I’m also wondering if I should ask for just 50s and get a pill splitter??
I’m Hashi/ hypothyroid and on current dose of 50mcg I’m still have bad symptoms- but also feel hper times jittery can’t settle etc. I’m taking vitamin D as this low in my last bloods but only from chemist until I see private Endo for follow up next week.
The T4 and T3 were in normal range last week, but antibodies means I have Hashimoto T.
Thanks 🙏
Other makes come in 25s so you don't need to have teva.
If you can put your test results with ranges, as we can then see if indeed you need an increase, I take wokhardt at the moment for 25mcg.
Hi Whispers I will do when I go next week as private doc discussed over phone and did direct referral to Consultant Endo so she’ll have them for me. He did say my TSH T4 and T3 in ‘normal range’ and he did say inverted commas- but my antibodies indicate Hashi and that I could need a higher dose for symptoms to start improving. My last blood at NHS GP two weeks ago was TSH 2.9 and he said there was no need to check T4- as in normal range no further action and review in one year! That’s not happening! Hence paying privately for second opinion. It’s trashing my life, not been in work for 6 weeks and I cannot go on like this, or wait weeks for Endo via NHS. I don’t have excessive expendable income of course so they have said they’ll write to GP with a treatment plan etc if the NHS don’t feel need to follow, I’ll just pay privately and eat soup 😁 otherwise I’ll have no money anyway without a job!!
TSH of 2.9 is too high when on levothyroxine
You need 25mcg increase and bloods retested 6-8 weeks later
Extremely important to test vitamin levels too
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 as you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels if not been tested by consultant
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
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
thyroiduk.org.uk/tuk/testin...
For thyroid including antibodies and vitamins
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
If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )
monitormyhealth.org.uk/thyr...
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range
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 (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
As you have hashimoto’s are you on strictly gluten free diet?
Poor gut function with hashimoto’s 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...
drknews.com/changing-your-d...
restartmed.com/hashimotos-g...
Thank you- I’ve come up negative for coeliac bloods but will look into the GF.
Stick with the brand you have ....if it’s the best option for you
Cutting 50mcg in half is perfectly acceptable
List of brands and dose sizes
thyroiduk.org/tuk/treatment...
Our pharmacy won't do this unless the GP has okayed pill splitting/alternating doses on the prescription. I don't know if this is usual, but it might be worth being aware it's a possibility and mentioning it if you're seeing a doctor anyway.
No, mine don't like patients splitting a tablet in half either.
Levothyroxine is a storage hormone. It’s perfectly possible to take 50mcg one day and 100mcg the next day ....this evens out at 75mcg average ......but some patients prefer to take 75mcg everyday ...This is only possible as 25mcg and 50mcg tablets or cutting 50mcg in half
Some patients only get on with Wockhardt....that only available in 25mcg
Ok thank you- how odd that only a couple of makes for 25s doesn’t make sense! Except for their costs I suppose!
It's a bit odd, isn't it? I decided not to argue, as I might need to reserve some goodwill for another time. It's interesting that you mention Wockhardt, as that was the alternative offered.
Thank you I’ll ask the Endo! Did I read the Wockhardt is reboxed but is actually Teva now? I might be mixed up here.
If you did read that, it is WRONG!
UK Levothyroxine Tablets
Last updated 05/02/2020.
This is a list of currently marketed levothyroxine tablets in the UK.
🔹 Accord – formerly Actavis (manufacturer)
50
100
🔸 Almus (brand owned by Walgreen Boots Alliance – Boots and Alliance distributor)
50 – This is repackaged Accord – formerly Actavis.
100 – This is repackaged Accord – formerly Actavis.
🔹 Mercury Pharma (manufacturer – part of Advanz) includes both “Levothyroxine” and “Eltroxin” which are identical.
25
50
100
🔹 Teva (manufacturer)
12.5
25
50
75
100
🔸 Northstar (brand owned by McKesson – Lloyds pharmacy and AAH distributor)
25 – This is repackaged Teva. ❗
50 – This is repackaged Accord - formerly Actavis. ❗
100 – This is repackaged Accord - formerly Actavis. ❗
🔹 Wockhardt (manufacturer)
25
🔹 – identifies manufacturers.
🔸 – identifies repackaged products.
❗ – Take particular note of the actual product which varies by dosage.
Numbers refer to tablet dosages in micrograms.
Brilliant thanks I’ve taken screen shots so I know what to accept at pharmacy. Really helpful 🙏
And everyone’s responses- I’m so glad for this forum 😁
Thank you I am so pleased you published that list. I’ve struggled for months to get non TEVA 25mg as the mannitol in them does me harm. I take 125mg and the 100mg has never been a problem. My surgery pharmacy thought this time they had found non TEVA for me and stocked up. However when I unpacked my monthly packages I saw the 25mg was Northstar. I wouldn’t have investigated if you hadn’t provided the list. Low and behold the information leaflet inside says manufactured by TEVA and contains mannitol . My pharmacy are now on the case ! Many thanks for the info.
Thank you for posting that.
It is because I am so aware that I made up that simple list.
Just goes to show:
You cannot trust a pharmacy or pharmacist - even when they might think they are being helpful.
You simply HAVE to check every time.
If you don't check, no-one else will.
The trouble is the pharmacy is not told what the suppliers are up to . As they said , they have no reason to open up any sealed box they dispense to see if is a different manufacturer . There is no clue on the actual box .
Not so!
Have a look at this document (preferably on a reasonable size screen):
dropbox.com/s/7tte490umnz6s...
Look at the package carefully. Usually along the lower long edge (but not always), it says who the MAH licence holder is.
Page 1 Almus
Page 9 Mercury Pharma
Page 11 NorthStar
Page 14 Teva
Page 25 Wockhardt
Sorry I do not currently have a proper picture of the "splat" of the Northstar 25 microgram pack. I'd be amazed if it were different in the sense of not having this information. 
A few weeks ago, I pointed this out to a pharmacist who had been just about to break a seal and open the pack to check...
Oh yes I see what you mean ( my dispensing label was partly covering it so you are quite right . I will point this out when I take it back on Monday . Thank you for that 🤗
Thanks I’ll ask the Endo- and then GP. Yes, of course, it’s the prescription on the script matching the box/ they’ll have guidelines won’t they? I’ll ask anyway
I hope you manage to find a solution!
Thanks Lyra
I’ll have to say this to the doctor. I’d rather stick to one make if possible after by Teva experience 😩
Thank you SlowDragon- don’t want to mix things up too much as I’m still v symptomatic and trying to balance against my oral HRT 🤞
If you're doing OK on your current brand, then I second what SlowDragon has said, stick with your current brand and split a 50mcg tablet for the 25mcg increase (pill cutter or sharp craft knife does the job), or even alternate 100/50 to average 75mcg daily.
Thank you Seaside- whilst I’m not better (terrible 24 hours) the trend is upward since switching from Teva 10 days ago. X
👍🙌 done! 🙏
I’m on 75 and break my 50 Actavis with my nails. They aren’t hard tablets and they don’t crumble when broken.
Brilliant Ellie Louise- is your GP happy for you to have 50s only?
He knows I break them but on the prescription he puts down to take one/ two alternately.
That’s great thank you 🙏
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