Eltoxin

[Johnljc]

After coming of teva leva 6 months ago and feeling pretty normal , 1st week on eltroxin and I already want to come off .

Feel bloody awful, is there a amount of time to give for them to kick in or should I just bin them off.

[fuchsia-pink]

Teva really is the Marmite brand - lots don't like it; some are neutral, and for other people it's their preferred brand. It's one of only two that are lactose-free. If it works for you and the new one doesn't, I'd call the GP in the morning and get a new prescription asap - with Teva written on it, and yellow-card the eltroxin.

Hope you feel better soon

[Johnljc in reply to fuchsia-pink]

Hi , Teva was the reason I stopped for 6 months ..... specialist suggested to try eltroxin... but 1 week in id rather be without .

[fuchsia-pink in reply to Johnljc]

Aah you don't like Teva either! Then try another brand until you find one you like ...

[SlowDragon Administrator]

In this previous post ..

healthunlocked.com/thyroidu....

you say endocrinologist has told you your results after not being on levothyroxine show you are hypothyroid

Have you got the actual results?

If not, email endocrinologist and request them, or get them from GP

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

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 as you have Hashimoto’s ....and especially if very hypo as you are after stopping levothyroxine

Add results and ranges please

Or come back with new post once you get results

What vitamin supplements are you currently taking

Have you had coeliac blood test yet

Are you now on strictly gluten free

[SlowDragon Administrator]

With Hashimoto’s your thyroid is being attacked and you need to replace missing thyroid hormones

Standard starter dose of levothyroxine is 50mcg

The aim of Levothyroxine is to increase the dose 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.

nhs.uk/medicines/levothyrox...

Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

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

Even if we frequently 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

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

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.

gp-update.co.uk/Latest-Upda...

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.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

Getting vitamin levels tested essential

[Thyb]

I felt ill on Eltroxin also. Lots of symptoms:- yellow tinges 'like a moustache, fatigue chronic, feeling of lump in throat, sweats n loads more.

I've also had Teva with equal amount of problems albeit different ones.

I'm on Actavis/Accord...but truth is don't feel good on any levothyroxine. I've had Endo blood tests yesterday + Monitor my Health Private finger prick test yesterday. I'll wait for results. Depending on results, I will ask for NDT and if I can't have it/try it I'll take nothing