Why only 25mcgs 50mcgs 100mcgs tablets available??

[jayne777]

I was first diagnosed with an under active thryroid 12yrs ago and like the vast amount of people out there have struggled to maintain good health. I have tried so many variable doses of Levothyroxine and have returned back to my GP on several occasions with the side effects of too much medication along with then the exhuasting effects of too little medication. It is astounding that there is no inbetween levels of Levothyroxine available out there ....25 mcgs being too little only to find jumping to 50mcgs is a double amount !!! If only there was 10mcgs options available surely the correct levels could be reached more easily and quickly ....is there any pharmaceutical companies out there that make 10mgs Levothyroxine if so lets get to hear about them please.

[bantam12]

Not in the UK.

[Clutter]

Jayne777,

You can fine tune your dose by halving a 25mcg tablet daily or by taking an extra 25mcg on alternate days.

Levothyroxine is available in 12.5mcg doses in some European countries and American doses are increased in 12.5mcg increments rather than the 25mcg used in the UK.

[jayne777 in reply to Clutter]

Thank you .....Yes I have tried to break the 25mcg in half but have found even with pill cutter being so tiny the tablets tend to splinter....however where there's a will there's a way and will consider trying again ....will also do a bit of research into the possiblilty of obtaining 12.5mcg doses. Hopefully one day the medical profession will recognise the requirement of inbetween doeses and bingo there would be a lot more healthy people out there.....thanks again will update with any success in slitting tablets.

[helvella Administrator Thyroid UK in reply to jayne777]

The Greek company Uni-Pharma make 12 microgram tablets. Getting them isn't so easy - rarely available from the sources of other Uni-Pharma products. Or anywhere else!

I feel happier taking 112 micrograms a day (100 micrograms Actavis and 12 micrograms Uni-Pharma) - but how much of that is psychological?

Logically, it makes sense to think of the total weekly dose. Maybe you are on 100 a day? That is 700 a week. You can readily add 25 to make that 725 a week; or remove 25 to make it 675 a week. Then make what you take each day as evenly as possible.

That allows adjustment as fine as 3.5 micrograms a day (25/7) - when averaged out.

[Weeble1 in reply to jayne777]

I have to take 62.5mcg per day with T3 and take the 25mcg every other day. It is much easier than trying to cut them.

[Jazzw]

How much do you take, out of interest? And when you're overmedicated, what symptoms do you experience? Just wondering, as many of our UK doctors try to titrate levothyroxine dosages to get a TSH reading above 0.5, when there really isn't any need so long as FT3 and FT4 are well up their respective lab ranges.

Are you sure it's too much levo that makes you feel odd? Do you know what your Vit D, Vit B12 and ferritin levels are? If any of those aren't optimal you will struggle when trying to raise your levo dose to one that mimics, as closely as possible, the thyroid hormone output of a normally functioning thyroid. 25mcg - and 50mcg - of levothyroxine isn't actually all that much.

[jayne777 in reply to Jazzw]

Hi Jazzw I am currently on 25/50 alternate days .....however have over the last 12yrs tried a huge range of combinations ....the current 25/50 being suggesed after being on 50 everyday followed by 75 on every 3rd day!!! This just resulted in extreme palpatations/weak muscles and general anxiety with a sense of fear thrown in !!! Saw Endocrinologist back in May who in fairness did a whole Endrocine Screening Test but not T3 or Vit12 or Vit D I did however mention I was taking Vit b12 and was considering Vit D. The good news was that all other tests he undertook came back clear and the only outstanding one being Free T4 - 15.1pmol/L TSH 6.56mIU/L Disappointingly the only suggestion he has come up with is to try to take 50mcgs a day but in next sentance said he was aware I might find that too much !!! So have an appointment with local GP this week and will push as to why my Vit B12 and Vit D have not been tested. To sum up the less I take of Levothyroxine the better I feel !!??

[Jazzw in reply to jayne777]

You know, I thought that might be what you'd say. You're not the only one who's reported struggling to tolerate what is really a very small amount of levothyroxine. Have you been poorly for a while (and by poorly, I mean "off", not completely incapacitated)? If it's been a few years, it's likely that other hypothyroid symptoms, like low absorption of nutrients, have got a bit of a hold. In particular, if your iron (ferritin) level is low your body will struggle to convert levothyroxine into the active version of thyroid hormone T3, which is the one your body really needs. Alternatively, you may have a degree of adrenal fatigue (which you should be warned many doctors don't believe exists but it does...) from your adrenal glands being very tired of having to cope with the prolonged stress of you being hypothyroid. Or - alternative explanation number 3 - you might be intolerant to one of the ingredients of the levothyroxine you take. A different brand might make all the difference. A few things to think about!

Your B12 needs to be over 500, your Vit D in the "sufficient" range and your ferritin level over 70. Doctors like to think that "in range" is ok - it usually isn't.

[jayne777 in reply to Jazzw]

Hi Jazzw yes I think you may have knocked the nail on the head so to speak...I did shift work at an airport for nearly 29years so mega stress involved and I think that has damaged my health big time, however luckily do not have to do that now but still struggling to get maximum benefit from Levothyroxine....I have learnt the value of Siberian Ginseng to support Adrenals and yes I was shocked when specialist was prepared to not just listen to my thoughts on adrenals but actually did a 24hr urine test along with a cortisol test. Also had a few tests done to eliminate the possibility of Antibodies being present in system that can sometimes cause the over/under active symptoms. Thank you for all your advice I will make sure I get some Vit levels out of GP by the end of this month and report back. In the mean time the cabinet is growing bigger by the day with more of the right kind of vitamins !!!

[Jose651 in reply to jayne777]

Hi jayne777,

I'm hoping you can give me some advice re the 24 hour urine test as I will be doing one in the next few days as requested by an Endo.

The saliva test that I did with Genova a few months back showed 3 out of 4 readings way above range for Cortisol.

My GP has sent the results to the Endo, and she has asked for the 24hr test to be carried out before I see her.

Do I have to stop any Supplements before the test?

Were you given any advice regarding that?

Can I also ask what brand of Siberian Ginseng are you using and in what way is it helping?

Sorry for asking so many questions.

J 👍

[jayne777 in reply to Jose651]

Hi Jose please do not apologise for asking so many questions it seems to me that there are a lot of us out there that have a lot of unanswered important questions!! Anyway the 24hr urine test was quite simple to do and there was full instructions included which outlined which tablets should not be taken before which if I remember correctly did not really outrule supplements but no painkillers to be taken before. In my case the endocrinologist was ruling out the possibility of a tumour on the adrenal glands....which is apparently rare but symptoms I had were indicating a possible unbalance in the adrenal area. The Siberian Ginseng I take is by Solgar. I was advised by Dr Peatfield the importance of supporting the adrenal glands with SIBERIAN Ginseng having struggled for a long time with intolerance of levothyroxine. Good luck with everything.

[Jose651 in reply to jayne777]

Hijayne777,

Thank you so much for your help, I appreciate it.

J x

[shaws Administrator]

When we are on any thyroid hormone replacements we should try to ensure that the generic is the same one each time (there used to be one Brand name in the UK but was withdrawn with the explanation that it would be introduced - but that was a few years ago and it's never returned). Many who were taking Eltroxin for many years then found they had symptoms they hadn't had previously.

Maybe they make more money from the generics but many people remain unwell. Thousands appear to do do o.k. on it and they wont be on this forum.

Different levos may have different fillers/binders which can affect us badly.

I would suggest that you add some T3 to your T4 (GP might not prescribe but many provide their own). You might find it of great benefit as it is the active hormone required in all of our receptor cells.

As few GPs will test FT3, I would suggest you get a pin-prick blood test from Blue Horizon for yours.

hormonerestoration.com/Thyr...

thyroiduk.org.uk/tuk/testin...

[radd]

jayne,

Welcome to our forum.

Because of the long half life of levothyroxine, it takes several weeks to fully saturate every cell into body . Therefore, dosing varying amounts on different days is acceptable as long as the weeks total is the correct amount.

Many members medicate two different doses on alternate days so the daily average works out to the correct amount required.

If you advise of your meds and post any recent thyroid hormone blood test results complete with ranges (numbers in brackets) members will comment.

[jayne777 in reply to radd]

Thanks Radd for the 'Welcome' good to learn that I am not alone with all the issues folk have with trying so desperately to get a fully functioning healthyThyroid...In the UK it seems impossible to get a GP to test for T3 ??? The only test results I have at present are Free T4 - 15.1pmol/L ( 9 - 24 ) and TSH 6.56mIU/L (0.34 - 5.4 ) I have over the years done quite a bit of research and have learnt the value of Siberian Ginseng to support Adrenals along with a good quality multi vit/and believe all thyroid conditions benefit from consistant sleeping patterns and eating patterns etc.

[radd in reply to jayne777]

jayne,

Yes a T3 result is immensely useful but we can see your T4 is too low (under half way through range) and TSH is too high.

Many members function best with a TSH around 1.0 and T4 in the upper third of range. You are under medicated.

When we have suffered low thyroid hormone for so long and incorrect replacement dosing, the adrenals become compromised and cortisol levels unbalanced and developing gut issues prevent us from absorbing nutrients//iron so well.

These common deficiencies will impair good thyroid function and induce possible hormone replacement intolerances.

Do you have any iron//nutrient blood test results to post for members comments ? ? ...

[jayne777 in reply to radd]

Hi Radd yes my research has indicated the importance of Adrenal support and did have Cortisol levels and antibody checks done recently and both TSH TPO antibody results came back as negative so whilst that is good news seems odd to have so many side effects whilst on such a low dose of levothyroxine. The other tests hospital covered were sodium/potassium/chloride/bicarbonate/urea/cretinine/estimated GFR/bilirubin/alk.phos./ALT/albumin and calcium. I do not think any of these are testing for Iron or Vit D or Vit b12 ??? On one occasion I did obtain a 1.99 TSH result when first diagnosed with under active and had been on 100mcgs daily for a few weeks and thought I was going to have a heart attack (pulse of 134) ended up being taken off Levothyroxine for a few weeks and prescribed anti depressents and valium and sleeping tablets!!!!

[radd in reply to jayne777]

jayne,

Your tests were for electrolytes, kidney and liver enzymes, etc.

Members with low thyroid hormone often have a reduced GFR and elevated liver enzymes. If you post your results members will comment.

You have ...[ .. so many side effects whilst on such a low dose of levothyroxine ...]... because you are under-medicated.

Good you haven't got thyroid antibodies as they are such a pain .. Anti-D's, valium and sleeping pills have their place and are sometimes much needed but they will not replace missing thyroid hormone ! ! ....

[jayne777 in reply to radd]

Thanks again Radd .....all good advice. Luckily it was some time ago that the Thyroid Crisis happened and no longer need the sleeping tablets and Valium and have resisted Anti Ds for a while. However it is alarming to discover that GPs just don't seem to know what to do when you present so many side effects so like a lot of others my own research has taught me a lot ......Possibly feel the need for an Anti D again whilst trying to deal with the low mood of an undermedicated under active thyroid so will be seeing doc at end of this week to discuss that but in the main the request for tests on B12 Iron and Vit D. Just got to keep calm and carry on I guess !!!

[radd in reply to jayne777]

Jayne,

When GP's are uncooperative, members get T3 tested using private labs.

.

thyroiduk.org.uk/tuk/testin...

[jayne777 in reply to radd]

Thanks Radd again very helpful and that was going to be my next question as to where in the UK one can get a T3 test done...I will investigate.