I switched from synthroid to tirosint and had a... - Thyroid UK

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I switched from synthroid to tirosint and had a really bad hyper symptoms and went back to synthroid. Anyone else have the same thing happen

JaclynB profile image
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Bad reaction to tirosint

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JaclynB
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helvella profile image
helvellaAdministratorThyroid UK

We have seen a few people say similarly.

My first guess, and that is all it is, the Tirosint is being absorbed significantly better than the Synthroid was.

I have certainly read that some people need a lower dose of Tirosint than they needed of any other tablet. What I don't know is by how much. Anyway, that could well vary considerably among patients.

This paper is very clear that Tirosint absorbs better and quicker than Synthroid.

It emphasises that absorption is most impaired if you have least stomach acid. Do you take anything that would affect stomach acid?

A comparative pH-dissolution profile study of selected commercial levothyroxine products using inductively coupled plasma mass spectrometry

Dimple Pabla, Fatemeh Akhlaghi, Hossein Zia

doi.org/10.1016/j.ejpb.2008...

Abstract

Levothyroxine (T4) is a narrow therapeutic index drug with classic bioequivalence problem between various available products. Dissolution of a drug is a crucial step in its oral absorption and bioavailability. The dissolution of T4 from three commercial solid oral dosage forms: Synthroid® (SYN), generic levothyroxine sodium by Sandoz Inc. (GEN) and Tirosint® (TIR) was studied using a sensitive ICP-MS assay. All the three products showed variable and pH-dependent dissolution behaviors. The absence of surfactant from the dissolution media decreased the percent T4 dissolved for all the three products by 26–95% (at 30 min). SYN dissolution showed the most pH dependency, whereas GEN and TIR showed the fastest and highest dissolution, respectively. TIR was the most consistent one, and was minimally affected by pH and/or by the presence of surfactant. Furthermore, dissolution of T4 decreased considerably with increase in the pH, which suggests a possible physical interaction in patients concurrently on T4 and gastric pH altering drugs, such as proton pump inhibitors. Variable dissolution of T4 products can, therefore, impact the oral absorption and bioavailability of T4 and may result in bioequivalence problems between various available products.

Full paper is behind a paywall, unfortunately:

sciencedirect.com/science/a...

JaclynB profile image
JaclynB in reply to helvella

Tank you very much for this information. I haven’t had anyone reply to me yet to tell me their own experience. I don’t think it’s being prescribed much.

in reply to JaclynB

It seems Tirosint is not available in that many countries, especially in Europe, so it may be that few members have tried it.

I have read that it contains liquid thyroxine and hardly any fillers so it makes sense that it's better absorbed than Synthroid.

Did you develop hyper symptoms while on it? That could indicate better absorption so higher hormone levels.

But, if you feel better on Synthroid, why not stick to it?

JaclynB profile image
JaclynB in reply to

I took 88 mcg of Synthroid and then switched to 88 mcg of Tirosint and they say levothyroxine takes awhile to convert. But it definitely effects you within 12 hours if the absorption is way more. I had a terrible time that same night tossing and turning, felt so nervous I could crawl out of my skin and heart racing it was awful.

in reply to JaclynB

I recognise these symptoms, I've been having the same on NDT which is why I recently switched back to levo.

I think Tirosint is referred to as hypoallergenic by some doctors with a more holistic approach, but that does not mean it works for everyone.

JaclynB profile image
JaclynB in reply to

What I did notice is that the Synthroid causes me a lot of burning sensation in my stomach about a half hour after I take it but the tirosint did not. I actually had a good day with my stomach but the morning after I took the tirosint I knew it must have been too stron because my ears started ringing and I felt pressure headache all day and by the time it was bedtime I was so jittery I could not lay still.

in reply to JaclynB

Did you try reducing it?

JaclynB profile image
JaclynB in reply to

No not yet. It was just two days ago that I took the 88 mcg. The next dosage down would be the 75 mcg and I’m waiting to talk with my endo and see if that would help. I still feel shaky even now by that one pill two days ago. I guess it’s definitely true that the absorbtion is sooo much more than the tablet forms

wellness1 profile image
wellness1

I think that my body deals with it better than other brands of Levothyroxine. I didn't make a direct switch from T4 monotherapy on another brand to T4 monotherapy on Tirosint, so I can't make the direct comparison you can, but maybe if you reduced your dose or tried splitting your dose you might get on well with it. Since you had the stomach issue whilst taking Synthroid, it might be worth trying to tweak your dose of Tirosint to see if it's better for you.

milkwoman profile image
milkwoman

I agree with wellness1.

Tirosint is better absorbed so you would need to take less to equate to the 88mcg of Synthroid.

I LOVE Tirosint as I experience NO nasty side effects. It’s the only brand I tolerate. On other kinds, I experienced horrible GI issues along with headaches and I found them overall to be not as effective.

I would stick with Tirosint and work with your doctor to get to a suitable dosage since you wrote that Synthroid upsets your stomach. Tirosint comes in many dosages: 13mcg, 25mcg, 50mcg, 75 mcg, 88 mcg, 100mcg, 112mcg, 125mcg, and so on.

The 75mcg gelcap daily *might* do the trick or you may need to actually go down to 50mcg because Tirosint is absorbed that much better! If 50mcg is not enough, you could take one 50mcg + one 13mcg daily.

It will be a bit of trial and error but in the long run, so worth it.

helvella profile image
helvellaAdministratorThyroid UK in reply to milkwoman

Or even alternate 50 and 75?

milkwoman profile image
milkwoman in reply to helvella

Yes. Lots of options for the OP..... 😊

JaclynB profile image
JaclynB in reply to milkwoman

Thank you so much for the reply. My stomach burns all day when I take Synthroid. Its like bad reflux all the time too

JaclynB profile image
JaclynB in reply to milkwoman

Have you ever taken Synthroid? If so what dose of levo tablet form versus Tirosint dosage

milkwoman profile image
milkwoman in reply to JaclynB

I started out on Tirosint then was switched to Unithroid for cost reasons. I switched back to Tirosint when I had issues with the Unithroid. FYI... my stomach issues got continually worse on Unithroid as time went on.

Since I was just starting my treatment, I was only on a starting doses at the time so when I switched back to Tirosint (was probably the same dosage level of the Unithroid), I was most likely ready for an increase. This was years ago.

I’ve been on Tirosint ever since and having regular increases (and seasonal decreases) over the years to be where I am now (125 mcg daily, except 150 mcg M, W, F). I also take custom compounded liothyronine transdermal cream once daily. (I tried oral T3 meds, even custom compounded ones but have only done well on the cream).

We are all different and have to find not only the formulation, but the proper dosage that eliminates our HypoT symptoms with no side effects.

Meanbeannyc profile image
Meanbeannyc in reply to milkwoman

What is this transdermal T3 you speak of?!

milkwoman profile image
milkwoman in reply to Meanbeannyc

I have Liothyronine (T3) custom compounded into a cream that I apply in the morning to my skin. I’m very fortunate to have a compounding pharmacy in my city (I’m in the US) as well as a physician willing to prescribe it. It’s not covered by insurance but for me it’s well worth it as oral T3 meds didn’t work for me. I also have my HRT custom compounded into a cream.

JaclynB profile image
JaclynB

I’ve only been on Synthroid after I had RAI in 2011. I tried Levoxyl once and it made me feel so hyper too. But I really wasn’t prepared for how potent the Tirosint was. I even alternate with 100 mcg every third day on synthroid and that dosage being higher doesn’t make me that way either. I’m three days out from the one tablet I tried of Tirosint and I still feel like my body is trembling inside. Just shows me how much my body probably doesn’t really absorb what I thought it was with the synthroid. Has Tirosint ever made you feel restless and jittery?

JaclynB profile image
JaclynB

Oh and what seasons do you need to increase or decrease and by how much?

Koola profile image
Koola in reply to JaclynB

Hi JacIynB, I find you here again-- about Tirosint. I've been alternating a lower dose of Tirosint, 75, with 88 Levo. Slowly going up to more 88. After posting my last results here, I was told to up my dose to 100. Since I don't have 100 levo in the house, I took 100 Tirosint yesterday early and I'm still in a total mess! I think I'm dropping Tirosint altogether. How have you been faring in the last 5 months and what did you decide to take ?

milkwoman profile image
milkwoman

I don’t post personal information here.

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