Hi again, I've been away for 5 months due to coming off Teva Levothyroxine.
During this time I've been feeling pretty much ok , still getting blurred vision , dizzy spells and mad sweats ...... not experiencing head pressure, anxiety/jitters , throbbing in throat or tingle under eyes.
Also libido has returned...☺.
Now during this 5 month period I've still been having blood tests and just had my first Endocrinologist appointment (overphone not the best but) .
He said my latest ranges are way out and have been deteriorating since I come off and would like to try me on Eltroxin, has anyone had any experience with the branded medicine or noticed any difference.
Also after my latest bloods it has flagged up low b12 but nothing has been said about this ..🤷♂️
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Johnljc
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So the same manufacturer produces two tablets which are exactly the same although one has a "brand" name the other doesn't.
On the other hand, you were on Teva and many, many members have had bad reactions to Teva brand due, it is believed, to the mannitol it uses instead of lactose:
So it's possible that all along it's been the Teva brand that has been the problem.
About 3 years ago Merck reformulated their Levothyrox and thousands of hypothyroid patients in France had adverse reactions to the new formulation - it turned out that it included mannitol. The French government intervened, after patients took to the streets and demonstrated, and insisted that Merck bring back the old forumulation (my potted version of events!).
Hopefully you'll do well on the new brand.
Just as an aside - many years ago in the UK we had a brand "Eltroxin", not the current Eltroxin by Mercury Pharma, but made by Goldshield. I was prescribed this, named on my prescription and to be prescribed Eltroxin only, it was considered the Rolls Royce of levothyroxine. However, it disappeared for whatever reason, never to be seen again. My pharmacy knew it was specified on my prescription and asked if I was OK to give Actavis (now Accord) a trial and I agreed. It suited me and I've had it ever since, again it's on my record at the pharmacy to only dispense this brand. So if you do well on your new brand, I'd ask either your GP to name it on your prescription or ask the pharmacy to note your records only to dispense that brand.
Having become extremely hypothyroid after stopping levothyroxine you are highly likely to have very low vitamin levels
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
Bloods should be retested 6-8 weeks after each dose increase in levothyroxine
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 as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Standard starter dose of levothyroxine is 50mcg (unless over 65 years old).
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients 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.
Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
guidelines by weight
Even if we don’t start on full replacement dose, most people need to increase dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months.
RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.
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