Which T3 brand on NHS?

[MCP80]

I have searched through past posts but can't really seem to find my answer.

I am going to be given a trial on T3 as I don't feel well on T4 only (Eltroxin) and my levels fluctuate dramatically so my Endo has realised that there could be an issue as he has now seen my results fluctuate over the last 9 months ad is going to trial T3.

I have spoken to my Pharmacy already and as they do not have any patients currently on T3 I am going to request the brand that I want to try but even after reading all the posts on T3 I am confused and do not know which brand to ask for.

I am unable to take Activis T4 so don;t want to try that as it doesn't agree with me. Mercury Pharma Eltroxin seems OK with T4 tablets but I don;t feel well so not sure if it is a binder/filler issue or a conversion issue making me feel so unwell.

My next set of bloods in 4 weeks time will include RT3 to rule that out but I think I have a low conversion issue anyway.

Results:

18 April 18 (150mg daily T4)

TSH 0.53 (0.27-4.5)

T4 25.7 (11-23)

T3 4.53 (3.1-6.8)

11 May 18 (150mg daily T4)

TSH 59.3 (0.27-4.5)

T4 14.9 (11-23)

T3 3.37 (3.1-6.8)

I do understand that tablets are very much determined by individual but I need a brand to start with and would like opinions please.

Thank you

[wightmouse]

I get 5mcg liothyronine tablets. There was two brands but Perrigo has stopped supplying. I now get Sigma pharm brand these I find stronger than Perrigo.

On my prescription it just says liothyronine 5mcg. I get mine supplied from Boots I have to wait a week for them as they request them from their supplier.

I believe commonly prescribed Mercury pharmacy 20mcg, Morningside and Teva.

[MCP80 in reply to wightmouse]

Thank you wightmouse.

Hopefully there will be more replies later with personal experiences for each brand.

Because I am unsure whether it is Eltroxin causing some of my symptoms it is hard to know which brand to choose.

[SlowDragon Administrator in reply to wightmouse]

Are these on NHS?

Any idea of cost in comparison to the 20mcg tablets?

I would love to try them. I currently cut 20mcg Morningside Healthcare tablets up and take 3 x 5mcg (approx) per day

[wightmouse in reply to SlowDragon]

Can't find a price supplied to nhs as its an imported product. Online prices come up from around 50 dollars for 100 to £118 on an online pharmacy that I not allowed to name.

Just found this in search which is interesting stating liothyronine 5mcg by Sigma pharma is the most cost effective way of prescribing liothyronine not my nhs area but may help others.

warringtonhaltonhospitalsfo...

[SlowDragon Administrator in reply to wightmouse]

Have you tried Mercury Pharma or Morningside Healthcare T3?

Just wondering how Sigma compares

I take 3 x 5mcg Morningside (difficult to cut into 1/4's accurately)

[wightmouse in reply to SlowDragon]

Was on Mercury Pharma many yrs ago I think?? Was a 20mcg tablet I had to cut. Don't think I got on too well. Luckily for me there was a production problem and my pharmacy suggested if I was cutting up tablets to ask GP to give me 5mcg ones. That's when I had a good GP.

Difficult to say if better because as I've learnt more and asked for results etc. Done my own testing my dose of levo has gone up, vitamins improved.

Now not in bed all day. All I definitely can say is Perrigo I needed 3 x 5mcg. Sigma Pharma I needed 2 x 5mcg.

.I can't get levels in top 75th percent of ranges because of my insomnia I will be awake for days.

My next repeat prescription has to be renewed by my GP who is new to practise has never seen me dreading getting the " your t3 has been withdrawn letter"

Why you cutting up 5mcg tablets? Or was that a mistake?

[SlowDragon Administrator in reply to wightmouse]

I currently cut 20mcg Morningside Healthcare into 1/4's and take 1/4 tablet (5mcg approx) three times per day

How's your vitamin D levels? Low vitamin D can be linked to insomnia

drgominak.com/sleep/vitamin...

Yesterday in parliament

You should NOT have T3 stopped

theyworkforyou.com/debates/...

[wightmouse in reply to SlowDragon]

I've read Vince Cables debate and keep up to date with everything on here. My vitamin D level is good thanks recently had all them checked. First time everything is in order. 😃

Might be worth saying to GP the pharmacist suggested as you cut up the 20mcg tablet that changing your prescription to a 5mcg one your dosing would be more stable. Sometimes a little white lie goes a long way.

If it's anything like my pharmacy these days it's never the same one anyway. Bit like GPs!!

Good luck.

[SlowDragon Administrator]

There are three choices, all virtually identical price charged to NHS (£9 per tablet)

Mercury Pharma - comes in small tub. Not blister packed. Possibly slightly weaker, also often has been supplied to many people, very near use by date.

Morningside Healthcare- blister packed. Some prefer it. Others don't get on with it.

Teva - only one that is lactose free. Many don't get on with it

As many of us take in small split dose , it's often necessary to cut the tablets up into 1/4's. Especially to start with. Using a small craft knife or scalpel or pill cutter

The pharmaceutical companies try to say, if you need dose less that 20mcg, you should dissolve the whole tablet in a measured amount of water. Using plastic syringe suck up the correct proportion required and squirt it in mouth. Throw rest away. Repeat twice or three times per day

It's a totally impractical suggestion

A) most pharmacies have no disposable plastic syringes to supply

B) unlikely to be more accurate at measuring, than cutting pills

C) the liquid from syringe must get to gut, not just in mouth to be correctly absorbed

D) would be using double or treble number of tablets per day (at £9 per tablet)

E) the remaining liquid should not be put down the sink/drain. Pharmaceutical companies, when questioned, said to collect it up and return it to your pharmacy!

It would be so much easier if one (or more) company made 5mcg tablets that were available on NHS

[MCP80]

Thank you slowdragon very helpful information.

[SlowDragon Administrator in reply to MCP80]

Are your vitamin D, folate, B12 and ferritin levels optimal?

Do you need to supplement to keep them that way

I see you are gluten free.

Did I detect you had difficult labour, when your first son was born? Did you have significant blood loss? If so have you considered Sheehan Syndrome as contributing to symptoms as well as Hashimoto's

[MCP80 in reply to SlowDragon]

Hi Slowdragon I haven't updated my details for a while.

Yes all my vitamin and minerals are optimal and happy with those. I have hireditary Hashis borderline since I was a teenager.

I was diagnosed in 2005 and just been ploddibg along but symptoms have gradually been getting worse over the last few years been continually with an Endo but due to moving quite often have to change every few years. Finally after following the advice of current Endo increasing and decreasing medication finally realised T4 not working as it should.

They can't offer an explanation and sought guidance from MDT.

Waiting on outcome of Fridays meeting following my last bloodtest results. But it will be a trial of T3.

No difficult birth just 6 weeks early and very quick. No significant blood loss. I wasn't diagnosed with Hypothyroidism until 9 months after the birth of my first son.

[SlowDragon Administrator in reply to MCP80]

Seems to be pretty common to eventually need some T3 added

[MCP80 in reply to SlowDragon]

I haven't felt well since being diagnosed. So I have now had to get stroppy with my Endo and provide all the evidence with the help from my GP tbat we know it is all down to either my body not accepting T4 or it is the tablets themselves. They now believe me finally and threw a strop at my last appointment that they need to listen to me and not just look at my results as I seem to know more about it than they do. Obviously I did this as polite as I could so I didn't get thrown out as a distruptive patient! 😂 this actually seemed to work and actually took all my evidence. Patient 1 Consultant 0