I’ve read the recent TEVA discussions with interest, but as I’ve had that brand on several occasions in the past and had no bad reactions (it’s Wockhardt I don’t get along with) I’ve not taken too much notice, so when my prescription in February was part filled with TEVA (75 mcg of which 25 mcg was given to me as TEVA) I thought nothing of it. However, after a month I started to feel “off” and by the time I got to the end of the prescription a month later numerous symptoms were back. My next prescription I insisted on it not being filled with TEVA, which the chemist was happy to do. It’s been less than a week off TEVA and some of the symptoms are already starting to go away.
However, for the last few months I’ve been getting my own Medichecks tests and they don’t seem to how anything untoward due to the TEVA.
My prescription is 75mcg/day, but I've slowly increased that to take an extra 25 three days per week.
TSH (range 0.27 – 4.20)
20/08/18 4.43(75 mcg/day)
12/11/18 3.42(75/day + extra 25 Mon & Thu from Oct)
28/01/19 2.48(75/day + extra 25 Mon, Wed & Fri from Nov)
08/04/19 2.64(as above but 25 of the 75 was TEVA from Feb)
T3 (range 3.10 – 6.80) same dates as above
5.04 5.54 5.29 5.97
T4 (range 12.0 – 22.0)
15.4 20.1 19.1 18.3
B12(range 37.5 – 188.0)
81.51059970.7
Usually take 25mcg/day but for April test I stopped three days before blood test – instructions said stop for a week.
Ferritin (range 30.00 – 400.00)
158 113 136 126
Folate (range 3.89 – 26.80)
3.51 4.22 9.33 11.7
CRP – whatever that is (range 0.00 – 5.00)
2.65 0.46 0.39 0.37
Vit D (range 50 – 175)
08/04/19 75.6
All antibody tests show tiny figures
The only NHS test was TSH, 12/09/18, 1.65 (range 0.4 – 4.5)
Slow digestion (not constipation, it still works but slowly)
Eyes feel strange (like they’re about to pop out of my head or under internal pressure)
Lack of energy
Weight gain of 5lb in the last fortnight (but I’ve strained my Achilles and haven’t run for a month). Possibly water retention because since changing back from TEVA I’ve visited the loo a lot more than I’ve drunk, though I’ve yet to lose any of the 5lb I gained.
So if the TEVA hasn’t really had any major impact on my thyroid hormones why the return of the symptoms, and why’ve they started to recede since going back to my usual brand? I’ve discounted it being psychosomatic because I’ve had TEVA before and never had a problem with them, and wasn’t expecting anything bad from them this time either.
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It's not easy to decipher those results the way you've posted them.
Were all your tests done under the same conditions, i.e. fast overnight, left off Levo for 24 hours, blood draw no later than 9am?
Do you take a B complex containing Biotin or a Biotin supplement? If so did you leave it off for 7 days before the test.
If so then your TSH is decreasing, as it should, but your latest result of 2.64 is still too high, when on Levo only, the aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well. Both FT4 and FT3 have increased well from the original result.
B12(range 37.5 – 188.0)
81.51059970.7
Usually take 25mcg/day but for April test I stopped three days before blood test – instructions said stop for a week.
So it looks as though 70.7 is your latest result, which is just 0.7 above the level where it's suggested testing for B12 deficiency according to Viapath at St Thomas' hospital:
Reference range: >70*; * between 25-70 referred for MMA
25mcg is a minute amount and if you're looking to raise your level you'd need 1000mcg sublingual methylcobalamin daily along with a good B Complex to balance all the B vitamins.
Ferritin (range 30.00 – 400.00)
158 113 136 126
Ferritin is recommended to be half way through range although I have read that for males 150 is good.
Folate (range 3.89 – 26.80)
3.51 4.22 9.33 11.7
This is recommended to be at least half way through range so that would be 15.5+
Vit D (range 50 – 175)
08/04/19 75.6
The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L so this could do with improving.
CRP – whatever that is (range 0.00 – 5.00)
2.65 0.46 0.39 0.37
Medichecks lists the tests in the bundle on the page when you are ordering and explains what this is
C-Reactive Protein (CRP) is an inflammation marker used to assess whether there is inflammation in the body - it does not identify where the inflammation is located. High Sensitivity CRP (CRP-hs) is a test which is used to detect low-level inflammation which is thought to damage blood vessels which can lead to a heart attack or stroke.
Raised levels are a risk factor for cardio-vascular disease.
If you think Teva might be a problem, don't accept it and do a trial of a few months without it, that should tell you.
Your immediate concern regarding your nutrient levels is to sort out your B12. You can check for signs of B12 deficiency here:
Thanks for your comments. The format looked a lot better when I wrote it in Word, but cutting/pasting lost some of the layout, I did my best to correct it but obviously not enough!
Yes, all the tests were finger prick tests at approx 7:30 in the morning before taking my levo.
I take one Complete B Complex from Holland and Barrett (the recommended dose is two) which contains biotin. I ordered the tests on Thursday and saw the instructions to leave off taking them for a week, but I wanted to take the test before I went back on to my usual brand of levo so didn't take one on Thursday to Sunday. My last was therefore Wednesday night before the test on Monday morning - not quite a week, but not far off. When I used to take two my urine turned bright yellow and I thought that was an indication I was taking too much and just passing what I didn't need. Taking just one it's a normal colour.
I looked at the symptoms of low B12 on the link you provided and don't have many of them generally, though some others reappeared while I was on Teva, but are now going away. The only ones I have that don't seem to vary much with changes in Levo are poor digestion, bloating and constipation, though they are all much improved since I went gluten free last June or July (I've been tested for Coeliac twice over the years, both results being negative). Unfortunately I've also identified that anything but a small amount of dark chocolate has the same impact as gluten - slowed digestion and bloating.
I googled foods high in vitamin B12 and I regularly eat most of the top five - not sure what more can I do?
I thought my ferritin and folate were low, but not sure what more I can do to increase those, either. I eat green veg every day and occasionally liver pate (but I can't stand liver - had it twice, been ill twice, even the smell makes me feel sick).
I'm a runner (of sorts) and spend a lot of time outside in shorts and a vest, and have recently (last fortnight) increased the Vit D supplements I take - hoping it will make a difference.
I also supplement with 200 mcg Selenium and 250 mg Magnesium and I eat lots of nuts of all varieties. And I've spent a lifetime loving bananas and tangerines.
One of my main queries when I posted doesn't come across at all, but I was wondering, given my thyroid hormones have barely changed during the two months I've been on Teva which was just 1/3 of my dose, why my symptoms returned, and since coming off it they've started to recede? Allergic reaction? Given the increase in symptoms I was expecting my TSH to have risen quite a bit and my T3 and T4 to have gone down, but that's not the case, TSH up 6%, T3 up 13% and T4 down 5%.
I had Teva for a couple of months and experienced some of the same symptoms, itchy scalp, itch in ear canal, pressure behind eyes as well as tingly feet and toes and general fatigue! Strange how much overlap there is.
I refused it in my last prescription and have been taking mercury pharma 50 and wockhart 25 and have noticed those symptoms have largely disappeared and it’s only been a week and a half.
Interesting that you’re taking an extra 25mcg a few times a week, I’ve been considering upping my 75mcg prescribed by GP in a similar way and have taken 100mcg on last 2 Monday’s. Feeling generally better. Have you noticed any side effects? I felt slightly hyper for a morning, lots of energy and quite anxious, also couldn’t sleep night before.
Also interesting that your Medichecks TSH results are all higher than the NHS tests. I’ve found this too, all my NHS checks have been between 1.2 to 1.8 since I started on 75mcg but my Medichecks result was 3.64!
Do they use a different scale to the NHS I wonder?
Yes, I initially tried taking 100 a couple of years ago but it made me worse and I went back down to 75. However, my symptoms last year gradually increased so I started taking an extra 25 on Monday, then Monday and Thursday and then Monday, Wednesday and Friday. I tried four times a week two years ago but it was too much and I dropped back to 75. Maybe the gradual increase this time is what's made a difference?
I also noticed the much lower result form the NHS. Could it be the difference between a finger prick and drawing from a vein? Or just different scale.
I have only just made the connection between TEVA and becoming really unwell over the last month. Chemist gave me TEVA in feb but I usually have wokhardt ... I have had muscle weakness, twitches, spasms, fatigue, more joint pain than usual, put on half a stone, and its funny you should mention it because at first I had ear itching / pressure as well and I couldn't understand it. I am going back to my usual combo of actavis and wokhardt tomorrow...
Oh yeah, I'd forgotten about the twitches. Just my left eyelid, but it was very annoying. It's been a week off Teva and everything is improving. Hopefully your escape from the clutches of Teva will result in a return to improved health.
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