Is there enough lactose in levothyroxine to cause a problem?

[Hashi-hacker]

I know I am caesin intolerant but not 100% sure on lactose (I know one is protein and the other is sugar and that the intolerances are different, and affect the body differently). I am starting on levo and am wondering if there is enough lactose in some levo brands to be a problem for me, or the actual amount is so low it wouldn't make a big difference? Is it worth taking a lactose intolerance test? What do you think??

[silverfox7]

Best person to ask is the Pharmacist. As far as I know the only medication Lactose free is TEVA. this has been the subject of complaints as many feel bad on it but I've come across people who need Lactose free happy with it so may be it's a case of it only working for the people it's been intended for. I don't know the answer but a pharmacist should be able to help.

[helvella Administrator Thyroid UK]

For as many years as I have been involved, we have seen doctors, pharmacists, etc., saying that the amount of lactose in levothyroxine tablets is so small that even those who cannot digest lactose should not notice any issues.

At the same time, we have had patients reporting time and again that switching to lactose-free has helped them. Not all patients by a long way! Enough individuals to undermine the case that there is too little to have an effect.

What has always appeared as an inconsistency is that many who cannot take levothyroxine with lactose in it are fine on some other medicines which also contain lactose.

I suspect that the issue is a touch more subtle - such as lactose actually reacting in the presence of levothyroxine to form something else?

As has already been said, Teva is the only UK product made without lactose. Some people do well on it, but we see rather a lot of people reporting that they couldn't tolerate Teva.

[Hashi-hacker in reply to helvella]

Thanks for the replies. I asked the pharmacist to look out for a lactose free brand for me, then came home and did my research (Thyroid UK) and found the Teva brand that you mention, and like you say the mixed response from people taking it. The pharmacist will hopefully contact me soon to let me know what she's found out about quantities of lactose in regular levo and if there is a lactose free brand I can get. This is one of those conversations that I find difficult with medical folk as they can be dismissive of food related intolerances and anything related to gut health. I think I will try the regular brand - I'm only just starting meds so have no experience of any, and with a 25mcg starting dose, I am not sure how it's going to go!

(Background, totally gf df (due to caesin), take LDN for Hashi's, good vit's levels but very low/bottom range for T4 and free T3. Have had treatment for SIBO and adrenal fatigue in the past which has helped).

[AnnaSo in reply to Hashi-hacker]

Hi Lyndsay,

I was prescribed liquid Levo (without any nasties as I’m also sensitive) before leaving UK but doctor was hesitant due to cost. Not sure if it’s still available- worth asking.

Also, how come you’re already taking LDN if haven’t even started meds yet?

[Hashi-hacker in reply to AnnaSo]

Hi AnnaSo, taking LDN was a bit of a coup. I pay for this on a private prescription, as I managed to persuade my GP that since I'd self diagnosed Hashi's based on a Medichecks thyroid panel, that I'd try LDN to calm down the auto-immunity, plus make some changes to my diet (gf df) and boost my gut health (supplements, treat HPylori, treat SIBO). I'm happy to report that since then, my Thyroglobulin antibodies have gone from 244 to about 30'ish (range 0-115) but by Thyroid peroxidase antibodies have stuck around 80-100 (range 0-34). More importantly I have had a reduction in symptoms.

However, I've felt that my health has plateaud and that I've done all the steps I can think of to be as healthy as possible, that it's time to try levo. This was not easy as my TSH has been all over the place from as low as 1 through to 6.3, which as forum users know, is what the GPs/endos are most interested in and as I've read this type of TSH fluctation is a common problem with Hashi's. I've had to do most of this by myself, with varying levels of scepticism/support from NHS medics, but have loads of support from my coeliac husband and the occasional input from a US based registered dietician (who I chat to on Skype).

[Sammy200]

Hi Lyndsay,

When I was Diagnosed with Under Active Thyroid ,I told the Chemist I could not have Lactose and his reply was that is all I have .Otherwise I have to order them from Germany at £200 .So I tried just one and was ill for two Days .So came on this Great Site and found Teva had just come back on the Market with Lactose Free .Went back to the Chemist and he ordered them .So l have been fine on Teva Lactose Free .I have to check every two months that my repeat Prescription is Lactose free. ( Blue Box ) as the Chemist tends to send ordinary ones (Brown Box ) I now stand in the shop and check them before I leave .I also take them at night .

[Hashi-hacker]

Thanks Sammy200, why do you take your meds at night? Did you switch from mornings?

[Sammy200]

Hi Lyndsay ,

Ifind it much easier at night .When I get up in the morning Ihave to have Painkillers .So Ihave my breakfast and Tablets together .

[Hashi-hacker]

Ah, so I changed my mind! My pharmacist got me Teva brand which is 'new formulation' (don't know when that applies from and what they changed). I will report on progress!!

[RedApple Administrator in reply to Hashi-hacker]

The 'new formulation' has actually been around for nearly two years now One of the things they changed is removal of lactose. See this announcement from 2016 healthunlocked.com/thyroidu...