erfa / armour prescription

[Masjntt]

Hi

Is a GP able to prescribe either of the above on NHS if patient cannot tolerate Levothyroxine ?

Have found a private GP who would prescribe but I would have to self fund for life and I’m not sure I can afford to 😔

[1tuppence]

Most unlikely either would be prescribed on NHS these days. I am now on Erfa, but it is a private prescription.

[Masjntt in reply to 1tuppence]

Do you mind me asking how much that costs each month roughly please ? DM me if you prefer to xx

[1tuppence in reply to Masjntt]

It would depend on what you are prescribed. It would be best for you to know the dose, and then contact various suppliers to ask what they would be charging you to fulfil that. I get my Erfa from Springfield Pharmacy in Richmond.

[RedApple Administrator]

In theory, a GP is 'able' to prescribed desiccated thyroid. However, in reality, it's 99.5% unlikely to happen. Desiccated thyroid is very, very expensive compared to levothyroxine, so almost all NHS prescribing is prohibited for that reason. Plus, it's an 'unlicensed' medicine, which means that the prescribing doctor has to take personal responsibility for prescribing a medicine that is deemed to be unnecessary anyway.

[RedApple Administrator]

Masjnitt, your question may elicit private messages being sent telling you where you can buy NDT without prescription. Please be aware that scammers lurk here waiting to pounce on unsuspecting people. Do follow the advice in our post about this healthunlocked.com/thyroidu...

[Masjntt in reply to RedApple]

Thank you - I just wondered if there was an nhs alternative for people who cannot tolerate or who are allergic to Levo

Will be vigilant thank you ☺️

[tattybogle in reply to Masjntt]

basically, (barring anaphylaxis) , the NHS don't really accept that anyone 'can't tolerate' levo.

so they don't see any need to routinely provide any alternative .

[Sparklingsunshine in reply to Masjntt]

The other options are again a private prescription, we have several members who use Roseway Labs, based in London. They can both prescribe and supply Armour, Erfa. They have a very good pharmacist prescriber and its cheaper by far than a private Endo. I'm sorry I dont know how much they charge but maybe start a new post asking for prices, maybe by PM only.

Or have you considered importing Thyroid S from Thailand. Its made from pig thyroid, just as other NDT is. I dont know how it compares potency wise to Erfa. No prescription required, no doctor either. Its the NDT I tried years ago. I found it pretty potent.

So you would be self sourcing, but only paying for the grains. Its entirely legal to import meds for personal use. Again you could post asking for reputable, reliable sources via PM. This would be the cheapest option for continuing with NDT.

[pennyannie]

Following on from my previous reply -

First off - have you thought of asking for a trail of Liquid T4 on the NHS - and being referred to an endocrinologist ?

Both Efra and Armour are meant to be available on the NHS as a ' named patient only ' prescription -

but local ICB rules and financial constraints mean that as a ' new ' prescription you are very unlikely to get NDT prescribed as it is the most expensive treatment option.

If it helps you - most people need around 2-3 grains NDT a day -

You might like see how supportive your surgery and ICB area are compared to other area / surgeries in the country -

if you go into openprescribing.net you can see by surgery and / or ICB area -

just enter Armour as the drug and for T3 enter Liothyronine as the drug :

T3 - Liothyronine is another synthetic, cheaper than NDT and more easily prescribed but you'll need a referral to an NHS endocrinologist to be assessed - as you likely do anyway as you are not getting any benefits from taking the T4 tablets.

[Masjntt]

thanks both, I have an apt next week so will ask then.

Is there much difference between thyroid S, armour and efra as to which works best ?

I believe I have Hashimoto if that makes any difference xx

[pennyannie in reply to Masjntt]

No - they are all just different brands - all made from the same Thyroid USP powder - which is pig thyroid dried and ground down into a powder and then made into tablets which are referred to as grains.

Natural Desiccated Thyroid is the original treatment option for hypothyroidism and used successfully for over 100 years until Big Pharma launched their synthetic cheaper treatment options on the back of NDT in around the late 1950's and then went about gaining market share.

If using a compounding chemist - the powder can be suspended in capsule form thereby with very few of the fillers needed to make the powder into a tablet that can be chopped into 1/4s.

Historically the NHS prescribes the 2 most well known brands Armour from the USA with a declared content of 9 mcg T3 + 38 mcg T4 in each grain/tablet -

and Efra from Canada - which is said to have the least ' fillers ' and with a declared content of 8 mcg T3 + 35 mcg T4 in each grain/tablet -

Thyroid S - is not prescribed on the NHS - and is a treatment option used in the hospitals and surgeries from Thailand - which is said to have the most ' fillers ' and with a declared content of 9 mcg T3 + 38 mcg T4 in each grain/tablet.

I was still rewriting my previous reply when you answered me - so you maybe need to reread my previous response.

And yes - you have Hashimoto's Auto Immune thyroid disease :

[SlowDragon Administrator]

previous results when on 175mcg levo showed you were on inadequate dose

Now only on 25mcg levothyroxine

No wonder you’re feeling rough …..surprised you can function at all

healthunlocked.com/thyroidu...

Suggest you try Levo increase FIRST ….slowly back up to bring Ft4 to at least to 70% through range….assuming Ft3 remains low look at getting T3 prescribed alongside levothyroxine

over 66,000 prescriptions for T3 in last year

openprescribing.net/analyse...

Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists who will prescribe T3

Ideally choose an endocrinologist to see privately initially and who also does NHS consultations

thyroiduk.org/contact-us/ge...

Very low vitamin D previously

Other vitamins were ok but likely low now as presumably extremely hypo

High thyroid antibodies confirms autoimmune thyroid disease aka Hashimoto’s

have you had coeliac blood test

Have you Tried gluten free and/or dairy free diet

[Masjntt]

I don’t think I am functioning to be honest.

I was hoping to change to NDT instead of carry on with Levo - I think I will have to self fund this but I can’t afford the weight gain with the Levo due to my other conditions - diabetes high blood pressure & cholesterol

I know it’s hard to guess but do u think I would need t3 medication as well as NDT?

I ve tried gluten free diet but not dairy free and never had coeliac test xx

[pennyannie in reply to Masjntt]

You need to make sure you reply with the reply button within the forum members post you are writing to - otherwise they have no idea of your replying to them : SlowDragon

[pennyannie in reply to Masjntt]

There is no reason to think you need NDT and T3 :

NDT is a complete full spectrum thyroid hormone replacement -

You might need T3 only :

Or a T3/T4 combo - if we can establish that you can take T4 in some form or another.

[SlowDragon Administrator in reply to Masjntt]

High cholesterol directly linked to being hypothyroid and should reduce as you get sorted dose increase in Levo/addition of T3 or NDT

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

High BP and high blood sugar also likely to improve once on adequate replacement thyroid hormones

Common for conversion to get worse the longer we are on just levothyroxine/post menopause and/or with low vitamin levels

It’s MUCH cheaper to get T3 prescribed alongside levothyroxine privately and you might eventually get T3 on NHS

[pennyannie]

Do you know now to find everything you have already written on this forum and all your replies and what to do if you get lost reading around the forum ?

Simply press your Profile Icon which sits alongside the My Hub-Chat-Post-Alert and Menu icons on this page - on my laptop facing me - it's top right on this screen.

You can read anybody else's thyroid journey by just pressing the icon sitting alongside their name in any reply they make.

You can also contact a forum member by typing @ directly before you start typing their user name and a list of names comes up as you type you then select the correct match and the user name should print out in blue - as then the forum member gets a pinged that they been called back to an existing post.

eg Masjntt

[Masjntt]

thank you so much everyone xx