Dear Erfa Canada: Stop this nonsense and change your desiccated thyroid back!!

Screen Shot 2014-05-08 at 8.13.37 AMNot again. 

It appears that one more time, a manufacturer of what was once a very good natural desiccated thyroid product has ruined it. 

In 2009, thyroid patients whose lives had changed in major and positive ways thanks to Armour, a brand of natural desiccated thyroid (NDT) made by Forest Labs, saw their hypothyroidism come right back. Why? Forest, in all their wisdom, decided to raise the cellulose, lower the sucrose, and make Armour a much harder tablet. And somehow in all that change, patients reported all their hypothyroid symptoms now returning. It was a disaster.

As a result of the above, thyroid patients moved to other natural desiccated thyroid products, and Erfa of Canada was one. And oh did patients love it. It was made like the old Armour, and we could also do it sublingually–a method many of us like. Erfa calls their NDT product simply “Thyroid” and it has always come in sizes of 30 mg, 60 mg and 125 mg.

Fast forward to 2014, and patients who have been doing wonderfully on Erfa are now reporting a major return of their hypothyroid symptoms!

And what’s the scuttlebutt we hear from Dr. Henri Knafo, the Medical Director for Erfa Canada?? That they changed the facility from which the tablets were made but not the ingredients. Really??

This is particularly disturbing for European patients whose lives have changed in positive ways thank to NDT, and know the inherent problems with T4-only.

All too many European doctors and their esteemed medical organizations are clueless about the efficacy of Natural Desiccated Thyroid and turn their backs on prescribing it. Like too many American and Canadian doctors, they worship the ground that T4-only medications unfortunately walk on, and fail to see the widespread problems that thyroid patients have on T4-only. So patients suffer. But luckily, thyroid patients in Europe had been pleased about being able to find Erfa in a few places and thus, see their lives change in major positive ways.

But that has now changed for European Thyroid Patients thanks to this latest egregious change in Erfa’s Thyroid, and the situation is horrific for patients once again, just as it was in 2009 when Forest changed Armour.

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What can you do??

  1. If you were once doing wonderfully on Erfa, and now see a return of your symptoms, email Erfa’s Medical Direction here:  Spell out how you were BEFORE the change, and what is going on SINCE the change. And email him multiple times, if necessary. Make it clear. Make it often.
  2. Post here what has happened to you on the “reformulated” Erfa. This is a widely read blog post and website for informed thyroid patients as well as doctors.

In the meantime, if you need to move over to another brand…or if you CAN change over where you live….here are your options for better thyroid treatment.

PLEASE POST THE LOT NUMBERS of the bottles of which your symptoms returned!


UPDATE May 12, 2014: A gal from Sweden heard from Erfa today, and they are admitting there have apparently been a bad batch or batches. I’ll keep you updated.

UPDATE May 15, 2014: Dr. Knafo has posted the following:
Dear all, 

As you know we are currently investigating all the complaints that I received and I would like to ask for your help in order to complete the investigation.

1.       Do you have a lot number and exp date written on the bottle of Thyroid ? If so please give it to us.

2.       Can you tell us what strength(s) you bough (30, 60 or 125mg) ?

3.       Also please mention what pharmacy you bought the product from.

Once this information is received we can go forward with the investigation.   Please feel free to email me if you have other questions

Dr Henri Knafo, MD, M.Sc, B.Sc

Email :



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526 Responses to “Dear Erfa Canada: Stop this nonsense and change your desiccated thyroid back!!”

  1. Stefania says:

    hello I have been reading to you from Italy for years.
    I started with Nature throyd in 2011 and I was fine until 2018, then in 2020 my TSH was at 12 and I quit just before they pulled it out of business.
    I tried taking galenic thyroid at the pharmacy but it doesn’t work. I wanted to buy Armor but here in Italy it costs 250 € 🙄, so I took erfa 125 and after 3 weeks I take 1½ but I got widespread urticaria in my legs, arms, stomach. I am hashimoto and in the past I have done cortisol tests which was very low, but in Italy there is no ACE.
    could it be Erfa’s fault for the hives? have any of you ever had? I was thinking of increasing the dosage again because I am always very tired but now I am afraid.

    • Hives do seem connected to a reaction to something. Possibly a filler in Erfa. Or to something else being consumed.

      We have found that very low cortisol needs prescription cortisol, not ACE. ACE is too weak for super low cortisol.

  2. Joanna says:

    I feel terribly on Erfa Thyoid lot LF 19523A, exp.01/2023, pink stripe on the bottle.
    During two weeks I got depression symptoms, tearfulness, thickened and puffy face, debilitating tiredness. Which is worse I bought 2 bottles of Erfa for a full price / my insurance does not reimburse NDT/. What should I do?

    • Not to take away that Erfa has been problematic based on patient reports, but first make sure that the problem isn’t about being underdosed. This is our goal to avoid those kind of symptoms:

    • Sj says:

      I’ve just started a new container of Erfa and the consistency of the tablets is totally different to what it has been since the last ‘change’. Instead of being firm they literally melt as soon as they are put on my tongue, before I can swallow them. Too early to really assess the impact although I have felt tearful this week too.

      Interestingly the most recent batch numbers have been quite short (sorry don’t have it to hand) but this new one is back to being a long LF… Does this indicate they were manufactured at different sites?

      Fingers crossed this isn’t a huge problem on its way.

  3. Suzanne says:

    Hi there everybody,

    any news concerning Erfa? My stock of Erfa is coming to an end and I wonder if I should order it again or try another brand (considering all the info here)? What is the best working brand at the moment?

    Best, Suzanne

    • Paul Portlock-Smith says:

      Hi Armour was a life saver for me literally but that has definitely gone South too as I felt nearly as bad on it as I did when I took the new W.P ie unmedicated with a huge return of hypo symptoms despite seeking to become optimal. Through my own research I have found that due to shortages of porcine powder more and dicfrtent fillers have bern added whuch comptomises effectiveness.

      • Before assuming Armour has gone south, know that if you didn’t get your frees optimal, it all backfires. That is different than Armour going south.

        • Anna says:

          Can I ask in what way Armour has improved? I remember that, a few years ago, the STTM said it did not work as well after it was reformulated. If it is now working better, how come? Has it been reformulated again? I am asking as I have been on Thyroid-S for a few years, doing really well, but it is on backorder everywhere at the moment. Also, the price has skyrocketed in recent months, and Thai NDT is now almost as expensive as prescription NDT…which is why I have been considering switching to a good prescription brand of NDT. I can find a doctor to prescribe it, but given the cost would need to know it really comes highly recommended.

          • Hi Anna. We really don’t know exactly why it’s working better. All we know, based on so many reports, is that people are able to get optimal on it and they report doing well on it. Yes, kinda shocking when three times (’09, ’12, ’15), a certain body of people reported going downhill on it when they picked up their next prescription. People are also reporting doing well on T4/T3 if they also get optimal.

  4. Edna says:

    I have been on Erfa for years after Armour changed its formula and binders. I order this in bulk. Today when I opened a bottle from around Nov. 2019 purchase, it did not have any of that smell that makes you know its what it is. The stress of Covid-19 is bad enough but now I realize why I maybe having other symptoms like my thyroid feeling weird and just more stressed and chest tight, more heart racing episodes. Must be lack of real T3 and T4 in this new batch. Anyone out there that went back to Armour or have it compounded?

  5. Linda McAllister says:

    I have been on ERFA for nearly 17 years. It worked wonderfully well in the beginning. I have Hashimotos Thyroiditis and watch my diet and doses carefully and my DR monitors me regularly. I am just posting my email here to add my name to the large number of people who notice a lack of ERFA where they live. I have had to take different strenghts of the pill over the past year due to shortages, or have only been able fill a month at a time, with no guarantee that it would be available for my next refill. there were times a few years ago when my syptoms came back. This year they are back , with a vengeance.. although taking my 2 x 60 tabs once a day for the past 2 months ( prior my pharmacy only had 125 which was too much ) all my hair is falling out , my skin is dry, I don’t sleep and it feel just like before I ever went on Thyroid meds. ERFA … you need to fix this.

  6. Nikkeia Hardman says:

    Hi everyone there is still hope!!! I have tried so many NDT medication, and your right they all have went south. So I went another route l. I’m doing great on T.R by T man. I ordered it from Thailand and I didn’t need a dr prescription. I am thyroidless and I haven’t felt this great in two years. I really think you all should give it a try. I paid $90 for 2000 pills( great). They come in 65 mcg. It taste very sweet like papaya.

  7. Nikkeia Hardman says:

    Hi everyone there is still hope!!! I have tried so many NDT medication, and your right they all have went south. So I went another route l. I’m doing great on T.R by T man. I ordered it from Thailand and I didn’t need a dr prescription. I am thyroidless and I haven’t felt this great in two years. I really think you all should give it a try. I paid $90 for 2000 pills( great). They come in 65 mcg. It taste very sweet like papaya. I’ve been on this brand for 3 months now. With zero side effects!!

    • This was in spam. Did I already approve this so that this one is a duplicate?

      • Ksenia says:

        Has anyone had luck getting Armour in Canada? I’m in Ontario and I called many local pharmacies and it’s not available through them. I’ve been taking Erfa for 3 months now (switched from Synthroid+Cytomel which didn’t work for me, though no major iron or cortisol issues) and some T4/T3-combo induced sympthoms are gone (extreme water retention and joint pain) but new are added and I feel more hypo now, which is consistent with some reviews of Erfa. So I would like to try Armour. Thank you

  8. Antoinette Lemos says:

    Hi has anyone had any luck on erfa thyroid lately?im on np thyroid and sadly its not working as good not sure why or maybe jist need to raise it.can anyone help me out there on the erfa subject?and any suggestions on what else i can try?t4 only doesnt work for me…please help thanks

    • Reports are mixed by patients. Some think they are doing well, while others say they aren’t at all. This is now what Erfa used to be at all for patients.

      • L Crossett says:

        I have been on ERFA since 2016 and felt well in general. I would say the last month or two I have been “off” and not my normal self. It was backordered for a couple of months so I bought a higher strength and cut the pills in half. It could be I wasn’t getting as much thyroid as the pills did crumble a bit. I have been back on the regular pills for a few weeks but still “off”. I’ve just been thinking I should go for bloodwork.

      • Antoinette says:

        Hi i had some erfa in my fridge and tryed it its doing good so far but the date is nov.2017 not sure if its the old or new can i tell?thanks

  9. Sandra says:

    Hi Janie,
    Thank you so much for clarifying for me about Erfa and please pardon my ignorance on FDA, perhaps the article mean our Canadian version of the FDA.
    Thank you!

  10. Sandra says:

    I am shocked at what is happening to what is our god given right to purchase dessicated thyroid in Canada. I read an article that proposes that the FDA is the reason that Erfa is now not available. Does anyone know any truth to this? Right now, we can’t get Erfa, no pharmacy has any and so guess what? It is back to synthroid for us!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! How is this happening to us!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

    • Hi Sandra. The FDA, which is a US organization, has no power over Canada or Erfa. They can pressure PayPal to stop certain website pharmacies from allowing PayPal to be used to collect payment, or they can stop outside medications from being sent to the US. But they can’t stop Erfa. Instead, what Erfa is stating is that they have been looking for a new supplier of porcine powder, thus the problems you’ve seen. And no, it’s not just going to Synthroid. It’s adding T3 to your T4 in optimal amounts in the meantime.

      • Lana says:

        I would like my doctor to switch me onto Erfa (currently on Synthroid & Cytomel), but learned that Erfa is currently on back order at my pharmacy. I live in Canada and now use a compounding pharmacy and even they have no supply of Erfa. This back order situation could be an ongoing thing. Is there a reason why it is not available?

  11. Desiree says:

    Erfa is unavailable currently (for a couple of months now) except in the 30mg tablets and that also was unavailable in November due to the massive increase in cost of the raw porcine thyroid gland powder. There is only ONE supplier and they are in the USA and got greedy.

    I was on Armour since I had thyroid cancer when I was 15. I switched to Erfa during the Armour severe shortage in 2009 and was happy with it but it is not currently available from Universal Drug (except for some 30mg tablets they just got in stock). Erfa is searching for a new supplier of the raw product but desiccated thyroid is now considered an “orphan” drug and we can expect more shortages and higher costs.

    I switched to NP thyroid and picked up my first prescription today at Wal-Mart. Wal-Mart told me that NP thyroid is in very short supply and they cannot get it on a regular basis especially in the lower doses (like 60 mg I take twice daily). Since dessicated thyroid was removed about 10 years ago from the Medicare formulary, my health insurer does not cover it. NP thyroid, 3 months supply, costs about the SAME as the gigantic increase in price for Erfa. Thank goodness, there is Good Rx and singlecare discount programs so I was able to pay the same price I was paying for Erfa before the ONLY supplier of the raw product got greedy and increased their price by about 300%.

  12. Felicity Lane says:

    I had been reading about the problems with Erfa and when there was a post about the doctor who is on the list of recommended( and who I have an appointment with in 3 months), and that he prescribed efra to her. I posted about the problem of efra and what should I ask for when I get there. I got a quick reply from our administrator that there was NO problems with efra. should I accept his prescription and make a note of the expiry dates at the pharmacy or ask for the neutral NDT?

    • Well, it’s totally false by the high amount of bad experiences that nothing became wrong with Erfa. But…a lot of those complaints have died down, so it may be doing better now.

  13. Hanna says:


    I got a new bottle of Erfa last week… Lot: LF07082A, exp. 05/2019. Now I’m feeling some symptoms that I haven’t experienced in years. My last bottle was exp. 2017 (unfortunately I don’t have the bottle anymore and I don’t remember if it looked different from this new one). Have you heard something like this from anyone else? Starting to panic here… 🙁

  14. Martin Stewart says:

    Hello all. Diagnosed with subacute silent thyroiditous in 2006. Symptoms, overweight, fatigue, poor sleep, dry skin rash on face, thin hair, bad digestion, heart palps. Initially prescribed nothing. Then after begging for a year was given a starter dose of eltorixin. Then went to another doctor in 2008 after still feeling like crap and was given Tapizole. Then realizing her error, was on .75 of synthroid. Then in 2010 I went to a natural doctor who put me on ERFA thyroid, 90mg. Weight loss, hair became thick, skin cleared up, I felt normal for the first time in years. Only side effect was heart palps. Then towards mid-2016, face rash started up. weight gain, hair thinning, skin cold clammy, Low Iron, diagnosed with sleep apnea. Changed doses up and down. Blood work was normal, Under .90 TSH and T4 at 11. But Heart Palps have gone since last year. ERFA thyroid HAS made a change either to whats in the pill, or to how its made. Plain and simple. Last bloodwork was 2 weeks ago and my TSH was down to .52 and T4 at 11. Feel like crap, tired, unmotivated, unable to exercise, blurred vision and an overall feeling that I am not myself. Still on 90 mg of ERFA….willing to try synthroid at this point, or anything but ERFA. Frustrated and tired.

    • Hi Martin. What happened to you wasn’t about Erfa. For one, 90 mg will be too little for most everyone. Overtime, you do get much worse, as happened to you, including the further lowering of your iron from being underdosed. Second, it’s important that iron (and cortisol) are good to find your optimal dose.

      So do two things. 1) Read this page and especially the green graphic 2) Learn about iron and cortisol:

      • Also, lab results have nothing to do with falling in the normal range. Always use this page with your lab results:

        As an example of how you are severely underdosed, I am optimal on 3 1/2 grains. That is 210 mg. Some are optimal around 2 1/2 grains (150 mg), some are optimal at 5 grains (300 mg). On and on. 90 mg is just above a starting dose from which we raise in search of our unique optimal dose.

        But because you’ve been held so long on such a low dose, you’ve now got low iron which will need to be brought up. And your so-called “sleep apnea” is actually a cortisol problem from being kept on such a low dose, not sleep apnea. You need to do a 24 hour saliva cortisol test, not blood, and compare the results to the lab values page I posted. Many order our own from My Med Lab shown on this page:

        Going to Synthroid is not the solution, we’ve had to learn the hard way. Being on T4 only promotes low iron and a cortisol problem, we saw over the years. The solution is bringing the iron back up where it should be (, and doing saliva cortisol and comparing to the lab values page and treating the results. Only then will we be able to raise NDT in search of our optimal dose.

        • Martin Stewart says:

          Janie, thanks so much for the reply. Here are my labs from February 17 and then 2 weeks ago

          Feb 17

          Thyroid Stimulating Hormone [TSH] 1.93 mIU/L
          Thyroxine Free [Free T4] 11

          June 17
          Thyroid Stimulating Hormone [TSH] 0.52
          Thyroxine Free [Free T4] 11
          Ferriten 187

          Both are on 90mg of ERFA. I will return back to my prescribing doctor, my endo, and see about an increase based on symptoms and get the cortisol checked. I am also shocked that 90mg is a low dose. It would stand to reason then that I have been under dosed for ages and have just accepted my new sleep apnea, weight gain and fatigue as just being “normal”. Yet as recent as 3 years ago, I was exercising, running, weight 25 pounds less. I will also have T3 checked as it seems none of my docs want to check it.
          Its funny, yet not funny how this creeps on you and then you accept the way you feel as normal. I have a little glimmer of hope today. Thanks Janie.

  15. Jenn says:

    I need help, from someone that knows a lot of this….I am seriously getting fed up. For years I dealt with a Dr that basically didn’t help… I did my own research, own investigation and am a lot more educated on my condition. We seriously shouldn’t have to have a doctorate in order to be healthy. I take 2 60mg of Desiccated Thyroid. Jan 2017 I paid 28.86 / Feb 42.50 and just TODAY (May 15) this has now jumped to 60.00. LIKE REALLY! I wrote to them but all I got was an excuse on an increase in an active ingredient in 2016. Either way, can someone please tell me the best pill? I want something natural, but the BS in this problem I would assume is contributing to my fertility issues as well. I just have no idea if what I am taking is good anymore. My confidence in this has diminished. I also lost all hope in trusting my Dr., which I was the one who told her what Thyroid I wanted, as I was so fat (should be 130 was 150), tired etc on Synthroid and Levothyroixin. I should not have to diagnose and figure all this out on my own but clearly Thyroid isn’t treated properly in North America. Anywho, if you have some information to share that may help me that would be great, thank you ahead of time!

  16. Fran Aldrich says:

    Hi Janie,

    I just got off the phone with my pharmacy (in Canada) and they told me that Erfa has stopped manufacturing and distributing Thyroid and are reformulating it! I am not sure if this is a good or a bad thing! I switched to Thyroid from Synthroid last summer but can’t say I ever felt the changes I was desperate to feel, so I am really hoping that I was getting “the bad stuff” and this reformulation will be a good thing. Have you heard anything about this reformulation? They had enough left to give my one bottle but are giving compounded from now until the change which they say they are expecting to take about six months. I am curious to try the compounded and see how it works for me but my very tight budget didn’t allow for the doubled price this month. Hoping Erfa gets it right!!

    • Marilyn says:

      Hi Fran, I also live in Toronto and just tonight got blown away by the 245% increase from SDM for 180 x 30 mg over January 28/17. I took this Shoppers last supply of the 30 mg. (they’re already out of the 60 mg)…they told me that future supplies are on back order and expected in May. I became very suspicious, remembering earlier reading of the Armour situation, so come to the Internet tonight and have just read about the ERFA situation. My pill container says ERA, is this the same company as ERFA that everyone is talking about here?

  17. Gerry Ahrens says:

    Thank you Janie for that great link on the armour thyroid comparisons.

    Have the issues with erfa died down? I’ve wanted to try it and it is significantly cheaper than my current BCBS price. I have done very well on 120mg of armour thryroid for about ten years.
    Chew it up and pop it under my tongue.

  18. Alina says:

    I got some ERFA Thyroid. How do I know if it is the bad one other than taking it and not feeling any results? If it is bad I would rather not waste time taking it.
    Would getting thyroid medication from a compounding pharmacy be a good solution?
    Any other good thyroid meds?
    I am in Canada.
    Thank you in advance

  19. Ren Gron says:

    FYI… InHouseParmacy is having trouble getting stock of almost all NDTs–i.e Armour and Erfa… Don’t wait until you’re almost out. Order early!!

  20. Lily says:

    Anyone with Thyroid Erfa exp. 05/19? I was totally fine with Erfa 07/2017 but with the new one…. oh no this cant be real…I started seaching online whats going on since my old symptoms started to appear in couple of weeks. I am desperate. I had thyroid inflammation two years ago and my thyroid never started to work after that. In my home country Finland we dont get treatment and medication as we should and in my despair I ordered meds from inhousepharmacy. Now I dont know if its that company that is fake or is it this thing I found online from this website, the change of the medicine. Totally dont know what to do now.

    • Lily, that’s a legit company. The problem is Erfa. Trying chewing it up completely to a fine moist paste and see what happens. That has helped some. If it doesnt, then perhaps take slightly more, say some.

      • Lily says:

        Thank you so much Janie! I started to take one more. I have used 3 grains per day, now taking 4. Hoping that will help.

  21. Sandra says:

    Is anyone aware of issues of buying Thyroid-S. I did and my payment went through but when I tried to track it I couldn’t and when I contacted the company repeatedly in email, have not replied. I fear that my money is taken and I will not get my purchase.

  22. Selma says:

    Hi all!

    I am reading all the reports regarding Erfa. I have beed using Erfa since Feb 2016. Before I used Nature Throid, Thyroid-S/Thiroyd(from Thailand) and Armour Thyroid. The only brands I haven’t tested areTMAN (from Thailand) and WP-Thyroid. I was on 3 grain NDT (Thyroid-s, Nature Thorid) before a switched to Erfa. With 3 grain Thyroid-S I felt fantastic.

    With Erfa I am taking 4,75 grain and doing fine but compared to Thyroid-S I am more hungry. But my skin is great and everone who ses me says that I look more healthy. I like the 60 mcg grain tablets more than 125 mcg. 30 mcg works fine as well. I found 125 mcg stronger and they are harder to dose. But with the same dose 3 grain on Erfa as Thyroid-S, I became hypo thats why I needed to increase Erfa because it is not as strong as the other NDTs I have used. I have no complaints about the Erfa as reported here. So it can be the dosage that should be adjusted may be thats why you are getting these problems with new Erfa as they are weaker then old Erfa.

    I felt terrible with Nature Thyroid and Armour Thyroid. I stopped using them after 1 month. With Nature Throid I felt very dizzy and the symptoms became worse after 4 hours taking the NDT. With Armour Thyroid I had as strong muscle pain during first 4 hours after taking the pil and it increased after that. I increased to 5 grain, the symptoms became worse so I quit Armour Thyroid as well.

    I am taking all NDTs in 4 doses during the day, chewing them always. I really liked Thyroid-S, It was my favorite NDT. I did fine on 3 grain Thyroid-S. But I cannot get prescription on Thyroid-S from my doctor, that´s why I stopped using them. I will now try WP-Thyroid in 2,5 months to compare with Erfa and Thyroid-S and see if there is any difference. But I think I will start to take 3 grains as I did with Thyroid-S and work up slowly. Besides the NDT I am on a gluten-free diet since 1,5 year as I have Hashimoto. It think the new diet and yoga make me also healthier. So for me it was the glutenfree-diet together with right dose of NDT , the solution for my new healthier life.

  23. Maria says:

    Hello Janie,

    I was wondering if you still use ERFA Thyroid or if you have switched?

    I must have gotten lucky 1.5 years ago when I received a bottle of 125mgs 500 tablets which expired in 4/2017…the tablets were not “spotty” in color or crumbly and I didn’t have any problems. But ten days ago I received a bottle (which also expires in 4/2017) of the bad tablets and I started feeling it not a week later.

    I’m considering re-ordering in the hope of getting a good batch or perhaps trying out NP Thyroid by Acella. Do you have any advice? Any ERFA batches that expire later than autumn 2017 which have been reported as good? Thank you.


  24. Kelly says:

    any update on the ERFA quality?

    • As STTM is about the results of solid patient reports, I can say that we’ve seen less and less complaints here about Erfa….

      • kelly says:

        awesome thanks! i am waiting for my 1st erfa shipment to be delivered. my dr is starting me on 30 mg per day. i was on levoxyl and weaned myself off. will keep e1 posted 🙂

      • Janine Davane says:

        Hi Janie. I, for one, have quit complaining on here about Erfa as complaining doesn’t help me feel better. I have noticed that Erfa
        does not smell as much like medicine lately. I still feel like crap and the endo is slow to raise. I currently take 3-30mg. Which by the way, has taken me almost a year to get up this high. Canadian endos?

  25. Gillian says:

    Anyone having trouble with a batch Of Erfa #00023965? I receive mine from Canadian Pharmacy thru Kansa City and in April I needed to reorder. I didn’t want to use Am Ex so they said they had to use a different vendor. Well, I suffer from Catamenial Seizures and we don’t know the source and since this new batch I’ve had the worst seizures ever. Coincindence? Also, my bottle comes from You Drugmart and has no exp. date on it. My doctor says as long as the pills say 125 ECI on them they should be the same.
    Thoughts anyone?

    • Jean L says:

      I think it is terrible that they change medications that are of vital importance. This is something we HAVE to take daily or we don’t feel good. Yes, to answer your question- based on all the people complaining about changes with ERFA. I believe it must be the ERFA.

      I wish they would stop changing these medications. I am on Nature Throid and I feel OK. Could be better, but there is nothing we can do. I wish we could get this medication from Europe or somewhere that the company who makes it isn’t going to change it. Was much, much better in 2002 before everything was changed.

      Best of health to you all. Praying for no more changes!!!!

  26. Anna says:

    I read somewhere that Health Canada is currently investigation complaints about Erfa. Is that true…?

  27. gina says:

    I am wondering if iradiating the pig thyroid is the new process to purify it??? This would destroy whatever we have left of our own functioning thyroids…This is the new method they are using on meat!

  28. gina says:

    WP thyroid EXP. 12/17 caused my thyroid to swell almost instantaneously. Stomach cramps and jitters also followed. Again the pills have that medicinal scent that Armour and ERFA now have, not that pork odor that NDT always had before they never changed it (joke) when it worked. It is as if the synthetic manufacturers have sabotaged the NDT powder that is distributed to all the NDT producers. My reaction to WP was similar to the changed ERFA. It’s almost as if they have added synthetic T3 to our beloved meds. I find it ironic that for years big pharma has tried to get rid of NDT and dishonestly push their synthetics. They have created and broadly advertised false info about NDT in an attempt to get it our of circulation. Now all of a sudden it appears all their false claims are reality. Someone had to make this happen. Very suspicious that the NDT companies have a change of hands and then the problems arise. There are no coincidences in business. I think it’s time we make our own NDT. How hard can it be? I would also like to gather all the pills that “haven’t changed” and have them tested to see what’s really in them. Does anyone know where we can have this done?

    • Hi Gina. You might want to rule out a few things if u reacted to WP that way. First, NDT will initially cause an increase in the attack on the thyroid if one has Hashimoto’s, thus thyroid swelling. We have to do both thyroid antibodies to know, not just one.

      Second, your reaction to WP could have been what is described under #2 here:

      • gina says:

        WP does not act in the body like NDT. It seems synthetic. Have you ever tried it Janie?

        • No Gina, I haven’t. But I see a lot of comments by many people who are soaring on it, Gina, as they do on Naturethroid and NP Thyroid and even NDTs from Thailand. You gotta explore what I mentioned to you….

          • gina says:

            I have. I’m not new to all this. I know the road all to well…What are you currently using?

          • Gina, the problem is that it’s not a conspiracy or sabatoge that you keep implying. Promise. If it was, there would be a growing body of patients having problems on WP, or NP or Naturethroid, and there are not. I would strongly recommend getting both antibodies done, all four iron labs, and the 24 hour adrenal saliva test.

    • tyra says:

      Gina, I have been using WP for a year, year and 1/2 now … ever since Erfa changed. Like you, I have used NDT for years and years… first the ‘old’ Armour, then the ‘old’ Erfa after Armour reformulated. I had to go hunting for a good NDT after the ‘new’ Erfa made me dizzy and feeling awful after a week or so. I am no expert but with the exception of TR Man (one of the Thailand NDTs) and the ‘new’ Armour, I have tried them all, it seems. WP and NP are the two brands that suit me best. Of course, we all have our favorites. Before you give up on WP or some of the other good brands, maybe have some labs done so you know what is going on, especially thyroid and iron, antibodies and RT3? Oh.. and I haven’t noticed any strange off-odor or side effects with the WP that I am taking (exp. 4/17).

      • Gina, I hope you will take these responses to heart. You do need to do both antibodies, all four iron labs, and test your adrenals via saliva. And Tyra recommendation to do RT3 is also a clue as to having either an iron or cortisol issue.

        • gina says:

          Yes I take all to heart. I am not new to the bloodwork. My doctor and I learned together. Thyroid hormone imbalance is the culprit for the other imbalances not the other way around. As soon as I was on the right dose of old Armour where I felt normal all my labs also came back normal including cortisol (24 hr saliva) and ferritin. The only time I ever tested positive to antibodies was apx 10 years ago after taking synthetic. I had the same symptoms from it that I just had taking the WP and the new ERFA then as well. Back then once I started old Armour the symptoms were gone within days and following bloodwork showed normal antibodies. I recall almost immediately after taking synthetic those awful symptoms started. Just like now after taking the changed ERFA and the WP. Totally the same reaction. I have been taking my old erfa EXP.5/16 for the last few days and symptoms have almost entirely subsided. There is no doubt it is a reaction to the pills. I can’t say WP has changed all I know is the problem it causes me is the same problem new ERFA causes and there is no doubt that ERFA has changed. Others have also reported the same problem upon starting WP. Aside from everyones reactions the change in the new ERFA pill is visual as well. I really want to get them tested by an independent Lab. Like DR knafo said he did. We never saw the actual results from his test. Experience tells us to always consider the source. Janie what are you currently taking? I dread running out of my old erfa and will probably take nothing rather go through this crap again. I would like to give NP a try but am so terrified. The fact that my reaction to both WP and new ERFA was the same tells me there is something in both of them that didn’t used to be in old erfa. OR possibly something missing in both that old erfa had. Either way old erfa still works for me perfectly and New does not. I am by no means the only one and we must get to the bottom of this mess.

          • Gina, most anyone (and it’s been quite the minority) who has reported problems with WP finds out it was actually their adrenals or iron. I know you are resisting all this terribly, but I can only strongly suggest you get both antibodies done, FOUR iron panels (not just ferritin), and 24 hour adrenal saliva test..then compare the results to the Lab Values page on STTM. When someone has the same reaction to other very good products as they did to Erfa, it’s usually about one or more of the latter, Gina.

        • gina says:

          My bottle of WP does not smell like the old erfa, old Armour, porky smell at all. It smells like medicine. Thats the best way I think I can describe it. The new ERFA has a slight pork smell but definitely more medicinal than it used to be.

      • Anna says:

        Has anyone taken both Thyroid-S and WP/NP Thyroid, and is able to compare the two/three? I have been on Thyroid-S for a couple of months, like it and it seems quite potent, but I really don’t like all the fillers…no other brand of NDT seems to contain as many fillers. WP is very pure. NP too, although it contains mineral oil (which it seems Armour used to as well, until 1996). I’m in Belgium where only Erfa and Armour are available by prescription, but I found a pharmacist who said he’d be able to order WP or NP for me even if the script is for Armour or Erfa, as the active ingredients are the same, and only fillers and binders differ…but I don’t know if I should switch brands again (I have been previously been on Armour and Erfa, both of which stopped working at one point), and am afraid my poor body will end up all confused…!

        • Many, many good reports on NP or WP.

        • tyra says:

          Hi, Anna. I had to scramble to find another NDT after I responded badly to the ‘new’ Erfa (after about 5 yrs doing well on Erfa) and tried Thyroid S, Thiroyd, NP, WP and Naturethroid. I gave each one a two week trial. The two Thailand NDTs trials only lasted for 4 – 5 days because they made me dizzy/spacey feeling.

          Naturethroid was a bust… not good, not bad. But the NP by Acella and the WP … well… wow !! I settled on the WP because finding a dependable supplier of NP is problematic in my area.

          The Naturethroid is chalky and none too pleasant tasting but.. tolerable. Doesn’t lend itself to taking it sublingually.

          The WP is just a tiny bit gummy (will stick to your teeth, for instance) when you remove the tabs from the main bottle and place them in one of those daily/weekly containers. It seems to dry them out a bit but
          doesn’t effect their efficacy. The WP doesn’t dissolve as readily as NP but it works.

          The NP… great stuff. Tastes like the old Armour or old Erfa? kinda sweet and the 30 mg tab is a tiny, tiny thing so the 30 mg tab can’t contain but so many additives, right? And it dissolves nicely sublingually.

          I don’t think anyone can advise you as to whether to change NDTs or not. You are fortunate to have a pharmacist willing to work with you. Maybe trial a few weeks or a month’s worth of NP and/or WP at a time and see how you do? If you don’t respond positively to either one during the trial period, you can always fall back to the Thailand NDT as backup.

          By the way, I switched from one NDT to another and used the same dosage I have used for years. I didn’t seem to have a problem. That’s not to say that everyone can switch between brands without consequence. Keeping track of body temp and heart rate when switching would probably be prudent.

  29. Megan says:

    My pharmacist informed me that the Erfa in Canada is made in a different place from the Erfa in the States. I’m in Canada, and Thai pharmacies are having trouble shipping here. Erfa is the only NDT available here, are the Erfa issues affecting both patients (US and Canada)? We don’t have many apparent options here right now.

  30. Donna says:

    Omg I just found out about the problems with Erfa..I switched after the Armour nightmare and was doing well until Jan 2015 when I started having regular episodes of heart rhythum problems . I just realized it coincides with whatever happened to Erfa..I have an order of WP Thyroid on the way to me and am praying that helps

    • gina says:

      Donna have you stated the WP and is it going well for you?

      • Donna says:

        Gina i took the WP 1day and had possibly the worst day I was back on synthroid…immense brain fog…achy legs, feet burning like fire…i was ive been taking the erfa since…i will wait a little bit and try it again in case something else was going on….i think the 60mg erfa i have right now is probably Ok…it splits clean and dissolves just like old Armour…i have some 125 mg Erfa that are bad that I reveived in error for the 60 a couple years ago….they crumble and I felt like crap when I took them.

        • gina says:

          Hi Donna, Have you tried the WP again yet? Is the ERFA still working for you?

          • Donna says:

            Hi Gina…No i’ve been afraid too..the Erfa I have now (60mg tabs) seems fine…Ihad some 125 mg tabs that I felt really awful on that I rfeceived a while back…Now I’m dealing with Afib….I have an appointment with Dr.Flechas in a couple weeks so I’m anxious to get his input on the mess that is me….

        • gina says:

          Donna what is the lot # and expiration date of the 60 mg ERFA that is working? How long have you been on it?

  31. Anna says:

    I have some questions about Thiroyd from Thailand…I took it for a few months back in 2011, before going on Erfa, and did great on 5 grains daily. FT4 levels about midrange, FT3 levels close to upper normal range. A few months ago, I decided to try Thiroyd again, after having problems with Erfa. This time, on 5 grains daily, I felt less well, and labs confirmed this: FT4 levels almost below normal lower range, FT3 levels only midrange.

    I’m trying to tell myself it’s not possible Thiroyd was reformulated as well…but does anyone have a clue what is going on??!!

  32. carol says:

    Does anyone have updated news on Erfa pills? I finally decided switching from Synthroid and considered switching my son also following his thyrodectomy 2 years ago but now i’m very unsure given the negative reports people are writing about. I’m reading so many failure cases it’s very discouraging. Also ordering from countries such as Thailand scares me as I have read several sources of health stardards being much lower than what we have in Canada and the US. Please if anyone has any updates I would love to hear from you! thank you so much!

  33. donna says:

    Hi, where do I find the batch number?
    I was wondering if anybody on this forum has adrenal insufficiency, also known as Addison’s Disease, and found themselves very sick after Erfa changed their pills.
    My RX used to say Erfa, but this bottle of pills says ERA followed by the numbers 00023949. Then there is the Bar Code with a number below it written this way TX# 11888978
    Below the description of the pills for this bottle below whrere it says Thyroid 30 mg, it says: CMR / RND / EC I30 {NONE}
    I’m in Edmonton in case anyone needs to talk.

  34. donna says:

    Okay, it posted.
    Lately for the last 18 months I have been very sick. And CONSPICUOUSLY About the time Erfa changed it’s formula. And I’m wondering if my thyroid pills from Erfa have something to do with it.
    I am going through complete hormone derangement, cortisol, insulin, and thyroid all out of whack. I have been very very sick, last year I got a call from a doctor from a walk in medical center in Spruce Grove Alberta who told me that my cortisol was very low, and that if I was feeling really weak and dizzy that I should go to the emergency. Well I was so weak and sick I could barely stand up on my own. I went to the emergency and there they gave me TWO LITERS of saline, which completely failed to bring my blood pressure up. About the same time I began to get sick I was being treated for high blood pressure, which is familial, and I have two younger brothers who are also on high blood pressure medicines. But for some strange reason, I was SUDDENLY CURED of high blood pressure when I got very sick 18 months ago, when it was first discovered that I had low cortisol. Now I am not sure what’s going on, I’ve been sick so long that I was finally sent to an Endocrinologist who is testing my adrenal response to ACTH to see if my cortisol rises as it should. The doctor thinks I might have a partial adrenal insufficiency, and is testing several other pituitary hormones including IGF-1, LH, Prolactin, etc.
    But all I know is this, I was getting my desiccated thyroid hormone from Shoppers Drug Mart, and always felt well on it, and always noticed a difference when switched over to Erfa’s thyroid hormone. Now after reading this, I’m wondering if my real problem isn’t Erfa’a thryroid which may be whacking out my other hormones. My T3 is hig, and my T4 is below normal. But I cannot rule out an adrenal problem, as I have aching back where my kidneys and adrenal glands are, and have been so sick, I cannot eat, drink, sleep, and on the verge of feeling like vomiting all the time, which is some of the very symptoms of adrenal failure.
    I know people who have adrenal failure often end up with thyroid failure as well, but I don’t know the statistics when people have thyroid failure, how many of them develop adrenal issues as well.
    I have called a compounding pharmacy where I get another hormone compounded, and I’m asking them if they can still compound desiccated thryoid, if they can I’m switching. At present the Endocrinologist has prescribe me Cortef for emergency use, which is Hydrocortisone, until she tests me to see what if anything is wrong with my cortisol hormone.
    I will write again later this week and let you all know what the Endo finds out. All I know is I”m tired of being sick.
    I do know one thing, I feel better when I’ve taken the Cortef, and notice that if I take my thyroid hormones first I feel aweful, but not too bad if I take the Cortef BEFORE I take the Thyroid hormone, But I’m still changing to compounding pharmacy’s thyroid hormone until this is settled. I did however, always notice that I always felt better taking Shopper’s Drug Mart’s compounded thyroid hormone…we shall see if my health improves dramatically when and if I can switch….and maybe my cortisol issues will straightened themselves out.
    If anyone has anything they might know that may help me, please respond to this message, I’ve been sick too long, unable to work, and even light housework makes me dizzy, sweat, and weak and feeling like i need to vomit….something is wrong with this picture…

  35. donna says:

    Hello, just checking to see if this posts before I write alot only to find out it won’t post….if it posts I will write a short thing about my health, then at some other point I’d like to write about the hormone hell the doctors put me through before I got on Desiccated Thyroid.

  36. Lou says:

    Hello from Belgium, I have bad news… My mother and I are using a batch 04/2017 of 125 mg and we don’t feel well anymore ( we use erfa sinds 5 years now…) It’s as if every tablet had a different dosage… We are very sensitive and in case of low dosage, we have severe ophthalmic migraines… For the moment we have it in an infernal rate… for us migraine is one of our indicator of hypo.. Never we both had so many migraines in so little time since we began the flask 04/2017…
    Personally, I get from 13,5 to 8,5 of blood pressure the next day without explanation while I have never had concerns about that ! With 8.5, believe me, I can almost not stand up…It is black veil at the edge of the syncope !! Palpitation, gets super tired… My feeling, it is dangerous to continue like that.. It would be necessary to make verify the composition by another laboratory…

    • Anna says:

      Hi Lou,

      I also get my prescriptions for NDT filled in Belgium, or rather used to. I did not do well on Armour back in 2011, was switched to Erfa, did fine on that until about a year and a half ago, and then I started going downhill. I now take Thyroid-S from Thailand. I am not too happy about all the fillers, but at least it seems to be working, and seems quite potent.

      I just wish the doctors prescribing NDT in Belgium would start offering us alternatives, such as WP or NP Thyroid…

    • Anna says:

      Lou, do you get NDT prescribed by one of the so called Hertoge doctors…? If so, do you know if they still prescribe Erfa? When Armour was reformulated, the doctors in H’s clinic switched to Erfa, but I have no idea if they still consider it to be a good brand, or if they are aware of any problems…since there are other brands available, such as NP and WP, I wonder if Armour and Erfa are still the only two NDT drugs available in Belgium…?

  37. Marilyn Borley says:

    More recently I have been trying to find out if Erfa has gone back to making their NDT the way they used to. I have found in checking their ingredients list that it hasn’t.
    I too was on Erfa’s NDT for many year’s. I had been on Synthroid but I had a damaging medical issue that made my body allergic to any kind of preservative and color, so that is why I had switched. I was doing very well until Erfa changed their ingredients…unfortunately at the time they denied it in their correspondence to me.
    I live in Canada and now I drive across the border to Omak and pick up my prescription at a pharmacy there. It’s quite an expense. I have been on RLC Labs WP Thryoid now for over a year and I am doing just fine. Unfortunately it is not available in Canada. I would highly recommend it.

    • Diane says:

      I just started taking NDT 2 days ago. After reading all
      the comment I’m really worried about my script that I had filled at Walmart Pharmacy. Marilyn how do you manage to get your script filled in the US? I’m near the border as well so it’s doable for me if I need to.

    • Marilyn Borley says:

      In answer to Darcy….My Doctor sends my prescription to a pharmacy in the States. I drive down and pick it up. My prescription is for 6 months so that I don’t have to go so often. In toll it takes about 5-6 hours to make the complete trip (it depends on how long it takes at the border crossing). I live close enough to the border that it is viable but not everyone is able to do this. I

      • Diane says:

        Thank you I will see if my doctor will do this for me.

        • Marilyn Borley says:

          Your welcome Diane. There should be no reason why your Dr. would not do this for you. When I was looking into this I phoned around first and talked with the pharmacy to make sure they would fill my prescription. Than I gave my Dr. the information.

          • Sandra says:

            Hi Marilyn,
            That is such great information you were good enough to share with us.
            I have been on Erfa for gosh must be 6 years now but since 2014 have only had two prescriptions of Erfa that worked for me and the last batch seems to be good so I bought as many (three months worth) as they had left of the bottle they dispensed my prescription from. I am slowly picking up the pieces of my life that fell apart when I just could not function the way I used to and now I know that there could be another option which is driving to the U.S. I am about an hour and a half away from the U.S. Niagara falls border so it won’t be too bad. The thing that sucks is that I won’t have insurance coverage for it I’m sure and the dollar exchange is killer.
            Now if I could only find some more of my batch!

    • gina says:

      Marilyn – Have you noticed that WP smells very medicinal compared to the ERFA? Did you get a bottle insert with yours? Do you use the same dose of WP as you would ERFA (when ERFA worked)?

      • Marilyn Borley says:

        Hi Gina,
        I didn’t notice any kind of odour to the medication. There was no insert. I used the same dose as I did when I was on Erfa. I have found a pharmacy that compounds close to home and have been getting my prescription through them now. It is much more costly than Erfa was. To continue to purchase my prescription in the USA for WP Thyroid was costly as well, with the Canadian dollar being so low.

  38. Dr. Vulpe says:

    Very interesting, indeed. However the info regarding the importance of Selenium and Zinc is missing.
    Also, in the labwork section Urinary T3 and T4 can be added, they seem to be more reliable for diagnosis
    Other than that is a great site, it has been an eye opener for me, keep up the good work!

  39. Dr. Vulpe says:

    I have two recommendations to make for all thyroid patients:
    1. Check for dr Peter Glidden and thyroid on internet to understand the causes of your thyroid problem
    2. For those speaking French there is a great book out there that will clarify many things for you, including treatement options
    En finir avec l’hypothyroïdie – Ce que votre médecin ne vous dit pas sur la thyroïde
    de Benoît Claeys
    Best wishes of health to you all!

  40. Cris says:

    I was on Synthroid for 19 years and I really didn’t have a problem. However, I was only 17 when I went on it. When you live a certain way for 19 years, you only know that one way…. Then I decided to make the change to Thyroid in 2012. Thankfully I have a supportive Dr. However, I have found over the last year that I have been getting all the symptoms back. I had no idea that this batch thing was happening. I take 125 every day. Its not a low dose so I’m really really effected when it doesn’t work. My thyroid itself is barely even there anymore. I have no idea what the best option is at this point… stay on Thyroid or go back to Synthroid. It was an extremely tough transition so I’m hesitant but I really feel like garbage. I’m not even 40…what’s a girl to do?

  41. Cullen McDonald says:

    Hello all, does anyone know if the THYROID by ERFA is safe to use today? I was just prescribed Levo for my TSH of 6.59 and after an instantaneous weight gain of 10lbs in 2 weeks I started googling natural alternatives and it lead me here. I live in Canada so I figure it when I go to ask my doctor start me on a NDT they will probably prescribe ERFA. So, I want to know if anyone knows if it is safe today 11/20/15? I’v read that they changed it and people complained and now the pills are softer but its not clear if the brand is still effective and safe. Please help? Thank you in advance.

  42. Lesia says:

    Thanks for your reply and for sharing Andrea.
    The reason I switched to NDT was because I’ve had difficulty swallowing since my surgery. I have gone up and down in my doses and after 17 months, I realised that my throat swelled on doses above 100 of Synthroid. I HAD to be allergic to something in the Synthroid and it wasn’t simple reflux or LPR like everyone said. Sadly, my symptoms have returned with the ERFA so…..since I’ve had 3 weeks of feeling like total c#@p AND the return of the swollen throat, I am going back to my comfortable dose of 100 Synthroid. Clearly, being hyper, even slightly effects my UES and LES. I am seeing a Gastroenterologist in a few weeks. DGL licorice is helping incredibly and I plan on supplimenting with a natural stomach acid supplement once I get the all clear from him. I am extremely sensitive to thyroid meds and all previous blood tests have confirmed that I’m converting T4 to T3 so….I just may be one of those people who do better on Synthetic T4 only. I desperately wanted to do well on the NDT but after battling this horrid throat problem for 17 months, I just can’t wait out this “kill me now” period while I try to adjust my NDT. Tomorrow morning I go back to Synthroid.

  43. Lesia says:

    I’ve just switched from Synthroid to Erfa 3 weeks ago. It’s not going as well as I’d hoped which is really upsetting to me as I can’t go back to Synthroid. Any dose over 88 gives me serious and uncontrollable reflux to the point that my throat swells and tightens. I’m heading over to the Erfa discussion board for some advice and support. I’m not feeling at all well on the 60 MG of Erfa. Dizziness and late afternoon fatigue are killing me.

    • Lesia, though there have been some bad batchs of Erfa, there appear to be others which are not bad. And by what you are describing, your problem may be that you simply haven’t raised that starting dose! We all have to raise it to find our optimal dose. Read the section on what we’ve learned:

      • Lesia says:

        Hi Janie. The Erfa batch I have is dated 04/17. My Endo used the Erfa conversion chart. I was on 100 Synthroid so he converted me to 60 Erfa. I am getting pretty significant head rushes and dizziness 1-2 hours after taking my Erfa so I cant imagine increasing my dose. It knocked me on my back yesterday so I only took a crudely cut 1/2 pill today. No dizziness or headrush but I have never felt so burnt out. I’ve had the same chest symptoms I had when I was on too high a Synthroid dose. I had a TT 16 months ago so I don’t have my own thyroid to fall back on.
        Ive read that 60 is the starting dose and I should increase after 2 weeks but I’m starting at what should be my target dose. I was on 137 Synthroid after my surgery and felt Fabulous but my TSH was .025 (range .35-5.0) and my FT4 was 30 ( range 12-22). We have had one heck of a time trying to find the right dose. I’ve bounced from 137 to 88 and 100 seemed to be the magic dose. I suppose I was naive to think it would be a simple transition to NDT.

        • Andrea says:

          Lesia – I am experiencing the same exact reaction to Erfa you are. I was on 2 and 1/4 grain of Armour until Sept. and switched to Erfa because of the reformulation of Armour by Actavis. I wasn’t sure what starting dose to start with on the Erfa because I wasn’t sure just how bad/ineffective the Armour had been. So I went conservative and took just one grain and over the next week worked up to the two grains I had been taking on Armour. That was a huge mistake since I thought I was going to die of a heart attack that night after getting up to two grains (again, I had just been on two grains of Armour for the last year, and 4 grains of Armour prior to that for years). So none of this made any sense to me. Why was my body able to handle 2 grains of Armour but can’t handle 2 grains of Erfa. So I stopped it for a couple days so the hyper symptoms could go away. I then started on 1/4 grain (and like you said “roughly cut”) and worked up to 1/2 grain. I have leveled off at 1/2 grain for the last month. But if I go just a smidgen over that I get hyper symptoms. I have tried everything I can to go to 3/4 grain but I absolutely cannot do it without going hyper. I have read and re-read the link Janie provided about why NDT isn’t working – but because for the last year I had been on 2 grains without being hyper, I feel it is something to do with the Erfa and not to do with low iron and low cortisol – and in fact, those have both been ruled out by my doctor. I also switched to the sub lingual method and that did make a difference by improving some hypo symptoms, but I can’t get rid of all the hypo symptoms unless I can go up to at least 60 mg. Today I switched to Nature Throid. It is so scary switching because you hate the idea of any new hypo or hyper symptoms cropping up but I felt I had to do it because I was getting no where on the Erfa. I still have hypo symptoms – mainly depression, fatigue, weight gain, and aching joints. But after doing the Erfa sub lingually, these have improved enough to where I can tolerate life but I am no where my old self. I will let you know how it goes on the Nature Throid and let me know if anything new transpires for you that might be helpful.

  44. Jill says:

    I live in the US and received a new batch of ERFA from a Canadian Pharmacy last week.
    I order 250 tablets at a time so it’s been almost a year since my last order. I immediately noticed my new scrip was crumbly and unable to cut with pill cutter – that was not the big issue. By the second day of taking the new prescription I thought I was having a heart attack. To feel this way for the next couple of days even though I tried to counteract with magnesium to calm down.I had my blood tested and waited 3 days for results. My results concluded my tsh levels were quite low. I stopped taking meds for two days. Now I am reading this post and have no idea what to do next. Should I reorder my ERFA scrip and hope for a better batch or switch to another desiccated formula such as ACELLA.? I have used ERFA since 2009 with great success.

    • Alayna says:

      I live in Calgary and noticed that my first prescription re-fill for ERFA 30mg in May 2015 worked fine and then my second prescription refill in Sept 2015 from Lot # LF04825A Expiry 01/18 does not seem to work even with an increase in dosage. So i will ask the pharmacy to compound themselves, and see if there is a difference in symptoms.

    • tyra says:

      Jill.. your story sounds like mine. I did fabulously on Erfa after being on Armour for years and years until they reformulated in 2008/2009. I tried the ‘new’ Erfa and in a few days, I was so dizzy and exhausted I could hardly stand up. I tried Naturethroid and the two Thailand brands of thyroid and they didn’t cut it. I know this sounds strange but my body ‘sang’ with the NP by Acella and with WP by RLC Labs. I settled on the WP since it seems readily available unlike the NP at times. I didn’t start low and work up or anything…. just went from one brand to another with no problem. So, yes…. you might want to think about changing to another brand like NP/Acella or WP. By the way, your TSH level will be low when you take natural desiccated thyroid. That is perfectly normal.

  45. Sarah says:

    I’m fairly worried I have a bad batch… But since I get mine from a pharmacy as prescribed by my dr incanada I don’t see batch numbers.. How do I know ? Should I talk to my pharmacists?

    • Sandra says:

      Hi Sarah,
      I am in Ontario Canada. I have been struggling for over a year now and have had mostly bad batches (yes this is my opinion after previously being properly treated for over 4 years with adrenals and iron all good) and had only one good batch. I would give anything to get another one of those again. Each time I get a new prescription I ask my pharmacy to record in my records what the batch/lot number is from the bottle (and get it written on the bottle for me) they dispensed from in case I decide to get another fill before I’m finished the old one (at my own expense as my insurance won’t fill it sooner) and want to make sure it is not a duplicate of the previous one.
      hope that helps.

      • Margaret Horvat says:

        Hi Sandra,
        I am in Ontario too, and my endo just switched me (at my request) to natural thyroid (after 30 yrs. on T4 only) which I filled at Costco, and it’s Erfa. I’ve only just started taking it two days ago, but seeing all this chatter about bad doses, am concerned it won’t work for me. Just wondering if you have had better batches since you wrote this post and if you have any other suggestions since you are at least in my province! Thanks.

  46. JOAN says:

    This is a letter we have sent to ERFA two days ago, awaiting the replay:
    We are from Barcelona, Spain

    My wife has Hashimoto disease, she has done very well with ERFA the last 3 years, but this year 2015 the symptoms of untreated hypothyroidism has returned clearly

    After reading in internet about some issues of ERFA I would like to know if these problems has been corrected.

    I will give you the lot information, the batch number we are using, so you can confirm us if these are defective since they definitively do not correct the hypo symptoms

    She has TSH test ok, BUT low T3 and she feels totally untreated

    Batches are purchased here, in Andorra

    Thyroid ERFA 60 mg lot number : LF03139A Exp 10/20/16
    Thyroid ERFA 30 mg lot numbre : LF03057A Exp 10/20/16

    We would appreciate your collaboration about this issue, the product has been working wonderful since now, and is really a big problem to see these dreadful symptoms come again..

    Thank you very much for your kind assistance


    • JOAN says:

      Response from Mjellma Hatipi , Erfa Medical Director to our letter:

      Thank you for the respond. After initially receiving your concerns about lots LF03057A and LF03139A of Thyroid 30 mg and Thyroid 60 mg an investigation was conducted to review manufacturing, analyses, and transportation of both lots. Please find below the conclusions:

      – No event has occurred during manufacturing that could alter the products potency.

      – All test results were compliant and within specification range. This includes the dosage of tablets.

      – Until this day, there is no evidence of lack of quality or possible dosage discrepancy of either lot that your wife was taking.

      In the meantime please feel free to contact us regarding any further questions and we will do our best to assist you.


      They deny any problems

      On Saturday a new batch of 60 / 30 ERFA with dates 5/17 is arriving. We will see if these correct the dreadful hypo symptoms my wife is experiencing. We will keep the community informed



      • Xenia says:

        Joan, I’m from Barcelona too, well, from Sabadell. I have Hasimoto and several days ago I was also diagnosed hypoth. I don’t know anybody here in Spain who would know anything about alternative ways to cope with this disease. Everybody, especially my endocrino, look at me as if I were crazy! Today I found about Erfa in farmsciaenandorra, and would like to try it, even if people say it is not very good now.
        So, I would like to know if it ispossible to get in touch with your wife and you? Just to ask some questions I need to resolve.

        I’m a little bit desperate but willing and determined not only cope with Hashi, but win the battle. Please, write me a Whatsapp to: 636588275. I would really appreciate to share experience with your wife and find a way to gain health again.

        I don’t know if I can post my number here, I hope, the admin won’t erase me. I’m just desperate at finding a cure.

        Thank you very much in advance and thanks this incredible forum where I could get so much information.

        • Nuria says:

          Hi Xenia,
          I am Nuria, Joan’s wife and Hashi as well. I’ve just sent you a wahts, but not so sure if came through. Please, contact me if you wish. I am an active member of a selfhelp group called hipotireos españa (facebook). It works pretty well.

          • Alexandra says:

            Hi Nuria and Xenia, my name is Alexandra and I am living also in Spain, close to St. Celoni and have Hashimoto too. I am supplementing with Erfa since 2 years ago and it works well. I buy it also in Andorra but they are rising prices every time I place a new order. I am considering to order it directly in Canada. Is there any advise from this blog how to order it via internet in Canada? As there are quite a lot cheat farmacies on the www. Thank you for any comment!

      • Susan says:

        Hello Joan,
        I find this message from the medical director reassuring.
        Here is what I read :
        -She made researches about the precise batches you were talking about
        -She didn’t find any quality problem with them.
        -Same for manufacturing and dosage of tablets.
        I don’t think that they “deny” problems. They just answer you with what they see.
        For me it’s enough.
        I do not have problems with my thyroid medication (erfa) but I can tell you that it scared me a lot when I found this forum. With no reason because I’m still alive and healthy (as much as I can be ^^)

  47. Adina says:

    I’m in the same situation as kezi, but I am in Romania. I was really hoping to get off eutyrox 200ug but now it seems there is nothing to switch to? Ugh.

    • Narda B says:

      ….there seems to be….such a struggle.. to make this change, from synthetic to natural hormone replacement therapy….I will be seeing someone tomorrow who sounds very excellent re thyroid matters and expect to receive referrals for blood work and tests…but I feel very unsure now….I’m 58 yrs old, been on Synthroid for about 4 yrs after thyroidectomy…yes, have had massive lifestyle changes since because of it (physical, mental, emotional) … but I’ve never gotten puffy, or had my hair fall out, or be unable to rise from bed or whathaveyou….. is the change over really worth the inconsistent batches, the illnesses….?? It’s all so sad, it seems…such a terrible manipulation by Big Pharma, cruel even…..

  48. Kezi says:

    Hi there,

    I liked to switch from a synthetic product (T4) to a natural product, since youu cant get these easily in Germany I wanne make sure that if I order and spend some money on it, I get a good quality product. Now I am doing some research:
    so Armour is not an option since the 2009 crisis, my next best option was ERFA which I could get from Belgium. But now I am reading that they have changed some things about it…so would you not recommend to order it or has the problem been solved ? On this website I got this quote “By 2015, we are possibly seeing those bad batches disappear hopefully. ” (
    Another option might be Naturethroid RLC Labs….
    I find this website and all the comments very helpful, I feel in the US and Canada the people are more aware and do some research than here in germany.
    I am thankful for any reply !
    Greeting from Germany

  49. TEmp says:

    I got the understanding that desiccated thyroid pills have to be stored in the temperature range of 15-30 degrees Celcius. Could improper handling / shipping / storage attribute to the variations experienced in batches? I opened ERFA 60mg 07/17 LF04142A last week, and am “doing fine”; living in a cool climate.

    • Natalie Briggs says:

      I have been using this for 2+ years and never had a problem and was blissfully unaware of this issue. I have been having problems for the last 2 weeks and I just stumbled upon this forum and realized that I had my Rx refilled in late October. Thinking that maybe my problems are due to a bad batch, I got the batch number from the pharmacy and it is the same as yours, 07/17 LF04142A. Maybe there is a storage problem or maybe my dose has been too low for too long (60mg)?

  50. Darcy M says:

    I am still on a compunded NDT and would really like to get back to taking it as a pill form. I am wondering about starting Erfa again. Which worked great for me before, but I stopped taking it a year and a half ago as I thought it may have stopped working due to issues with Erfa. I also wonder about Thiroyd?

    Can anyone confirm that Erfa has sorted through the issues they were having with bad batches? ANd has anyone had success with Thiroyd.

    Thanks in advance and I look forward to hearing back from someone.

    • Darcy, lots of folks do like Thiroyd. Also check the other STTM blog post about Erfa. If you need feedback, here’s a list of many groups you can use:

    • Diane Dvirnak says:

      I have been on Armour for many years but since ObamaCare was implemented my cost of Armour 120mg has jumped from $21.00 for a 90 day supply. My prescription this week for 90 120mg tabs this week was $101.90.I will be starting on Medicare in a month and they do not pay for Armour..but I have been paying out of pocket for yrs. The increase in a 90 supply has hit the top. I am told it will continue to increase.
      Someone told me about getting ERFA out of Canada. I got set up and ordered a 100 day supply of the 60 mg tabs I will take 2 per day for my 120 mg daily dose. After reading all the negative reports on ERFA I’m not sure that I care to “rock my boat” I am stable on Armour but tired of paying the huge costs for Armour. I am VERY corn sensitive and would like to
      get it out of my thyroid. The corn in armour does not appear to bother me. I am stable and have been for 1 1/2 yrs.
      on the Armour.Do you have any thoughts for me on this?

  51. Anna says:

    There is another question that I’d like to raise, and I hope Janie or someone else can answer it: there have been rumors in some forums about Armour being reformulated AGAIN, this time by the new owner (Actavis), and being even worse now than before the 2009 reformulation…could that be true?! I have been considering going back to it lately, since I cannot seem to make Erfa work the way it used to (plus the latest batches have giving me a terrible rash that is driving me crazy, and it goes away if I don’t take any Erfa in 24 hours…).

    I’d appreciate any input on this!

    • susan says:

      after reading all comments many have developed a rash on the face: look up bromism, that’s exactly what is caused when you get too much bromine in your system I’m afraid those batches may have been tainted (guess only). It slows the thyroid big time! Look up “Bromo Seltzer” mental disorders.

  52. Anna says:

    OK, so I just saw Suze’s excellent post right after posting…

    I really went downhill on Erfa 3/16. It did not work at all for me.

  53. Anna says:

    Sorry if this is a stupid question, but my head is spinning right now…is Erfa working or not?!?! I got one batch of 125 mg pills that did not seem to work very well, so I went back to a bottle of “old” Erfa that had just expired, but it’s still effective…but I only have a dozen or so pills left. I don’t know if it would be worthwhile going back on Armour (I have been thinking about taking it with cellulase to break down the cellulose), or just ordering a new batch of Erfa…?!

  54. Suze says:

    I read through all the posts in the May and June 2014 comments on Erfa and made a list of the reported bad and good batches. Based on this I found I had a few pills for the two good batches. I used my 4/17 batch of 125 and cut it in half making it one grain, as it was reported to be extra strong. So far so good – no ill effects and I feel all right. I have been using Synthroid and Cytomel since March and I am not feeling as well as I did on the good Erfa in 2013 so I determined to try any Erfa I had which had no bad reports. I didn’t list the lot numbers for these, as not everyone gave those, just the expiry dates, so it might not even be the same lot number but I thought it was worth trying.

    The good batches (no one reported them as bad, and one or more people reported them as good) are: 8/15 (reported by 3 people) and 4/17 (4 reports).

    Some batches were reported as both good and bad by different people: 5/17, 7/17, 7/16, 2/17, 10/16, 3/15.

    Some were reported only as bad: 11/15 (3 reports); 11/17 (1 report); 3/16 (3 reports); 8/17 (3 reports).

    No reports for 1/17, 3/17 or 6/17 so these are unknown.

    I don’t know if this will interest anyone at this late date but I thought I’d post it in case it helps someone. To sum up: the known good batches are 8/15 and 4/17!

    • Suze, thank you!! I’ll add this to the posts about Erfa. Good job!!!

      • Suze says:

        I have found that the 4/17 Erfa, 125 mg, is very strong, as someone else mentioned. But I gave it a chance, cutting them in half, as I began to feel better overall. But they are failing me now. Even taking half or one grain, it is too strong and I am thrown into a hyper state each day which takes hours to come down from. So I cannot recommend these. I am just sick of this. It’s as if the body welcomed it at first because I was so hypo, but now finds it too strong. I thought it was going to be fine because I’ve taken this for 12 days and was tolerating the hyperness which was a relief from hyponess. But it is just not acceptable to live through this every day. I am going back to Synthroid tomorrow because these clearly have way too much T3 in them and I am very sensitive to that. The other good batch, 8/15, I don’t plan to take as it is actually expired now.

        • Suze says:

          My Synthroid experiment was hellish so I gave it up after just two days. It was worse than the hyperness the Erfa gave me. I went one day with nothing and my body calmed down as the hyperness wore off. Then I took 62.5 or about one grain for the past 2 days. So far I am good with it. I feel hyponess creeping in at night, but that’s OK. A good day for me is when I can write “no attacks.” If necessary I will keep skipping days periodically if I get too hyper, or even lower it to 31 or 1/2 grain. When I use up this 4/17 batch – there are only a few left – I will have to ask my dr. if he can get Armour or another US brand for me. If not, I will take a chance on the latest batch of Erfa. Despite the occasional attack I had on Erfa, the attacks were much worse on Synthroid. I have often wondered what these attacks mean. Is the body saying “too much exogenous thyroid all at once” or is it saying “we can’t use what you just took and it’s turning into a toxic mess inside and stimulating the natural adrenaline flow.” And why did I use to take huge doses as high as 150 Erfa and feel GREAT in 2013 and early 2014? My health went downhill beginning around Sept. 2014 and I don’t fully have it back yet. I wish medical science knew the reasons for all of our reactions to thyroid. I am not the only one reporting bad reactions to all kinds of thyroid pills. But if I don’t take any I become too hypothyroid so that is not a long term answer. Just now I have had it with being revved up and jittery so I would rather stay on one grain or less.

          • Suze, this is probably the reason you get hyper when you try to raise above a starting dose:

          • tyra says:

            Suze.. I assume you are in Canada? If so, you have little choice but Erfa or levo. There is a lady from Canada on another thyroid forum and she gets her natural desiccated thyroid meds from a compounding pharmacy. It only has natural desiccated thyroid and the filler is glycine. Seems she is very sensitive/allergic to a lot of things but the glycine gives her no problem. I think she is on 2 grains per day.

            If you are going to the doctor anyway, maybe you can ask him about this option? Or ck with a compounding pharmacy near you and see what they have to say first?

    • Maggie says:

      Hi there. I got the 10/17 batch – LF04443A. I’ve never been on NDT before but I’m getting allergy symptoms to it after only a couple days. Could it be a weird filler? Says only cornstarch, sugar and magnesium stearate…

  55. LEF says:

    I am Canadian and have been on desiccated for years now thank goodness. Spent years trying all the synthetics as my doctor was bound and determined it was going to work finally including a T3 to help, still didn’t feel good, then one day went to fill my Cytomel perspiration and they wanted almost $800 for a month!! Went back to my doc and said to h(*L with this!! Have been on desiccated ever since and finally my symptoms are basically gone and I feel half decent! Now I have moved to the US and have not gone to a Dr here yet for my thyroid pills but am almost out of my Canadian ones….starting worry about what is available after reading this post!!

  56. Jkm says:

    I am literally on my way to the doctor to ask to change to desiccated. And now I’m really confused because I have no idea where to get quality desiccated thyroid. Help!

    • Kerri says:

      This was me today too! I’m in Canada, need lactose free and gluten free, and the only dessicated one available here is erfa thyroid (thankfully lactose free and supposedly GF)! Seriously holding my 1st pill in hand trying to get courage to try it! Hoping the bad batches are gone and hoping my tiny pharmacy actually had new stock in… But maybe they’re all bad now? Groan… Who knows! Fingers crossed!

  57. TurboKitty says:

    Levothyroxine is synthetic.

  58. T.J. says:

    This may be a dumb question, but here goes. Do you think Thiroyd is just as standardized as ERFA or Armour? Meaning it’s the same dose pill per pill batch by batch? Thanks in advance! 😊

    • NOT a dumb question! And I think the answer is yes.

      • Anna says:

        I’d like to chime in: very interesting indeed, as both Thyroid-S and Thiroyd are so much easier to order, plus so much more cost effective…I have been worried, though, that they are not potent enough, or that individual batches are not potent enough, etc, etc…you will occasionally find concerns like that expressed in US or European forums.

        Janie, you have a lot of experience in this area, and are also in contact with literally hundred of patients on various thyroid drugs. in your (expert) opinion, is there any need to worry about the safety, consistency, or potency, of THAI NDT (I am especially thinking of Thyroid-S which contains or dozen or so fillers, including, but not limited to, aluminum??!)

        • I’m not crazy about the fillers. But…I’m about reported patient experiences, and from those, all I know is that there are plenty of patients who love both and have not reported any problems.

        • Lisa says:

          I am on my third year of using Thiroyd brand thyroid from Thailand. I have always had good success with Thiroid, and appreciate that I can take it sublingually. However, I had problems with the batch I am currently using. I usually take 2 grains in the am and 2 in the pm. I have been in so much pain I decided to up it to 3 grains this morning. I felt a little better but feel that the batch I am using might be weak. So I added one grain the TR TMan brand on top of the 3 grains of Thiroyd because I have a trial-sized packet. It helped immediately. I don’t know what the fillers are so I am hesitant to order the TR Tman but it did work when my Thiroyd batch is not. Does anyone know if the Thyroid-S is strong and works consistently? Thanks.

  59. T.J. says:

    Oh boy, you guys, I have been taking the “new” batch for about 2 and 1/2 months now. They crumble like crazy! Not only that, I’ve lost so much hair that I just want to sit and cry. My face is puffy and rough looking again. My heart palps are back, ugh. Why can’t they ever leave s good thing alone?! Lot: LF04570B Exp: 11/2017 60 mg tablets.
    Has anyone tried Thiroyd from Thailand as of late. I’m debating on switching to it. It helped me through the 2009 armour crisis. I had a lot of adrenal problems then too. So, I’m not sure if it truly worked well for me or not.
    This is so damn frustrating.

    • TJ, did you try raising the Erfa you’re on? Because heart palps and hair loss can happen from not raising and raising again after you start on it. Raising is explained here: and the reasons for problems on NDT are explained here:

      Granted, there seem to be bad issues with some of the batches of Erfa now!! We’re not saying it’s all you, because you could have one of the bad batches. But you also have to be sure whether your issues are with the Erfa you have, or the fact that you didn’t raise enough.

      • T.J. says:

        Thank you for responding, Janie! Yes, I have raised enough. Doing the T3CM for over two years helped me to optimize. Unfortunately, this new “ERFA” is just crappy. I did try using more in week 3 of this new batch and quickly felt worse. It’s also difficult to get an exact dose from cutting as it crumbles so badly. I think I’m ready to, once again, start on the treacherous journey of switching meds, ugh…. The reason I ask about thiroyd, is that I was running low on Erfa and added a little of my left over thiroyd from 2010 to get me by till my script came in. Well, I felt a nice little boost. I had hesitated to take it cause it was so old, but I can’t deny feeling somewhat better. This is my second script of “bad” ERFA. May the Lord continue to bless you! Thanks for all the time and hard work you’ve put in to bless so many of us! 😃

  60. Caroline says:

    I am starting to feel hypo symptoms since switching to a different pharmacy 5 weeks ago and starting on a new batch of 60mg (lot# LF03831A, exp: May 2017) and 30mg (Lot# 14J01, exp. July 2107). Is anybody else having problems with these lots?

  61. Kerry says:

    So glad to see this. My Erfa tablets crumble when I try to split them. Bought from Costco in B.C., there is no number to compare, as they are put into a standard prescription bottle. I am ready to give up, I feel horrible of late, I ache from head to toe. Almost ready to go back to synthetic

    • Brenda says:

      Hi there. I live in BC as well and haven’t been feeling good for awhile now. I noticed my Thyroid pills had changed with the last refill and they are speckled. I asked the pharmacist at save-on foods and she said she would look into it. A few days later I dropped by the pharmacy and she told me that nothing had been changed. I too am contemplating asking my Dr to put me back on Synthroid. Even though I don’t want to – it feels like the ERFA Thyroid Prescription is making me worse not better!

  62. Sandra says:

    I too have experienced a good batch, been completely fine, able to walk 1 hour a night etc, then started a new batch this week and wham! I literally wanted to go to sleep on my drive home last night. Pushed myself to walk and I am not even experiencing the overload of stress from work these days like I was on when I was on the good batch.
    I am pissed!!! I purchased 400 pills this time and wont’ get any insurance coverage now on any further ones I buy for some time. Now I have to pay out of pocket to try another batch. When the hell is this going to stop!!!!

    • Marilyn Borley says:

      Hi Sandra,
      Just thought I’d let you know that I’m working on having my prescription made at a pharmacy that does it’s own compounding… in a city close by (about an hours drive). The pharmacist requires a prescription from my Dr. of course which needs to include the dessicated thyroid and amounts in mcg of T4 and T3 and the filler (which will be lactose for me). Because it is compounded they make it in a capsule which I won’t need to swallow. I’ll be able to remove the medication from the capsule. Because of my allergies this is substantially wonderful for me. It has taken me some time to be able to work this out for myself. I see my Dr. mid month and hopefully will be on a good road. I have had to do a lot of my own leg work to find this pharmacy…it took me a long while.
      Because of our Canadian dollar this will also be a huge savings. It is more expensive than getting a prescription for Erfa but I will be confident in what I will be taking into my body. It will work out to about $30.00 a month. I hope that you will be able to work out something positive for yourself. Take care.

      • Chloe says:

        Can you tell me whereabouts in Canada you are? I am in British Columbia and would like the opportunity to order the same thyroid as you are talking about.

        • Marilyn Borley says:

          HI Chloe, the pharmacy is in Kelowna, it is Dycks Pharmacists, 1460 St. Paul St. 250-762-3333

          • Marilyn Borley says:

            Hi Chloe, I just wanted to add one more thing. It would be wise to check out what kind of fillers you can request to have in your prescription. The first one recommended by my pharmacy was not a good one. I knew this because of information I gleaned from Janies posts.

  63. Cindy says:

    I also emailed this info to the address included in the article for Henri Knafo and I received a Mailer Daemon reply that the address doesn’t exist.

  64. Cindy says:

    I switched to dessicated about 2 years ago. At first there was a lot of fluctuation and finally I settled out at 125mg. I have been using Erfa the whole time. I moved to a new city in January and started taking the same dosage filled from the new pharmacy about one month ago. Over the last two to three weeks my hair has started falling out at an alarming rate and I am beginning to feel very tired. My Dr has increased my dosage by 30mg, which I have only been taking the last few days now. The Erfa Lot # on the recent 125mg tablets is 13C06 with an expiry of March 2016.

    • Anne says:

      Cindy I am surprised you have that batch – 125mg 13C06 expiry March 2016. It’s the one that I got in November 2013 and which made me ill within half an hour of taking it when I started it in early 2014. Several other people have reported similar problems with that batch number and several of us have reported it to ERFA as being faulty in some way. I have changed to a different brand now. I also believe that Dr Knafo left ERFA and has been replaced by someone with presumably a new email address. I’ve seen it somewhere possibly i the other thread about these problems with ERFA.

      • Cindy says:

        Thanks for that info Anne, I will pass that along to the pharmacy I got my prescription from.

      • jill says:

        please pass along the new thyroid drug you are now taking and how you are doing.

        • Anne says:

          Sorry Jill, I’ve only just seen your post. I now take Thyroid-S from Thailand. I’m not keen on all the fillers in it but needed something quickly and that was the easiest for me to get in a hurry as I’m in the UK and my GP refuses to prescribe for me since my specialist died! I used to take Armour but haven’t since its reformulation in 2009. I also have some WP to try out as I have decided it’s essential to know of two brands which work so I’ll never again be in a position of having to search around when there’s a problem with the main brand I take.

  65. Keren says:

    I switched to Erfa in May this year as it was cheaper than the Naturethoid I had taken previously. I did really well on Amour initially, and then Naturethoid, but I have gone steadily downhill on the Erfa, to the point where all my symptoms have returned, and I feel like I did when I was on levothyroxine. Mine are in the new bottle with a best before of 04/2017. I am really shocked that I feel so different on Erfa, and hugely frustrated by the waste of money on a pot of 500 tablets! I have just ordered an alternative and they can’t arrive quickly enough…..

    • Winnie says:

      What NDT brand do you find the most effective and where can I order?

    • gina says:

      I just received a bottle of erfa with the 04/2017 expiration date and am terrified to try them. I have done great for years on erfa since they chaged Armour back in 09. Now I just don’t know what to do?? Help!

      • I don’t blame you. I’d be terrified, too. Perhaps get another brand or Thyrogold to have on hand?

        • Anna says:

          Janie and others,

          What is your opinion of Thyro-Gold? I have been considering it lately, as I really am worried about all the fillers in Thyroid-S, and am not sure I’d like to take it long-term for that reason…TG seems very pure, and I like the fact that New Zeeland livestock is treated better than anywhere else…no pesticides, antibiotics, 100% disease- and GMO-free…no single case of BSE has ever been reported in NZ.

          • Hi Anna. STTM represents reported experiences rather than opinion, and based on all those reports, ThyroGold is a pretty solid NDT, even if they are forced to called it a nutritional supplement. lol.

  66. Anna says:

    I have a 500 ct bottle of 30 mg pills, batch no LF04265A, exp 08/17. They seem ineffective, but give me a terrible rash…

  67. Cathy says:

    I was doing really well on the old “Thyroid” product sold in Canada. After the product was changed I started developing a terrible blistering rash on my face, which went away immediately after I stopped using it. Now I have to use t4 only, and I am not happy about it. Please change it back!!

  68. Tessa osborne says:

    Just received new batch of ERFA and pills have reverted to being crumbly. I have taken up to 3 and a half grains for a number of years, on old ERFA, then new ERFA. I had a slight degradation with new erfa but not enough to make me do anything – just more fatigue. However the new new erfa, is not only crumbly, but super crumbly and I can’t cut them any longer . I have pill cutters that have always worked, and now I just end up with crumbs. I get them on the NHS on the condition that I cut the pills so they don’t have to get me two types. What to do? That said, my fatigue is lessening ….

    • Tina says:

      Hello, could you please tell me how you are getting the NHS to pay for your ERFA? I cannot even get a GP or endo to prescribe it. x

      • Nancy Adams says:

        Hey sufferer I insisted and educated myself on what I was talking about I also think helped I said Hilary Clinton takes it ha I was in. My pharmacist says I know more than Dr. Sound like you know and it’s your body stick with GP you might have better chance cause he knows you! I hope you get them. I’ve just started a few months ago and it’s gradual I started at 2 at 30 then I’m up to 90 3 tabs I’m feeling sick again and think I need more. Hypothyroid mom taught me that. A big point to make is that blood work does not tell how I feel. You gotta listen to that. If all this fails my friend find another Dr! The Endos don’t like this way of doing it! All my best I’m right with you it’s awfull I’ve had it my whole life and just found out because I no longer wanted to live! I took Synthroid to begin and even my first pill I felt something! This sight is a God send! I’m not crazy I have Thyroid problems!

  69. Trav C says:

    Sub-clinical Hypothyroidism is what I have. That means im not fully hypo. In my case I suffer from all symptoms of hypothyroidism and its been this way for 10 years. Before I went on synthroid my TSH was 7.48, Free T3 6.5, Free T4 18. Notice my free T3 is at the max end of normal. Now my latest blood test after being on synthroid for the first time at 100mcg 4 weeks in are TSH 1.5, Free T3 4.9, Free T4 19. My question is if I switch to NDT wont it potetinally make my free T3 go to high? I feel extremely lethargic on synthroid, worse than before. I will be taking erfa thyroid since thats the only one covered by my medical.

  70. Janice says:

    Interesting discussion. I am using a compounding pharmacy for my L-Thyroxine. They really wanted to put microcrystalline cellulose into the capsule. I finally had the doctor write the prescription that they had to use glucose as a filler. However, there is another problem, which is pertinent to the discussion here. I looked up the various patents that deal with how to create L-Thyroxine as a raw ingredient, such as a compounding pharmacy would use. As far as I can tell, all L-Thyroxine is produced by an efficient process that grows the L-Thyroxine on a substrate of . . . microcrystalline cellulose. Therefore, the manufacturers of various thyroid supplements can truthfully say that they don’t add microcrystalline cellulose to their tablets. If my information is correct, the cellulose already exists in the feedstock used for all thyroid supplemental meds.

    After realizing this, I open up my capsule of L-Thyroxine and glucose, and pour the powder into a coffee filter (paper cone inside mesh holder). I then pour filtered water through the filter. I use two glasses, and move the filter from one to another, and pour the same water through the filter about four times. I then drink the water (effluent). L-Thyroxine is water soluble, microcrystalline cellulose is not. I use the same filter for about three days, and then have to discard it because of the white powder buildup in those three days.

    So I am dumping out the powder from a gelatin capsule. I suppose a person getting a normal tablet could crush the tablet, put the resultant powder into a coffee filter, pour water through it about four times, and then drink the water.

  71. Teresa says:

    How I wish I had found this website a few weeks back when I convinced my new family doctor (with the help of my pharmacy) to switch me from Eltroxin (levothyroxine) to Erfa Thyroid. I was diagnosed with Graves Disease almost 20 years ago – though now I am doubtful as I was hyper, hypo, hyper, hypo, hyper, hypo. The endo told me I was wasting her time and that I was in imminent danger of heart failure and she wouldn’t give me longer than six months. I then had rai. The Eltroxin has never stablized and my results are still up, down, up, down, up, down. With the retirement of my old family doctor I decided that it was time to get better educated and figure out how to get my life back with the new doctor. Ordering the books today, hopefully that will help in easing the worry I now have about having screwed up terribly. Teresa in Canada (where we only have Erfa Thyroid from what I understand)

  72. jobeth says:

    Just wanted to say I can’t believe all these problems with Erfa are still going on a year later.
    I was on Erfa 5 years then end of December 2013 I went down hill. I changed to nature thyroid and picked right up. Like anyone depending on thyroid hormone to live, I wasn’t going to suffer on Erfa any longer. I’d not trust Erfa again absolutely never. Not playing with my health. And Erfa you know exactly what you’ve done. Do you really think WE are all imaging it.
    Truth always comes out.

    • Sandra says:

      at least those in the states have alternatives, unfortunately those of us in Canada do not.
      I am very pissed off!!!!!

  73. Cujet says:

    As a pilot, I must maintain my T4, T3 and TSH levels perfectly to pass my flight medical. I don’t do well on Synthroid alone. What works for me, and gets my levels absolutely perfect, has always been 75mcg Synthroid and 90MG Armour, now Erfa. It’s foolproof.

    I’ve been experiencing extreme fatigue lately. And, on a whim, I searched for Erfa problems and found all the above!

    I’ve been noticing that as soon as I take an Erfa pill in the morn, I start to feel weirdly tired. Which in itself is quite unusual. By 6 or 8 PM, I start to feel normal again. (Labs are still great) , so I concluded that something was wrong with my Erfa 60Mg pills. I’ve noticed that if I don’t take an Erfa, and double up on Synthroid, I feel fine for that day, weird.

    Every time I try a long term return to just Synthroid, I have trouble with low T3 labs, constant hypoglycemia, and I start to feel awful after about 2-3 months. So simply going back to T4 is not going to work.

    I just received a new batch from Canada. (I live in FL) and I will take note of any changes. I may try Armour again.

  74. Mike says:

    Hi Guys!

    I’m going to be living in Europe for work soon and I’ve been trying to figure out how much it will cost for me to get an Armour or another desiccated thyroid prescription while I’m there. Does anyone have experience buying a month’s supply of Armour in Europe (specifically in either Germany, Italy, Spain or France) and knows how much it costs for non-Europeans that aren’t covered by the national insurance. I tried calling a couple pharmacies, but they didn’t speak english. Any help would be much appreciated! I really don’t want to pack a 6 month supply with me.

    • Marie says:

      Hi, Germany uses Armour as treatment still, dont know about those other countries. You will need a perscription from a doc. in what country you are in. Bring a letter from your primary doc. with you. Prizes on meds are the same as in USA or Canada… least they are in Norway 🙂


    • kim says:

      Mike, I live in the Netherlands and I am on Armour, if is very very expensive here, so I would bring it when possible!

  75. Jim Morphet says:

    Hi Everyone,

    I am a long time sufferer of Hashimoto’s / hypothyroid and have been on “Thyroid” for about fifteen years. At one time my symptoms were improved but over the last couple of years most are back. I found this blog very interesting and am now stuck with a GP who did not know desiccated thyroid existed and as long as my numbers are close to normal is not willing to discuss the issue using CFS / ME as the source of all my problems. As a male, 66 years old, 175 lbs and 6′ in height I have never been able to find out what the correct dose should be? I have been on 60 mg (plus .05mg Synthroid T4) for all this time. Your information seems to indicate that it may not even be that high? I get my meds in a drug store prescription bottle and do not know the batch number, etc.. Blood tests show normal range, suppressed TSH around 0 and T3 at low end of scale. Does my dose sound right? Is there still a problem with the actual Thyroid dose in 60mg? Thanks

  76. Anna says:

    I have been on Erfa 125 mg pills for the past six months (pink and white label), and I have had to raise the dosage from 6 to 8 grains daily (I used to be on 125 pills with a blue and white label). I have also noticed terrible itching since being on the “new” Erfa, and I need to take Benadryl in order not to go crazy. The other day, I decided to try the old version as I still had some pills left (expired). The itching went away within a few hours and, within 24 hours, I started feeling slightly hyperthyroid.

    So, in my case, the old version of Erfa enabled me to take less, and it did not cause any itching. The new one, with the different label, is causing terrible itching, and I required a substantial raise in dosage (2 grains) in order to feel the same. I doubt these changes would occur simply because Erfa switched production facilities…

  77. Mary says:

    I was treated with radiation for Hodgkin’s Dx in 1972 and it destroyed my thyroid. After a miserable 3 yrs of trial and error with Levothyroxine and Synthroid, I was finally given Armour. It was liking turning on the lights in a dark room. My life and health were restored. Throughout the ensuing decades, I had to change MD’s twice and each time they knew what was best for me and refused to listen to the fact that I was vibrant on Armour and insisted on putting me back on either of the 2 synthetics. After all, the pharmaceutical reps had told them that these were the standard and the reps carried more weight than the patients. Eventually they saw that I wasn’t responding and I was put back on Armour and life resumed. More years passed with no problems until 2008 when all my symptoms returned. I initially upped my dosage, to no avail. My doctor was not receptive and continually waved my lab reports in my face, telling me I was “in the normal range.” He actually told me that he thought I was making it up in order to take a higher dose for weight loss. I was 5’10 and 130lbs. No need of weight loss. I was also in Nursing school and in desperate need of my brain. Then came the shortages of Armour and trying to find a pharmacy that still had a supply. It was at that time that a pharmacist told me that the shortage was due to Forest Labs having to reconstitute their product. Much research revealed the addition of cellulose and that many, many people were suffering, like me, with an inability to assimilate this new formula.I was back to zero, with all symptoms raging. All the while, I got no help from the medical profession. Rather, I was labeled a hypochondriac. So, I was on my own and starting from scratch. I found a source for both Naturethroid and Westhroid in New Zealand. Naturethroid made me terribly sick with severe gastrointestinal symptoms and Westhroid was unpredictable with minimal improvement. At some point I discovered Erfa and my life was restored. It truly was life altering and such a tremendous relief after all the struggle. So, after some years of comfort, problems, again, arose. Having been diagnosed with MS a decade ago, I thought that the new symptoms of brain fog, severe, severe exhaustion, inability to get warm, insomnia, anxiety, alternating sweating/freezing and what seemed to be IBS were part of the MS profile. Finally, after months of thinking that I was regressing to the point that I was just slipping away, and even wrote my will, the brain fog cleared just enough to connect the dots to my previous thyroid problems.That was how I happened upon this site and saw how the pieces of the puzzle began to come together. I suppose that’s the good news. The bad news is, where do I go from here?

  78. Amy says:

    I ve been on erfa for years now and I don’t feel a difference… I still have some “bad hypo days” but it’s occasional and I accept that.
    When I saw the difference in the pills I was a little scared but nothing changed in my daily life.
    I don’t know why all those symptoms appeared for you guys but I don’t think I’m alone in my situation otherwise thyroid wouldn’t be on the market anymore. and honestly I hope it will never happen.

  79. Tracey says:

    I am in the process of trying to switch to NDT as I have had 0 luck with synthetic drugs. I am in Canada and after some research I am at a loss as far as what I should do. I do not want to start yet another treatment option that may or may not work. Any suggestions for which brand of NDT to go with?

  80. Randy B says:

    I have been on thyroid medications for 40 yrs. as a result of Graves disease so I have no thyroid. I was started on Synthroid and did very poorly on that. After trying every thyroid replacement you can think of I still did not feel well. I then discovered Armour and was on that until it changed in 2009. What a shame as I loved it and felt great. From there my option was to switch to EFRA which was an answer to prayer. Then in early 2014 I started not feeling very good and my thyrpod levels were very low. I ordered several different batches and had no improvement. If anthing, symtoms were worse. At the same time I had unwelcome symtoms I switched Naure-Throid. I had tried this one before and it was O.K., but not nearly so effective as Armour and EFRA used to be . I also have tried compounding pharmacies for natural thyroid, but eqach one is a little different. I feel like I am stuck with Nature-Throid and feel I am out of options. I need to know that dosage is accurate and does not fluctuate as I have run into problem with EFRA just recently with too much thyroid and ended up in the emergency room with A-Fib. I am now working with a doctor to determine the right dosage with Nature-Throid checking my thyroid more frequently. Once that is determined I will stay on this for safety reasons. I don’t like it…. I don’t understand why both manufacturers can’t return to the orginal formulas. With all the complaints and out cries you would think they would listen. Seems like if we can get men into space we could figure out how to treat thyroid disorders.

  81. Darren says:

    Total thyroidectomy and finally convinced my Dr to switch me from Synthroid to NDT this past summer. The change was immediate and I cannot begin to describe how good I felt. Went into the Dr. Mid summer and she was absolutely stunned at how good my numbers were.
    Then later in the fall, my numbers started to falter for some reason. She upped my doseage to 185 per day. Was in the Dr today and she says that my numbers where off again even worse than in the Fall. She has upped my NDT even higher. She commented that it’s like the whole makeup of the EFRA Thyroid changed?

    I had commented on what I had seen here. OK Efra… Something’s definitely up. What are you folks messing with?

  82. Gord says:

    Severe hives???
    My wife has been on ERFA for many years. Starting in August 2014 she developed severe hives that have become increasingly worse, bouts of anxiety, inflammation, sporadic swelling in the extremities and just feels generally terrible. Her hormone levels test good when we do her blood work. We have tried everything (changes to diet, laundry detergents, elimination of anything and everything known to cause hives). She got the first batch of the new ERFA pills in June and started using them shortly after. I am suspicious ERFA may have changed the innert ingredients or there is a contaminant she is highly allergic to. Has anyone else had similar symptoms?

  83. Keith M. says:

    Hi All. I am relatively new to this whole thyroid thing and treatment with NDT. However, I was diagnosed several years ago by my GP in Vancouver, Canada who immediately put me on Synthroid. Six months later when I encountered problems I told my GP I was done with it and went to a Naturopath, who put me on NDT. The benefits were immediate. The product was ERF, Moving forward to today, I am living in Lima Peru for the last year and had to rely on trips back to Canada or family and friends coming down to resupply me for the past year. The mail/courier system cannot be relied on to get anything important here. My most recent prescription came several months ago (DIN 00023949) expiry date?? Since taking this batch I have noticed a significant relapse of symptoms. Once I started searching on the internet was surprised and happy find out why but also very disappointed to discover the extent of the problems and lack of an immediate solution. I will be sure to read more and update my progress as my personal situation changes. Best Regards.

  84. Suze says:

    Thank you for replying, Janie. I hope for the best. I really hope they fix the Erfa problem. If the synthetics don’t work for me in the long run, I will try the desiccated again. I just want what works.

    • Suze, combining T4 with T3 works! 🙂 But there are lots of folks over the years who switched from those two to NDT and reported even better results. That impressed us.

    • Michelle G. says:

      Suze the following info is something else to consider, I’m going to look into it as well. I got this excerpt from an article on thyroid pharmacist.
      Compounded T4/T3

      Compounded T4/T3 products offer another alternative. These medications also offer the advantage of being made without fillers such as lactose or gluten, which are present in some thyroid medications and can be problematic for thyroid patients.

      However compounded T4/T3 products need to be prepared by a specially trained compounding pharmacist. These compounds are usually much more expensive and may need to be refrigerated to preserve activity.

      Thyroid compounds are usually prepared in the same physiological ratio that is found in Armour®, however, physicians can elect to change the amount of T3/T4, as the compounding pharmacists are literally making the medications from scratch. This can be a huge advantage for those patients that did not feel well on conventional treatments or natural desiccated treatments.

      The benefit of the T4/T3 is that they can be made devoid of any fillers that people may not tolerate, and they do not increase autoimmunity. Most T4/T3 compounds are immediate release versions, like Armour®, however, compounding pharmacists can also make sustained release versions. Some professionals recommend sustained release formulations so that the hormone is released continuously throughout the day, however, these types of formulations may not be absorbed properly by people with Hashimotos and gut issues.

      The downside of T4/T3 compounds is that specially trained compounding pharmacists need to make them, and do take some time to prepare. Additionally, not all compounding pharmacies are equal, and a specialized process is required to prepare an accurate dose of compounded thyroid medications. Thus, patients might have to travel out of their way to find a compounding pharmacy.

      Questions to ask your compounding pharmacist:

      What types of fillers are used?
      What is the source of the materials?
      Is the compound slow release or immediate release?

  85. Suze says:

    I really can’t find anywhere else to post this so I’ll do it here. Today I started on .50-Synthroid and .625 (one quarter of a 25) Cytomel. I got up early, took them, and went back to sleep. When I got up I was able to have a normal day. Yesterday I took no thyroid, and I was very hypo but I wanted to clear the Erfa out. The difference today is like night and day. No anxiety, no hyper or hypo feelings; I had normal energy to do my errands. No racing heart, no weakness. I calculated this dose based on 60 Erfa being the one that worked best for me, before they ruined it. 60 Erfa is 35 T4 + 8 T3. This dose of the synthetic 50 T4 + 6.25 T3 is a little bit better in the ratio of T3 to T4 but I will be adjusting it upwards as needed. The best year of my post-RAI life was 2009 when I was the most euthyroid, and I was on 100 + 10. That is what I will gradually go back to. I know that this website is a strong defender of desiccated but also approves synthetic T4 plus T3 if the desiccated can’t be tolerated or there is no source available. I did tons of research before I decided to go off the desiccated. I am very hopeful that this will be my answer.

  86. Suze says:

    After two days in a row feeling horribly ill on Erfa I have decided not to trust it anymore. I will go back to synthetic T4 and T3 as soon as I can get in to see my doctor. If you can’t trust the lab that makes desiccated thyroid, if they lie when people report that the pills are not working right, I don’t want anything to do with them anymore. I have had far too many severe hyper and hypo attacks on it, more than I ever had on synthetic. The argument has been made that every batch is tested to be consistent, and yet that is no longer true. Yes, in the 23 years of taking thyroid replacement following the radioactive iodine which destroyed my thyroid, I have had severe effects adjusting to all types and doses of thyroid, but the problems have been more frequent on the desiccated. Either it’s me or it’s the inconsistency of the pills. Either way I can’t take ERFA anymore. I am now hypo from cutting out all pills and letting my system try to clear out whatever toxic thing was in the Erfa. I so wanted to believe in the need for natural thyroid but I can’t take this horrible toxic reaction to it anymore. Would I go on Naturethroid or another brand if I could get it in Canada? No. I had a bad reaction to Armour in 1998, I am having a bad reaction to Erfa now, and I’ve absolutely had it with giving it another chance. First, no doctors understand HOW various thyroid hormones work in the body. They always guess what dose I should try next. (PS my endo is on every top doc list. My doctors are as good as you can get). Second, the batches cannot be guaranteed. I never dreamed they were bad until I looked at this site and saw all the warning posts that were not there last time I looked. Without suspecting the pills are bad, the patient wastes time and energy changing everything about her life to try to feel better when all along it was a substandard batch of the thyroid pills. I certainly have had enough.

  87. Suze says:

    Further to my recent post – I read all of the comments in the May thread and realized I’ve been having some of the symptoms others reported: strange itching of skin, brain fog, heart palpitations being the main ones. Also someone else mentioned the same expiry date as my batches – 10/16. I am going to the pharmacy and ask if they have a 2017 batch. I feel enraged that this medical mystery which my endocrinologist said didn’t make sense (the hypo/hyper swings) could be from a bad batch. Since I kept details of doses and symptoms for the past 22 years, I am looking back at the grief that Erfa has caused me. I can’t pinpoint it to one moment because when I got a new batch, I often cut pills and still used the old batch to make the right dose. It wasn’t until sometime this year that I was out of the old batch, except the ones in the pill cutter that I just left there. That is why I know they look different than the newer ones. In desperation I did try Synthroid a few days and I have to admit I felt better on it. I never wanted to go back to synthetic T4 but I think I might have to. First I will check if the pharmacy has a 2017 batch of Erfa. PS – other symptoms I’ve had are insomnia and diarrhea and catching every cold that comes around. I wondered for awhile if I was sensitive to the sugar in the pills or something else. I wondered if I had developed an allergy to them. Because like clockwork I’d usually feel sick one to two hours after taking the pills. Then it wears off by late afternoon or evening.
    Then I often feel OK but have insomnia.

  88. JoAnn Gray says:

    Hi all, I also have not been feeling good on Erfa lately after taking it for several years and doing great. I’ve gained weight, I’m really sluggish and tired, and most of all I’ve have been having headaches daily. I’m on 4 grains of Erfa, I’m going to try taking it sublingually and see if that helps. I have blood work scheduled for this month, and then I’m going to talk to my doctor about switching brands. I don’t want to go back on Armour, and I’ve also tried Naturthroid, and didn’t like it. Can anyone tell me what they switched to, and if they are happy, and feeling good! Thanks! 🙂

  89. Cathy Poland says:

    Hi, I’m 65, I’ve been on Canadian thyroid for 12 years. 3 weeks ago I got a new bottle of (125mg) Erfa 0375-016 is written on the pill bottle (not the original bottle which I don’t have) expiring in november 17th ’15. I’ve been feeling very flat, less energy, gaining weight, but worst of all is my digestion, although it’s never great these days and a weird skin sensitivity along my ribs on one side which reminds my of when I got an attack of shingles.
    I don’t know if it’s paranoia or what since reading the blogs but, one can tell there’s a difference after taking it daily for 12 years. I’m trying to find something in the US. Someone mentioned that ND can be gotten without ‘scripts’. Is it the same quality and strength as other types?

  90. Michelle G. says:

    Update to my ERFA experience. I started taking this product at the advice of my ND back in Sept/October, 2014. She started me at 60 mg and I didn’t feel any improvement for weeks until I bumped up the dose to 90 mg at the advice of STTM after I’d left a comment back in October (unfortunately I cannot locate my previous comments to leave an update there).

    I’ve felt none of the terrible side-effects that so many others have experienced here & elsewhere. This is my first experience with ERFA after being on Synthroid for more than 20 years. I’m relieved that I feel better, so much so that I can say unequivocally that my life has turned around! I have loads more energy even though I’ve just got my Cortisol test results back which appears to be rock bottom! Obviously there is more going on than just poor thyroid function but I have the energy to deal with it now whereas before I could barely get off the sofa…it’s been 180 degree turn around for me since getting on the correct dose (for me) of ERFA, which is also due to the help I received here especially from the Janie Bowthorpe! Thank you so much Janie. (btw I’m currently checking out your new book).
    I’m just about to get my FT3 & 4 plus TSH, Ferritin, and hopefully, CRP levels checked tomorrow…I’ll keep you all posted.

    • Michelle G. says:

      It took a while but eventually I experienced some rather unwanted & unpleasant side-effects to the ERFA. They came on slowly & subtly but it’s become apparent to me that I’ll need to find another solution to my thyroid issues. The really difficult part is that the ERFA addressed my crippling fatigue amazingly well BUT some mild itching, which began, about 2-3 weeks after starting on 60mg then slowly titrating up to 90mg, has morphed into unbearable around the clock itching plus I’ve inexplicably gained 10lbs mostly within the first 60 days of starting to take the ERFA. My hair is thinning as well. I have an excellent diet plus I hike/walk regularly…it’s NOT my diet. I chew the tablets then take a digestive enzyme with them & I’ve been using the same enzymes for nearly 9 months without any issues. Very frustrating. I think I might try Suzes’ idea of going back to synthetic…

  91. Colin says:

    I have been on Armour Thyroid for about 8 years and have felt great. I have had to self-medicate because the NHS in the UK won’t treat “borderline” conditions. However, in April of this year a test conducted by my GP showed that I was over in my T3 levels and so he asked me to reduce my dosage. When I did this, my T3 and T4 plummeted and gave him a test result that meant he could medicate me! Of course, he’d never heard of Armour but was able to prescribe it for me, so my first NHS prescription of Armour arrived a couple of days after. When I went to get my next prescription in August, the Pharmacist was “unable to get Armour any more” – could this co-incide with Forest Pharmaceuticals’ MASSIVE price increase this year!?? The Pharmacist put me on Erfa, telling me it was the same thing as Armour. I was working crazy hours in August and September as I am self-employed and was taking a three week vacation in October, so as I noticed myself getting more and more tired and lethargic, I dismissed it as the hard work in the lead up to the vacation. Now that I’m back I’m just getting worse and worse and feel like I’m non-medicated again. I’m horrifically depressed, cry at the drop of a hat, have no energy or motivation and my immune system is rock bottom – I picked up a head cold and cough on vacation and have now had it for almost 5 weeks without being able to shift it. Needless to say, I reverted to paying my private pharmacist for my Armour medication and the new bottle arrived this morning! I can’t wait to get back on it to see my symptoms improve, as I am so very deeply depressed on the Erfa. Has anyone else experienced this in such a dramatic way? I feel totally un-medicated at the moment… 🙁

    • Colin, you are now experiencing what MANY have experienced this year with Erfa…and which Dr. Knafo and the owner of Erfa completely deny is wrong with Erfa…..

    • Anna says:


      I have not been doing well on Erfa at all in the past few months. I have been considering switching to Armour, as many say they feel better on it now, and you say you have been doing great on it all along…even since before the 2009 reformulation, I take it?!

      I just seem unable to feel right on Erfa, I cannot really explain why…some of the pills make me itch all over my body, while others just seem ineffective…I admit to being at a loss here. I have tried both 30, 60, and 125 mg pills, and they all seem problematic…

  92. Anna says:

    I have been on 6 grains of Erfa (360 mg) for the past eight weeks. I combine 30 and 60 mg pills as I find the 125 mg less effective (all “new” Erfa with white/pink, white/blue, and white/green labels).

    I have been having terrible itching for the past few weeks. One day, I forgot to take Erfa because I was away all day, and the itching got a lot less intense. It came back the next day when I went back to my usual dose.

    Recent labs show mid-range FT4 levels, FT3 levels just below the upper normal range, and a completely suppressed TSH, so I don’t seem hypothyroid…not sure this is caused by Erfa, but I started on the “old” version (blue/white labels regardless of strength), and I never had this problem before…

  93. Dayna says:

    So almost two weeks ago now I renewed my ERFA prescription (it’s the only NDT available to me in Canada) Since then my skin has been so itchy! It’s all over but especially my scalp. Oh my god!! I wasn’t having any problem at all with ERFA before my renewal. I’m wondering if its the medication or if it’s just a coincidence.
    Yesterday i was busy and missed my afternoon dose, i then skipped my evening dose on purpose. i was itchy through the night and still itchy this morning. It’s been TWO weeks. This itch is driving me nuts. Would you have thoughts on this incredibly itchy skin situation? I’d really like it to stop! PS if its not the ERFA, what else could it be?

    Thanks Dayna

    • Anna says:

      If you are itchy (so am I), that must mean the composition of the drug changed, right?

      • If you were successfully using Erfa before and weren’t itchy, but now are with a new bottle, it can mean 1) you have developed an allergy, or 2) something is wrong with the new Erfa.

    • Marilyn Gilmore says:

      I had that itching all over and it nearly drove me mad until I ran out of anti-inflammatory pills I was taking for arthritis. I had developed a sudden reaction to NSAIDs, so I know you can develop itching suddenly without warning in response to meds you have been taking with no problem for years. Now I have terrible arthritis and cannot take anything to relieve it. I also have a t-3 shortage, but my doctor insists I only need t-4 and I happened across this site in search of some natural thyroid that I can buy over the counter with t-3. Can anyone help?

  94. Pamela Coughlin says:

    I’m starting ERFA in a couple days. I’ve seen others ask if anyone has had any problems with the ones expiring in 2017. If anyone has started some that expire in 2017 – please post. Otherwise, I’ll let you know in a few weeks.

    • Anna says:


      I opened a bottle a couple of weeks ago, batch no LF03505A exp: 02/2017. 30 mg pills. Since opening this bottle, the itching has been driving me crazy.

      I am also having the same problems with a bottle of 60 mg pills, batch no LF03141A, exp: 10/2016. Same reaction (terrible itching all over). I got both bottles at the same time, from a pharmacy in Belgium, this summer.

  95. Holly says:

    Figures! I’m Canadian, on Synthroid for 17+ years and just waking up from the “trust my MD knows best” daze. I’m experiencing so many hypo symptoms its not funny. So I’ve been reading and trying to get informed and came to the conclusion that I should try NDT and guess what, it seems that ERFA, the NDT available in Canada is in a bit of a quality control or reformation mess right now. I don’t want to try ERFA and be unsuccessful because there is something wrong with it. Is there another NDT option in Canada that can be recommended? Is there another method of obtaining effective NDT in Canada? Is there an update on the nature of ERFA’s problem; is it quality or reformulation? Based on what I’ve read it seems like they had a QC problem when they moved locations but its hard to say for sure. Any info would be appreciated. Thx.

    • Giz says:

      I’m in the same boat. Finally got an endo who will take off my synthroid shackles. Now I can’t get the DTH that has helped so many 🙁

    • Darcy M says:

      Holly, you can just get a compounded NDT at a compounding pharmacy. Not sure where you are but there should be something. And you can ask them to make the same ratio of t4 to t3 as erfa.

  96. Jen says:

    Has anyone used the batch that expires April 2017 for a few weeks? Is it still terrible?

  97. Anna says:


    Would you mind sharing with us the source(s) where it says that NDT is best absorbed sublingually, as my doctor insists it should be swallowed (not chewed or taking sublingually), and I have not found any online sources supporting the sublingual use of NDT?

  98. Joann Love MD says:

    Dear Janie, since forever I send patients to your web site. I was happily on ERFA and now have to order more natural thyroid. After reading about the problems with ERFA and after reading the list of natural thyroid from Germany, Netherlands, Thailand, etc. I am confused. I am wondering if you would share with us which thyroid you are taking. I remember reading the ERFA was your choice a while ago maybe 2009 or 2011 or so, and on that information I changed from Nature-throid to ERFA and was happy. Now I can’t bear the idea of going low again. So would you mind giving up that information Also I have a lot of patients who sent to Canada for ERFA and I have to either recommend Nature-throid or whatever else I can find out. I want to use this medicaiton sub-lingual. thanks for your time, work and dedication.

    Joann Love MD

  99. Janet Wright says:

    I have been on Efra 125mg a.m. and 30 mg x 2 during the p.m. Previously, Leothyroxine 0.175 for 20 years or more. I have virtually no thyroid left. I had radio active iodine 40years ago and went from severe hyper thyroid to severe hypo. I started having problems on the old med. which included almost every symptom of hypothyroid. My Doctor here in Canada switched me to desiccated thyroid Efra at the above dose. I really liked the feeling I experienced on the change over. Mostly, mood. I am taking a fair amount of this med. but am experiencing severe symptoms of hypothyroidism. Including low temp. of 94 am and not getting much above 95.6 during the day and dropping again in the p.m. Like Patricia July 2, 2014 I am experiencing extreme fatigue, can’t sleep, severe leg cramps etc. I am concerned that my batch of Efra is bad and compounding my problems. I have normally very low blood pressure and lately have seen a rise in my blood pressure to what most would consider normal but not for me. I also have extreme nausea and sometime feel my food is not digesting. I will try and get a cortisol and iron test done. My doctor is three hour drive away and the local doctors don’t believe in natural thyroid and certainly don’t understand what is going on with me. I have MCS chronic fatigue and severe food allergies. I will contact the company about my concerns. Upping the dose does not seem to work. I get thyroid tests every month and they are all so messed up my TSH was 46 last time T3 12. Any help appreciated.

    • Janet, sorry to read what you are going through. You have a predicament with Erfa being lousy right now and causing a return of hypo symptoms in many. But it also does appear that you might have a cortisol and/or iron problem on top of it all. So do the 24 hour adrenal saliva as well as all four iron labs, and let’s see what’s up there. See http:/ In the meantime, you might want to get on a different NDT med, but you’ll need to stay low until you treat potential cortisol and iron problems. Join the FTPO Canada group. It’s listed under #2 here:

  100. Chris says:

    Back in 2010, when my doctor decided to try me on NDT, I requested that it be Erfa, and avoid the problems that others were complaining about with the reformulated Armour. My last Erfa order for 3×100, 60 mg. tablets was placed in September 2013. It was filled with product manufactured in Belgium; Lot: 13G05, Exp.: 07 2016. Yes, one of the lots that has been associated with complaints. With roughly half of the third bottle remaining; in recent months, with symptoms reappearing, I have been feeling that I must now need a larger dose. In May, Free T4 was on the low side of the mid range (1.3); and Free T3 was scraping the bottom of the barrel (2.7). TSH was the same as it was five years earlier (1.3) before thyroid was prescribed.
    For years I have taken various HTN meds for BP, and now another doctor wants me on statins, to which I say: Absolutely NOT!
    One thing (amongst many) that I learned from “The Thyroid Summit” (June 2-9, 2014) was that both High BP and High Cholesterol levels drop if hypothyroidism is adequately treated. Originally, to listen to the week of (30+) interviews was free, and the introductory purchase price was discounted; but by the second day, I decided it was well worth purchasing, and did!
    Even at full price, I’m sure that I have paid much much more than that over the past thirty years to be told by at least five different doctors that my thyroid was “normal”. There is something therapeutic about hearing enlightened doctors say the same things about their uninformed colleagues, that I have thought.
    Catherine, I received a call back from Caroline Kort just this morning. Erfa no longer sells direct to patients; only through two Canadian pharmacies. There would have to be a lot of positive comments made to counter all the negative ones that Erfa has earned in this past year. I will ask to try WP-Thyroid next, and it may well even be covered by my insurance, and not require $36.00 in postage to purchase!

  101. Catherine says:

    Can someone tell me if ERFA is working again??

  102. Patricia says:

    This is my email today to Dr Knafo. I have been feeling like everyone else, wondering what the heck was happening, so I stopped by this site again & low & behold we have the same issue as when Armour reformulated their NDT. All the same symptoms I had with the Armour change I now have again with ERFA. Very disappointed to say the least. I am in the USA & have been ordering ERFA Thyroid directly from ERFA for a couple years now & the last two of my invoices state the “Country of Manufacture” are Belgium.

    Dr Knafo
    In March of 2013 I ordered 3 x 100 30mg bottles of ERFA Thyroid
    According to the pro-forma invoice the lot # was 12G16, Order # D70178-3770
    I was doing fine on taking 2.5 pills or 75mg per day I have been taking this pill & dosage for a long time

    In November 2013 I placed another reorder, however you were out of the 30mg at the time
    I ordered 3 x 100 60mg bottles Lot # 13G05, order # 70786-4210
    I started out taking 1.25 pills for 75 mg but found I felt like it was too much, so I switched to 1 at 60mg
    I was doing ok until I started taking the third bottle of pills, of which I have 69 pills left, so the last 31 days
    It could have been since the 2nd bottle of pills, I just cant remember how long its been that I have felt awful

    Many of the horrible systems I experienced when Armour reformulated their Thyroid, I am now experiencing with ERFA
    Light headedness, dizziness, complete exhaustion, not being able to fall asleep, not sleeping thru the night,
    Not wanting to wake up in the morning, muscle aches, psoriasis acting up, severe hair loss, major brain fog
    Where I use to be able to work 7-8 hours a day, I can barely make it thru 4-5 hours a day

    I am trying to get another appointment with my doctor, but it is a month out unless I can get a cancellation
    I sincerely hope you can figure out what happened to your Thyroid soon
    Thanks for reading my email

  103. miggie says:

    I was taking ERFA for 2 years and doing well on it. I saw some very positive changes such as weight loss and improved sleep after switching to it from Synthroid. However last summer I started to notice some strange side effects. I developed an irregular heartbeat, woke up in the middle of the night clenching my jaw and became fatigued. I wrote Dr. Knafo and he actually called my cell phone as he said this was the first he was hearing about any issues.

    I switched to Armour right away. I was not on Armour prior to the reformulation so I can’t make a comparison, but I’m doing the best I’ve ever done on Armour. I’m on a relatively high dose – 4.5 grains but I have no side effects at all.

    • CatherineM says:

      Hi Miggie,

      I have been on Erfa for a few years until starting experiencing bad symptoms recently. I had never considered Armour because they also have reformulated and received complaints. Would you suggest switching to Armour? How was the transition for you? Did it take time to adjust your dosage? You said you have to take more, can you explain?

      Many thanks, Catherine

    • Anna says:

      That is very interesting that you are doing well on Armour! I have also been considering switching to it, as only Erfa and Armour are readily available in Belgium where I live. I have been on Erfa for the past three years without any problems but, when I recently filled my prescription, my skin started itching, driving me crazy. At first, I thought I was reacting to something in my body lotion or shower cream, but then I forgot to take Erfa one day, and the itching went away in 24 hours…only to come back the next day when I took Erfa again. I have no idea what causes it, but it is driving me crazy. ..

      Therefore, I am glad to read about someone actually doing fine on Armour! Maybe I should give it a chance…

  104. Karen says:


    My Ferritin was above normal and I do not take any iron supplements. I see the DR tomorrow on that.

    Do you know if Synthroid has iodine in it? One of the inactives is Povidone . But that could be the straight filler.

    Thank you for your comments.

  105. Karen says:

    Janie – that is good to know. I throw out a lot of information main stream medical doctors say- I have yet to find an informed cardiologist – I find that I have more information than most DRS have. I would like to get back to NDT, probably compounded if I could find a good endo to follow me. Now that Erfa is having problems, I would be hesitant to go back to that product. I have tried all the other NDT and have reactions to their inactives. NONE of them are pure, even Whesthroid Pure has inulin which bothers me terribly.

    I pretty much follow the recommendations of Sherry Rogers M. D. in her books regarding heart health. I am trying now to get off Coreg, but when I skip a couple of days my heart beat goes up considerably. I believe I have too much adrenaline, so naturally Coreg stops infow of adrenaline and masks the disease. I am hoping my primary can advise me on that.

    • Karen, be prepared that it is very rare, say many patients, to find an Endo who is knowledgeable enough about NDT to know how to use or dose it. Most thyroid patients avoid Endo’s like the plague and instead reply on any other kind of doctor. But also understand that the reason you have reacted to other NDT’s may have nothing to do with the “inactives” and more to do with your low iron and/or cortisol problem. Did you read this?

  106. Karen says:

    Janie: NDT is not recommended for patients with a heart history. Especially at my age at over 65.

    • Karen, you have decide for yourself, but many patients have poo-poo’d comments like that and saw their heart health improve thanks to NDT!! One gal I remember was told she had congestive heart failure, got on NDT and overtime her heart improved! It’s the direct T3 that clueless doctors are so afraid of…yet many informed heart surgeons outright give their heart surgery patients T3 since the heart recovers better with T3!

  107. Karen says:


    At each ER for A Fib since Jan I had complete blood work. My iron was normal. All else was normal except for thyroid levels. I did not have any saliva testing of cortisol this year, but 3 years ago I did the saliva test and had high night cortisol.

    In all these past months of more than a year of hypothyroid, 6 months on desiccated, not one doctor or endocrinologist suggested saliva testing. At my worst point I was 60 + TSH and FT4 .3 and I had no idea how I functioned. I was not aware of the hypo in Jan, I think I was running on high adrenaline. I still feel it is high . But I take Coreg for the heart, and that blocks adrenaline. I would assume I would have to get off Coreg for a couple of days to have an accurate saliva test reading of cortisol.

    Important NOTE I found the lot number on the bottle of ERFA thyroid(that made me so sick) which I took in Jan of this year. It had an expiration date of JUL 23 2013. The date of the prescription was DEC 27 2013 and I received it 7 days later. It came from PharmaWest Pharmacy in CANADA. It had NO package insert. It did not mention “ERFA” thyroid on the bottle. IT just said thyroid. Even the personnel at the ER at Pomerado Hospital thought that was unusual. I had taken the bottle with me. An hour after I took a 30 mg pill I started A Fib.

    As I mentioned earlier, I had started ERFA in Jul 2013. I got two prescriptions from NORTHWEST Pharmacy. I had no problems at all with those two bottles.

    When I called PharmmaWest, I asked the pharmacist “How do I know it was really ERFA in the bottle – there was no mention of ERFA – no package insert?”.
    He was terribly defensive and even told me to go to another pharmacy, he would not help me. At that time, I had not seen the expiration date. I gave Dr. Knafo the entire story at that time. Today I e mailed Dr. Knafo with the lot number and ex date of the PharmaWest bottle with the history.

    Appreciate your comments.

    • Karen, you can’t go by what they told you. There’s no such thing as normal iron results, nor do doctors or most medical people know how to read lab work. It’s about “where” the results fall in those ranges, not the fact that the result does. I have no doubt that you have either inadequate levels of iron…and/or a cortisol issue, and that is why you aren’t tolerating NDT.

  108. Karen says:

    To Janie:

    I had no cortisol, iron or other issue. The 60-75 mg Erfa was not providing enough T4 – when I upped the dose I had heart palps. I have a history of heart surgery and the direct T3 was too much for my heart. Hospital DRS and 2 cardiologists told me in March to stop the Erfa.

    The first two scripts were from Northwest Pharmacy. These bottles were used through DEC. When I ordered the refill, it was from PharmaWEst Pharmacy and the pill was larger and a different color. I noticed it immediately. I tried it and felt awful. I called Pharmawest and the pharmacist there was very upset with the complaint. I complained to Dr. Knafe, told him I thought it was a bad batch, and he told me to order a new bottle from the Canadian Pharmacy which I did. I could only get 30 mg end of JAN. When the new bottle came, one hour after taking one pill I had an attack of A Fib. I started ERFA again Feb 2 and did not feel the terrible off feeling I had with the Pharmawest pill. Again, I could not get over 75 mcg without heart palps. I would have had to take at least 105 mg to get the optimal dose to get the FT4 normal. I had to stop Erfa less than 2 months after starting the 2nd refill. The pills from Canadian Pharmacy were also a different size. I was very suspicious, but knew I had to stop it so left it at that. I mentioned to the Pharmawest pharmacist “How to you know you were getting Erfa”. There was nothing on the bottle that mentioned ERFA. Only “thyroid”. Very strange. He was so upset about my questioning the authenticity of the product that he told me to go to another pharmacy. He hung up on me after a telephone conversation. I reported all this to Dr. Knafo. I have no doubt now that there was something different with the two refills I got in 2014.

    • Karen, I’m curious–what were your saliva cortisol results? What were your iron results?

      • Angie says:

        I understand that cortisol and iron issues can cause cardiac type symptoms and events BUT I do not have a problem on the old ERFA, Nature-throid..only on the NEW ERFA. My worst symptom was a crushing fatigue and a heavy feeling in my chest. At times HR would slow to almost nothing..consistent with A-fibbing. This was ERFA, not anything else as it dissipated on the old ERFA or Nature-throid.

        • Understood. Lots of people who once felt great on the old Erfa have seen terrible symptoms on the new Erfa that do not point to cortisol or iron issues. That’s clear.

  109. Lori T says:

    I just received a 500×30 bottle shipped from the UK, exp date:02/2017, lot # LF03508A and it seems to look like an old bottle. When I compared these new pills to my pharmacy ones ( came in a brown pharmacy bottle so no idea of date or lot) they looked exactly the same, not any shinier or spotted or indented. I am currently titrating up but am pretty sure my brown bottle pills are okay so hopefully the new ones are too. Strange that the exp date is 2017 but they look the same and what I have now and am not experiencing any side effects.
    Could this mean there was a bad batch dated 2016 only?

    Are all these pills made in Canada? My bottle says Montreal Quebec Canada.

    • Anne says:

      Lori have you stated those tablets with the 2017 expiry date and if so are you ok on them? I’d love to know where we could get them from with that date if they are ok! They used to be made in Belgium and shipped to Canada for distribution, but the new manufacturing plant is in Spain.

      • Lori T says:

        Hi Anne, yes I have started them and so far they are the good ones. I bought them from a company in the UK but the bottle was marked made in Montreal Canada. Not sure why this is but I am very glad they are the old version.

        • Anne says:

          Thanks Lori T, this sounds hopeful then that as stocks are gradually replenished we can go back to a good supply of ERFA. it’s interesting that you get them from the UK and I live there/here and have to get them from an offshore pharmacy!

          • Toni says:

            Hi Lori & Anne!
            Thanks for your information! I feel terribly awful since I started the 10/2016 tablets in mid April. Foggy brain and lots of pain all over my body. I’m desperate. I’m in Spain and I only get ERFA online. I will travel to UK next month for 15 days and I wonder where did you get the 2017 ones. I don’t have a prescription THANKS A LOT TO JANIE AND ALL OF YOU! Hope this nightmare is ending soon!

          • Toni, we’re all hoping with you that it ends soon. It’s just too bad that Erfa can’t be open about the problem they have in their tablets.

    • CatherineM says:

      Dear Lori T, I am experiencing the same problems with a new batch of Erfa. I was wondering if you could send me the link to that company from which you bought this good one? Thank you so much in advance. This precious information means a lot.

    • Jen says:

      Are you still good on the 2017 batches? I might cave and order it.

  110. Karen says:

    Correction: Levoxyl went off the market in FEB 2013.

  111. Karen says:

    I took 60 mg ERFA from August 1 through December 2013 and did fairly well on it. I tried every alternative out there when Levoxyl went off the market in FEB 2012, and had poor or no results from everything, even compounded.

    I had no side effects from the inactive ingredients of ERFA. End of DEC ERFA was off the market. I went the month of JAN with no ERFA at all, substituting instead Synthroid but not consistently due to severe reactions fo inactives. On JAN 28 my shipment of 30 mg ERFA arrived and an hour after taking one 30 mg I had an attack of A FIB, something I never experienced before. Went to ER for treatment. Converted within 20 minutes, all heart and other tests normal, and went home. I had a TSH of 46, DRS thought it was the hypo that triggered the A Fib. I had also taken a dose of ELTROXIN I had just received. No mention was made to stop ERFA. . With no ERFA to take in JAN and a minimal amount of Synthroid each day, I certainly became hypo that month.

    On Feb 2 I started back on 30 mg Erfa two times a day. It was definitely different! I reported it immediately to the Canadian Pharmacy that sold it to me. They made no effort to investigate, said I could NOT return it, and were very rude.

    Feb 19 I am back in ER with A Fib. I was still on ERFA. TSH was down to 26, DRS thought it again was the hypo as a main factor. My FT4 was .6, an increase in dosage was recommended. In the interim I reported all this to Dr. Knafo. He insisted ERFA was not the cause. I told him it was different from what I took in 2013. I even sent him 3 pills from the bottle and I never heard back from him.. I still have the last bottle I received in Jan 2014.

    MAR 6 another A Fib. This time the ER DRS said “GET off ERFA. I did. Switched to Synthroid, and after some fine tuning of doses I am doing fine on 100 mcg a day. I take a double dose pill and cut in half to eliminate half the inactives. No more A Fibs. No response from the Canadian Pharmacy I purchased the ERFA from or Dr. Kanafo. I KNEW there was something wrong with the batch I received in JAN. I almost fell off my chair today when I received notice of the STTM info on the ERFA problem from a friend. I will contact Dr. Knafo once again. See if he remembers me. Something is very wrong here!

    I am in SAN Diego CA.

    • Karen, not to take away that Erfa is now a problem and may have affected you…but it sounds like some of your issues were from taking too little, or having either an iron or cortisol issue. See

    • Jayne Nicholas says:

      I live in England and im taking 120mg efra thyroid for 6 months but my levels keep going up, my last TSH level was 136, my hair has died and had to have it shaved off, all my joints feel like they are broken, i get spasms in my legs, i lose my balance, i cant grip anything, my periods are really heavy and painful, i cant even walk to the shop as im in 2 much pain, my kidney keeps becoming inflamed as well.
      I had to give up work in December 2014 cos of being really tired and in pain all the time, im on 40 years old, can anyone give me some advice.


      • Jayne, so sorry what you are going through. It may be that you are simply seriously underdosing yourself. Read this page carefully:

      • gina says:

        Jayne Nicholas – OMG Jayne! I too ended up in the ER with kidney inflamation! I NEVER would have associated it with the bad ERFA I had been taking if I didn’t see your post. WTH is going on with this stuff?

        (From Janie: Gina, it’s not that Erfa directly causes kidney inflammation. Instead, it’s the return of the hypothyroidism that some experienced with Erfa last year that might cause that in some individuals. “Hypothyroidism” can cause issues on our body.

        I managed to get a hold of some 30mg Nature-throid tabs that 2 per day did me great for about 3 weeks. Baby hairs sprouting all over my entire head like crazy. So I had my doc give me a script for Nature-throid. Been on the new bottle expiring 3/19 for 2 weeks. Leg cramps are creeping back in and all my new hairs are dropping like flies!

        (Gina, that can be because you aren’t on an optimal dose yet. Any of us can go backwards on the lower doses if we stay on them too long)

        • gina says:

          I’ve been on this dose of NDT for apx 10 years. I had gone higher years back and it was too much. I finally leveled out at 30mg in the AM and 30 mg in the PM. At times 30 in the AM and 15 in the PM.

          • Gina, no one is denying that some batches of Erfa have caused a return of hypothyroid symptoms as reported by some patients (and note I said “some”–it apparently has not been true for all batches, luckily). STTM has been reporting this for a longgg time now, as indicated by the slew of posts, as well.

            But when you stated that you had issues with WP as well, that implies that something may have also changed in YOU, Gina, not in “both” Erfa and WP. WP overall has been a fabulous product as reported by patients. And when patients have problems with two or more completely different brands, they then find out that yes, they either had inadequate iron or a cortisol issue as revealed by doing all four iron labs and doing saliva…plus comparing their results to this page: And no, you can’t go by older results, Gina. Your iron levels or your cortisol levels could have changed since then.

  112. Carol Smith says:

    I can’t comment on whether Erfa has changed, but I can comment on my own experience. I was put on 30mg tablets 6 weeks ago and told to raise as I felt appropriate. I was previously on 50mcg thyroxine + 3 x Nutri Thyroid. I raised to 2 x 30mg tablets of Erfa and experienced constant, severe headaches and sore, stiff leg muscles. I stopped the Erfa and went back to thyrox/NT and all the symptoms disappeared within 48 hours.

    • gina says:

      Janie – Has DR Knafo ever sent us a copy of the results from the testing??? We need to have our own testing done. Is DR Knafo even really a doctor??? He has stated there have been no other complaints about certain batches that we know he has recieved. He has said nothing has changed in the formulation when the new pills are very different n many ways that can only come with a change in formulation, and now the is no DR Knafo to contact! hmmm. Didn’t Armour deny changes at first as well???

      • They all deny it, Gina. All we know is that there are quite a few patients who noticed a negative difference. If you want to pay a laboratory to find out what’s in the tablets, go for it.

  113. TRIN says:

    hello, i just received these 2 emails from Dr. Knafo.

    Sorry for the late reply. All the batches you mentioned are fine since we did run all the required tests.

    Best regards,

    Dr Henri Knafo, MD, M.Sc, B.Sc

    Directeur Médical/Medical Director

    Erfa Canada 2012 Inc.

    **Prière de prendre en note notre nouvelle adresse courriel

    **Please take note of our new email address

    Phone : 514-931-3133 Call free : 1-888-922-3133

    Fax : 514-931-7330

    Email :

    Thank you for your email. We just received all the retesting on the product and everything looks fine on our end. Did you have a blood test done ?


    Dr Henri Knafo, MD, M.Sc, B.Sc

    Directeur Médical/Medical Director

    Erfa Canada 2012 Inc.

    **Prière de prendre en note notre nouvelle adresse courriel

    **Please take note of our new email address

    Phone : 514-931-3133 Call free : 1-888-922-3133

    Fax : 514-931-7330

    Email :

  114. Sonia says:

    Can’t believe this … I have been feeling poorly for the last 6 weeks or so, and only realized today it coincided with switching from taking 4 x 30 mg or 2 x 60 mg to taking 125mg due to supply shortages. I got the 125mg in March, finished up the others first, and then started the 125’s. Almost immediately my symptoms returned, predominately fatigue, poor sleep, hair loss and dry skin. Finally went in to the doctor today, mostly because it seems my thyroid is larger, lots of neck pressure causing discomfort. The I came to do a search to see if I could get more of the 30’s or 60’s, and this is what I found!

    Whatever has been changed has caused return of my symptoms and inflammation. It will be interesting to see what the blood work shows. I am not sure what alternatives there are for me, this is the only brand I know of in Canada now.

    Any suggestions?

  115. TO EVERYONE: for some reason, I haven’t been getting notices for your posts. I am so sorry!! I just realized it and approved posts. I’m trying to get it fixed.

  116. TRIN says:

    I got a new batch in february and when i took the 125mg 100 tablets 12A30 01/2015 i knew immediately something was wrong. I contacted dr. knafo and this was his response
    Feb 20

    We did not change anything to the fillers and both strength contain the same fillers.
    Dr Henri Knafo, MD, M.Sc, B.Sc
    Directeur Médical/Medical Director
    Erfa Canada 2012 Inc.
    Then I had 60mg exp date 03/2016 and they were okay . a week ago I changed to a new batch 60MG 500 tablets LF03140A 10/2016 and I dont believe this , this is exactly the same nightmare I had with armour back in 2009. I dont know what to do . I never tried acella and im scared trying armour again.
    Does any of you have a batch from 2016 which is okay ? does anybody know a farmarcy which still have the good old tablets in stock.
    Does anybody does have one of these and are the okay.
    Erfa Thyroid 30mg 500tabs., lot LF03506A exp. 02/2017
    Erfa Thyroid 60mg 100tabs., lot LF03139A exp. 10/2016
    Erfa Thyroid 60mg 500tabs., lot LF03140B exp. 10/2016
    Lot: LF03057A Exp.: 10/2016 –
    Lot: LF03139A Exp.: 10/2016
    Sorry for all the questions .please let me know.

    • Anne says:

      Trin I hope you see my post here – you say you got a new batch in february lot number 12A30 expiry 01/2015, 100 x 125mgs and that something was wrong with them. I have been taking 500 x 125mg lot number 12A301 expiry 01/2015 for a year now and thought I was ok on them. I’m wondering what the ‘1’ at the end of mine means and if they’re the same batch as yours were or not.

    • Jen says:

      Hey Trin, did you get any info on whether or not the 2017 batches are OK or not? You posted this in June an I’m currently not finding much info on them at all!! People are still talking about the bad batches with the 2015 and 2016 ex dates.

  117. Cindy says:

    First, thanks to everyone who has posted and to Janie for opening the forum for us to share information and get to the bottom of this. Also thanks to Dr. Knafo for being responsive – I’ve emailed my information directly to him today also.

    I had also noticed a return of all of my symptoms (fatigue, hair loss, brain fog) since starting on a new bottle of Erfa Thyroid 60 mg. The lot number is the same as several other people having issues: Lot 13G05 expiration date 07/2016.

    I purchase my medication from Northwest Pharmacy in Canada (I live in the US) and am a prior Armour Thyroid user who needed to change when their formulation changed.

    I am hopeful that this is a batch issue and will try to get a refill from Northwest today with a different batch number to see if there is any change.

  118. Darla says:

    Has anyone heard from Dr. Henri Knafo yet? I switched from Synthroid .150 in February to Erfa 60 mg..latest tests results May/14 TSH:15.03, T4-7.0, Free T3:2.1….no wonder I have been feeling awful. So, my doctor has said to increase by 30 mg and if I still don’t feel well increase by another 30 mg. This is all fine and good if I knew that the pills would actually help and not make me sicker. I thought this would be my “Saving Grace”…

  119. Suzanne says:

    Is anyone feeling better on the most recent refills of ERFA? I am going to need to reorder soon and am very skeptical. I did try Westhroid P last summer as it was a lot cheaper for me to obtain. I went downhill fast on the medication and returned to ERFA after giving it a few months. I’ve heard about NP Thyroid being pretty good. I had taken Armour and Naturethroid with success before the reformulations. Where do we go next for medication? I am not sure I want to risk again with ERFA? Anyone try NP thyroid ?

  120. Sandra says:

    I called a pharmacy that used to fill my prescription before I changed to one closer by and asked if they knew of another dessicated thyroid besides compounding that I could try in place of “Thyroid” and she asked my why I wanted to change. I told her about how everyone including myself is feeling sick and the return of hypo symptoms since the start of the year and she said oh that is interesting, that coincides with when they were on back order due to the change of the supplier to Erfa and that the delay in shipping anymore out was due to the fact that they were conducting quality control tests until they passed.
    Ok, so, what is the truth?
    Among the other symptoms now, my joint and muscle pain has returned and feeling like an old woman going up the stairs, hips tight when just going for a walk. On the weekend, no energy the day after my chore day and was a write off, had to sleep 1 1/2 hours in the middle of the day, and I NEVER sleep in the daytime. I also experienced the return of depression and that resentful anger that I used to feel on synthetic. I am also have more food reactions, sensitive digetstion issues.
    So Dr Knafo. What is it, a change in compression of the tablets (which I have read on other message boards you have verbally told other people), a change in facility which you have told us or a change in supplier (which you have told our pharmacies) or all the above. Whatever it is, it is a disaster and needs to be fixed immediately! We in Canada do not have other options as others in the US do and you might as well be holding a gun to our heads as there are those of us who cannot afford compounded formulations.
    I am looking into filing a complaint to Health Canada and who ever that Erfa must answer to. I suggest others do to.

  121. Sheila says:

    I had been taking ERFA since the Armour Reformulation of 2009. I was very well regulated on ERFA and truly felt amazing. In late January, the Canadian Pharmacy was unable to fill m 60 mg ERFA Rx due to a shortage so they substituted the 30 mg tablets and doubled the order which also made it much more expensive. As I still had a couple of months of the 60’s I did not take these new 30 mg tablets until April, and I got very sick to my stomach and began to experience Hypo symptoms within days of taking the new 30’s. My doc had written me another script for ERFA but I would be very hesitant to fill it at this point. Instead I’ve asked for an Rx for Armour. Does anyone know how long it will take to begin to feel better with Armour? Is this going to be like starting again from scratch? Should I start low and work up to my full dose? How long should it take to kick in?
    The other question I have: Why isn’t Dr. Knafo asking for some of us to return our bad batches of ERFA. Am I the only one wondering if there has been some sort of counterfeit pills in the supply chain. I know that I’ve seen stories on tv about counterfeit prescription meds, though granted those usually involve meds with high street value, but still I am curious why the manufacturer isn’t more interested in making sure that there isn’t something else going on here. On the other hand, maybe it’s just my “brain fog” playing tricks on my mind.

  122. Sandra says:

    Not sure what is happening, I can’t see my comment from earlier today, just wondering if it awaits moderation?
    I was asking if anyone is in the Toronto Ontario area who has had a Thyroid prescription filled very recently and is feeling good on it and where did they get it filled.
    I would also like to know if there is any other options for us in Canada besides expensive compounding natural thyroid hormone. I need full replacement.


    All the bottles were sent last week. It takes about 12 business days to get the results. We should get the results by next week. I will keep you all updated as soon as I am in my office next week.

    Best regards,

    Dr Henri Knafo, MD, M.Sc, B.Sc
    Directeur Médical/Medical Director
    Erfa Canada 2012 Inc.

    • Angie says:

      Good! Will write in my calendar to expect a response from ERFA on or close to the 15th! Just to make sure that the problem was the med and not me, I again added a small amount of ERFA to my current Nature-throid regimen (1/2 grain in eve). Within a few hours, fatigue beyond description. Wondering if perhaps raw product is the issue. Interestingly enough, I have also had elevated porphyrins in my urine that are have normalized while taking N-T. Enough for my primary to refer me to a porphyria expert. Porphyrins can be elevated for all sorts of reasons…among them, heavy metal contamination..My levels are fine and consistent with older tests, BUT..something has most definitely changed. Wonder if T1, T2 and calcitonin levels are off in the raw product also? I sincerely hope, as ERFA was a wonderful med for me for 5 years now, that we are not being patronized and that ALL possibilities for problems are being reviewed..Look forward to hearing form ERFA mid-month.

      • Clare says:

        You make an important point – which is that there could be a contamination issue (as opposed to reformulation or a bad T3/T4 ratio). I switched to compounded after having a return of hypo symptoms with the new ERFA. Everything was fine once I switched to compounded. After a few weeks on compounded, I did the same as you and subbed a 1/2 grain of ERFA with my usual compounded dose. Immediately, I had extreme all-over body pain and my heart started pounding. There is no way I can take this new ERFA.

  124. Sandra says:

    I am at a loss due to the fact that I cannot know what batch I had my prescription from as my pharmacist said they cannot be sure what batch my pills came from. As I’d stated previously, the new batch he has is different in appearance, has the shiny coating and the ones that I currently have which I am going to run out of in the next week as not shiny. I know that some of you have felt unwell on pills that are not shiny as well.
    So here is my question.
    Is there anyone who has recently had a prescription filled in the Toronto (Ontario) area that is feeling better or hasn’t been affected or feel worse and do you know the batch number of your pills. If so can you let me know so I can call them and see about getting my prescription changed to them so that I can get a possible good batch of pills.
    thank you

  125. Kallu (thyroid removed ) says:

    I just buy few year Erfa pills, (cost 500 €) here in Finland. I see it’s not look same, it’s harder and color is little different.
    I have little left Lot:12K16 which is obviously old one.

    My whole thyroid is surgically removed and if there is so big difference in new Erfa Thyroid, I’m just thinking how it effect to me?
    I “keep alive” with thyroid hormone pills.
    I’m not feel very well even now, so maybe there is no so big difference between old and new for me (I hope).
    Anyway maybe still use all old pills, before start new one.

  126. Angie says:

    Janie, thanks for contacting ERFA directly and adding pressure to help those pts who are not doing well. ERFA was LIFE CHANGING for me back in 2009. How disappointing now just to limp along on another med and not feel well. Do we have any idea when we will hear from Dr. Knafo on the “independent lab testing” that they have performed? While my lab levels did not change, most definitely something has. Coming from an environmental testing background, I suggest..examining whether or not contamination has occurred and this includes contamination of raw product. Since manufacturing has moved from Belgium to Spain, one also wonders whether the source of raw product has changed. And whether T4/T3 ratios are perhaps different. All of this needs to be investigated. With 179 ciomments and growing, there IS most definitely a problem.

  127. Angie says:

    I want to add that I have had VERY negative experience with The Canadian Pharmacy (particularly David Zimmer) during all this ERFA “change”. Have recently asked for lot # for my first prescription and as far as I can tell, that email has been ignored. As have my requests for refunds on my 2nd refill (should be asking for refunds on both!).

  128. Angie says:

    I too have experienced many problems with the new ERFA. I can also report sore throat and allergic type symptoms. I have ordered two separate refills, but was only given the lot # for the 2nd. (LF03117A). I did have labs done on 2 grains of ERFA and am actually closer to hyper than hypo, yet something has changed. I, like a couple of others in this group, have seen symptoms so severe on this med (disappear on Nature-throid, but don’t do as well on N-T as on the old ERFA) that I too thought I was dying. Heavy chest feeling, severe weakness and fatigue. While ERFA at this point assures us nothing has changed, and claim to be investigating the problem, I have not felt well since my first refill in January. That will soon be 6 months of my life lost that I can not get back.

    Am disappointed to hear that Dr. Knafo has said he hasn’t heard from physicians. Most of us in the U.S. are ordering with ‘scripts from US physicians that might not be in a position to complain. My physician, if desired, I’m sure will be happy to communicate with Dr. Knafo.

  129. Dee says:

    That is strange because this batch, 125mg 13CO6 Exp date: 03/2016, is one of the batches that is causing problems for some of us.

  130. waveylines says:

    I started on a new batch about three weeks ago and am feeling much better. They all come in 500 bottles. My new batch numbers are:-
    30mg 12J25 Exp date: 10/2015
    125mg 13CO6 Exp date: 03/2016

    My old batch numbers that I became so unwell whilst taking them were:-
    30mg 13C01
    125mg 11H291
    (Pharmacist can’t find expiry dates…as he has thrown the containers out.)
    I think maybe I had a faulty batch rather than the actual composition changing? -otherwise why would i feel better on the ones that expire in 2016 which are my main dose of Erfa? If so this bodes well for all us Erfa Thyroid users as at least Erfa can put that right. My doctor says faulty batches happens all the time in pharma world…..scary! He was not concerned. The downside is as I took them for 5 months I have put on three stone….argggghhhh. At least i can go walking now without crashing and hopefully will be able to exercise properly soon and get the weight off!

    • Sandra says:

      I am at a loss due to the fact that I cannot know what batch I had my prescription from as my pharmacist said they cannot be sure what batch my pills came from. As I’d stated previously, the new batch he has is different in appearance, has the shiny coating and the ones that I currently have which I am going to run out of in the next week are not shiny. I know that some of you have felt unwell on pills that are not shiny as well.
      So here is my question.
      Is there anyone who has recently had a prescription filled in the Toronto (Ontario) area that is feeling better or hasn’t been affected or feel worse and do you know the batch number of your pills. If so can you let me know so I can call them and see about getting my prescription changed to them so that I can get a possible good batch of pills.
      thank you

    • Sandra says:

      So do you mean that if you exercised then you would hit a wall the next day, exhaustion? I too can’t seem to make my regular walks without paying a price in a day or two after. So very frustrating.
      This had better get sorted out. I am sure we are all at the end of our ropes with this change/error/bad batch/whatever it is they have done differently. How can they do this to us and get away with it? This affects my lively hood, I am a kitchen designer and it is affecting my ability to make creative and important renovation decisions at work, and it is hard sometimes to remember customers details when they come in a week later and I can’t, so very very embarrassing and enough is enough.

    • waveylines says:

      30mg 12J25 Exp date: 10/2015
      125mg 13CO6 Exp date: 03/2016
      500 tablet bottles
      I was doing much better now I had moved onto these new lot of tablets -as above. However i crashed at the weekend after having a really good week at work and even doing some gardening! Haven’t improved -now into my third day of feeling absolutely exhausted, just wanting to sleep with pain in the crease of my thighs -friends tell me I look tired and pale & ill. I really don’t understand what is happenng. My workplace have been kind up till now but I feel so awful that in reality I am struggling to do any work. Although I don’t want to I am going to have to look at changing brands -I can’t carry on like this never knowing how I am going to be. I just don’t understand what has happened…..Erfa please sort it out. 🙁
      Am so so so so so dissappointed.

  131. Marjaana from Finland says:

    I started to chew Erfa on last friday… don’t know if it’s the reason but I was in hospital on wednesday! I started to feel very sick
    at home, BP 188/115 and heart was wild 120/min even if I was lying down. At the hospital they took tests and my heart was ok
    thank god but they suspected that I was hyper. They give me Propral (beta) to calm down heart rate. It worked and I was able to
    go home at the evening. I will get my tsh, T4 and T3 results tomorrow so I have not taken erfa today. Let’s see. It was rather horrible

  132. Pete says:

    One thing I’ve also noticed with these new pills is the smell. I feel the new pills (and the bottle) smell much stronger than before. Has anyone else noticed the same?

  133. Dee (the Dee who posted on the first page) says:

    the guy who writes the prescriptions. He did write me a prescription for Compounded Thyroid hormone, though (note to ERFA!).

    Ive re-read the response from ERFA/Dr. Knafo, dated May 16, 2014; and I have to say that although I appreciate any form of communication from ERFA on this matter, the tone of the response doesnt reflect that ERFA is taking us at our (ERFA Thyroid patients) word that something(s) has changed with ERFA Thyroid. To say they havent heard from any physicians my experience was, I went to my doctor and told him Im reacting badly to the new ERFA. He wasnt surprised, and told me this type of thing happens at times with drugs, in that drug companies will up and change formulas with devastating effects on the patients who take them. He wasnt under any obligation to contact ERFA, though, to make a complaint to them. Hes just the guy who writes the prescriptions. He did write me a prescription for Compounded Thyroid hormone, though (note to ERFA!).

    I feel ERFA should take us at our word. Its not like one or two of us are having problems its many people from many countries on different continents. Its not just a few as Dr. Knafo states. To tell us to see our doctors to find out why this is happening? We dont need to see our doctors to tell us why this is happening. We are intelligent people who know that we felt we got our lives back on the old ERFA, at least as much of a life as some of us can possibly have; and now with the new ERFA we feel very sick and like we lost our life line. Please dont pass the buck, ERFA; and take responsibility for what has happened. Dont put the blame on us.

    If I sound a little frustrated it is because I am. Personally, I’ve been in contact with ERFA since January, and almost six months later we seem to be no closer to finding out what has gone wrong. Many of us deal with autoimmune diseases, and all of the ramifications of that; and to deal with this kind of stress, is harmful to our health.

  134. CHECK OUT THE PILLS and BOTTLES I ADDED i.e. EXAMPLE PHOTOS #3 and #4. It gets confusing if you go by the design on the bottle. But it “appears” that if your expiration is in 2016, you may have the new pills. If the indentation on your pills is deeper, you may have the new pills. if your lot number is larger, you may have the new pills.

  135. Theresa says:

    Any update re Erfa? My MD has switched me to compounded NDT but I am feeling worse. He wants me to try it until the next appt in June. Hair fall has doubled (really upsetting). I don’t know what is normal anymore or what to do. Just wish this had not happened.

  136. Robyn says:

    Hi Everyone,
    This is a copy of e-mail I sent Dr. Knafo …
    “I recently sent a prescription to you for a refill of Erfa’s Thyroid, and I was informed that Pharmasourcing was discontinued as a dispenser of your product. Your office directed me to another online pharmacy, The Canadian Pharmacy.

    At the same time I became aware of a widespread backlash from patients who were experiencing a return of symptoms with Erfa. Though this seems to be directly related to unannounced changes in the production facility, the machines, the formulation and final appearance of the Erfa Thyroid tablet, you personally assured me that I had nothing to be concerned about, that all the outcry was a coincidence, that your product was absolutely unchanged, and I could send my prescription and spend my money with confidence ….. Erfa Thyroid was perfectly the same.

    Regrettably, this is not so. I am experiencing a return of distressing symptoms that I have not had since I started on Erfa’s Thyroid in November 2012.

    The symptoms are numbness in arms, fingers and extremeties, severe hair loss, swollen face, hands, and knees, bloating, weight gain, burning and stiffness in muscles and joints, patchy skin, hoarse voice, fatigue and brain fog. It’s hard to imagine that all this would return in less than a week, but it did.”

  137. Lorraine says:

    Hi Everyone

    I also spoke with Dr Knafo last week. He came up with many other reasons why I feel off since I started my new bottle of Efra. The back of my throat is very sore and my tongue has sores all over it. Has anyone else experienced this. I am at a complete loss at this point.

    • Sandra says:

      Hi Lorraine,
      It might be interesting to hear what his “other” reasons were, if it is not too personal for you.
      That sounds like an allergic reaction or sensitivity. I know that when I eat nonorganic celery I get sores on my tongue. Is it nonstop or after you take your thyroid med?

      • Pete says:

        I also get sores on my tongue when I chew this present Erfa Thyroid…And my stomach objects to it, as well.

  138. jobeth says:

    Your symptoms are like how I was suffering from jan/ 14
    I have blood test from jan 14and again 12/ may 14 both very low.. Hypo. And me too packed hospital bag and told my husband its just in case. It might sound crazy but I was actually scared I was going to die somehow. Really frightened.

  139. Mary says:

    Erfa Thyroid 30 mg 500 tablets : LOT: LF03672A, Expiration date: 10/2016
    From Universal Drug Services Ltd, filled February 2014
    The changes in tablet appearance are very, very small: ‘new’ are much more glossy with hard coating compared to older batches. Color is the same – light beige/tan

  140. Cynthia says:

    Email to Knafo:
    I am one that has experienced terrible side effects since the beginning of 2014 (perhaps longer) with ERFA. Ive been on it since the 2009 Armour reformulation debacle although I have periodically taken Acella NP Thyroid with success during that time.

    I didnt get so sick until 2014 although I did have a significant drop in Free T4 during a 2013 Fall lab test but I just thought that was a fluke. Lab tests have never done a lot of good for me. Symptoms tell my story. And honestly, Ive never been sicker in my life as I have this year.

    Thankfully someone pointed me to Janies blog post in early May and I stopped ERFA immediately and started taking my Acella NP Thyroid. About the same time, another friend pointed out many of my 2014 symptoms were celiac reaction type symptoms. So I also went gluten free shortly after that. I have had significant relief of symptoms (severe digestive pain/problems, hair coming out by the handful, extreme muscle weakness, waking up with panic attack symptoms/heart palpitations, vision disturbance, numbness/tingling in extremities, pounding headaches, unable to sleep more than a few hours at a time, brain fog, and more) although the weakness and fatigue is still fairly profound.

    First, although you say there has been no change in the formulation you HAVE changed ERFA if you are compressing the tabs differently. These subtle things affect us. For example Nature-throidss so-called subtle changes have made it a thyroid med that doesnt agree with me well. I can take it, but I dont feel so great on it.

    Sometimes I wonder if our FDA is trying to ruin all natural thyroid hormone? Which has made me wonder how you ship into the USA since ERFA isnt a FDA approved drug? Certainly they didnt make ERFA make changes to continue the agreement to let ERFA through customs?

    But second, since so many of my reactions were those that can be gluten related, I would also ask if the new processing facility in Spain processes medications with gluten and if there is also a cross-contamination going on that perhaps is affecting those who are gluten intolerant?

    In any event, Im scared to death of ERFA now. I had originally ordered a 500 count of ½ grain tabs from one pharmacy and felt bad on them and actually wondered if they were counterfeit especially because it had a new label on the bottle. So I ordered some from my usual UK pharmacy and saw it had the same new label but I still had problems. I even packed a hospital bag in April because I was sure I was dying from something and didnt know how much longer I could live and yet was too weak to even get to a doctor. So something has changed it is not our imagination. And for those of us who lived through the 2009 Armour fiasco and worked so hard to regain our health, this was the last thing we needed. We TRUSTED that ERFA would not be changed and like I said, even making the tablet different IS a change.

    • Anne says:

      Cynthia if you think you may have been unwell since before January 2014 and had a drop in FT4 last year, do you know the batch number of the ERFA you were taking last year?

      • Cynthia says:

        I have always preferred the 30 mg. tabs but when I couldn’t order that (not available at the time), I did order 60 mg. tabs. My 60 mg. lot number is 12026 – Exp 04/2015 and I received it 5/13. That lot may be okay – although I’m not sure – because I think that would be the bottle on which my Free T4 dropped.

        I do know the problems really started when I was able to order 30 mg. tabs (that have the new label). I’m not sure when I received my first bottle of 500 tabs of 30 mg. But I started getting sicker when I went totally on the 30 mg. tabs.

        The info for the two 500 tab bottles of 30 mg. I ordered are:
        Lot 13C011 Exp. 03/2016
        Lot LF03057B Exp. 10/2016

        But I mostly have used only that first 30 mg. lot – so that is definitely the one that made me so sick!

  141. DIna says:

    Anyone has a link to an online pharmacy that sends working NTH to European countries?

  142. FYI: Dr. Knafo’s recent reply to a patient. We will all hope that the testing reveals the reason for the bonafide issues that all too many of you are experiencing, and which cannot be discounted. Janie

    I am sorry to hear that you are not doing well on the medication and we do take every concern seriously. I have reported all the patients side effects to Health Canada and we are currently retesting (full test) several batch in an independent lab. The result takes a few days and we will be able to give the results to all. This is in accordance to Health Canada standard in order to investigate patient complaints.

    All this is very surprising to us since we did not change our formulation and since the new facility making the product is up to all pharmaceutical standards. We will inform you as soon as I have more news.


    Dr Henri Knafo, MD, M.Sc, B.Sc
    Directeur Médical/Medical Director
    Erfa Canada 2012 Inc.

    **Prière de prendre en note notre nouvelle adresse courriel
    **Please take note of our new email address

    Phone : 514-931-3133 Call free : 1-888-922-3133
    Fax : 514-931-7330
    Email :

    Disclaimer :

  143. Sally Taylor says:

    Purchased in Late April/early May ordered online, shipped via Mexico
    Lot: LF03139B
    exp 10/2016
    I am on 3 grains RX Armour – felt hypo after hysterectomy. Tried to raise a half. Honestly can’t tell if it is doing anything…….

  144. Michelle Rossum says:

    Lot LF03141A. Exp 10/16. Safeway Pharmacy Edmonton

  145. Melissa Prefontaine says:

    I am so glad I saw this post as I have been struggling with my symptoms all reappearing for quite some time now. I have been using this Thyroid brand from Erfa for over 4 years now but just within the last year I have been having alot of issues… maybe this could be why? I have also been recently diagnosed with Celiac Disease but have been following a gluten free diet for over 4 months but I’m not feeling any better so it’s hard to know what the root of the issues are. Here is my latest prescription. I didn’t have access to the Lot# so hopefully these details can still be of use:
    DIN #: 00023957
    Strength: 60mg
    Pharmacy: Rexall Drug Store in Saskatchewan (Canada)

    Thx for keeping us informed. Much appreciation!

  146. jobeth says:

    has anyone switched then from erfa yet. i started feeling unwell hypo say in jan 2014.
    i switched monday from erfa 150mg
    to nature throid 130 mg plus 19mg = 149mg. brought me some relief, but by this friday
    i feel like am either going hyper or intoxicated. i stopped it a day.helped abit. i know i need the dose but its like i cant
    tolerate it. i feel my heart pounding and i am weeing every 15 minutes ,and my mouth is
    dry and i have a dehyration type headache, i cant stand noise or lights..driving me mental. i am craving salty foods so i am eating chopped tomatoes by the load and drinking lots of water so i am very worried.My eye lids and fingers are swollen again.
    so should i of restarted on a lower grain again and work up again. has the hypo affected
    my cortisol levels?. i have a ferratin of 58 and still working on it. i am swiiming in b12 , from b12 injections for
    my perniciouse anemia. i have had this hashimoto hypothyroidism ,16 years.
    erfa got me well after 11 years on Elroxin hell.switched to erfa 2009.. Never any luck with doctors or endo’s . i convinced them of the erfa and now nature-throid and i ran. ran out the door . JUST GRATEFUL TO GET IT.
    i cant tolerate lactose so dont have it. i will go for a coeliac test just to check.
    gluten free it daunting.
    i would be very scared to try erfa again. i cant play this roulette game with my health ever again..
    its unbearable at times.

    thanks so much x

  147. lilli says:

    500 125mg
    exp: 03 2016
    from canada

  148. Here’s a new twist, fellow thyroid patients. On the following page, you’re going to see a bottle of 125 mg Erfa, and the bottle is the new one. Yet on the right, you’ll see the pills inside, which appear to be the old 125 mg ones. Are they? Anyone have the “new” 125 pills they can send me? Are they out? I’ll post it on this page.

    In fact, send me closeup photos of any size of the new pills and/or a photo with it, side by side, of the bottle yours were in. Email me here: and let me know you have photos and what they are. I’ll email back, and you can attach your photos and send them to me.

    • Anne says:

      Janie I have the supposed ‘new’ batch you show in that photo, 13C06 expiry 03/2016, but I’ve been told they are from the old factory and yet I am also having problems with them, so badly that I only took them for 3 days. In comparing the photos shown in your Facebook post of April 21st, where you first showed the old and new bottles, you can see that the labels on the old bottles were all white with the name ‘erfa’ to the left of the bit showing the dose, but on the new bottles the labels have a coloured strip plus the name is now ‘ERFA’ and shown under the dose bit. On this latest photo you’ve just put up and asked about, the label shows the name as ‘erfa’ and to the left of the dose still, but with the coloured strip. This to me means that the labels began to be changed at the old factory and having a coloured strip on the label doesn’t necessarily mean they are from the new factory, there are possibly three different types of labels in circulation – the old all white one with ‘erfa’, the intermediate coloured one with ‘erfa’ and the new coloured one with ‘ERFA’. I hope this isn’t too confusing! I’ve also emailed this to you. By the way the tablets look exactly the same as usual but do not have such a strong smell. Mine do not have any shiny coating.

      • Anne says:

        Correction – the name ‘erfa’ on the 125mg tablets was always underneath the dose size. The difference is purely that in the photo of 21st April the name is written as ‘ERFA’ not ‘erfa’. My point is that the label doesn’t signify whether it’s old or new batch and I’ve been told by Dr Knafo that the batch number 13C06 is from the old factory and that no-one else has complained about it (but I know others have).

      • Sandra says:

        Hi Anne,
        I was trying to make out what you were saying above (could it be brain fog?) and wondered if you could clarify for me as I cannot determine with my pharmacist what batch my pills are from because my prescription was filled in March and my pills are dispensed into another bottle so we are not sure if it was from his current bottle he has on the shelf or not. I went in yesterday and we compared the pills to his current supply and it was very clear that my current pills do not have a coating and are not shiny but his are. When I explained what is going on, he was very very surprised that they had not been notified in what is a very clear change, that they are always given a notification if any medications ever change and that includes a coating. He was very thankful to have Janie’s website for this reference. So are you saying your pills that you feel unwell on are the ones without a coating?

        • Anne says:

          Hi Sandra, yes, the pills I have are the ones in the photo Janie has put up, they are batch 13C06 expiry 03/2016, they look exactly like the old ones did, they don’t have any coating, and are 125mgs and I bought them last November. I am in England and have to buy them myself so buy a year’s supply at a time and have enough already to last another month but tried those when I heard about the problems some people were having. Within a short time of taking those from batch 13C06 I had a badly upset stomach, and this happened for the three days I tried them each time after about 15 – 30 minutes. On the third day I also nearly fainted and felt light-headed for the rest of the day but I don’t know if that was caused by them or not. I haven’t taken any more since. I have been told by Dr Knafo that they are from the old factory in Belgium not the new one in Spain (this ties in with the fact they look just like the old ones) and that no-one else has complained about them, but I know of 4 others now who have that batch and are having problems.

          • Sandra says:

            Thank you so much for your reply Anne. Are the other people you know who are having issues with the noncoated pills posting here as well? Perhaps people can not only post their batch number but also if they know if there pills are the coated ones or not.
            Unfortunately I can’t even determine what batch I have since the Pharmacy dispenses into another bottle to give me but what I do know is that without changes to my diet (gluten, dairy and refined sugar free), exercise level, etc I am slipping backward. I am currently on my vacation, a staycation at home and a little gardening yesterday left me exhausted last night and today. I had such great plans to accomplish things at home this week, perhaps have people over and can’t even think straight to figure out what I or can or want to do. How depressing!
            thank you again for your reply Anne

          • Elizabeth says:

            Hi Anne, I’m also in England and I’ve been taking half grain tablets with an expiry date of 03/2016 and the ones I have definitely have active ingredient in them. What you experienced reminded me of what happened to me when I got a new order, though. Like you, I’d been working my way through a large batch of tablets and I think that they’d lost potency, so when I started on the new ones (from the same source and with the same expiry date, but presumably stored under better conditions than my sideboard) they were comparatively stronger and because I have high cortisol I got adrenalin-y symptoms, which reduced when I reduced my dose.

            All the best, Elizabeth

  149. Becky says:

    I switched to Erfa last year and seem to be doing much better. I do find it difficult to take off weight and have gained weight, finger tightness, but my labs were good with a low TSH of 0.1 on 60+30 mg Erfa. My lot # is 12K16, Exp. 11/2015 (60mg 500) and LF03057B, Exp. 10/2016 (30mg 500). Mine are from Inhouse Pharmacy

    • Becky, do you feel you are still on the old Erfa, or the new one? By the way, it’s the free T3 and free T4 you need to pay attention to once on NDT, not the TSH. Sounds like the 90 mg is underdosing you, which is common. Most people don’t resolve their hypothyroidism until they are at least somewhere in the two grain area or high.

      • Pete says:

        That was the good old Erfa Thyroid. My previous bottle was the exact same lot (12K16) and I felt fine with it. It wasn’t until the next lot that I noticed the tablets were harder and I turned back into a zombie.

  150. Diana says:

    What batch number and expiry date are the old batch?

  151. Linda Hess says:

    I did just send this info to the email as provided, but thought I would share here as well.

    I have Lot # LF03057B
    Expires 10/2016
    30 mg
    In House Pharmacy (online)

    My symptoms have returned, lack of energy – mild depression, and a sudden weight gain of about 7 pounds. Swelling fingers (ugh) means no rings again . . .

  152. Theresa says:

    What about those of us who just started on Erfa. I started the first of February. What does this mean to us….I was feeling a lot better, maybe felt 60% better….not sure what to do now. Was a huge struggle and production to get Erfa from my Nurse Practitioner.

  153. Theresa says:

    I could just cry. After much research and expense to find a doctor who would prescribe Erfa Thyroid, I found one(not covered by my insurance) and started Erfa Thyroid and was doing wonderfully well for two months. I had a prescription refilled in Dec. Soon after, the old hypo symptoms came back with a vengeance. TSH up to 4.8, hair falling by the handful, depression, no energy! I have been buying vitamins and supplements trying to get more energy, and stop the hair fall which is the worst. Now I find that it may be because of a reformulation? What now.

  154. Dr Knafo says:

    Dear all,

    I am Dr Knafo from Erfa Canada (the maker of Thyroid). I wanted to thank all of you for contacting me so I can compile and seriously check all the data. I wanted to clarify some facts in order to give the right information. We have over 15 000 patients in North America taking our product and the numbers are growing every day. We have had a few requests pertaining to Thyroid and we are currently investigating all those requests one by one. Those requests are from patients only and I have no complaints from any physician until now.
    Let me first tell you there was NO change in formulation. We are oblige to inform Health Canada of any changes in the formulation. The labels were changed a long time ago and a lot of older batchs have the same ‘newer’ labels.
    All the initial testing were fine prior to releasing the batchs. However, we have decided to reassure everyone and to retest several lot via an indepedent lab. We should get all the results of all of this pretty fast. Until then, if you do have persistant symptoms I suggest you contact your physician so he can investigate as why this is happening.

    Hope this clarify things a bit.
    Regards to all,

    Dr H. Knafo

    • Dr. Knafo, we are so glad to see you reply. That means a lot to patients. And many people love Erfa. In fact, many patients in Europe especially are dependent on it.

      We are also glad to see that you are taking these complaints seriously and are looking at retesting! Thank you.

      But Dr. Knafo, there won’t be many physicians who are going to know what to do when patients know this is about the “product”. The proof is in the volume and details of testimonies above. And more testimonies are coming into many forums as well, not just here.

      We hope you’ll figure this out. Erfa has always done a wonderful job for patients, and it’s disheartening when so many patients are seeing a return of their symptoms on Erfa, without having ANY other changes to explain it, after fighting so hard to be well again thanks to NDT.

    • Lora says:

      Dr. Knafo,

      I sincerely appreciate you taking the time to address all of our very legitimate concerns. Many of us have been quite ill for some time and Erfa Thyroid was the light in a very dark place. After many years of being unwell, upon starting on Erfa Thyroid, I began to feel healthy again. I am incredibly disheartened that, although no lifestyle and/or dietary changes occurred, my hypothyroidism symptoms have returned. You state that there were no formulation changes made to Erfa Thyroid; then why is it that the new pill even looks different – smaller, shinier, harder? Without a change to the formulation, how does our medication look so noticeably different?

      Again, thank you for addressing our concerns. I look forward with great anticipation to this problem being remedied quickly and efficiently…so do my three year old daughter and husband, as this has seriously affected my health.

  155. Suzanne says:

    I am so glad I came across this website. I never think of symptoms being bad thyroid medication. I need to start paying very close attention. I have extremely dry sinus passages(bleeding), weight gain, exhaustion, migraines, and dry eyes. My thyroid TSH has been moving upward toward 3.0 from 0.4. I just emailed Canada. I hope that this is a temporary problem or I will need to change medication.

  156. jobeth says:

    Hi there,
    Can anyone say what will happen if all this is proven, what will erfa do for all the people who have suffered from ill health from this. Its quite serious this.

  157. Marjaana says:

    I have been takin’ Erfa 60 mg since August 2013. I felt great allmost immediately, before that I took synthetic Thyroxin (=Finland).
    I went to blood test on November 2013 and everything was great there also. But… on february-march I started to feel sick again,
    tired, swelling on hands and ankles, gaining weight, dry skin… I thought whatta hell??!! Then I went to the lab again to take the
    blood test and all had been going worse, T4 and T3! I was right, something was wrong. I thought it’s my fault somehow, but now
    when reading these, I know it’s not our fault. The pill is not the same anymore. I’m so fcn sad now, must take synthetic T4 again,
    because in Finland we only have Erfa and Armour. And btw Erfa costs 195 €/500 pcs and 120 €/100 pcs… Quite expensive I think but I was ready to pay because I felt alive then!!

    • Pete says:

      We have also Liothyronin (synthetic T3) in Finland. I’m going to swap Erfa Thyroid for synthetic T4 + T3 combination if Erfa doesn’t change Thyroid back to what it was. I don’t trust Armour Thyroid anymore (because of the reformulation) and I am beginning to lose my faith in Erfa Thyroid too…

  158. Trisha says:

    Thyroid 60 mg 500 Tablets
    Lot: 13G051
    Exp. 07 2016

    Having a tough time since January. Just CAN’T get it right.
    Certainly do NOT feel on the mark or stellar by any means.
    Very difficult to function at times!

    * Sincere THANKS for looking into this! Thank you.

    • Pete says:

      I have a bottle from the same lot too and it’s not working. Please email Dr Knafo from Erfa about this ( so maybe he believes that this lot is also bad and does something about it.

  159. Marjaana says:

    Also the bad symptoms came back:-(, new bottle bought 21.1.2014, LOT : 13G051, EXP: 07/2016,
    60 MG/ 500 pcs bought in FINLAND EUROPE.

    • Pete says:

      I have the same lot and exp. date, bought the bottle in February. It looks the same as before but the tablets are much harder. And all my symptoms are back. I hope you also send Dr Knafo email ( about it.

      • Cindy says:

        I too have been using the same lot and expiration date since Feb 2014 with a return of symptoms also. I emailed Dr. Knafo yesterday. Has anyone tried taking Erfa from another more recent lot with any success?

  160. Marilyn says:

    100, 30 mg, LF03057A, exp 10/2016

  161. Theresa from New York City says:

    This Blog was very helpful ,was wondering can I ask my Dr. to prescribe me Efra. I have been on Armour Thyroid.

    • Janice says:

      Have your doctor write out your prescription to read “natural dessicated thyroid” versus a brand name. Then you can use it get ERFA or whatever brand you decide upon.

  162. Neeti says:

    That’s fantastic – I’m glad its being looked into:
    Lot #: LF03141A
    Expiry: Oct 2016
    Strength: 60mg
    Pharmacy: Sheridan Centre Shoppers Drug Mart, Mississauga

    • Neeti says:

      I’ve also sent an email directly to Dr. Henri Knafo.

      • Dee says:

        Hi who is your doctor in toronto i cant get anyone to prescribe erfa i am on syntroid right now i am going insane i cant seem to find a resolution to make myself feel better i am 28 i was misdiagnosed since age 22 just found out 2 years ago so much time and I’m still struggling to find proper treatment

        • Neeti says:

          Hi Dee, I totally understand your plight. I know of a doctor and pharmacy (joint office) that treats/supplies NDT in Etobicoke: Cloverdale Walk-In Clinic, 225 The East Mall, Etobicoke, ON M9B 6J1 (unit 9). I hope this helps! There are several doctors in that office. I recommend you call the pharmacy counter and ask which specific doctor prescribes desiccated thyroid and then make an appointment to see her. I am currently being treated by a different Dr. downtown Toronto who is retiring in the next few weeks. I too will be visiting this walkin soon.

  163. TO EVERYONE: Dr. Knafo has posted the following:

    Dear all,

    As you know we are currently investigating all the complaints that I received and I would like to ask for your help in order to complete the investigation.

    1. Do you have a lot number and exp date written on the bottle of Thyroid ? If so please give it to us.
    2. Can you tell us what strength(s) you bough (30, 60 or 125mg) ?
    3. Also please mention what pharmacy you bought the product from.

    Once this information is received we can go forward with the investigation. Please feel free to email me if you have other questions

    Dr Henri Knafo, MD, M.Sc, B.Sc
    Email :

    • Siri Simonsen says:

      Janie! There is full confusion about this matter now on my Norwegian FB-group 😉 We have studied the photos of ‘new’ and ‘old’ box, but we are still in doubt here… When, exactly, did Erfa change their manufacturer? And how, exactly, can we see if we have a box from the old or the new producer? There can still be old boxes sold from the pharmacies stock… We can see that earlier, all the different doses came with a white label, like the ‘old’ in the photo. But now, it seems like they ‘tagged’ the label on the different doses with a green stripe for 60 mg, and a pink stripe for 125 mg. (I don’t know how the 30 mg look like now). But there is also a change in the Erfa logo…. Old one with ’round’ fonts, and new one with ‘square’ fonts…. I have 2 empty boxes of 60 mg, both has this green stripe, but different Erfa logo. I bought the one with the old logo in 2012, and the one with the new logo in 2013….. Hope this makes sense to you, and that you can help us to find the answer 🙂

      • Siri Simonsen says:

        I’ve found out that the 30 mg box now has a blue stripe on the label 🙂

      • Siri, we were aware of a change to Erfa in January. Also, might be more insightful to examine the pills instead of the boxes. Some here have described the pills as now being harder with a coating on them.

  164. jobeth says:

    Just received email from mr knafo, erfa. Asking for lot numbers exporation date, strengths and suppliers.
    So they are listening and trying to get to bottom of this.
    Email him. It all helps.

  165. jobeth says:

    Hi, 500, 30 mg bottle
    Lot:LF03073A exp10/2016

  166. Sandra says:

    Has anyone tried to increase there Erfa dose to see if it helps, if you have you may be interested to know I was informed by Dr Knafo at Erfa that it is a bad idea as it could cause heart damage which of course is a very scarey thought. I would also like to know if anyone does know of another option besides expensive compounding natural thyroid hormone for those of us in Canada.
    thank you.

    • Sandra, yes, there are have been some in these posts report they raised Erfa and got no improvements whatsoever. I doubt nothingness will cause heart damage. In fact, even if someone raised the old better Erfa too high, we’ve not seen heart damage!! They figure it out by their hyper symptoms that they went too high, and they go back down.

      • Sandra says:

        Hi Janie,
        Thank you for easing my fear, would not want to have put my 76 year old mom in any position that would compromise her health by suggesting she try a small raise to see if it helps her hypo symptoms.
        thanks again!

  167. Neeti says:

    I’m so glad to have stumbled across this forum as weight gain, fatigue and excessive hair loss has been creeping up on me over the last few months with no change in diet, stress or lifestyle in general. For it to be Erfa’s Thyroid is devastating news in light of the obstacles I had to overcome to get treatment in the first place (Toronto, Canada). The thought of having to persue a different treatment now seems daunting. While symptoms speak for themselves, I’m curious, whether anyone tell me if their symptoms are accompanied by a change in TSH/T3/T4 levels? I had blood work from Nov 2013, Feb 2014 and more recently earlier this week. I will compare and post once I get my hands on the latest results (if anyone is interested).

  168. jobeth says:

    Me too unwell on erfa.
    Been taking it since 2009
    Had no probs, now became hypo on same dose. Tablets seem harder. I’ve switched ti nature- throid and chew it up. Feel better already after 3 days.
    I dont know whats going on.
    Just trying to stay well and its like climbing a mountain with this disease. Between hopeless doctors and now this, what the hell is going on.


  169. Dee says:

    If we have two choices, those being a change in cortisol or iron issues; or a change in the formulation I vote a resounding, ‘it’s a change in formula’!!! Confirmation for me is: I took one tablet of the new ERFA – > I had horrible, almost instant (probably about 30 minutes after taking it) debilitating symptoms. It took me about three days to recover from it. In the meantime I got a hold of some older stock, took one tablet – Aahhh! Relief. Felt much better. Got a different batch of ‘new’ ERFA a couple of weeks later (I ordered online because I was under the impression it was old stock but it turned out to have expiry 2016) -> took one tablet -> had horrible, almost instant debilitating symptoms. Took me about 3 days to recover again. In the meantime, went back to the old stock and scrounged up some more old stock from local pharmacies (yes, plural). Started the old stock again while recovering from the new-ERFA incident – same thing -> relief. Felt much better. That is 100% proof for me that something has changed with the ERFA Formula. Like I said above, it’s TOXIC, to me. It’s just not a coincidence that so many people are reacting negatively.

    • Samirah says:

      Did you email him about that Dee? Did he give you some sort of “explanation” as to why that was happening?

  170. Cynthia says:

    Hi, I just wanted to add my two cents – I’ve been on 5 grains of ERFA since the fall of 2009, spending a brief time on T3 in 2011. I have been feeling unwell for the last three to four weeks, my last refill being four weeks ago. I came across this post a few days ago and feeling a little less crazy, thanks Janie! Having some T3 leftover from 2011 I decided to take a dose last night before bed and two doses today and I feel much better, fog is gone, so is the fatigue and low energy, I still have a low grade near constant headache but I hope that will pass too. I contacted my pharmacist to see about getting different desiccated thyroid and living in Canada ERFA is the only option (unless someone else from Canada knows different). But for now I have T3 and feeling grateful that I do.

  171. Honey says:

    I am so glad I checked the blog today because I too have noticed that Erfa didn’t feel the same. I commented to my partner after I started my new bottle that I didn’t feel the same and wondered if something was different but then didn’t give it a second thought. Then after a few weeks I noticed I was feeling more tired so increased my dosage by another 30 mg but overall not feeling as good as I did before. I started to get back to more supplementation and adrenal support that I had stopped doing for a while because I felt so good and also going in for some Vitamin C IV’s to build up my energy. I also have been noticing that the tightness in my throat is starting to return which I was so happy when it went away when I started on Erfa. Having Hashimoto’s I was sooo happy when enough Erfa thyroid allowed me to feel normal again and if it wasn’t for the STTM website I would never have found a way to be normal again! I really hope they can change it back to the way it was I am even thinking of adding more, maybe another 30.

  172. waveylines says:

    My pharmacist has just phone me with the batch numbers i was on when I became ill. These are:-
    30mg 13C01
    125mg 11H291

    Anybody else become ill whilst on these?

  173. waveylines says:

    I feel I am going round in circles. My latest email from Erfa has told me I should see a physician to find out why my hormones have ‘fluctuated” (actually they have dropped) Dr K is also saying they have only had a few complaints…..maybe he should look online!! He’s also told me there is no problem with the batch I’m using yet I notice several people in this post are complaining about it. So what am I supposed to make of what they saying when it conflicts with comments on here. Am so disappointed with Erfa.

    • It is a fact that we have to discern the difference between

      1) doing badly on Erfa due to cortisol or iron issues, explained here: http:/…vs
      2) doing badly on Erfa after having done so well for so long, which implies a change to Erfa.

      And what I am noticing is not #1 for most of you, but #2. And I, Janie, am not a flippant nor quick-to-judge person. I analyze, pause, analyze again…and I have come to the same conclusion. It’s not rocket science when you consider all the experiences being expressed here and elsewhere. So yes, it’s disappointing to read what he said to you.

  174. Lorilee says:

    Hi Lorraine, I am in south Mississauga (thyroid cancer in 2010 with complete thyroidectomy) and just made the same transfer to ERFA yesterday! I was also on Synthroid together with T3 supplementation. Levels won’t be done for 6 weeks…don’t know what batch I received but it is interesting that the 1 gr tab I take in the AM has NO taste – just sort of a sugary taste…and the half gr I take in the afternoon has a completely different aftertaste. Do you find the same?

  175. Emma Rushe says:

    Am also taking Erfa (I live in the UK and have been able to get it here on prescription), used to love it but now I just feel TERRIBLE! I emailed Henri Knafo a couple of weeks ago, and today I emailed again to ask about the bad batch rumour in the hope it will be changed back, and I just got this reply this afternoon that I wanted to share with everyone – I hope it makes its way to Janie. Sadly it doesn’t seem like we’re getting anywhere… am trying to get hold of WP thyroid in the hope it’s better…

    Dear Mrs Rushe,
    There is no bad batch only rumors. I just checked your batch number again with the team and there is 2 letters missing (LF). This is indeed a new batch and therefore it should look different than your older batch.
    The look is different indeed but this is only because of the new equipment used. However the formulation is the same and all analysis are the same (in term of dosage).
    Only the blood work will tell us more information so I would wait for them.

    • Emma, that is an extremely disappointing email you got from Erfa to imply that reported multiple experiences from numerous level-headed and intelligent people is nothing more than rumor.

      Yes, Dr. Knafo, the look is different, and it may be because of new equipment. Yes, you may think the formulation and analysis are the same. But repeated and solid patient experiences worldwide tell the truth—SOMETHING IS WRONG. If you want to continue to deny the reality of so many reported experiences, get ready to lose money. Because patients will be leaving Erfa behind in the dust.

      • Emma Rushe says:

        Absolutely, couldn’t agree more! Thanks for all the fantastic work you’re doing Janie, I love your book, it really has helped me so much.

  176. Lorraine says:

    I just started Efra one an a half months ago. I had switched from Synthroid after being on it for three months, only to gain weight, and have a celiac reaction. I had read this site before excited to find out Efra was gluten free and it had the T3. Two days ago I started my new batch of pills, wow something it wrong. I feel very off! Never did I think they could do this. Everyone you are right they look different, so how can they say this. I would like to know if anyone out there with celiac disease , who has had their thyroid remove because of thyroid cancer is using a compounded T4 and T3. If so, are you liking it. I live in Oakville , Ontario.

  177. Clare says:

    Dear Erfa:

    What is beyond belief here is that your company, which has a reputation the world-over for a quality product, is allowing this discussion to go on without your input. In this day and age, it is unheard of for a company to allow such a widespread online debate go by with no comment. Your absence in this discussion is creating fear, confusion, mistrust and anger.

    Please, join the conversation and tell us the facts, and the steps you’re taking to address this issue.

    Thank you

  178. Dee says:

    Janie, if the physical differences are because of the change of manufacturers, it doesn’t make sense that ERFA would allow them to put on a pharmaceutical ‘glaze’ (which I would react to for sure) and then tell everyone that the formulation hasn’t changed. Well, it has changed if there’s a coating on it. So, that’s one reason for my skepticism. I also believe there is huge possibility that there is an ingredient change of some sort.

    Eaamon, it is true that ERFA did run out of their supply once the demand increased after the Armor reformulation. That’s why there was the shortage last Fall.

  179. Eaamon says:

    maybe this is part two of the Armour fiasco. what do I mean? is it possible when everybody fled to ERFA and they ran out of their supply they found some one who could supply them with some emergency pills and they were the Forrest Lab, Armour (compounder) that was left for dead. it may be the supplier who was making the Armour for Forrest.

    what scares me is the poor quality of China, India and made by who knows drugs sold on the internet. who made them? are they re-packaged and US label put on them? sold from other countries? almost sounds like street drugs. this is part of the reason why I would like to see where drugs become legal.
    legal for anybody to go into a pharmacy and buy what you want. at least you are getting drugs, you hope, that fall under USDA guidelines.

    if the thought of drugs from those countries scare you. I am also worried that “foods” prepared in those countries are next….. (if not here now)
    think “soylent green.”

  180. Dee says:

    Janie, I mentioned on another forum that although I am happy to hear they may be acknowledging about bad batches, it still doesn’t explain to me the actual physical differences in the size of the new 30 mg ERFA – it’s smaller, darker, and now has a shiny coating, whereas the old 30 mg ERFA was larger, whitish, and matte with no coating. And the difference in hardness and texture with the new ERFA. I don’t see what that would have to do with a bad batch of an ingredient. It still makes me suspect an ingredient change(s), too. It just doesn’t add up for me. The fix is – go back to the old ERFA formula, and of course, if there are bad batches, fix that, too.

    • The physical differences seem to fit that they changed pill manufacturers. But yes, it also appears that ingredients have changed somehow, similar to the 2009 Armour fiasco. We’ll see. I’m proud of all of you who have emailed Erfa. It’s simply the “power of the people” which will create the needed change. Good job!!

  181. JMR says:

    I’m so sorry all of you taking Erfa are suffering. Why don’t these companies understand that the slightest change can cause horrible problems? I take compounded T3 from Dr. Holtorf’s clinic. Some of my symptoms have been returning the past few months and I’ve been going crazy trying to figure out what’s wrong. I’ve tested everything, been very scrupulous with my diet and rest routines, etc, but I couldn’t figure out what was going on. Then I noticed my last few prescriptions have included Methocel in the meds. Previous versions of T3 had only T3, Avicel and food color. My only explanation for my symptoms is the Methocel must not agree with me or must make the T3 not be absorbed as well. Dr. H should know better. I’d be interested to know if any other readers of this site go to Dr. H’s clinic and if they’ve noticed a difference.

  182. UPDATE TO EVERYONE FROM JANIE (May 12, 2014): I have added this to the actual blog post, but wanted all of you to know that a gal from Sweden heard from Erfa today, and Erfa is now admitting that there was a bad batch or batches. Of course, this is NOT good news for those of you who have suffered from it. But it is good news that all your emails to Erfa have not been in vain, and we can hope to see them ensure that the Erfa everyone loved will come back!!

  183. Judith says:

    I’m on Nature-Throid, not Erfa. But Nature-Throid was reformulated a few years ago and became less effective, and I only learned about the change from this blog post. (Thank you!!) Three days ago, I increased my dose from 2.25 grains to 2.50 grains a day. Today I started clearing up a huge pile of stuff that has accumulated in the house over several years. I have made minimal progress on it in the past, and then given up, in exhaustion and too much brain fog. Today I cleared up about 1/4 of it and I believe I’ll do more soon. This is a big change. I can’t prove it’s because of the increased dose, but I suspect it is. I may need an even higher dose; I’ll see how the temps and pulse, symptoms, etc. improve. All I can say is that the work was easier than it has been, and normally I have no “get up and go” to do that sort of work.

  184. Dwood says:

    I feel like it’s not enough. Janie, are you still doing one on one consults, and if you are can you send me some info about it. Thanks.

  185. Nirak says:

    I just informed my doc about this, and she wants me to switch brands, to Naturethorid. But you can’t take that sublingually, can you? I think I can only choose between ERFA, Armour and Naturethorid … But if I can get something else what would be best? Is there any way to get an update on the different conversations with ERFA?

  186. Dwood says:

    It’s almost a week that I switched from 2.75 of Erfa to 2.50 of WP Thyroid, and my pulse has definitely dropped to 57. I was cautious about going straight across thinking WP might be absorbed better because of less inactive ingredients. I feel like it’s not going well. I know everone is different, but has anyone heard if one is stronger than the other. Bumped up today at 2.75, I’m a Zombie on a pulse of 57, and temp is 97.3. I appreciate any thoughts. Thanks

  187. Daisychain says:

    Thanks for saving my sanity, Janie!
    After being stable for a while I have been feeling more and more hypot for the past few weeks, feeling just awful. And with the brain fog returned I couldn’t work out why…..then I read this info and realised what was happening. Luckily I found some old tablets and tried them….voila! Within two doses I felt so much better and back to how I was a couple of months ago – before I started the NEW Erfa tablets. So, it’s definitely the change in tablets that are making me hypot – that’s proved it. I’m going to email Erfa to tell them.
    I’m in the UK so I’ll have to ask my doctor to change my prescription – is Westhroid better liked by most? Compared to Nature-throid or Armour?

  188. Dee says:

    I’m beginning to suspect an ingredient may have been switched over to cellulose – ie. maybe the talc was changed to cellulose. Because I’m guessing that cellulose is CHEAPER. I have an allergy to cellulose, so not only would that explain the allergic reaction I had; but the cellulose itself would also explain the immediate and drastic hypo symptoms I experienced on the ‘new ERFA’. Also there is a new shiny coating, and I’m sure I would react to that too.

    Another thing I’m guessing is that when the US’s Armor was reformulated, many more people starting buying our Canadian ERFA, which was sort of our little secret ; ) I believe then, that ERFA got a little greedy and started selling it in huge quantities. Then, lo and behold, they ran out! Then they thought ‘hey, let’s produce this stuff cheaper and we’ll make even more money’! Let’s call it a recipe for disaster because now ERFA no longer works for ANYONE. Just guessing, though.

    • Dee, those are interesting observations, especially your allergic reaction and thus, your premise.

      • Dee says:

        Janie, it may even be some other new ingredient beside cellulose, or maybe a bad batch of ‘something’ because in all of days, even prior to being diagnosed with Hashimoto’s, I don’t think I’ve ever felt as bad as I have after I took the ‘new’ ERFA. It was like I was literally falling apart (and in a very painful and horrifying way!). It’s like the new ERFA is toxic for me.

        • Daisychain says:

          Dee, I’ve been feeling exactly the same – just absolutely awful! Toxic is a good way of describing it!
          But it came on quite slowly for me, one symptom at a time.
          I kept thinking it was iron or cortisol or something else that was making me feel so bad, but once I tried some old ones I had in the back of the cupboard I felt good again.

    • Pete says:

      I suspect the same thing. When Armour was reformulated and they added more cellulose in the tablets they became much harder. Just like my Erfa Thyroid tablets are now.

      • Marjaana says:

        Can’t be true!!! I have been suffering now about 3 months of fatique and other symptoms. And bloodtests said that
        my feelings were right, unfortunately. I have been taking Thyroxin (synthetic T4 in Finland) 0,25 and Erfa together now
        but it doesn’t help!! Perkele#”%§ I’m mad now if this is truly happening!!! I’m not going to pay 120 euros of nothing!!!

    • gina says:

      Dee I was thinking along similar lines… I was wondering if these thyroid companies are trying to help establish that NDT is no good so that they can all start making more money selling synthetic which costs them even less to make and they can sell at a much greater profit.

  189. dawn says:

    I suspected a change a year ago when all my hypo symptoms returned just as they did in 2009… everyone kept saying no, no, no it has not changed.. yeah right. unreal.

  190. waveylines says:

    I have had a couple of emails from Dr Khnafo in response to my complaints. The latest lot of tablets that my pharmacist had ordered in he tells me comes from their old factories. So yesterday I switched across them -my ankle swelling has reduced overnight and today I can think a little clearer. However i have been completely resting for the last three days so it could be that -too early to say. He assured me they were investigating and was also concerned by my drop in Ft4 level. He was absolutely adamant that they haven’t changed any componant of their product. However he implies that the complaints that they were receiving were to do with lots from their new overseas factories….he said he didn’t know what the problem was but they were investigating and would let me know when their investigations were completed..
    My pharmacist buys Erfa Thyroid in for me on a special prescription (UK) -he buys the big tubs of 500 that would take me several months to get through. If I have had a faulty lot then this would fit in with the symptoms and signs that have been accruing as I have felt not well for several months -slowly declining.
    I am going to see what happens now i am on a new lot from their old factory in Canada –
    Really hope that Erfa sort this – I am on a fine line with my UK doctor and though it is tempting to switch if i ask the doctor he will probably take the opportunity to put me onto a T4 only medicine rather than another NDT, as i have already had to do recent battle to keep my prescription for Erfa going.. Nightmare!

  191. Cath says:

    This might be a silly question but is it possible for Canadians to get Naturethroid or Westhroid? My doc says no but he was also very hesitant to prescribed NDT.

  192. Darcy M says:

    Hi Janie,

    I have always had a hard time getting my dose up above 60mg. My iron is back down again right now, but was up at 130 for awhile and also working on low am cortisol by dosing with T3 at 4:30 am. I have noticed a difference with this overall.
    Today though, I did feel hypo symptoms again more than a few days ago and wondered if it was because of this new batch. But I have been on these new Erfa ones since Jan 31. The prescription then was in the new bottle.

    I will try the compounded ones if this 5 day sampling they gave me works. Would just like to know Erfa is going to be ok but don’t want to take a chance with the 120 pills I just purchased.

    • Sandra says:

      Hi Darcy,
      I am just outside the GTA and would dearly love it if you could give me the name of the pharmacy that is going to compound NTH for you so that I could also try them to see if it helps me. Also are you happy with your doctor who is working with you as I am always looking for someone better.

      • Darcy M says:

        Hi Sandra.

        Yes. So far I am very happy with my doctor. She treats with NDT and she is also very open to learning what really works with each patient. And, she really just gets it. Email me here and I can give you more info.
        The compounding pharmacy is called York Downs pharmacy on bathurst street. The doctor is in the same building.

  193. Darcy M says:

    I just came across this discussion today on FB. Now I am wondering if this has something to with the way I have been feeling for the past couple of months or more. I am currently taking 30mg twice a day, but back in Feb of this year, I started dosing with T3 in the early am. This has helped quite a lot and my temps are up closer to optimal because of this. But in January and until I started dosing with T3, I was having a hard time with hypo symptoms coming and going. At least more than before it seemed.

    But I have still been struggling trying to feel like I was, let’s say a year ago. Janie, when did Erfa make this change? I did read somewhere that Erfa made changes even as far back as Jan 14.

    I just got back from the doctor and am going to try a compounded desiccated thyroid. I never knew this existed. They did assure me thought that the T4 and T3 powder they use is a desiccated thyroid. And the formulation they gave me is close to Erfa’s. Or very close to it.

    If this works I would let anyone in Toronto Canada know so they can get their NTD compounded. Especially if Erfa is going to brush this whole thing aside.

    • Darcy, in your situation, it may have had more to do with the fact that you were terribly underdosing yourself. One grain (60 mg) is a starting dose from which patients have to raise.

      • BB says:

        Not so! That really depends on the person and situation. If I had started at a grain, I might be dead from cardiac arrest. My maintenance dose is half a grain and an eighth every day! (I think I calculated that right–1.25 of 15mg tabs in morning and night.) Any more than that, and my numbers are way too high and I’m hyperthyroid and can’t function. Please be careful how you advise people. It’s always best to start low and work up slowly to avoid overdosing.

    • Samirah says:

      I’d like to know that too, if we in Canada can get other brands of NDT over here. I’m from the Toronto area as well, please keep us posted on the compounded thyroid 🙂 I’ve looked at some international pharmacies and I think we have pretty strict regulations about these things here in Canada unfortunately. I’m going to talk to my Dr. about it when I see him the end of May, maybe he might know, I know he has a lot of thyroid patients on Erfa.

    • Marilyn says:

      Hi Darcy, Just wondering if you are taking the NDT compounded and how it’s working for you? I too live in Toronto. Thank You.

  194. Sandra says:

    I too have seen a return of some of my hypo symptoms and did notice a change in the formulation of the pills by texture, etc, I find they actually dissolve sublingually much quicker and crumble very easily. My pharmacist told me that the batch he currently has may have been used to fill my current prescription but can’t be sure. He told me the bottle label is the new one shown above and gave me the batch number LS03140A.
    I spent 5 years being severely hypo before finding the miracle of your website Janie and you have been my saving grace and cannot fathom having to go back to hypo hell. I too am in Canada and have been told by my Pharmacist that Erfa is all he has for natural thyroid hormone!

  195. Anne says:

    I don’t think it’s just this year’s production of ERFA that has changed. I have to buy mine, I bought 500 x 125mg last November, lot number 13C06 expiry 03/2016 and they too are wrong in some way. The most obvious difference was that there was a pink colour around the label, but other than that the lettering on the label was exactly the same as before, not like the new font lettering I’ve seen on your Facebook page Janie. The tablets looked the same but were a bit harder and the smell was a bit less. I don’t run out of my current jar for another month or so but tried the new ones when I read there were problems. I take 2.5 grains a day and gradually substituted new for old starting with 1/2 grain (I split the 2 grains). Firstly I had stomach issues within half an hour of taking them, then by the time I was up to 1.5 new and 1 old I felt lightheaded and faint as well. I have had a series of emails now with Dr Knafo and his Quality Control manager Daliah Saleh, 13 emails in all, and he insists that my tablets were made in Belgium not the new plant in Spain and that nothing has changed, but I think something changed before the move. It may not be a new formulation, it may be a lesser quality filler supplied or a new supplier of one of the fillers, or even a contaminated batch of filler. Whatever it is they are not inclined to tell us but let’s hope they are trying to solve this problem behind the scenes. I have pointed out to him that in the UK we have difficulty convincing our endocrinologists that NDTs are better than synthetics and that every time something goes wrong with them it adds to their scepticism. Not to mention that I cannot afford to discard £130 worth of NDT and buy a variety of other types again to see which suits me!

    • Your theory may be correct about it being a lesser quality filler because of a new supplier or even a contaminated batch of filler. Who knows. If you look at the history I explain in Chapter 2, you will discover that this isn’t the first time that a batch has been a problem. It’s the very reason Synthroid was thrust upon us by 1960–a bad batch of NDT came into the US and Canada.

      The important thing is that everyone needs to counter Dr. Knafo’s insistence that nothing changed, or his need to imply that it’s something in all of you that is the problem! There are simply too many of you experiencing problems worldwide for him to discount your experiences.

    • Ronda says:

      Anne, I have that exact same batch number (Lot 13C06, expiring 3/2016) of 125 mg Erfa pills. Same bottle of 500 pills with the pink band across the top of a mostly-white label. I have been using that lot for almost 3 months, but I didn’t start to feel unwell with a return of hypo symptoms until this past week, oddly enough. But something seems off with these for sure. I have enough Westhroid to be able to switch to that, so I am going to try that to see if my hypo symptoms go away.

      • Anne says:

        Hi Ronda, you’re only the fifth person I’ve found with that batch number who’s become ill! Dr Knafo told me I was the only one complaining about it so I’m thankful to know I’m not. I just keep on emailing him but it seems they may now found whatever has gone wrong and Ilm hoping they either reimburse us or replace our jars with decent ones! I knew within half an hour of taking mine that it was different and wrong in some way.

        • Anne, great thought you have there about replacements. Hope Erfa figures this out, goes back to the wonderful Erfa it used to be, and is ethical enough to give all of you the replacements or refunds you deserve.

          KEEP UP THE EMAILS TO ERFA. You have all done a wonderful job and it needs to continue to send a strong message that what has happened is absolutely not acceptable.

  196. Trisha L. Hogan says:

    This is absolutely, unequivocally BEYOND MADDENING! I lost my health 4.5 years ago with the Armour FIASCO and reformulation. It took me 1.5 – 2 years just to put the pieces together and discover the truth. By then however, I had developed Adrenal Fatigue which put me into a tailspin. Naturethroid did NOT work well for me, but then I was able to get on ERFA. I still wasn’t great though, because of my adrenal fatigue. I finally started on Iodoral (iodine) and I truly believe that that has healed my adrenal fatigue in large part, though it took me almost a year to be able to increase the dosage. The VA sent me Armour which I have no use for! Finally, after running out, I was able to get back on ERFA this past December. After implementing a couple other holistic remedies, I am now the best I have been in 4.5 YEARS! Did you hear me – 4 1/2 YEARS! And NOW today – I get this news! I just want to LYNCH THESE COMPANIES! It’s nothing but politics, corruption and outright greed! IT SICKENS ME to even THINK about it! 70 years or so ERFA has been out there. I thought it was the U.S. FDA and big pharm behind the Armour & Naturethroid reformulations, and that Canada’s ERFA would be safe; particularly given its longevity & efficacy. This has GOT to stop! I want to swear out every side of my mouth – and that is NOT me! If these preliminary reports of ERFA are as bad as they are reporting – then I hope ERFA goes out of business totally!
    4.5 YEARS to get my health back! Endless hours of research and jumping through hoops left and right. Somebody, I don’t care WHO – but SOMEBODY has got to
    get to the bottom of what is going on… and STOP THIS MADNESS & INJUSTICE!

    • Tamarah says:

      This is EXACTLY my story! I became sooo sick after the armour reformulation fiasco that I was housebound (and bedridden after my 5th child was born). I have spent the last 4.5 years clawing my way back to some resemblance of health, all the while trying to raise my five kids (and having gone through a very frightening time during the entirety of my 5th pregnancy). This makes me feel so incredibly hopeless…… could they change the one thing that has given me a life again?! I’ll be praying for all of us. Praying that God Almighty intervenes and causes them to realize this enormous disservice! praying that they will spin on their heals and go right back to the original formula! And I will also be praying that our bodies are somehow able to miraculously utilize this new formula if all else fails. I CANNOT afford to go back to where I was 4.5 years ago!

      Blessings and fervent prayers for everyone!

  197. waveylines says:

    I’m on Erfa and in the last month have just crashed – pharmacy gets my Erfa in on a special prescription so don’t see actual bottle it comes in…….have been wondering why i feel so so so ill. i have tried increasing my dose by half a grain (normally my winter dose) but to know avail. my latest Ft4 shows a drop from 25 down to 19 -now surely that is evidence that they are not being effective? Yesterday I increased another 1/2 grain as i am getting worse not better. Today I have had to take time off work as I literally cant function: swollen ankles, loads of weight, exhaustion, word finding difficulties, no stamina at all, poor memory, dry skin, blurred vision -i am back to how I was before treatment -shocking!
    I too have already been through this with Armour in 2009…….Erfa transformed my life back……no idea which direction to go in but will look through your list Janie. The cellulose fillers seem to eb the problem for me.
    And I will complain complain complain!!!! So shocked at Erfa.

    • Now that is interesting that your T4 is now lower, and it’s concerning that in trying to increase it, you are now worse. That could imply that your cortisol has risen due to your returning hypo (due to whatever has gone wrong with Erfa), and thus, you are now making more RT3 from the T4.

      Yes, definitely complain via the email I gave. We have to send a strong message that it’s something wrong with the product.

      • waveylines says:

        Thanks Janie -I use the CT3M method to support my adrenals with Erfa Thyroid……so it will have impacted on both levels…….sigh….

    • BB says:

      Please don’t change your dosage so fast without allowing 4 weeks for the new dosage to take affect. You could land in the hospital. Overdose symptoms can mimic hypo symptoms. If your heart races at any time or you feel winded walking a short distance, please check your levels and consider going to ER. I’ve overdosed accidentally before, and my friend did on NatureThroid because she thought she knew what she was doing but she ended up in the hospital in A-fib and hasn’t been the same since. Please please please be careful and get someone to help you figure out what’s going on.

  198. Chel says:

    When did they reformulate? I had a bottle with the green label from October 2013 and didn’t have any recurring symptoms- felt great through the end of the year. In December they had the shortage and so I had to order a higher dose in January 2014 but this one had the all white label. That was actually the time I started having all my hypo symptoms reappear. I do have an immune disorder though and I think my symptoms returned because I started “flaring” from that and don’t think it was related to the Erfa. I just got a new bottle in April 2014 that has the green label again- it’s only been a few days so no change in any symptoms good or bad. I just wonder if the color label is supposed to be the one that was reformulated then it must have been done back in the fall of 2013?

  199. Dee says:

    For me it was more than just hypo symptoms returning. After just one tablet of the new ERFA, I had the most horrible reaction. I had both allergic/intolerance reactions to something in it, along with the most severe hypo symptoms I’ve ever felt. For me, it is the end of the world. I live in Canada, so it’s the only ndt available to me.

    • jobeth says:

      Omg tell me, as I had gasgastrointestinal problems after taking the erfa. Also
      nausea, banging headaches.
      All went when I stopped and I am feeling better for last 3 days on nature throid. Strange ay.

  200. BB says:

    I don’t think it means it doesn’t work anymore. If that were the case, when I went on the new Armour from synthroid, it never would have worked, but it did and I’ve been stable on it and symptom free for a year.

    Please don’t be so quick to sound the alarm and cast off a med just because it changes. It sounds to me like patients just need to adjust their dosage on the new formulation. Here’s why:

    NDT has such a small range between under/overdose and right dose that a formulation change can be just enough to throw the right dose over or under. So adjust the dose until you find your new optimum one. It took me two years to find mine because changes had to be by quarter tablets and slow (my optimum is 1.5 grains total a day), but once there, it’s stable and I’m wholly well.

    Take heart, whatever they did, it’s not the end of the world.

    • Conversely, it’s important not to condescendingly discount the intelligence and experiences of a large body of patients who are now reporting hypo symptoms coming back…

      • BB says:

        Absolutely. They need to be taking these complaints very seriously and investigating.

        Correction: I calculated my maintenance dose wrong in my post. It’s half and an eighth a grain, I believe–in other words, 1.25 of 15 mg tablets.

      • jobeth says:

        You are absolutely right. And how can anyone dissmiss the length of it it takes to readjust to finding your right dose again, feeling ill mean time.

  201. Mary Jane says:

    Seeing this – I have to ask, has anything happened with the Acella Thyroid? Just 3 days ago, Walgreens was “out” of Acella and the pharmacist tried to literally force me into taking Armour. He told me that Acella is just the “generic” version of Armour!! I did not think this was the case? Anyway, I have been taking Acella for 3 years and in the last 6 months I have noticed being tired again. I am in the Stage 3, phase 3 of Adrenal fatigue though and am on Naturally Compounded Hydrocortisone. That capsule has been changed from non-clear to a clear capsule. I am on only .5 mgs of Acella and now I was told by a doc I just saw that with Adrenal Fatigue, I should not be on any Thryoid until that clears up! I am so confused…… Anyway, I feel for those with this change of medications – I know that can truly mess with our lives!

    Thank you for any info on Acella and not taking Thyroid with AF! Good luck to you all!


    • Yes, your issues are probably due to your cortisol issues. And absolutely not have patients found they need to be off thyroid meds while working on adrenal fatigue. You just will need to stick with lower doses for awhile, we’ve discovered.

  202. Pete says:

    I opened a new bottle of Erfa Thyroid two weeks ago. I realized right away that something was wrong. The bottle looked the same as before but the tablets were much harder than before. And surely, just a few days after that, my hypothyroidism symptoms returned. I was hardly able to function at work.

    I emailed Dr Knafo after that. He tried to reassure that only the factory had changed and nothing else. And that in fact, the lot (13G051) my bottle was from was made in the old factory. But something has changed, just as with Armour few years ago.

    Here in Finland we have only two NDTs: Armour and Erfa. So now I’m trying decide what to do. Go back to Armour or even back to synthetic thyroid treatment? I mean, synthetic t4+t3 combo can’t be worse than this, can it? Or should I just wait and suffer and hope that Erfa changes their product back?

  203. ME says:

    When this problem started with Armour and everyone found ERFA and we were able to buy without a prescription someone emailed Dr. Knafo. He swore that as long as pigs existed there would never be a change in formula. Clearly, once again money/greed played into this and his promises are useless. There is only one reason to change a perfectly good formula (ERFA, Armour) and that is because it’s cheaper to make. My heart is breaking for all those how need it. Very very sad day.

  204. Susy says:

    I was put onto Erfa by my endo at the beginning of february, having been self treating with armour for the past two years, within 3 weeks I had totally crashed. I have no thyroid function of my own, and have never felt so bad, even when previous tests have had my tsh over 200. I emailed erfa but got no response, got no response from the endo either and had to pay a fortune for express airmail of new pills from my old supplier. I was given them on the nhs because we are having to go without food and essentials to pay for them. back to square one, and now the added difficulty of actually buying them without a prescription, as more online pharmacies now want them. Its a very sad state of affairs, one which will eventually kill people like me who cannot get what they need and when they finally do the damn things dont work anymore 🙁

  205. Anna says:

    Janie, when you say that Armour is not as bad as it used to be, do you mean the formula changed again? I have been thinking about trying it, as it is readily available at my local pharmacy, whereas Erfa has to be imported. Not sure I want to go through that trouble if it is not working the way it used to.

    I emailed H. Knafo some time ago, on an unrelated matter, and he told me it was crucial to maintain a normal TSH at all times…

    • Yes, Anna, some of pills were changed back to being softer. And chewing the harder ones also helped. And sadly, Knafo is clueless about the TSH while on NDT

      • BB says:

        I notice that when I first fill my script of 90, the pills are hard. By the end of the script, they have softened considerably. I actually prefer them harder because they quarter better and don’t mush as much. I suspect the softening is from exposure to room air. Who knows, maybe it might help some people’s absorption better if they keep tops off new scripts for a few days. ???

      • gina says:

        Janie Is there someone else we contact now about the ERFA change? Dr Knafo’s e-mail is dead. I supect he was just a set up to begin with because all he ever did was say there is no change. Common sense says if the pills look different, smell different, taste different, and work different – that there must be a change. Do you know of a lab we can send the pills to to be tested?

  206. Mary says:

    Thank you so much for this heads up. I would have had no idea and I am do for a refill. Thanks Janie!

  207. Samirah says:

    I have some of the old Erfa pills and some of the new ones, and I can see a clear difference in the color of the pills, the older ones are lighter in color and more white, and the new ones are a bit darker and more beige in color, did anyone else find that? If they haven’t changed the pills, why are they a different color?!? (I have two different bottles of the older stuff, and one bottle of the new stuff, and both the older ones are the same more whiteish color, and the new one is darker and more beige\yellowy)
    Thanks Janie for keeping us all informed and up to date! appreciate everything you do soo much 🙂

    • Lauren Heizler says:

      Yes, the newer pills are a beige color. That was the first thing that I noticed when I opened up the bottle. When I went to take the pills sublingually, I noticed that they didn’t dissolve in my mouth like the older ones used to. They were much harder and were “grainy” in texture. It doesn’t matter how many of the pills you take. They’re dead.

  208. Ann says:

    What do we do if we can’t tolerate any ndt? I had to NP Thyroid, Nature Throid didn’t do anything for me – like taking a sugar pill and I’m having a horrible time on Armour. I had hoped to try Erfa, but now this. What do we do? I’ve been to many doctors and they just want me to go back to Synthroid.

  209. Paul Thomas says:

    In February this year I changed from Armour to Erfa. I did this simply on the basis of cost., assuming that they were basically both NDT. I suffered catastrophic decline in my health and have reverted to prescription T4. I wrote to my supplier InHouse Pharmacy who could offer no help. They are just suppliers.
    It is such a relief to know that I am not the only one suffering ,,, and that “it is not all in my mind”. When these things happen it is so difficult to work out what has gone wrong. Is it the pills, is it something else?

  210. Samirah says:

    What if we chewed up the Erfa and then stuck it under our tongues to take it sublingually? Or is it better to just chew it and swallow?
    I also wrote him an email, I sure hope they fix this!! I can’t function without those pills 🙁

    • Samirah, try it!! Let us know. And glad you wrote him. We need to POUND him with emails and stop the replies that it’s about YOU. It’s not. It’s about the pills having changed.

    • Lauren Heizler says:


      I tried doing that for two weeks. It doesn’t work. Whatever they’ve done to the pills can’t be undone by chewing the pills or grinding them into a fine powder before you take sublingually. The pills have been ruined, whether one swallows them whole or grinds them into a fine powder.

  211. Delan says:

    I am literally sitting here crying as I write this. I went thru the pits of Synthroid for years; I went to doctor after doctor begging for something to take other than Synthroid, to no avail because none would prescribe any thing different or EVEN mention there was anything different other than the generic Synthroid. I finally found a D.O doctor that prescribed Amour, A few weeks into it and getting NO better, I then found out the formula had changed. Eventually, found Erfa. After a few months on it, I was getting my life back. I was looking and feeling better than I had in years! However, the last scripts of Efra I noticed the pills were bigger! They were NOT in the dark blue bottles like before, but regular orange script bottles. I had suspicions then. I continued with them and slowly over the last month I have been feeling terrible day by day with return of those HORRIBLE hypo symptoms. I mentioned to my husband, I think something is WRONG with those Erfa pills! NOW I FIND OUT I WAS RIGHT! I sit here in despair, tears rolling down my face. I was FINALLY getting my life back after the horrible synthroid, numerous doctors, reformulations to other brands, tried compounds to no benefit, and now what? Back to the search for something else! I have NO thyroid gland from radiation. I HAVE to have something to take to keep me alive. Erfa was the one that worked for me until lately. Why why why, do these people keep changing things that work? Can someone PLEASE answer that for me? Also Id like to mention that my script recently went from 77 dollars to 111 dollars! Janie THANK YOU for keeping us informed!

    • Esther Newman says:

      I wonder…could the FDA be putting pressure on NDT manufacturers? Something must be going on for all of them to change their formulas! They will ban them, if they don’t change the formulas so the NDT doesn’t work, and people will have to go back to Synthroid? How much pressure can Pfizer, et al put on those manufacturers through the FDA or “other” government entities?

      • Betty says:

        Hello Esther,
        I am wondering the same thing as you. I was thinking that it can not be coincidence that the same thing keeps happening over and over and there must be an underlying reason. It is not so far fetched to suspect the FDA might be behind this.

  212. June says:

    THANK YOU for writing this article! I AM NOT CRAZY!! I just received a brand new bottle of 500 pills (exp-3/16), and I immediatley had every symptom return. I searched the internet trying to find out if my beloved Erfa was changed, and never found anything until now. I almost feel their is no thyroid in the new pills, and only fillers. I switched back to NP and chew it. No great, but better than Erfa!

  213. Lauren Heizler says:

    I sent Dr. Knafo an email last week informing him that because I had suspected that the new ERFA pills had the efficacy of a paperclip in treating hypothyroidism, I popped 10 pills into my mouth and waited to see what would happen. If the pills had truly been “unchanged,” as Dr. Knafo insists, I would have been rushed to the Emergency Room at our local hospital. As fully expected, however, NOTHING HAPPENED. Not even a raised heart beat. That told me right then and there that something had occurred to destroy the effectiveness of these pills.

    Dr. Knafo emailed me back and asked me to call him, which I did. We spoke for about 45 minutes. He gave me the same spiel that he’s giving everyone….nothing has changed…just the manufacturing location. Blah, blah, blah. He then suggested that I get my TSH levels checked out (who cares about TSH anymore?????) as well as my iron and my adrenals, etc. I told him that I get checked out regularly, and that none of these situations were causing the problem.
    He then said, “There could be hundreds of reasons why this product isn’t working for you. Perhaps you’re going through perimenopause right now?” I then said to him, “Dr. Knafo, what about the hundreds of other people who are writing to you and complaining? Are they all going through perimenopause? Have they all of a sudden overnight developed adrenal or iron deficiency problems? It’s obvious that the problem lies at ERFA’s end, not with any deficiency in people who up until this time have been meeting with great success with ERFA.
    I knew when I opened up my new bottle of ERFA that something was wrong. As soon as I saw the pills, before I even started taking them sublingually, I said to myself, “Here we go again. It’s the Armour nightmare all over again.” My instincts proved me right, as they always do.
    Now, I’m being forced to pop 12 Nutri-Meds into my mouth a day just to be able to slink along. With only 90 capsules per bottle, you can well imagine the expense this is going to incur.
    I’m so brain-fogged and depressed that all I want to do is stare at a wall all day long. I can’t clean the house; I can’t home school my daughter, I can barely communicate effectively in emails, which is why I leave most unanswered.

    Dr. Knafo was very friendly to me over the telephone, but he lives in the land of Oz.
    ERFA has definitely changed something. If Dr. Knafo believes that they did not, then I guess he’ll believe anything.

    I’m just wondering if I should try Nature Throid. I have to pay for these pills out of my own pocket. I just purchased a bottle of 500 (60 mg.) pills of ERFA (Lot #LF03139B) (Exp. Date: 10/2016) and paid a fortune for them. I don’t want to shell out more money for pills that may be equally ineffective.

    We KNOW that the product was changed regardless of what Knafo, et al. says. What we need to figure out now is WHY?

    You know what else I don’t understand….if Armour is so horrible, why are people still buying it? Why is the product still on the market? If people keep purchasing this crap, the manufacturers won’t have any incentive to make a change in their ineffective products.

    • That is disgusting. Glad you shared that.

      Armour is not as bad as it used to be. Plus a lot of patients are chewing it up. People are pleased with Naturethroid; also with WP Thyroid and NP Thyroid. Many of those on Erfa will end up moving over.

      • Judith says:

        What about Thyro-Gold? A friend of mine uses it, though I don’t know details of her thyroid condition. All I know is that her adrenals were weak, and she had to adopt a Paleo type diet and also take cortisol for some time before she could take much thyroid.

        Do many people use Thyro-Gold? What are the pros and cons?

        • Judith, patients love ThyroGold. The pros are that you will feel better. The cons are that you won’t know exactly how much NDT is in each capsule, so patients start on the 150 mg capsule and some pour it out and take it twice a day to start. Then they move up. You will know you are optimal when 1) all symptoms are gone 2) your mid-afternoon temp is 98.6 3) your free T3 is towards the top of the range 4) your heartrate and BP are good. If you have a higher heartrate/anxiety/palps etc, go here:

      • Aimee says:

        I am starting Armour in the morning. I was able to convince my doctor that the compound I was on wasn’t working for me. After reading some of these posts, should I chew my pills or put it under my tongue? Also, which is the best natural thyroid medicine to be on?! All comments welcome! !!

      • lori brosseit says:

        ive never chewed mine but all of a sudden my hair started falling out again and i thought maybe the pills were expired but maybe this new erfa thyroid is different and thats why..

  214. Judith says:

    This is so sad about Erfa.

    What happened to Nature-throid? I take it, and lately I’ve felt my symptoms returning in a big way. The coating got harder, and I e-mailed the company to ask what was changed. They said it was only a change in the coating, but now I suspect the formula has changed and it’s not as effective. I’ve been miserable, and wondering why I can barely move or think.

    • Within a year after Armour did it’s faux pas, Naturethroid also changed something, and patients saw a return of symptoms. But people still take it and report liking it. They may just take more than they used to, or chew it up. You might try doing the same.

      • Judith says:

        Thanks, Janie. I do chew up the Nature-throid, have done so for years, just in case. I might try taking more. Do we know how much more people have to take to get the same effect, or should I just go by my temperature chart? I don’t want to take too much.

        I’m not sure when my hypothyroid symptoms started. It seems they have been coming on for a while, gradually getting worse.

  215. Myriam says:

    Can’t we just start a petition…? I just switched to Erfa last week, there aren’t tons of NDTs available in Canada (Quebec) and I sure as hell don’t wanna switch back to Synthroid… I heard you could take it sublingually, did that change too? It just felt natural to swallow it… it doesn’t look like a pill that’s gonna melt under my tongue. What did they change?

    • Yes, anyone can start a petition. But not sure it will be any better than patients bombarding Erfa with the email I posted above. They need to hear this from all of you and often to figure out that they WILL lose a lot of business if don’t listen. They have already told another patient that it can’t possibly be their product, or that the patient needs to check her TSH (that is stupid)….yet there are too many who are having problems for them to continue to say all that nonsense.

  216. Anna says:

    The bottles now look different. The labels look different, they are now green, white, blue or pink, depending on the pill strength. The last batches I got expire in mid-2016, and all seem to be the reformulated version.

    I cannot believe this has happened again, after what happened to Armour and Naturethroid!!!

  217. Laura says:

    Is there a way to tell if we have the ‘reformulated’ version on a bottle? What was the date the manufacturer switched facilities?

    • Kara says:

      I took Erfa Thyroid from 2013 to 2016 and switched to sustained release T3-only for 2 years. I have recently switched back to NDT (because doctors said I needed T4) and I noticed the pills looked different right away. They used to be a flat matte grey but now contain brown flecks. I was hypo before the switch and now my TSH says I’m hyper but I don’t feel hyper at all and I definitely haven’t lost any of the weight I gained when I was hypo. I am also once again having trouble getting out of bed.

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