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

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

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

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

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

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

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

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

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

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

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

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

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


  • Want to keep track of these “fringe web­site” blog posts? ;-) Curious what’s on Janie’s mind? Use the noti­fi­ca­tion on the lower left of the links, called a News­let­ter, or an RSS Feed.
  • The extre­mely hip and sophis­ti­ca­ted STTM t-shirts are half price! Great BUMPER STICKERS, too. Spread the word – YOU may make a dif­fe­rence in someone’s life.
  • Check out the patient-to-patient book with even more detail (and which doc­tors seem to res­pect more than websites).
  • Need to unders­tand all your best options for thy­roid treat­ment? Go here.
  • Keep infor­med of each live Thy­roid Patient Com­mu­nity Call on Talkshoe by sig­ning up as a follo­wer.

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

  1. Jane C. said:

    Dec 03, 09 at 7:05 pm

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

  2. Florence said:

    Dec 03, 09 at 10:08 pm

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

  3. Jenn said:

    Dec 03, 09 at 10:30 pm

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

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

    Thanks in advance!

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

  4. Jon Ewens said:

    Dec 04, 09 at 12:10 pm

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

  5. Bill said:

    Dec 04, 09 at 4:26 pm

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

  6. Starrie said:

    Dec 05, 09 at 12:52 pm

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

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

  7. Lorie said:

    Dec 08, 09 at 8:57 am

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

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

  8. valerie said:

    Dec 10, 09 at 11:03 am

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

    (From Janie: there’s more to the story, though. Read this: http://www.federalnewsradio.com/?nid=37&sid=1834704 )

  9. Siobhan said:

    Dec 11, 09 at 12:17 am

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

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

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

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

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

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

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

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

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

  10. Jane C. said:

    Dec 11, 09 at 8:05 pm

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

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

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

  11. valerie said:

    Dec 12, 09 at 10:33 am

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

  12. Jane C. said:

    Dec 12, 09 at 4:13 pm

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

  13. Mary said:

    Dec 12, 09 at 9:08 pm

    I am defi­ni­tely in agree­ment with you, Jane.

  14. Laura said:

    Dec 14, 09 at 9:56 am

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

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

    I will try it sublin­gually as some have mentioned.

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

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

  15. Jean said:

    Dec 14, 09 at 10:16 am

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

  16. Leenie Balto said:

    Dec 14, 09 at 11:27 am

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

  17. Lisa said:

    Dec 15, 09 at 9:43 am

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

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

  18. Lisa said:

    Dec 15, 09 at 10:03 am

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

  19. valerie said:

    Dec 16, 09 at 10:58 am

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

  20. Alexia said:

    Dec 16, 09 at 5:44 pm

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

  21. Gale Ackerman said:

    Dec 19, 09 at 2:25 pm

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

  22. Tasia said:

    Dec 29, 09 at 11:26 pm

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

  23. Leyna said:

    Jan 23, 10 at 2:04 pm

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

  24. Leyna said:

    Jan 25, 10 at 5:49 pm

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

  25. mair jones said:

    Feb 21, 10 at 8:17 am

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


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