Brand problems

[Annettie269]

Hi, I've been taking Mercury Pharma levothyroxcine for 3yrs and always stick with this brand because I'm very sensitive to others.

Recently I've been feeling blah!!...insomnia, headaches etc. Collected my prescription on Sat and noticed on the strip of tabs that it said " Eltroxcin" instead of "levothyroxcine" as it usually says.

Could this be the reason why i feel worse recently? Are the fillers different?

Thanks.

[SeasideSusie Remembering]

Annettie269

According to the list of thyroid treatments on ThyroidUK's main website

thyroiduk.org/tuk/treatment...

the licence holder for Eltroxin (Concordia) is Mercury Pharma and the ingredients are

Anhydrous Levothyroxine Sodium, Sodium Citrate, Lactose,

Maize Starch, Acacia Powder, Magnesium Stearate

Levothroxine (Concordia) is the same - licence holder is Mercury Pharma and ingredients are

Anhydrous Levothyroxine Sodium, Sodium Citrate, Lactose,

Maize Starch, Acacia Powder, Magnesium Stearate.

so they are the same tablets.

You say "Recently I've been feeling blah!!...insomnia, headaches etc", how long have you been feeling like this, did this come on before you started your new tablets that you collected on Saturday?

[Annettie269 in reply to SeasideSusie]

Hi Seaside Susie, thanks for reply. Well that's good to know the fillers are the same so something else is causing my symptoms.

I had some tablets left over from last mths supply and they were also Eltroxcin, but all the previous ones were mercury levothyroxcine so that was the reason.

My last results mths ago were...tsh 2.38 and ft4 16.

Sorry don't have ranges.

[SeasideSusie Remembering in reply to Annettie269]

Seems a bit silly to me for the same company to make two "brands" of Levo with the exact same ingredients.

Your results from months ago showed TSh too high for a treated hypo patient, most of us need TSH to be around 1 or below. Can't comment on the FT4 though because there are so many different ranges for that, with my surgery you would be at the top of the range (7-17) but with a common range we also see here of 12-22 you would only be 40% through.

[SlowDragon Administrator]

How much Levothyroxine are you currently taking?

When were levels last tested?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Have you had antibodies and vitamins tested?

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

[Annettie269 in reply to SlowDragon]

Hi SlowDragon thanks for reply.

I'm currently on 75mcgs Mon to Friday then 100mcgs Saturday and Sunday.

My vitamin D is 100 atm

B12 injections every 3mths

Folate 20>

Ferritin 130

My Doc won't check T3 🙄

Tsh 2.36 and ft4 16 checked 8wks ago.

I do have Hashimotos though.

Yes I do all of what you've asked regarding times of taking dose etc.

[SlowDragon Administrator in reply to Annettie269]

TSH over 2 is likely too high

What's the range on FT4?

Strongly suggest you get TSH, FT3 and FT4 tested together as early as possible in morning and fasting and last Levothyroxine dose 24 hours before blood test

Vitamin levels look pretty good

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

New NHS England Liothyronine guidelines November 2018 clearly state on pages 8 & 12 that TSH should be between 0.4-1.5 when treated with just Levothyroxine

Note that it says test should be in morning BEFORE taking Levo thyroxine

sps.nhs.uk/wp-content/uploa...

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH under one) and FT4 in top third of range and FT3 at least half way in range

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (note recommended to avoid calcium rich foods at least four hours away from Levo)

[SlowDragon Administrator]

Couldn't see any mention on previous posts on gluten free diet

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly.

Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet




(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)




Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

healthcentral.com/article/t...

Other gut issues due to being hypothyroid

healthunlocked.com/thyroidu...

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's gut connection is very poorly understood

You don't need ANY gut symptoms to still find strictly gluten free beneficial