mercury pharma thyroxine...what do people think about it now?

[ianessex]

I'm getting to point of despair,, been on this since last summer and never felt good. I am trying to just get on with it but wonder what other people now think about it now ...

[shaws Administrator]

You have definitely been on this long enough to know whether it suits you or not. Do you know what your recent blood test results are, with the ranges? If so, post them.

If you have already been on another levo product, did you feel better on that?

If you didn't feel better on it, ask your GP to add some T3 and that might do the trick. If not, you will have to ask for an alternative which doctors don't usually prescribe but might if you ask for a trial.

[ianessex in reply to shaws]

The only other one I was on before was eltroxin and was happy on that, the prob came when I had to switch,, I tried actavis for a week but wasn't so sure but I suppose that's not long enough.my t3 is 5.5 range to 6.5

[helvella Administrator Thyroid UK]

My response is based entirely on how I feel – and there are no blood tests or anything else to objectively measure anything!

I take two 50mcg tablets at bed-time.

To begin with I used to take Goldshield/Mercury Pharma, Actavis and, possibly, Eltroxin without noticing any difference. At some point I was given Teva and like so many others went downhill. Resuming the MP/Actavis products I again felt OK.

More recently I was feeling under-dosed after a week or so on Actavis. (I was surprised that one day I suddenly felt massively under-dosed.) So I swapped back to MP. A few days on that, and I was feeling over-dosed – too warm in bed and simply not right. So I tried the obvious thing, one MP and one Actavis every night. This was definitely better but somehow still not right.

Next step, buy some German Aliud tablets. I have been taking them for a while now and have felt, somehow, more stable. I really cannot break down the details –I tend not to think about my levothyroxine when things are good, but dwell on it when they are not. At present I am simply glugging my tablets every bed-time and forgetting about them the rest of the time.

Explanations? This bit is pure speculation. I wonder if Actavis is not always delivering its claimed dose. (This might, of course, vary from one person to another.) But MP is delivering its full dose and doing so quickly. I wonder if MP have made changes to conform to the new dissolution requirements and, in so doing, produced something that increases blood levels of levothyroxine too quickly?

I doubt that the amount of levothyroxine as measured by lab tests is wrong. But with the Teva experience we can be quite sure that is not a measurement of efficacy in real people.

Rod

[Moggie in reply to helvella]

Good explanation Rod, as always, and I think you have it spot on.

Moggie x

[ianessex in reply to helvella]

Didn't know you were on them too rod,, they felt super strong to me, scared me a bit. Wonder if you felt that at first and it calmed down

[PR4NOW in reply to helvella]

Rod, the other thing I wonder about sometimes is whether or not they get all the dextro out when they make the stuff. I read an account by a woman who was from Austria and understood stereo chemistry. When she moved to France the brand they gave her caused pain in her joints. When she switched back to her usual stuff the pain went away. Unfortunately she only had a small supply of her old medication and had to switch back, again more pain. She checked and the product was being made in a third world country. She thought the QC was terrible and that it had the dextro form in it. Of course the various fillers and binders seem to cause enough problems as it is. PR

[helvella Administrator Thyroid UK in reply to PR4NOW]

Not impossible - but...

Typical doses of dextrothyroxine are massively greater than those of levothyroxine. Just read an abstract where they gave someone 6 MILLIGRAMS of DT4 for a month.

The assays done of levothyroxine should detect any significant levels of DT4. For example, we know they allow up to 1% of T3 (think that is true in UK and USA) - and they do that because they know they have seen T3 at that sort of level. Surely any appreciable DT4 would also be detected?

Certainly I believe all sorts of issues such as the entire composition of the tablets, the crystal sizes of the levothyroxine, etc. might all have impacts or which some will be noticeable by patients. So the idea of someone get joint pains or not is perfectly feasible to me. Not convinced of the mechanism!

Rod

[Hidden in reply to helvella]

Hi Rod

I agree with the MP experience, it seems to deliver the thyroxine into the system too quickly. I find on MP that I was experiencing palpitations and light-headedness about 1.5 to 2 hours after taking the tablet. I take 50 mcg Actavis and 25 mcg MP. However, this was going on before the January change date for the dissolution requirements. For the past month I have taken only Actavis by halving one of the 50 mcg tablets to keep an even 75 mcg a day. This seems to have made a huge difference and I have fewer palpitations. However, I am not sure if the tablets I have were produced before the change date or not!!

That does beg the question, which tablets are being changed to meet the new dissolution requirements and in which direction? If the post-tablet 'rush' is related to the dissolution issue (and not simply the different excipients), are tablets being changed to dissolve more quickly or more slowly? If MP is slowed down compared to before, then I might be able to tolerate them, but if Actavis is being speeded up then I could have problems! Just when I thought I had solved the problem!

Do you have any insights into which manufacturers were required to make changes with regards to dissolution speed? If so, any ideas on the likely consequences? Any thoughts on how we might find out except by trial and error?

Thanks for your insights, they always make a lot of sense.

Liz

[helvella Administrator Thyroid UK in reply to Hidden]

Wouldn't you have expected them to change to the new formulation well ahead of the deadline? After all, they might have to ensure that the supply chain is flushed out so that no-one gets any pre-dissolution change tablets after January. My guess is that this happened somewhere around the middle of 2013.

As for the rest of your response, I don't know! This goes round and round in my head without ever stopping and forming a sensible picture of things. Keep hoping someone else will make the necessary connections...

Rod

[Hidden in reply to helvella]

Ah, thanks Rod. I didn't think about the change coming into effect before January of this year! I kind of thought that they had to change the manufacturing process by January and that the new tablets would appear in due course after that!!

You could go crazy trying to make sense of it all. I think I'll stick to Actavis if I can.

[helvella Administrator Thyroid UK in reply to Hidden]

What do you mean "could go"?

Think that should say "have gone".

Rod

[Hidden in reply to helvella]

:-)) ... haven't worked out how to add smileys!!

[helvella Administrator Thyroid UK in reply to Hidden]

If you had typed : - ) - without that extra ")" and the spaces I have added - your reply would have started with a smiley!

[Hidden in reply to helvella]

[Hidden in reply to helvella]

Just checked the date of manufacture of my current supply: Actavis 05/13 and MP 01/13 .... so these are likely to have been produced before any changes! Liz

[helvella Administrator Thyroid UK in reply to Hidden]

Actually, I suspect that was when changes started for MP. It ties in with Eltroxin disappearing. However, it might have taken a while from manufacture to distribution.

So far, I have not seen anything that convinces me Actavis have changed anything - maybe they have? Maybe they haven't? Might already have conformed.

Rod

[Aurealis]

I take T3 mainly but with 50 Levo at bedtime. I previously took Eltroxin only but as no longer available switched to MP Levo. Initially, no difference, then felt I had to increase dose to 75, but this wasn't successful for long, felt overmedicated. Back to 50, then not sleeping as well, for me a sign of being under medicated. Overall, I'm not satisfied with MP. It doesn't do the same for me as Eltroxin. Often wake with palpitations, I think as it wears off, often waking early and can't get back to sleep.. 50mcg tablets not available, so have to take 2x25, or 3x25 with all the extra fillers. So in total, I think it's pants ! Any suggestions what I should try next, and how to obtain supplies please?

[Hidden]

I came off MP a month ago.My Endo increased my Levo. to 100mcgs thinking it might make me feel better and gave me a month's supply from the hospital pharmacy who supplied Actavis.However,I feel even worse.My Endo also ordered an FT3 test which has come back low,so may be a conversion to T3 problem.I am seeing him on Monday.

Have you had an FT3 test yet? We seem to have to fight for that to be done,but I think it's important to have a complete picture of what's going on.If you aren't converting your T4 you are going to feel bad what ever brand you are on.

[Moggie]

As you know I took the same route as Rod almost 6 months ago now and have never felt better, just a shame it didn't work for you, but MP definitely made me over medicated and caused heart palps. Like Rod I now no longer think about my levo, just take my dose at bedtime and forget about it until the next day.

I hope you find your answers soon.

Moggie x

[kimbo in reply to Moggie]

Hi Moggie do you have the link please when I try I just get it in German thank you

[Hidden in reply to Moggie]

Yes I made note of your German Aliud tablets which you gave me previously Moggie.The possible conversion problem will need to be discussed on Monday but I still have Aliud in mind.X

My TFT3 was 4.1( 4.0 - 7.8)

[ianessex in reply to Moggie]

Did you find the aliud strong too start with then calm down after while,, interesting how you felt over on mp ,, feels opposite to me.

[Moggie in reply to ianessex]

No I didn't, I just kept on taking my normal 112.5mcg's but when I tried that with MP I had heart palps, which I am presuming meant that I was over medicated again.

Moggie x

[TSH110]

I was on Mercury Pharma but got a lot of heart pains on it and didn't feel great so swapped to Activis - it seems better heart pain wise tho I still get bouts of it but I have suddenly slumped into a massive depression like I had before and during initial treatment for hypothyroidism - thought I had kissed goodbye to that . I have had continuing symptoms with both medications. I take it am no food/drinks for 2hrs after. I tried taking it before bed but it sent me haywire. Both are less than ideal for me.

[ianessex in reply to TSH110]

Your right,, both are less than ideal,, make sure your vitamin d is good,, makes massive difference,,

[Clutter]

I switched to Actavis because I was so ill on MP. I still had racing heart, palpitations etc. but not so intense. I now add T3 and this calms the palpitations most of the time.

[ianessex]

My opinion is that I don't trust it or the company any more,, wouldn't be shocked if they're constantly sourcing the cheapest ingredients, fillers etc . Every batch I get seems to feel slightly different to the last. Plus the regular t3 shortages really make me view this company negatively.

[crimple]

Medication issues seem to be cropping up more on this site. I was caught up in the TEVA problem (100).Doc then reduced me 75mcg and I had issues with 25mcg MP (+50mmcgActavis). Now on 100mcg Actavis, I am better in many ways but getting terrible pains in my hands (?carpal tunnel) Back and find it tiring climbing the stairs as though my leg muscles are not working. Have just had one batch of tests waiting to do others before trying paleo.

I think the big issue is poor QC in overseas factories and the NHS wants to pay the least amount possible for meds.

[helvella Administrator Thyroid UK in reply to crimple]

All three UK levothyroxine tablet products are manufactured in the UK.

There may be poor quality control in overseas factories but I do not see why that would affect our products? It is, surely, the function of QC to check the quality of all ingredients. Hence it would be a UK failing to allow sub-standard ingredients through to the factory. Or for manufactured products to be released which are sub-standard.

Rod

[crimple]

Hi Rod it may well be the function of QC to check, but do they?!. More and more I hear about industries/manufacturers being self regulating/ self testing and often things go awry. I have become increasingly cynical about regulation, not just where our health is affected. The bottom line is invariably cost. and cutting corners.

[helvella Administrator Thyroid UK in reply to crimple]

Indeed they might not - we cannot know. But I would still put the responsibility on the UK factory and its managers and owners, not the possible foreign supplier. That is, were you to sue someone, then it would not be the foreign ingredient supplier but the retailer (pharmacy) and UK manufacturer and/or supply chain.

[ianessex]

I've just started new batch of mercury,, they instantly feel different to previous batch,, very muzzy headed, fatigued then suddenly feel hyper. Not feeling at all good,, will try another box tomorrow then if I get same issue then I'm changing brand,, honestly some days I feel like stopping it all together,, feels like the medication is worse than the problem.

[infomaniac in reply to ianessex]

I agree Ian, I had some symptoms but felt more or less OK at first but since taking Mercury Levo since August I now feel absolutely crap. I lay in bed last night wondering if I would feel any worse if I just stopped taking the bloody stuff

[ianessex in reply to infomaniac]

makes you feel that way doesnt it,,, why did u change onto mercury ? was it because of eltroxin stopping ? thats what happened to me,,, now i suddenly need high dose ppi every day and feel awful...

[infomaniac in reply to ianessex]

I've always been on Mercury and I thought it was OK at first. I've had the most horrendous depression in the last few months but just thought it was me and maybe my dose isn't right but your post has got me thinking. What a ridiculous situation to be in isn't it-having to come on forums to try and sort ourselves out as our GPs are inept. I wonder if there is any other condition that is as badly managed by the NHS?

[ianessex in reply to infomaniac]

Have you had your levels tested to see if they've dropped at all?

[infomaniac in reply to ianessex]

Yes, just recently. My GP reckons I am now stable and if anything slightly over-medicated. I wonder why I am depressed, unable to lose weight, have insomnia, problems with hair and skin and feel like a zombie ? I'm supposed to see her again in 6 months but I cant stand being like this until July! What are your plans?