Different brands of Levothyroxine

[Mevamum]

Very interesting, knew I wasn't going mad! Both my Mum and I have always maintained that we felt different when treated with different brands.

[Santolina]

one reason why one brand may make you feel better than another is that some brands cheat on the amount of levothyroxine they use; over time this may make you feel less well. Keep track of the different ones and monitor how you feel. Many European countries refuse to use levothyroxine generics as they say it's not in the patient's best interests.

[RedApple Administrator in reply to Santolina]

Santolina, "some brands cheat on the amount of levothyroxine they use"

I don't know where you get that idea from. Certainly here in the UK, there are very strict rules and regs about such things. The MHRA (Medicines and Healthcare products Regulatory Agency) exists to ensure this sort of thing cannot happen. If it did happen, their license would be pulled and the medication taken off the market. There may be plenty of reasons why one brand doesn't work for some people, but it won't be because the manufacturer has 'cheated on the amount of levothyroxine'.

[helvella Administrator in reply to RedApple]

I'd add to that by referring to the only make of levothyroxine that has been withdrawn in recent years. Old formula Teva levothyroxine.

That actually contained the right amount of levothyroxine! The problem appeared to be a change of ingredient (the precise form of dextrin) which prevented the levothyroxine being delivered properly.

Further, one of the issues which was widely reported in the USA was overage. Where the company puts extra levothyroxine in so that when it is taken, it has the right amount. For example, they put in 110% of claimed dose, when the patient gets it, it has 105%, and even if they keep it in the cupboard for a considerable time, it will probably still contain 100%.

Effectively, this allows a longer shelf-life claim. But there are problems. Firstly, the drop from manufacture to the patient swallowing is uncontrolled and variable. Secondly, if one company does this and another does not, they are inevitably not likely to deliver the same dose.

(I have a suspicion that one of the reasons for Synthroid keeping its high market share was that it would often deliver a higher dose than other makes which did not go for overage. If anyone was swapped to another make, their dose would often be slightly reduced.)

Overage is now categorically banned by the FDA. All manufacturers must target 100% potency.

[helvella Administrator]

You and your Mum might well be going mad, I couldn't possibly comment on that, but different makes often have at least slightly different effects on us!

When I started on levothyroxine, I tried to have the attitude that it wouldn't make any difference to me. Experience has shown otherwise. I do notice a difference.

BTF are entirely wrong to say "Very rarely people may feel less well with certain brands of levothyroxine." It is NOT very rare; it is common. I suspect most people here sometimes notice a difference.

Indeed, people sometimes notice a difference between a single 100 microgram tablet and two 50 microgram tablets of the same make.

[littlecandle]

I got a different brand of the 25mcg levo in my last batch of drugs and I felt the effects at once. The pill was less than half the size of my usual brand. I stuck it out, because the pharmacy was having issues getting the other brand, but assured me that I would get my usual brand this time, which I did. Less than a week in, I feel a bit better than I did.

[silverfox7]

helvella got there before me as I found they was a difference between 100 and 2x 50 of the same brand. Prior to that the pharmacist had given me all my doses in 25 mcg and I suddenly decided after many years to change to 100’s + 25’s as it would work out a little cheaper for the NHS. I quickly changed back! Tablets are allowed a tolerance which will be stable throughout time but the different sizes won’t necessarily be interchangeable. I then realised that’s why my pharmacists always gave me 25’s! So that would be my main reason for always sticking to the same brand but also all tablets contain fillers to keep them stable and also to bulk them up and finding fillers that can upset you is not unusual either. Also potency can be very slightly different between brands as well. On a low dose may be not noticeable but on a higher dose it could be. I’ve always thought consistency goes a long way towards wellness with thyroid issues.

[MarkT80]

Spoke to my Dr last week about this. Was on 75mg 1x50 1x25. When first started taking them, they were same brand. Then few months ago they changed the 25gm tablet. Felt rotten within 2 weeks. Had blood test last week and levels so low now on 100mg. The 100mg tablet same has the 50 mg. Perhaps been better if they just given me same brand. Blood test in 6 weeks. Bet to high by then lol

[Odinil]

Such a relief to hear that, why are we not listened to it doesnt seem like an uncommon compliant, its got to be a recognizable problem, we need help not people making out that we are going mad