Replacing 30 mcg Erfa with Liothyronine or NP thyroid while using up my 60 mcg Erfa

[The-Wasp]

Okay so this may be a confusing and complicated question, but I'm really hoping someone can advise me

I’m moving to Sweden soon and need to find a new doctor to prescribe my Erfa (NDT). I’ve heard it can take 6 months to see a private doctor in Sweden. My current dose is 90 mcg Erfa in the morning and 60 mcg in the evening.

I have quite a few extra jars of Erfa 60 mcg so I will be okay there for a few months, but am running out of the 30 mcg I need for my morning dose. I don’t like to split thyroid pills as I don’t seem able to split them evenly in half. I have some Liothyronine as I was using it previously.

Does anyone know how much liothyronine is the equivalent to 30 mcg Erfa?

Also, if I’m able to source another type of NDT in Sweden, does anyone know if I can add 30 mcg Thyroid S or NP Thyroid to my 60 mcg Erfa in the morning so I can use up the 60 Erfa mcg while waiting to to see the NDT specialist (if there is one)?

So, just to recap (since this is probably confusing), I’m wondering if there’s anyone who knows if you can add Liothyronine to an Erfa prescription and/or if it’s okay to add 30 mcg of another NDT medication.

Hopefully it’s okay to ask this question! I realize the obvious solution would be to split the 60 mcg Erfa, but I cannot, for the life of me, get the pill to split in half. I’ve bought pill splitter after pill splitter and just cannot do it!!! There's some really knowledgeable people on this forum so I thought it was worth asking.

Honestly, it’s just so frustrating that we have to go to such great lengths just to access a medication that affects every system in our body.

[Regenallotment Ambassador]

 helvella blog/vade mecum document will list the products available.

My Swedish MIL lived near Lund /Malmö and before that Karlskrona and the regular GP prescribed her Levo.

I’m interested too as we will retire there in a few years.

As its EU, private prescriptions may be sourced from Germany 🇩🇪 (I am guessing based on previous discussions about Irish prescriptions) which perhaps opens up more opportunities.

[helvella in reply to Regenallotment]

Not necessarily!

EU prescriptions are not automatically accepted between countries, nor by individual pharmacies.

And it is not necessarily the case that all medicines can be sent between EU countries. A classic example is France and that desiccated thyroid is illegal there.

(You might get away with all sorts of things. I am only going from strictly applied law.)

This document might be helpful:

helvella - World Desiccated Thyroid

Contains details of all known desiccated thyroid products including information about several products not considered to be Natural Desiccated Thyroid (NDT/Desiccated Thyroid Extract/DTE).

📄 dropbox.com/scl/fi/gx6dmz5i...

[Hidden in reply to Regenallotment]

NDT is not a licensed drug in Sweden. This means that each prescription for NDT has to sent to the the Medical Products Agency (MPA) for approval. The approval is granted for one year and then has to be renewed. This means that a patient can be given the green light one year but not the next. Even if a doctor agrees to issue a prescription, it still has to be approved by the MPA before being sent to the pharmacy. I know this was the reason many thyroid patients in Sweden resorted to using Thai NDT. While there were three brands available everything was fine, but then two were discontinued and Thyroid-S was unavailable during the pandemic, and then was rumoured to have been reformulated and working less well.

So not sure how it would work to import unlicensed drugs from Germany even with a valid prescription.

[The-Wasp in reply to Hidden]

Hey Sunflower64! Thanks so much for your response 😃 Would you mind if I private message you?

[Hidden in reply to The-Wasp]

Of course not!😊

[Hidden]

I know several thyroid patients in Sweden.

NDT is available in some pharmacies (Erfa and Armour I think), but few doctors prescribe it. Most if not all are in private practice, and some cannot accept new patients or have a very long waiting list. I could ask around for some names if you ’d like.

Thyroid-S is only available as 60 mg pills so would have to be split as well, and the pills are pretty hard.

Many thyroid patients in Sweden have been ordering Thai NDT from suppliers in the EU. There are two legitimate ones that I know of, but they don’t have websites so patients hear about them from other patients. Right now, however, they only offer expired batches of Thyroid-S (exp in 2022 or 2023) stockpiled at the beginning of the pandemic.

In Sweden, only e-prescriptions are issued.

[helvella in reply to Hidden]

Thanks - that is more than I knew!

In case Thyroid S is wanted...

Thyroid S Batches

A summary of known and suspected potency of Sriprasit Pharma Thyroid S batches.

Regularly updated so please check the blog directly.

And if you have any more information, or corrections, etc., please let me know. I am entirely dependent on your experiences.

Last updated 10/10/2024

helvella.blogspot.com/p/thy...

[The-Wasp in reply to helvella]

Thank you Helvella! You've done a tone of work to help all of us! I started reading something you posted yesterday about NDT and didn't get through it, but look forward to doing so asapy. It was a really good article. Would you mind if I private message you?

[Kuto100]

I think you are making things more complicated than they are. You can absolutely safely cut the tablets approximately in half. If it comes to be 60/40 or 55/45 or whatever close to 50/50, it won't be a problem one day to take slightly bigger dose and the next one slightly smaller. This way, for the 2 consecutive days you would take 100% of the dose needed for 2 days. I do not see any drama here.