Is compounded T4/T3 as good Armour or ERFA

[ainslie]

My partner is on 1/2 Grain ERFA and she wants to increase by 1/4 Grain . Her doc has suggested compounded combo which consists of 27 Mcg of Levothyroxine and and 6 Mcg of Liothyroxine per capsule, this looks odd to me because if 60Mg of ERFA ie one Grain has 8Mcg of T3 and 35 Mcg T4 then a 1/4 Grain should have 2mcg of T3 and 8.75mcg of T4. Hence the compounded capsule looks like more like 3/4 Grains of ERFA equivelent and not a 1/4 grain, do I have that correct?

Also is a compounded Lev plus Lioth as good or healthy as ERFA or Armour?

thanks

[greygoose]

Depends on your definition of 'good' and 'healthy'. Something you should be aware of is that there is no one form of thyroid hormone replacement that suits everyone. Erfa may be brilliant for one person but poison for his second cousin, or the lady down the road in the bread shop. We are all very different with different needs. And we have to find out what suits us best by trial and error.

Never mind about the maths - doctors are rarely good at that, anyway (neither am I!) - but the problem with all NDTS and compounded pills is that they are so inflexible. If the T4:T3 ratio doesn't suit you, you have to start messing about with adding a bit of T3 here or a bit of T4 there, and it gets complicated. And, as compounded combos are made of synthetic T4/T3 anyway, you might just as well go for one pill of T4 and one pill of T3 that you can adjust to suit your own needs. Or your wife's. But, if the whole point of taking NDT is that you want something 'natural' then taking a compounded combo isn't going to suit anyway. (I think I'm right about it being synthetic but if not, please correct me and ignore all I just said!)

But what is not clear from your post is whether the GP wants her to add the compounded combo to her Erfa, which would be far too much of an increase in one go. Or to take the compounded combo instead of the Erfa, in which case I cannot fathom his reasoning - unless it has something to do with cost? I think you/she should ask for a more detailed explanation before doing anything. Just increasing the Erfa by 1/4 grain would seem to be the most sensible course of action, if Erfa suits her well - why change?

[ainslie in reply to greygoose]

I think whats happened is we asked for 1/4 Grain to add to existing dose of 1/2 Grain Erfa to make 3/4 , she assumed we were going to bin the ERFA (85 pills£££) and just use the new 3/4 Grain equivelent synthetic ones ones but didnt mention it. Fortunately we spotted it.

Not sure if you can mix ERFA with t he synthetics,I think I heard it being done, in which case we will change the order to 1/4's alternatively I am going to see if I can split the 1 Grain ERFAS in to to quarters. Got to keep an eye on these docs 😉

[greygoose in reply to ainslie]

You certainly do have to keep your eye on them!

You should be able to split the tablets to make 3/4. And I really think that's the best way to go. You can mix synthetic with NDT, a lot of people do. But it really shouldn't be necessary when on such a low dose of Erfa.

[ainslie in reply to greygoose]

Oky thanks👍

[greygoose in reply to ainslie]

You're welcome.