Newly diagnosed

[jodyelliott]

Hi just been diagnosed with an underactive thyroid and have been on levothyroxine for a week and a bit. Anyone else have a problem with the brand nightstar as I have to have an ecg in the morning as I get a racing heart sometimes - not all the time so only on 25mg and doctor can't understand why I am reacting to such a low dose! Help?

[greygoose]

You haven't been on it long enough to tell if you're having a reaction to it. What dose did he start you on?

[jodyelliott in reply to greygoose]

I am on 25mg for two weeks and then up to 50mg for 4 weeks then blood test to check levels. Due to the heart issue today doctor said stay on 25mg until next blood test and see what happens with ecg tomorrow

[greygoose in reply to jodyelliott]

OK, but you said above that you've been on levo for a week and a bit. That's rather confusing, and not conducive to helpful replies.

How long have you been having these heart issues? When is your next blood test? Do you have the results from your last blood test?

[jodyelliott in reply to greygoose]

I had a heart issue in January which is why I went to the doctor and for him to also give me a hormone check to see if I was in menopause. Came out with the result of slightly abnormal reading of thyroid. I dont have a copy of the results. I do suffer with anxiety and although I am safe we are going through redundancies at work and I have had to take on extra work so with the heart issue today I could put that to medication and stress but the one in January I can't. I just wanted to know if anyone else has had side effects from the teva brand of levothyroxine and if so what.

[greygoose in reply to jodyelliott]

Oh, plenty of people have side-effects with Teva, but if you had heart issues before starting it, then it's not the Teva to blame. It's more than likely that low thyroid has caused your heart problems, because that's one of the symptoms of hypo. As is anxiety.

You are going to be under-medicated with just 25 mcg levo, which isn't going to help, but symptoms will improve as your thyroid hormone levels rise. However, you do want to get your doctor to write a prescription with a named brand of levo on it, so that your pharmacy can't palm you off with Teva. See if you can't get a blood test before 3rd of March. Blood tests should be done six weeks after a change of dose.

Oh, and always, always ask for a print-out of results after a blood test. You need to know exactly what was tested and exactly what the results were.

[jodyelliott in reply to greygoose]

What brand should he write if not teva? 3rd March will be 5 weeks of taking meds as tuesday this week was a week so been on them a week and two days. Yes I will ask for a print out of the test from a couple of weeks ago and in march so that I can see the difference. Thanks for your help

[greygoose in reply to jodyelliott]

But not 5 weeks on the same dose?

I'm afraid you can only find out which brand suits you by trial and error. As you've only tried Teva, any other brand would do for now.

[jodyelliott in reply to greygoose]

Doctor said today dont increase dose and stay on same until blood test

[greygoose in reply to jodyelliott]

Yes, I know, but that wasn't what I was saying. What I mean is that there's no point on testing unless you have been on the same dose for six consecutive weeks. From what I can work out from what you've said, you haven't been on 25 mcg for six weeks. Have you?

[greygoose in reply to greygoose]

Just seen you say below you've only been on 25 mcg for 1 week and two days. So, testing on 3rd March would be too soon.

[jodyelliott in reply to greygoose]

No but I will be just about when I have my test

[SlowDragon Administrator in reply to jodyelliott]

Thousands of people react badly to Teva brand levothyroxine

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. But lactose free liquid levothyroxine is available if Teva tablets don’t agree

Teva is the only brand that makes 75mcg tablet.

Teva poll

healthunlocked.com/thyroidu...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap. Some like calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

List of different brands of levothyroxine available in UK

thyroiduk.org/tuk/treatment...

Standard starter dose of levothyroxine is 50mcg

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)

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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

Bloods should be retested 6-8 weeks after each dose increase

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)

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 and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten.

So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

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

[jodyelliott in reply to SlowDragon]

Many thanks for all of this it seems a complete minefield and I just dont know if I am up for learning all of this it seems so intense. I just cant cope.

[SlowDragon Administrator in reply to jodyelliott]

Take one step at a time

Sounds like you are finding Teva brand an issue

Trying different brand....either now if symptoms are intolerable....or at next prescription

Perhaps try Activis brand at next prescription. It’s one of the most widely available brands and well tolerated by many

[jodyelliott in reply to SlowDragon]

But how do I go about getting new tablets? Only been on this med for a.week and 2 days and dont have first blood test until 3rd march. Do I have to go back to doctor again and ask him for different brand?

[SlowDragon Administrator in reply to jodyelliott]

If it’s unbearable on Teva ....yes

See GP

Explain your symptoms.

Say you have taken advice from Thyroid UK - the NHS recommended support group

You understand from Thyroid UK that many patients find Teva brand of levothyroxine causes upset due to different fillers

Ask GP ....can you have a new prescription so you can try a different brand

You could even do this via email/phone

Posts mentioning Teva

It’s a Marmite brand....

A few love it ....many loathe it

healthunlocked.com/search/p...

Levothyroxine is only £1 a packet.....cheap as chips

[jodyelliott in reply to SlowDragon]

Thanks

[lilacbunny in reply to SlowDragon]

Just looked up NorthStar on the list of different products available in the UK and it is made by Activis - does this mean they are the same thing or similar do you think ?

[jodyelliott in reply to greygoose]

Have booked next test 3rd march

[SlowDragon Administrator in reply to jodyelliott]

Make sure to get tested as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

25mcg is only half the standard 50mcg starter dose.....so frequently causes symptoms to get worse

Levothyroxine doesn’t “top up” our own thyroid production .....it replaces it....so until we get on decent dose it can cause issues.

[lilacbunny]

Hi, I've just started on NorthStar and have a tight chest and am very tired. I'm wondering if it is the brand and I had to take Levothyroxine years ago and this didn't happen although I am older now.

[SlowDragon Administrator in reply to lilacbunny]

Which dose of Northstar

North star is just a Brand name. The content inside the box comes from different pharmaceutical companies

50mcg and 100mcg are Activis Pharmaceutical

25mcg North Star has very recently changed to Teva pharmaceutical

This has caught several patients unaware. Patients who already are aware they are extremely intolerant to Teva Levothyroxine.

healthunlocked.com/thyroidu...

[helvella Administrator in reply to SlowDragon]

Afraid that link won't work! Gets truncated at the apostrophe.

I have reported the issue to HU!

The information you were trying to link to is this (I think):

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.

[SlowDragon Administrator in reply to helvella]

Yes it was

Thanks