Wockhardt Levothyroxine

[janeold25]

I am on Wockhardt Levothyroxine 50mcg. I have to take this brand as it seems to be the only brand I can tolerate. Unfortunately I had to take Mercury Pharma which really upset me (dizzy exhausted) for 2 weeks due to Wockhardt not being available. I have been back on my Wockhardt for a week now but I am still feeling dreadful. Does anyone know if Wockhardt have changed ingredients in tablets that I could possibly be reacting to? Unfortunately I do not know what ingredients I am sensitive to.

[helvella Administrator]

There are so many factors - not just the listed ingredients but how they are sourced, manufacturing processes, etc. We often see people point at Acacia powder in Mercury Pharma - but I think that is on the basis of best guess. I found this Patient Information Leaflet which was recently updated - but very likely to be something like adding this rather than a change to ingredients:

Pharmacotherapeutic group: thyroid hormones, ATC code: H03AA01

Which has been done on a lot of PILs.

6.1 List of excipients

Lactose

Sucrose fine powder

Maize starch

Magnesium stearate

10. Date of revision of the text

31/01/2020

medicines.org.uk/emc/produc...

[janeold25 in reply to helvella]

Thank you for your reply really helpful to know that. Have funny feeling might be that I need time to adapt back to Wockhardt, was fairly well before brand change. What symptoms can acacia powder give you?

[jigsmoore in reply to janeold25]

It took me nearly 2 weeks to adjust to Wockhart after taking Mercury. I had a suspicion that I was alllergic to Mercury with it's acacia. I already knew Wockhart suited me at 25mc but the Mercury really upset me both 25 and 50mc. I had a past allergy to Zyban which I used to give up smoking (3 tablets and I ended up in A& E with severe reactions) Zyban, I found out contains Buproprion which has acacia in it!! WhenI took the Mercury, all symptoms came back - especially bloating and depression. Felt like my body was re-acting against it with a feeling of swelling all over and other symptoms of hypo re-sufaced. I have had to put up with palpitations when I swapped back to Wockhart but now I feel myself again! I think it takes a while to adjust and also to get the acacia out of my system. Very difficult to find Wockhart and if Boots fail to find some W off their usual meds listings I might have to swap to Almus. (Apparently they are the same as Wockhart and have no acacia in them.) I'm crossing my fingers I can find Wockhart to stay on!!Good luck!

[SlowDragon Administrator]

Likely to take 6-8 weeks to settle after any upset

50mcg is only a starter dose of levothyroxine

How long have you been left on 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 and thyroid antibodies if not been tested yet

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

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)

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

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

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

We frequently see patients on T3/T4 combination have levothyroxine dose reduced too much

[janeold25 in reply to SlowDragon]

Thanks for reply, did wonder whether it could be due to change and my body needs time to adapt. I was fairly well before brand change so hopefully need time to adapt again!!!

So you recommend starting with 25mcg of Levo? How long should I wait before increasing to 50mcg?

Have been on Wockhardt Levo for 2 years now, also on 20mcg T3 prescribed by NHS. See endocrinologist once a year who oversees me but GP sees me in between. I have full Thyroid test done on NHS twice a year.

My last results Oct 2019 were:-

Free T4 *9 Range 10-22

TSH level 0.57 Range 0.30-5.50

Free T3 4.00 Range 3.1-6.8

[SlowDragon Administrator in reply to janeold25]

No not at all

First question

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).

when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

when on Levothyroxine plus T3, frequently endocrinologist reduces levothyroxine far too much

Your results from Oct 19 show very low Ft4. And Ft3 pretty low

This suggests you need 25mcg dose increase in levothyroxine. This would increase both Ft4 and Ft3

Retesting bloods 6-8 weeks later

Many, many people on levothyroxine plus T3 need optimal Ft4 and optimal Ft3.

What’s optimal varies from person to person, but it’s typically Ft4 at least half way through range

How much levothyroxine were you on BEFORE endocrinologist added T3?

How do you take your T3? As single dose or split into 2 or 3 smaller doses?

Do you have Hashimoto’s?

When were vitamin D, folate, ferritin and B12 last tested?