Teva and Paroxetine interaction

[Levo_bro]

Hi All,

I was diagnosed with hypothyroidism last October. I've been taking Teva Levothyroxine, gradually moving up to 100 mcg. Had some side effects, but nothing like those I'm experiencing on 100. I've still not brought my TSH into range, so originally put this down to hypothyroidism symptoms. But the last few weeks I've felt rotten. Muscle spasms, joint pain and weakness - wrists, fingers, back. It is important to note that I take paroxetine and it would appear this can interact with mannitol. Given the number of people on antidepressants, I thought this could be very important.

drugs.com/interactions-chec...

I'm going to give another brand a go and will let you know how I get on.

[SlowDragon Administrator]

Important to regularly retest vitamin D, folate, ferritin and B12

Low vitamins can contribute to lots of symptoms

Low Vitamin D causes joint pain

Muscle spasms can be low magnesium, common when low vitamin D

Ask GP to test vitamins

[Levo_bro in reply to SlowDragon]

Thanks, I do need to check my vitamins. I was insufficient, borderline deficient in vitamin D back in the winter. Been taking a vitamin D supplement quite regularly since then. But definitely need to check that and also magnesium. Other results were ok.

[SlowDragon Administrator in reply to Levo_bro]

Can you add the actual results and ranges of previous results

Often “Ok” isn’t good enough ...we need optimal vitamin levels

Vitamin D

GP will often only prescribe to bring levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D

There’s no point testing magnesium, test only looks at magnesium in blood not cells and always comes back in range

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Importance of vitamin D for fighting Covid

moxafrica.org/post/the-vita...

[fuchsia-pink]

Teva is the Marmite brand. Lots of people on't get on with it - see poll - although others like it best as it's one of the few that is lactose-free - so it would be worth you trying a different brand and seeing if that suits you better. When you get one that's good, get it all the time and ask to have it put on the prescription - and check you've been given the right one before you leave the pharmacy

[SlowDragon Administrator]

Obviously depression is common hypothyroid symptom and suggests you may not be adequately treated

[minus]

Levo- Bro

Why? Does Teva contain Mannitol then? Is that why your concerned about fatal hyponatremia interaction?

[helvella Administrator Thyroid UK in reply to minus]

Teva levothyroxine contains mannitol (but no lactose).

It is currently the only UK make which contains mannitol.

But we need to be aware that Northstar 25 microgram tablets are just repackaged Teva - hence they too contain mannitol.