Re: Labs and Medicine Question (Compounded vs ERFA)

[Guest guest]

How do you feel on the ERFA? How did you feel on the NT?

If you are feeling well, I would not change what works. Your Free T4 looks good on the ERFA. Your Free T3 is at midrange. If you like it a little higher, you could take a slightly higher dose of the ERFA.

The difference in your Free T4 between NT and ERFA points up the importance of fillers. NT contains calcium which binds T4 much more than it does T3. It also contains cellulose. I think the calcium is a bigger problem than the cellulose.

ERFA has slightly lower amounts of T3 and T4, but what it has is more bio-available because it contains no filler which interferes with absorption.

I would take compounded thyroid meds only as a last resort. If you do decide to try the compound, you do not have to use your doc's preferred pharmacy. Call around and see what fillers other pharmacies have and what they would charge. Some compounders charge 3X as much as others.

Abrams Royal uses sodium bicarbonate as their default filler, but says they have others.

>> I got my most recent labs after being on ERFA for about 5 weeks.> > FT4 1.41 (.82 - 1.77)> FT3 3.2 (2.0 - 4.4)> TSH <.006 (0.450 - 4.5)> > Quite a change from my previous labs on Naturethroid (for about 3 months)> > FT4 0.87 (.78 - 2.19)> FT3 3.51 (2.77 - 5.27)> TSH <.003 (.465 - 4.68)> > > My current doc would like to switch me to compounded natural thyroid (using same porcine powder as Armour/Naturethroid, etc.). I asked at the pharmacy and they said the filler they use is Avicil as the filler. Searching around online I found it is microcrystaline cellulose, which some say causes the problems in the new armour and also with Naturethroid.> > I am wondering if it is worth switching to the compounded meds or if I should just stay on the ERFA. I have both and Dr. is open to me finishing out ERFA if I'd like. Or I could try the other for a while and see how I feel/check levels to compare later. Does anyone have a comment about why I might do one or the other? Do you think the Avicil could have been why I didn't do well on the Naturthroid? (All of the comparisons are at the same dosage of medicine, though I know ratios are slightly different with ERFA.)> > Thanks,> Grace>

[Guest guest]

How do you feel on the ERFA? How did you feel on the NT?

If you are feeling well, I would not change what works. Your Free T4 looks good on the ERFA. Your Free T3 is at midrange. If you like it a little higher, you could take a slightly higher dose of the ERFA.

The difference in your Free T4 between NT and ERFA points up the importance of fillers. NT contains calcium which binds T4 much more than it does T3. It also contains cellulose. I think the calcium is a bigger problem than the cellulose.

ERFA has slightly lower amounts of T3 and T4, but what it has is more bio-available because it contains no filler which interferes with absorption.

I would take compounded thyroid meds only as a last resort. If you do decide to try the compound, you do not have to use your doc's preferred pharmacy. Call around and see what fillers other pharmacies have and what they would charge. Some compounders charge 3X as much as others.

Abrams Royal uses sodium bicarbonate as their default filler, but says they have others.

>> I got my most recent labs after being on ERFA for about 5 weeks.> > FT4 1.41 (.82 - 1.77)> FT3 3.2 (2.0 - 4.4)> TSH <.006 (0.450 - 4.5)> > Quite a change from my previous labs on Naturethroid (for about 3 months)> > FT4 0.87 (.78 - 2.19)> FT3 3.51 (2.77 - 5.27)> TSH <.003 (.465 - 4.68)> > > My current doc would like to switch me to compounded natural thyroid (using same porcine powder as Armour/Naturethroid, etc.). I asked at the pharmacy and they said the filler they use is Avicil as the filler. Searching around online I found it is microcrystaline cellulose, which some say causes the problems in the new armour and also with Naturethroid.> > I am wondering if it is worth switching to the compounded meds or if I should just stay on the ERFA. I have both and Dr. is open to me finishing out ERFA if I'd like. Or I could try the other for a while and see how I feel/check levels to compare later. Does anyone have a comment about why I might do one or the other? Do you think the Avicil could have been why I didn't do well on the Naturthroid? (All of the comparisons are at the same dosage of medicine, though I know ratios are slightly different with ERFA.)> > Thanks,> Grace>

[Guest guest]

I thought that was the filler the old good Armour had in it? Is that wrong?

I didn't get a chance to try EFRA. I have been on the compounded thyroid med

from Dr. G for 4 weeks now.. Just got my refill yesterday..

Anyway, I am still feeling pretty great.. I plan to test again in 2 weeks.

[Guest guest]

I thought that was the filler the old good Armour had in it? Is that wrong?

I didn't get a chance to try EFRA. I have been on the compounded thyroid med

from Dr. G for 4 weeks now.. Just got my refill yesterday..

Anyway, I am still feeling pretty great.. I plan to test again in 2 weeks.

[Guest guest]

How is he to work with? Has he wanted to change your dose?

I think he is great, but I can get a chimpanzee in a white coat to order the tests I want and write my thyroid prescriptions. How do I do that? I speak "doctor talk" and make him feel like he is talking to another doctor.

I was appalled, however, that he would not prescribe desiccated thyroid for Fatima, who had thyroid cancer.

> > > > >> > > > > I got my most recent labs after being on ERFA for about 5 weeks.> > > > >> > > > > FT4 1.41 (.82 - 1.77)> > > > > FT3 3.2 (2.0 - 4.4)> > > > > TSH <.006 (0.450 - 4.5)> > > > >> > > > > Quite a change from my previous labs on Naturethroid (for > > about 3 months)> > > > >> > > > > FT4 0.87 (.78 - 2.19)> > > > > FT3 3.51 (2.77 - 5.27)> > > > > TSH <.003 (.465 - 4.68)> > > > >> > > > >> > > > > My current doc would like to switch me to compounded natural > > thyroid (using same porcine powder as Armour/Naturethroid, etc.). I > > asked at the pharmacy and they said the filler they use is Avicil as > > the filler. Searching around online I found it is microcrystaline > > cellulose, which some say causes the problems in the new armour and > > also with Naturethroid.> > > > >> > > > > I am wondering if it is worth switching to the compounded meds > > or if I should just stay on the ERFA. I have both and Dr. is open to > > me finish! ing out ERFA if I'd like. Or I could try the other for a > > while and see how I feel/check levels to compare later. Does anyone > > have a comment about why I might do one or the other? Do you think > > the Avicil could have been why I didn't do well on the Naturthroid? > > (All of the comparisons are at the same dosage of medicine, though I > > know ratios are slightly different with ERFA.)> > > > >> > > > > Thanks,> > > > > Grace

[Guest guest]

How is he to work with? Has he wanted to change your dose?

I think he is great, but I can get a chimpanzee in a white coat to order the tests I want and write my thyroid prescriptions. How do I do that? I speak "doctor talk" and make him feel like he is talking to another doctor.

I was appalled, however, that he would not prescribe desiccated thyroid for Fatima, who had thyroid cancer.

> > > > >> > > > > I got my most recent labs after being on ERFA for about 5 weeks.> > > > >> > > > > FT4 1.41 (.82 - 1.77)> > > > > FT3 3.2 (2.0 - 4.4)> > > > > TSH <.006 (0.450 - 4.5)> > > > >> > > > > Quite a change from my previous labs on Naturethroid (for > > about 3 months)> > > > >> > > > > FT4 0.87 (.78 - 2.19)> > > > > FT3 3.51 (2.77 - 5.27)> > > > > TSH <.003 (.465 - 4.68)> > > > >> > > > >> > > > > My current doc would like to switch me to compounded natural > > thyroid (using same porcine powder as Armour/Naturethroid, etc.). I > > asked at the pharmacy and they said the filler they use is Avicil as > > the filler. Searching around online I found it is microcrystaline > > cellulose, which some say causes the problems in the new armour and > > also with Naturethroid.> > > > >> > > > > I am wondering if it is worth switching to the compounded meds > > or if I should just stay on the ERFA. I have both and Dr. is open to > > me finish! ing out ERFA if I'd like. Or I could try the other for a > > while and see how I feel/check levels to compare later. Does anyone > > have a comment about why I might do one or the other? Do you think > > the Avicil could have been why I didn't do well on the Naturthroid? > > (All of the comparisons are at the same dosage of medicine, though I > > know ratios are slightly different with ERFA.)> > > > >> > > > > Thanks,> > > > > Grace

[Guest guest]

With a compound, you are dependant on the skills of the compounder. I have had subpotent estrogen from two different compounders.

I also like the flexibility to fine tune my dose (with my doctor's permission) especially when switching to a different brand. And sometimes, if I am having an afternoon slump, I may steal 30 mg from my evening dose.

When I have imaging with iodinated contrast, it is necessary to reduce my dose to avoid tachycardia, and I cannot afford to just omit the evening dose.

> > >> > > I got my most recent labs after being on ERFA for about 5 weeks.> > > > > > FT4 1.41 (.82 - 1.77)> > > FT3 3.2 (2.0 - 4.4)> > > TSH <.006 (0.450 - 4.5)> > > > > > Quite a change from my previous labs on Naturethroid (for about 3 months)> > > > > > FT4 0.87 (.78 - 2.19)> > > FT3 3.51 (2.77 - 5.27)> > > TSH <.003 (.465 - 4.68)> > > > > > > > > My current doc would like to switch me to compounded natural thyroid (using same porcine powder as Armour/Naturethroid, etc.). I asked at the pharmacy and they said the filler they use is Avicil as the filler. Searching around online I found it is microcrystaline cellulose, which some say causes the problems in the new armour and also with Naturethroid.> > > > > > I am wondering if it is worth switching to the compounded meds or if I should just stay on the ERFA. I have both and Dr. is open to me finishing out ERFA if I'd like. Or I could try the other for a while and see how I feel/check levels to compare later. Does anyone have a comment about why I might do one or the other? Do you think the Avicil could have been why I didn't do well on the Naturthroid? (All of the comparisons are at the same dosage of medicine, though I know ratios are slightly different with ERFA.)> > > > > > Thanks,> > > Grace> > >> > > > > >>

[Guest guest]

With a compound, you are dependant on the skills of the compounder. I have had subpotent estrogen from two different compounders.

I also like the flexibility to fine tune my dose (with my doctor's permission) especially when switching to a different brand. And sometimes, if I am having an afternoon slump, I may steal 30 mg from my evening dose.

When I have imaging with iodinated contrast, it is necessary to reduce my dose to avoid tachycardia, and I cannot afford to just omit the evening dose.

> > >> > > I got my most recent labs after being on ERFA for about 5 weeks.> > > > > > FT4 1.41 (.82 - 1.77)> > > FT3 3.2 (2.0 - 4.4)> > > TSH <.006 (0.450 - 4.5)> > > > > > Quite a change from my previous labs on Naturethroid (for about 3 months)> > > > > > FT4 0.87 (.78 - 2.19)> > > FT3 3.51 (2.77 - 5.27)> > > TSH <.003 (.465 - 4.68)> > > > > > > > > My current doc would like to switch me to compounded natural thyroid (using same porcine powder as Armour/Naturethroid, etc.). I asked at the pharmacy and they said the filler they use is Avicil as the filler. Searching around online I found it is microcrystaline cellulose, which some say causes the problems in the new armour and also with Naturethroid.> > > > > > I am wondering if it is worth switching to the compounded meds or if I should just stay on the ERFA. I have both and Dr. is open to me finishing out ERFA if I'd like. Or I could try the other for a while and see how I feel/check levels to compare later. Does anyone have a comment about why I might do one or the other? Do you think the Avicil could have been why I didn't do well on the Naturthroid? (All of the comparisons are at the same dosage of medicine, though I know ratios are slightly different with ERFA.)> > > > > > Thanks,> > > Grace> > >> > > > > >>

[Guest guest]

Jan,

So far I'm happy with Dr. G... She gives me a written script.. so I can

technically take it anywhere... You would take it to WIP, right?

What is their turn around? - I'm supposed to go back in a couple of weeks..

Also, we are again trying to get pregnant, and any med change I would want to

get pretty quickly..

I didn't ask, but based on Grace's post, I'm guessing Dr G. just won't work with

the Canadian option..

Am I right?

Thanks!!!

Kim

[Guest guest]

Jan,

So far I'm happy with Dr. G... She gives me a written script.. so I can

technically take it anywhere... You would take it to WIP, right?

What is their turn around? - I'm supposed to go back in a couple of weeks..

Also, we are again trying to get pregnant, and any med change I would want to

get pretty quickly..

I didn't ask, but based on Grace's post, I'm guessing Dr G. just won't work with

the Canadian option..

Am I right?

Thanks!!!

Kim

[Guest guest]

I don't think that was what he said. You had reported earlier that he said that being on natural thyroid made it more difficult to monitor a recurrence of the cancer. That could only have reference to the serum thyroglobulin test.

Many thyroidectomy patients benefit greatly from being on natural thyroid, and most docs who prescribe it have no problem writing it for thyca patients.

How are you feeling? Are you doing any better on the slightly larger dose of $ynthroid? If not, it might be time for you to move on to a new doc for thyroid. I know he flat will not prescribe Cytomel, but I never talked to him about compounded timed release T3.

> > > > How is he to work with? Has he wanted to change your dose?> > I think he is great, but I can get a chimpanzee in a white coat to order the tests I want and write my thyroid prescriptions. How do I do that? I speak "doctor talk" and make him feel like he is talking to another doctor.> > I was appalled, however, that he would not prescribe desiccated thyroid for Fatima, who had thyroid cancer.>

[Guest guest]

I don't think that was what he said. You had reported earlier that he said that being on natural thyroid made it more difficult to monitor a recurrence of the cancer. That could only have reference to the serum thyroglobulin test.

Many thyroidectomy patients benefit greatly from being on natural thyroid, and most docs who prescribe it have no problem writing it for thyca patients.

How are you feeling? Are you doing any better on the slightly larger dose of $ynthroid? If not, it might be time for you to move on to a new doc for thyroid. I know he flat will not prescribe Cytomel, but I never talked to him about compounded timed release T3.

> > > > How is he to work with? Has he wanted to change your dose?> > I think he is great, but I can get a chimpanzee in a white coat to order the tests I want and write my thyroid prescriptions. How do I do that? I speak "doctor talk" and make him feel like he is talking to another doctor.> > I was appalled, however, that he would not prescribe desiccated thyroid for Fatima, who had thyroid cancer.>

[Guest guest]

Don't just take her word for it. Email her and ask her to send you a copy of the actual lab report.

> >> > Hi> > He didn't want to prescribe the natural product because he said that patients that had a total thyroidectomy don't really benefit from doing so. > > He wanted me to stay on the synthroid. > > I had some labs done last week. I am waiting for the results. We will se what happens then> > Fatima