Does Erfa take a good while to get into your system? 3 weeks in and feeling rubbish

[bettyspagetti]

New to Erfa...need advice , I have just started ( 3 weeks ago on Erfa-90 mgs-1 and a half grains) after seeing a private endo and feel worse than before. Has any one had an experience of changing meds ( from Levothyroxine) to Erfa and can you let me know if this got better over time. I m only literally about 3 weeks in and wondering if I m expecting too much too soon. I wasn't that impressed with the endo but just wanted to try NDT to see if it helped as felt exhausted on Levo for years.

[Lalatoot]

You have gone on too high a dose too soon. Half grain of 30g efra contains 4mcg t3. That is the starter dose. Stay on it for a week or two then add another half grain and if ok after 2 weeks add in another half grain either as a complete dose or doses throughout the day. On that basis you would take at least 5 weeks to get to your current dose. The body needs time to slowly adjust to the t3.

[waveylines]

What were you on before? You can do a dose equivalent switch. There is no need to start from scratch....though some people prefer to start of with a little less because of the T3 in a ndt.

[Ratkinson]

I’m about 3 weeks in too ( from 100mg of levo) . I increased to 1 1/2 as instructed by my endo and felt really rubbish, after advice on here I have reduced to just 1 grain a day and I still feel rubbish. I particularly have really bad sinus type headaches ( constantly) which I have googled and they are linked to hypothyroid, but my hands have the shakes which suggest hyper!

I’m going to stick at 1 grain for a week more and see what happens.

I keep wishing that I had stayed on levo , keep posting so I know how you are getting on please .🙂

[pennyannie]

Hello Bettyspagetti

Well it took me 5 weeks to reach 1 + 1/2 grains of NDT :

I switched from 125 mcg T4 to 1/2 grain NDT the following day and increased by a 1/4 grains each week.

When I got to 1 + 3/4 grains I felt anxious and edgey and not as good as the week before so dropped down to 1 + 1/2 grains and stayed on this dose for 6 weeks and then took a blood test to see if my T3 had moved fro my bench mark numbers.

It had, my T3 was coming in at 110% and my T4 at 25% the exact opposite of my results when on T4 only.

I wasn't hyper in any shape or form and my temperature rose from 35.4 to 36.6 and my pulse and blood pressure daily readings remained stable.

I think you may have gone too fast too soon as it takes 6-8 weeks for the T4 to fully leave the body and as your T4 declines you slowly build up the NDT hormone replacement .

I now just run a yearly private blood test more to track my vitamins and minerals than my level of T3 and have been on this dose over 3 years and run myself slightly hypo.

[osokaki in reply to pennyannie]

Hello Pennyannie,

The 1 and half grain you are describing how much mcg is it? 30mcg per grain?

[pennyannie in reply to osokaki]

The NDT I take states 1 tablet/grain is 60 mg so I take 1+1/2 tablets so that's 60 + 30 = 90 mg daily :

[bettyspagetti]

Well thanks everyone. I ve weirdly felt better for the last few days …but I do have an upset tummy just very crampy ….. which could be unrelated ! I m going to keep with it and see if this new energy continues. Fingers crossed

[jamesal0]

No NDT is almost instant if you get dose right. But this is the hardest part. Follow the NDT protocol you will be fine. Start on half a capsule (30mg) take it with food, and lots of water or coffee. Then see how you feel for the rest of the day. If you feel like your energy levels plummet at 4pm, take half of a half (15mg) again with food. Then repeat the following day. Do this for a few weeks and slowly slowly add more (15mg ) . Repeat. At some point you will go hyper and get heart palps, now you have gone too far, have a rest from the stuff for a day and then return to the dose you were on last week. Keep attempting to increase from time to time. You need to eat with NDT as it slows/delays the release of the t3 component and also stops it burning a hole in your stomach. Yes you loose a tiny percentage but it doesn't matter as you are tuning your dose daily to what you actually absorb/need. You will get slight tingles (hands / feet /groin) 30min after dosing, again this is a sign of being on the money with your dosage.

[helvella Administrator Thyroid UK in reply to jamesal0]

You need to eat with NDT as it slows/delays the release of the t3 component and also stops it burning a hole in your stomach.

That is an extreme claim. Which could cause huge concern in members.

Please provide references to back it up or your reply will be deleted.

[jamesal0 in reply to helvella]

Personal experience and as I say if you are using daily symptoms to guide NDT dosage you will get it spot on - my blood tests are perfect. Re "burn a hole" in you stomach - if I take NDT twice a day on an empty stomach I'll have reflux in no time. And I see plenty of HealthUnlocked contributors complaining about this and nobody is putting two and two together .

[helvella Administrator Thyroid UK in reply to jamesal0]

"Burn a hole in your stomach" is MAJOR CATASTROPHIC damage. It would likely require other factors than simply taking thyroid hormone (in any form). Such as gastritis.

Having reflux says little about the stomach itself - probably far more about the lower oesophageal sphincter. And, yes, it is important and needs to be addressed.