Erfa’s “Thyroid” has been our saving grace–here’s more info from Dr. Knafo and Erfa!

erfalogoThe year of 2009 will long be remembered for two nightmares straight out of Twilight Zone for thyroid patients: 1) Armour desiccated thyroid by Forest Labs was reformulated with patients globally reported a return of symptoms and new frustrating ones, and 2) shortages of all US-made natural desiccated thyroid like Armour, Naturethroid and Westhroid occurred, as well as no more generics thanks to the FDA.

Additionally, as I write this, Naturethroid and Westhroid by RLC Labs are still hard to get–making too slow a return on pharmacy shelves which may not improve until 2010. You can read details and a good summary about this on

But there’s been a silver lining to this situation: Canada’s “Thyroid” by Erfa.

Many patients made a switch to this desiccated thyroid product, using online pharmacy websites and their prescriptions from their doctors. And overall, the experience of patients with Erfa’s Thyroid has been extremely positive.

I had a wonderful chat this week with Dr. Henri Knafo, the Director of Medical Affairs at Erfa Canada Inc. My first and most important question: Is there enough Thyroid for all your patient customers?? And I got an unequivocal “Yes” from Dr. Knafo. He explained there are no concerns with running out and they have plenty in stock, now and in the future. He stated that if their stock gets low from sudden demand, they can easily get more and quickly.

I also asked: Is shipping timely? Definitely yes, Dr. Knafo stated. But he also qualified that Erfa is overloaded with orders. And though they are keeping up, your prescription order can take time to process. But, he stated “Be Patient. It will arrive!”

What is going on with the FDA and Erfa? He underscored that the FDA is cooperating completely, and they see a good future with the FDA. They are completely tolerant, said Dr. Knafo, because they seem to understand the shortages. Erfa’s Thyroid is also completely approved and regulated by Health Canada. As far as the future and the FDA, Dr. Knafo strongly feels that once the FDA is reassured about desiccated thyroid, things will only get better for US patients with brands and availability. He feels that issues with the FDA are far more positive than many thyroid patients and leaders seem to get or want to see.

Do you see changes towards opinion of desiccated thyroid? Definitely, yes. Dr. Knafo recently attended a European medical conference with over 50 specialists and he saw many doctors not satisfied with Synthroid and noticing the better treatment with desiccated thyroid. “It’s booming in Europe”, he underscored about Erfa and desiccated thyroid “Even Endo’s are noticing”. He also said that Belgium was experiencing a huge medical trend away from T4 and towards desiccated thyroid.

Why has the cost of Erfa’s Thyroid gone up even more than 50%?? His explanation was three-fold: it was first a financial decision, since they have never made much of a profit on desiccated thyroid. Second, Health Canada requires a lot of expensive testing from Erfa on products. And third, since they buy their powdered desiccated thyroid from Europe, an increase in Euros meant they needed to increase the price.

Any final comments? Dr. Knafo clarified: Erfa has been making Thyroid for 30 years and not only will that continue, they will not change the formula. He thinks the sugar in Thyroid is what makes absorption so good, and that will continue as an ingredient just as it is. Nothing will change! To see ingredients of Erfa’s Thyroid and other brands, go here.

You can read more about Erfa from my September 2nd post. Thank you to Dr. Knafo for being so candid and informative!

See my post below about my mother, who lived her entire adult life undertreated on T4 with depression and electric shock treatment and had no internet to compare notes. If you have a relative from the past with a similar story, add the story to the Comments.

*HO HO HO! Have a STTM book sent to someone you care about as a CHRISTMAS or HOLIDAY present. A card will be included, and the book will be in an envelope with a red bow!! Save money the more you buy!

Important notes: All the information on this website is copyrighted. STTM is an information-only site based on what many patients worldwide have reported in their treatment and wisdom over the years. This is not to be taken as personal medical advice, nor to replace a relationship with your doctor. By reading this information-only website, you take full responsibility for what you choose to do with this website's information or outcomes. See the Disclaimer and Terms of Use.

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31 Responses to “Erfa’s “Thyroid” has been our saving grace–here’s more info from Dr. Knafo and Erfa!”

  1. Kerin

    I posted this on the STTM Facebook page about my recent experience with the 125mg Erfa. I have been taking two 60s and one 30 mg for a total of 150 mg and it has been working well.

    I just received a script for 125 mg from a pharmacy in Canada and what they sent is not working for me. My doctor prescribed that to take with the 30s so I didn’t have to take so many pills. It has more of the effect of 30 mg rather than 125. The bottle is different and the pill size is huge compared to the 30 and 60 mg ones I’ve been taking.

    My doctor wrote a new prescription for 200 60s and 100 30s. I don’t mind taking an extra pill as long as it will work.

    I sent a photo to the pharmacy to make sure I get the white bottles that say ERFA rather than the amber bottle that just says “Thyroid”. I am concerned since they say Erfa is the manufacturer of all of them. I hope the formula has not changed because these don’t work for me.

  2. Anna

    I switched to Erfa two months ago after Armour did nothing for me (actually, I felt better on thyroxine alone than I did on Armour). But Erfa is wonderful! I have finally resolved my adrenal issues and worked my way slowly up to 4 grains of Erfa/day and that seems to be just right for me. I only see only one problem with Erfa: that it’s not available in as many strengths as Armour. I would love to have Erfa pills of 15 mg, 90 mg, 180 mg, 240 mg and 300 mg as well.

    • KZ Roe

      hello Anna– it’s over a year since you posted & like you I await the Erfa offering a variety of strengths. (For example when I split a 30mg “thyroid” rarely do I get equal halves) However, like you & others, I am so grateful for Erfa’s product. Blessings.

  3. Cathy


    I read somewhere on this site that you currenly take 4 grains of Erfa. How much Armour did you take before you switch meds? (I used to take 3 grains of the “old” Armour and is trying to find the equivalent dose of Erfa; it seems that 3 grains is a bit too weak for me but I don’t know if that’s because it contains less T3 (25.5 g vs 27 mg i 3 grains of Armour or less T4; 105 mg vs 114 mg in 3 grains of AT)

    From Janie: Yes, I was on 4 grains Armour, then Erfa, but dropped to 3 1/2 after meno and the lowering of my estrogen levels.

  4. mair jones

    does anyone know a GP in UK who prescribes natural thyroid?

  5. Leyna

    Good news!! My ERFA Thyroid shipment arrived today — will pick it up tomorrow! Woo hoo! Only 7 days in the holding pen in New Jersey. If anyone else is still waiting, don’t give up hope!

  6. Leyna

    I ordered Thyroid from ERFA, and like Jean who posted back in December, my shipment seems to be stuck in a mail receiving facility in New Jersey! Jean, did yours ever arrive? Has this happened to anyone else? What should I do? Thanks for any advice.

  7. Tasia

    Is there a way for foreigners to pay for prescription coverage in Canada? Just trying to think of ways to lower the cost for meds.

  8. Gale Ackerman

    Hi everyone I have been reading all of your responses. I was diagnosed with thyroid cancer 14 years ago and had a total thyroidectomy. For all of the past years I have been on levoxyl (spelling?) Things seemed to be alright up until the last 7 years when I became the sole caregiver for my elderly mom who resides in a nursing home. Long story short many awful things have happened to my mom in the first nursing home which resulted in a law suit and for her own safety I relocated her to another nursing home just a block from where I live. Anyways due to all of the stress of my mom and my son deployed to Iraq I finally had a breakdown. I cried all day everyday I was so anxious that I couldn’t focus on anything except myself. It was weird the world just went flat nothing around me had any definition to it. I felt like I had no purpose in life. Geese things were really bad. This lasted all summer My doctor put me on antidepressants (which did you know if you are taking thyroid replacement hormone the antidepressants absorb the thyroid hormone) I wasn’t aware of this until I became so lethargic that I couldn’t move. I asked my doctor he said I just needed to take the antidepressant longer for my body to adjust. Thank god I have a working brain I started researching my situation and the information I discovered was that people on thyroid replacement hormones are not good candidates for antidepressants. I further discovered that my depression and weird physical sensations were probably due to the fact that my thyroid hormone was pretty much void in my system from all of my stress. I have never understood that how taking one pill each day would make up for the function of the thyroid gland especially during times of almost unbearable stress. I would think that a person needs to take something throughout the day so that your body always has the proper hormones to draw from to keep its balance. I get so frustrated with all of the doctors I have ever been to for my thyroid condition (lack of thyroid) I am tired of feeling worn out,I know there has to be an answer but whenever I mention to my doctor that I am depressed and feel so worn out he just wants to change the dosage of my levoxyl. Even though my TSH reads of normal range. I guess my question is if you don’t even have a thyroid gland to work with what are my best options for an alternative to the Levoxyl? I am a very active person who just wants to live life to it’s fullest and not be drug down into the pits of despair. How do you order from Canada?

  9. Alexia

    I also spoke to Dr. knafo. My doctor faxed a ‘script. will call tomorrow if they got it. Erfa will be closed Dec. 23 to Jan 4 and there is a back order of 4 weeks..but I have enough meds to last 6 weeks

  10. valerie

    well…lets just say this then…did you hear about them voting on stopping us from get our meds on any main stream TV station…or on CNN…all liberal by the way FOX news said they would do this on Tues and guess what…it happened..they defeated the bill allowing us to go other countries…they do what Obama wants them to do…they will not allow us to get our meds else where..maybe if some of you knew what they were trying to do to us you could have called and told them you didnt want it..l try to call daily and the lines are either busy or off the hook…..but you wont hear it on any of the liberal TV stations including CNN…listen to conservative radio…watch conservative TV if you want to be informed…liberals dont want you to be informed..they want to pass things without your comment…we need to fight these things…call write..go to washington if you have to..this our health we are talking about…dont let them take it away!

  11. Lisa

    **Correction. My above post should have said $310.00 for 500 2 grain tabs from Canada Online pharmacy

  12. Lisa

    I just received my Erfa in the mail last week from Canada Drugs online. They charged me $300 for 300, 2 grain tablets! I would have ordered directly from Erfa but I have heard they are behind and take much longer to fill a Rx. Canada drugs got it here in 4 days. I will switch to a different pharmacy for my refills though.

    I feel so much better on Erfa than I did on Naturethroid. I am taking it sublingually and I am sure I am absorbing the Erfa better. I will stick with it even if Naturethroid becomes available here again. The benefits outweigh the cost. I wish Erfa could supply our pharmacies here directly.
    WHY can’t they?

  13. Leenie Balto

    I had been getting my ERFA thyroid from Universal Drugstore in Winnepeg. Unfortunately, they recently doubled their prescription prices (now $43.00 for 200 60 mg. tabs). If anyone knows of anything cheaper or even if this is a reasonable price, please advise. Thanks.

  14. Jean

    I ordered from ERFA, who were very helpful, but it seems that my shipment is STUCK in New Jersey!!! Has anyone else had this problem? If so, any suggestions? Please help, I am getting VERY low and desperate at this point. Has anyone found any in the US lately?

  15. Laura

    I’ve been on Erfa’s Thyroid since September, but it has not been the same for me as Forest’s old formulation of Armour.

    Muscle pain, aches, headaches, joint pain…It’s all back.

    I will try it sublingually as some have mentioned.

    I just want my old Forest Armour back, but I talked to someone over there today who told me that they have no plans to going back to the old formulation.

    I feel like my life is over. The OTC desiccated stuff doesn’t work for me, the Erfa isn’t working, either.

  16. Mary

    I am definitely in agreement with you, Jane.

  17. Jane C.

    Val…the fact that you keep referring to “govt run media” proves how misinformed you are. Unless you’re referring to C-Span or possibly PBS, there is no such thing as “govt run media”. Corporations, such as Viacom, TimeWarner, News Corp, Disney, G.E., together own over 90% of media holdings in the US, NOT the government.
    It’s easy to check out:
    And if you want to look further into it, you’ll find out that they all have interlocking boards of directors with all the major drug companies and the insurance industry.
    So before you go passing judgement on others opinions and accuse them of not thinking for themselves, take a good look at where you’re getting your information from.

  18. valerie

    Yes Jane C. you like many others these days…attack the messanger…Fox news is just about the only news station left in this country…whether or not we can get our meds from other countries is being discussed in congress and Obama does not want us to be able to do this. Who do you think is paying Obama..big pharma thats who. Yes thats US drugmakers. How do you suppose this money gets to the higher ups…yes lobbyists who Obama said he would not allow into the White House…guess what..thats not true either….if your watching a govt run are the one who is not getting actual news…and all you are doing is chirping what they want you to say…who do you think has been telling you that fox is not the real news…govt run media….your just repeating the lies they want you to believe….think for yourself…dont let people who want to radically change this country do it for you… want to live in Cuba…Val

  19. Jane C.

    Thanks for the link to the Federal News article in Val’s post. Not surprisingly, there usually IS more to any story, and you’re certainly not going to get the truth from FOX News. So I appreciate you keeping us properly informed.

    I never understood this fear of getting meds from other countries. You’d think that we’d hear about all the Canadians dropping dead in the streets because of the bad pharmaceuticles they’re suppossed to have up there.

    The article lays it out very clearly…U.S. drugmakers stand to lose billions of dollars if imports are allowed. The drug industry has alot of money for lobbyists and that buys alot of political influence.
    It’s the Golden Rule – those with the gold, rule.

  20. Siobhan

    I don’t have a relative, but I knew someone who went through a similar experience to your mother. I got to know her through a friend when her cat was very sick. We talked a lot, and she had been through so much stress in her life. Her brother had suffered from severe depression and recently killed himself, and at the time we talked, her last beloved cat was dying, which he did sometime later. She adopted two other cats from a shelter, only to discover one of them was terminally ill. This pushed her over the edge.

    During the time we talked, I realized the symptoms she was describing were eerily familiar. It was what I’d gone through. She had dry skin, dry hair, had gained weight, no energy, no memory, no eyebrows, and antidepressants weren’t helping. I suggested STTM to her and told her my story. I even suggested a doctor in her area. With everything else going on, she never got around to it.

    A while later, she wrote to say she had a severe depression crisis and was going in for ECT. It didn’t help and when I next talked to her, she sounded really strange, and very paranoid. She changed her phone number several times, and it was difficult to reach her. She went back for another round of ECT, even though I tried to talk her out of it.

    After that round, she was very very suicidal and no less depressed. She wrote to tell me she was going back to the hospital. I’ve never been able to catch up with her since then, nor has the friend who introduced us or anyone else that knew her. Mail to her address is returned to sender, and the last phone number is disconnected. I can’t help but wonder if she went the same route as her brother.

    It’s too sad because it could have all been avoided if doctors stopped looking only at TSH!

    One of my other friends contacted me a few months ago about a friend of hers who was on Synthroid for years and was severely depressed and suicidal. She has Hashimoto’s. I talked to her and tried to convince her that there were better treatments. I suggested STTM and RTH, but she never looked. She said her doctor had suggested she go for ECT to help her depression. I tried and tried, but when she mentioned Nature-Throid to her doctor, he scoffed and said it hasn’t been used for 100 years. She believed him and thought I was on some weird alternative thing. She went for ECT.

    The friend who introduced us said she spoke to her around Thanksgiving and that she was still very depressed and heavily medicated-sounding, and was considering another round of ECT.

    When are doctors going to realize that Synthroid doesn’t work?

    Thanks for the work you do, Janie. Maybe some day ….

  21. valerie

    wow…the above is great…but for those who do not listen to Fox news..maybe you should…congress has been debating whether or not to allow Americans to get their meds from other countries so we can save money…well l dont know how we are saving money….l just know what l need is not available…Obama has come out and said he is against us getting our meds else where….wake up people…he is not for us…pay attention to what it happening b4 the country we all know and love is GONE…Val

    (From Janie: there’s more to the story, though. Read this: )

  22. Lorie

    I’ve been on Erfa thyroid since October and I love being able to take my thyroid meds sublingually again!!! I am still having digestive issues reflux, indigestion, etc.. so to be able to by pass my GI tract is really wonderful. To not have to time my food, or other supplements around my thyroid meds is great too.

    I did not do well on nature-throid at all. I gained 15 pounds and then I started getting aches in my thighs. When the shortage of nature-throid was getting serious, I was ready to switch. I am glad I did, I am thankful that we have an alternative. I LOVE ERFA!!!

    • Cornelia


      It sound fantastic that you’re better with efra! I am in desperate need of finding a site where I can ship from. Where did you buy it from? I have tried t3 (lio) and I felt better in the beginning but now I am back to normal..

      I would really appreciate your help!! I can’t find a site that I trust and I believe getting efra would change my life forever!!

      Best Regards,

      Cornelia Eriksson

  23. Starrie

    I received my first bottle of ERFA Thyroid yesterday and I can tell already that it is awesome. I was on Nature-throid and when that ran out started using compounded Nature-throid. I had to double my dose to get a relief from a recurrence of symptoms. ERFA Thyroid is definitely just like the old Armour. Actually I think it is probably sweeter AND dissolves sublingually more quickly. I am even feeling the same old “t3 buzz” after I take a pill again. Woo hoo! Thanks ERFA!

    I am so relieved to hear that there is plenty for everyone and that the formula will not change. I am kind of disappointed that it costs 3 times as much and I cannot use my prescription benefit, though.

  24. Bill

    Naturethroid is available through Clarks Pharmacy in Phoenix, AZ. However, they don’t deal with prescription insurance. I have had repeated problems filling my natural desiccated thyroid prescriptions and it really scares me. I have even contemplated contacting a neighbor who raises pigs to attempt to harvest the thyroid the next time they have some hogs butchered. However, I have been able to purchase desiccated thyroid from Thailand (Thyroid-S), about $115 for 1,000 1 grain pills – no prescription required! I feel much better now that I have a backup that will last about a year in case the FDA caters to more big pharma requests! Thanks for all the great insight and info Janie!

  25. Jon Ewens

    Good news Janie. Thanks for the info and keep up the good work.

  26. Jenn

    I’m in the process of trying to get my doc to fax a prescription for Thyroid to cross the border pharmacy. I’m reading conflicting reports however, regarding what is required. The cross the border pharmacy says it only requires a prescription. I read here that FDA form 1572 is required as well.

    Has anyone from the US successfully ordered Thyroid from cross the border pharmacy without the FDA form and received their product?

    Thanks in advance!

    (From Janie: Jenn, I’ve updated that info on more recent posts i.e. the form is not required anymore)

  27. Florence

    I hope that Dr. Knafo is right about the growing acceptance of natural thyroid even among the medical community. I probably worry more about the lack of doctors that will prescribe natural thyroid and prescribe at the level to treat symptoms than the shortage of natural thyroid in the US. Right now I can get compounded porcine thyroid capsules and if I needed to get Thyroid from Canada my practitioner would fax a prescription. However, what would happen down the road if my very good practitioner retires or moves to another state, then I may not be able to get a prescription to get natural thyroid. Practitioners that will prescribe natural thyroid and at the needed dose are hard to find. The approach now is to keep looking until you find one; this is easier in some locations than others. I would feel better if there was a more proactive approach or something proactvie that I could do. Maybe that is why I have a hard time not worrying about the issues with natural thyroid even though I have a supply and one that works for me. Trying to get Natural thyroid accepted as an acceptable treatment by the medical community at large is up against all the money Abbott Labs uses to buy-off the medical community; the kind of money natural thyroid doesn’t have. It is also up against the ATA spreading lies and many physicians and patients access the ATA website and materials because they believe the ATA is reputable. Sorry for the long and not positive rely but I worry.

  28. Jane C.

    I faxed my refill order for Erfa yesterday and just got an e-mail that my order shipped out today. Should arrive mid-next week…thank goodness! And no delays!
    This after I called RLC Labs yesterday to get an update on the release of Naturethroid, which was supposed to happen at the end of Nov. Seems NOW there has been a delay in manufacturing and that next week they’ll have a better idea as to when it will be shipped out. Good grief!
    So a HUGE thank you to Dr. Knafo for doing what apparently can’t be done in the good old U.S.of A.


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