Hi I am new and diagnosed hypothyroid 2011. I am looking to change brands of Levo since the Actavis and Mercury Pharma and Wockhardt brands do not improve thyroid levels and the Teva ones upset my stomach. Any other brands out there that I can try? Thanks
Changing brands of Levo: Hi I am new and... - Thyroid UK
Changing brands of Levo
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Dominikka
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•
Hello Dominikka,
You might be under dosed if your levels are not good. Can you post your latest results?
And how do you feel? As the levels are a guideline.
UniPharma is another brand.
Unipharma is not a UK brand of Levo.
Dominikka you have named all the UK brands of Levo. There is liquid Levo if you can get it prescribed.
As EbonyEvans has said, post your results, with reference ranges, for comment - TSH, FT4, FT3, thyroid antibodies
Good afternoon SeasideSusie, I’m aware of Unipharma (Greek) not being a UK brand. The OP didn’t specify so I advised what I know. There’s also the Merck brands: Euthyrox and Eutirox also a foreign company with different brand names dependent on which country.
All are easily sourced if the U.K. ones are not working.
Brain fog memory loss constipation heavy periods goitre tiredness depression feeling flushed feeling cold sweats weight gain
Can I go back on T3 that was my lifeline and none of these symptoms existed
Dominikka If you've previously been on T3 there's a lot more to it than just changing brands of Levo.
Can you give us more details please, eg
Results on Levo that prompted the addition of T3.
Results from when you were on T3, presumably added to Levo, with dose details
Why were you taken off T3, when, and who by?
Have you had thyroid antibodies tested - were they high - Hashimoto's?
Have you had vitamins and minerals tested - supplementing any of them?
What dose of Levo are you on that's giving these results:
TSH 6.8 (0.2 - 4.2)
Free T4 13.9 (12 - 22)
Free T3 2.8 (3.1 - 6.8)
100mcg levo produced the above results and I now take 150mcg levo
Taken off T3 by endo in July 2017 because of overmedicated results (200mcg levo and 10mcg T3)
TSH <0.02 (0.2 - 4.2)
Free T4 20.8 (12 - 22)
Free T3 5.6 (3.1 - 6.8)
Well as a patient not an endo I would say that this combination was good for you. Maybe a tweek to the dose over time but not the drastic action that they took. The issue would appear to be prescribing T3 and then withdrawing it. Sorry that they did this and that you fell bad.
I want to complain about this because my symptoms are now negatively affecting me at home and at work but because it's happening to others I don't think I am able to. Every day I wait for my symptoms to go and it doesn't happen. The brain fog is so bad it is making me lose my concentration and I get things wrong and when that happens I get frustrated. I want my endo to know how bad this is making me feel and I am tempted to reintroduce what T3 I have because of my situation
Do you have anymore endo appointments? Can you request one urgently due to your new symptoms? Should you wish to persue a complaint the ITT Campaign may be helpful as well as TUK. The BTA clearly state that T3 should not be withdrawn and that if there is clinical need the treatment should continue. Was this a discussion or a command?
Next week I have an appointment with the endo and it was a command. Thanks
Dominikka,
Insteading of making drastic changes to your dose and withdrawing T3 your endo should have reduced dose if s/he considered you were overmedicated. Suppressed TSH in the presence of normal FT4 and FT3 doesn't indicate overmedication however. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email louise.roberts@thyroiduk.org if you would like a copy of the Pulse article to show your GP.
Looks to me like you weren't doing well on Levothyroxine only because you were undermedicated on 100mcg.
The BTA issued guidance that patients doing well on T3 should not have their prescriptions with-drawn. See FAQS for patients, GPs and endos in british-thyroid-association...
• in reply toDominikka
I am on T3 too......These results look good to me 😊
Results which prompted the addiiton of T3 (on 175mcg levo)
TSH 1.25 (0.2 - 4.2)
Free T4 19.6 (12 - 22)
Free T3 4.0 (3.1 - 6.8)
Supplementing folic acid (5mg)/B12 (1 injection every 3 months)/vitamin D (800iu)
Ferritin 51 (30 - 400)
MCV 76.3 (80 - 98)
MCHC 378 (310 - 350)
MCH 28.2 (28 - 32)
Haemoglobin estimation 119 (115 - 150)
Red blood cell count 4.40 (3.80 - 5.80)
White cell count 7.12 (4.00 - 11.00)
Haematocrit 0.41 (0.37 - 0.47)
Platelets 250 (150 - 400)
Iron 9.3 (6.0 - 26.0)
Transferrin saturation 15 (12 - 45)
Folate 2.3 (2.5 - 19.5)
Vitamin B12 223 (190 - 900)
Vitamin D 26.5 (<25 severe vitamin D deficiency...25 - 50 vitamin D deficiency....50 - 75 vitamin D may be suboptimal....>75 adequate vitamin D)
helvellaAdministrator
Dominikka,
Those are the only four makes of levothyroxine tablets licensed and available in the UK. (Some may be packaged under other names such as Almus or Northstar which are still the Actavis product.)
Getting unlicensed products is possible but would usually need your doctor to prescribe approrpiately - pharmacists are expected to supply UK-licensed products if they are available.
There are at least dozens of products across Europe - and many more in the rest of the world.
SeasideSusieRemembering
Dominikka
Results which prompted the addiiton of T3 (on 175mcg levo)
TSH 1.25 (0.2 - 4.2)
Free T4 19.6 (12 - 22)
Free T3 4.0 (3.1 - 6.8)
And that was exactly the right decision by your endo as your conversion is poor.
**
Taken off T3 by endo in July 2017 because of overmedicated results (200mcg levo and 10mcg T3) TSH <0.02 (0.2 - 4.2) Free T4 20.8 (12 - 22) Free T3 5.6 (3.1 - 6.8)
You were not overmedicated. Your endo saw a suppressed TSH and panicked. When taking T3 it can suppress TSH and your endo should know this if he's prescribing T3. Your FT3 is well within range so you can't be overmedicated (over range FT3 would show overmedication). If you were well on this combination of Levo and T3 then that's what you need and you should stay on this dose.
**
TSH 6.8 (0.2 - 4.2)
Free T4 13.9 (12 - 22)
Free T3 2.8 (3.1 - 6.8)
100mcg levo produced the above results and I now take 150mcg levo
Dose changes should be done in 25mcg increments, another thing your endo should know. It would be interesting to see what your results are 6 weeks after being increased to 150mcg. Make sure you are retested and given an increase in dose if necessary, repeat every 6 weeks until you feel well.
**
TPO antibodies 377 (<34)
TG antibodies 259.3 (<115)
This is a big part of your problem. Your high antibodies mean that you are positive for autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.
Most doctors attach no importance to Hashi's nor do they understand how it affects the patients. Read and learn so that you can educate yourself and help yourself.
You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
Gluten/thyroid connection: chriskresser.com/the-gluten...
stopthethyroidmadness.com/h...
stopthethyroidmadness.com/h...
hypothyroidmom.com/hashimot...
thyroiduk.org.uk/tuk/about_...
**
Hashi's and gut/absorption problems tend to go hand in hand and very often low nutrient levels are the result, as can be seen here.
Ferritin 51 (30 - 400)
For thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range. You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...
MCV 76.3 (80 - 98) MCHC 378 (310 - 350)
These results suggest iron deficiency anaemia, for which the treatment guidelines are here NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines):
cks.nice.org.uk/anaemia-iro...
How should I treat iron deficiency anaemia?
•Address underlying causes as necessary (for example treat menorrhagia or stop nonsteroidal anti-inflammatory drugs, if possible).
•Treat with oral ferrous sulphate 200 mg tablets two or three times a day.
◦If ferrous sulphate is not tolerated, consider oral ferrous fumarate tablets or ferrous gluconate tablets.
◦Do not wait for investigations to be carried out before prescribing iron supplements.
•If dietary deficiency of iron is thought to be a contributory cause of iron deficiency anaemia, advise the person to maintain an adequate balanced intake of iron-rich foods (for example dark green vegetables, iron-fortified bread, meat, apricots, prunes, and raisins) and consider referral to a dietitian.
• Monitor the person to ensure that there is an adequate response to iron treatment.
If your GP hasn't addressed this then you need to discuss it with him/her.
*
Folate 2.3 (2.5 - 19.5) Vitamin B12 223 (190 - 900) Supplementing folic acid (5mg)/B12 (1 injection every 3 months)
This seems to be being taken care of.
*
Vitamin D 26.5 - vitamin D (800iu)
You are 1.5 away from severe deficiency and 800iu D3 isn't going to ever raise your level. It is hardly a maintenance dose for someone with a reasonable level.
You should be on loading doses - see NICE treatment summary for Vit D deficiency:
cks.nice.org.uk/vitamin-d-d...
"Treat for Vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU] given either as weekly or daily split doses, followed by lifelong maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regims are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and ask that he treats you according to the guidelines and prescribes the loading doses. Once these have been completed you will need a reduced amount (more than 800iu so post your new result as the time for members to suggest a dose) to bring your level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and then you'll need a maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/
There are important cofactors needed when taking D3
vitamindcouncil.org/about-v...
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.
Magnesium helps D3 to work and comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds
naturalnews.com/046401_magn...
Check out the other cofactors too.
As you are Hashi's, once you are buying your own D3 for maintenance, you will find that for better absorption an oral spray is best. BetterYou do D3 only, they also do a combination D3/K2-MK7.
Check out SlowDragon 's reply to this post for information on how to deal with gut/absorption problems associated with Hashi's healthunlocked.com/thyroidu...
SlowDragonAdministrator
Endo's don't seem to understand, they can't just add T3 without looking at high antibodies, and low vitamin levels too
It's essential to improve vitamins FIRST, before adding T3.
Also your very high antibodies mean you have Hashimoto's so likely necessary to be strictly gluten free too BEFORE adding T3
You are now very under medicated and with low vitamin levels as result
800iu vitamin D isn't enough for a hypothyroid mouse!
Following SeasideSusie vitamin advice, slowly increasing Levo back up and being strictly gluten free will help a lot.
Once stable on this, if FT3 remains low, (pretty likely) then adding small dose of T3 back in is next step
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
thyroidpharmacist.com/artic...
thyroidpharmacist.com/artic...
amymyersmd.com/2017/02/3-im...
chriskresser.com/the-gluten...
scdlifestyle.com/2014/08/th...
drknews.com/changing-your-d...
Low stomach acid can be an issue
Lots of posts on here about how to improve with Apple cider vinegar or Betaine HCL
thyroidpharmacist.com/artic...
drmyhill.co.uk/wiki/hypochl...
scdlifestyle.com/2012/03/3-...
Other things to help heal gut lining
Bone broth
thyroidpharmacist.com/artic...
Probiotics
carolinasthyroidinstitute.c...
Importance of magnesium
hypothyroidmom.com/two-vita...
magnesiumeducation.com/how-...
integratedhealthblog.com/ma...
I would also give endo copy of this
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