T4 and that worked but I feel much happier on NDT and for me, it's the difference between wearing shoes two sizes too small or slippers, and I've opted for the softer option.

I'm with Graves Disease, post RAI thyroid ablation in 2005 and became very unwell about 8 years on in around 2013/14. I failed in getting either NDT or T3 prescribed by my doctor and hospital and found myself on this amazing forum, looking for help, when referred to as a conundrum by my doctor.

Your previous post shows raised but not over range antibodies so it should be a smooth and positive transition moving over to, I my opinion the Rolls Royce of thyroid hormone replacements.

You have nothing to be scared about : you have an endocrinologist to lean on and you can always pop on here and check out anything that doesn't sit right with you.

[Beachcombe in reply to pennyannie]

Thank you for words of encouragement and detailed reply. I really appreciate you taking the time and yes, absolutely, this is an amazing site. I feel much more reassured. Thank you 🙏

[humanbean]

The NDT you are going to be prescribed is called Erfa, not Efra. It's always worth being very precise when discussing prescribed hormones or drugs.

[Susieibbo301]

Please could you pm me with the name of your endo? Thank you. Susie

[HashiFedUp]

Ive switched to Erfa and it suits me much better.