Synthoid or levo?

[swtjamie]

Hello everyone i havent posted in awhile been busy. I have a question i went to my GP on Tue and broke down crying in her office telling her how i feel that my symptoms were worse since starting levo i explained that i heard synthoid was better because of all the fillers in levo she agreed but said insurance wont pay i said ill pay if itll help. She said she wanted to get my tsh at a 1 and was a 3 last time (months ago) well they called earlier and said it was 4.8 and she switched me to synthoid and upped me to 88mg....my question is how many think the name brands better? My pharmacist told me she would take name brand over levo.. im paying $43 instead of $12 but if it helps its worth it

[helvella Administrator]

Just accepting random, indeterminate tablets from your pharmacy is a bad idea.

Synthroid have a massive budget to try to persuade you to buy their product. If I were in the USA I would have chosen Unithroid (also sold as Lannett generic levothyroxine), but more recently might have chosen Sandoz which has been shown to be more biologically available. The actual amount of active ingredient is tiny so all levothyroxine tablets have masses of excipients in them.

I just did a search on an official site for levothyroxine. This is the link:

dailymed.nlm.nih.gov/dailym...

(Repackaged versions also appear there but they are sorted to the end of the list.)

[helvella Administrator in reply to helvella]

If money were not an issue, I would choose Tirosint.

[swtjamie in reply to helvella]

Ive never heard of that helvella

[helvella Administrator]

It potentially has a huge amount to do with make.

A few years ago, as I implied earlier, Sandoz was delivering a dose more than 12% greater than another make. So once at 100 micrograms a day, that is as much as a dose increment on USA products.

If the issue is dose delivered, the make can be a vital factor - even ignoring excipients ("fillers").

[helvella Administrator]

The paper I was quoting from memory, published in 2006, includes this paragraph:

There are now four generic formulations and three reference preparations for LT4 approved. Although the 90% CIs fall within the accepted limits, the arithmetic mean differences of the AUC0-48 reveal clinically significant variations. For example, the Sandoz generic LT4 product is 12.5% more bioavailable than Synthroid® (Abbott Laboratories, Abbott Park, IL), but is 2.3% less bioavailable than Levoxyl® (King Pharmaceuticals, Bristol, TN). Synthroid® is 9% less bioavailable than the generic product from Mylan Laboratories, and 3% less bioavailable than LT4 Lannett (the generic version of Unithroid®, Jerome Stevens Pharmaceuticals, Bohemia, NY). Data on the relative bioavailability of the generic LT4 product from Genpharm are not yet available.

medscape.com/viewarticle/54...

[helvella Administrator]

They cannot patent levothyroxine either. And didn't patent it in the USA when they could have done so.

[swtjamie]

I will start synthroid in the morning please wish me luck. Its 88 mg .