change in make of tablet

[daftbat1987]

So, my TSH has been around 0.2-0.4 for the last 18mnths after being up'd to 175mg levo. Id managed to loose some weight and the tiredness not so bad. My tablets have always been a mix of Teva and Actavis.

Since Covid19 everytime Ive gone to get my tablets there have been different makes. I was due my 6 month check up this week and it came back as 0.02 so they want to drop me 25mg and I have an appointment Monday.

I think it is due to the constant change in tablets, i have just looked and my 25mg are Mercure Pharma but say Levothyroxine Sodium instead.

I dont want to be dropped down, medication go back to normal once covim calms down and then have to fight to go back up over the next 6 months.

I havent felt right lately due to heart palpitations and feeling really walm! But the TSH score and ive read side effects of levo sodium would cause this

Any advice so I can fight my corner at my appointment would be helpful.

Thanks

[SeasideSusie Remembering]

daftbat1987

i have just looked and my 25mg are Mercure Pharma but say Levothyroxine Sodium instead.

Levothyroxine sodium is the ingredient in all Levothyroxine tablets, it's the fillers that are different. You can check ingredients of all of them here:

web.archive.org/web/2020021...

If you want to keep to the same brands, ask the pharmacy to make a note of this, my pharmacy always dispenses the same brand for me.

Also, TSH is not an indicator of thyroid status, it's not a thyroid hormone, it's a signal from the pituitary. The thyroid hormones are FT4 and FT3 and it's these results that doctors should use to decide if our dose needs changing, unfortunately doctors are taught that it's only TSh that matters.

To ensure that you get the highest possible TSH, which is needed to avoid a reduction in dose, then when having thyroid tests we advise:

* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).

These are patient to patient tips which we don't discuss with doctors or phlebotomists.

[tattybogle]

Feeling warm could indicate slightly overmedicated. If you were previously on 150 and not good, then have been better on 175 but now feeling too warm how about suggesting you take between 150 /175 ? (either by alternate dosing or splitting a 25 tablet each day )

I have found 25 mcg changes too much and prefer to adjust by 12.5.

maybe offer to try it for 3 months , but will return to 175 if you don't like the result. ?

If you want to challenge any reduction at all, then say you want to see an FT4 test first to see if it's over-range now (as it was well within range on 150)

If TSH is all you have to go on, then for eg. in my case i feel overmedicated( with tremor) at 0.02, ok at 0.05ish , and undermedicated (with constipation) at 0.5....... so a very small change in dose can make the difference between 'just right' or 'not right' in some people.

i have noticed that Mercury brand seem to affect me stronger than other brands, but not in blood results , just how it 'feels'

Obviously , if you can get full testing FT4/FT3/TSH that would be better to see what's actually going on.

[helvella Administrator Thyroid UK]

Some information about what levothyroxine tablets are available.

UK Levothyroxine Tablets

➖➖➖➖➖➖➖➖➖➖➖➖➖➖

Last updated 30/04/2020.

This is a list of currently marketed levothyroxine tablets in the UK.

Please note that re-branding (whether by a manufacturer or as an ‘own label supplier’ - which has happened with several products) does not mean any change to formulation.

—————————————————————

🔹 Accord – formerly Actavis (marketing authorisation holder)

🏭 Accord-UK (manufacturer)

🥛 contains lactose

  50  PL 0142/0104

  100  PL 0142/0105

White

6mm diameter

—————————————————————

🔹 Advanz – branded both “Mercury Pharma Levothyroxine” and “Mercury Pharma Eltroxin” which are identical (marketing authorisation holder)

🏭 Custom Pharmaceuticals Ltd. (manufacturer)

🥛 contains lactose

  25  PL 12762/0016 5.5mm diameter

  50  PL 10972/0031

  100  PL 10972/0032

—————————————————————

🔸 Almus – (an ‘own label supplier’ brand owned by Walgreen Boots Alliance – Boots pharmacies and Alliance distributor)

  50 – This is repackaged Accord – formerly Actavis.

  100 – This is repackaged Accord – formerly Actavis.

—————————————————————

🔹 Aristo – (marketing authorisation holder)

🏭 Aristo Pharma GmbH (manufacturer)

  100  PL 40546-0159

—————————————————————

🔸 Northstar – (an ‘own label supplier’ brand owned by McKesson – Lloyds pharmacies and AAH distributor)

  25 – This is repackaged Teva. ❗

  50 – This is repackaged Accord – formerly Actavis. ❗

  100 – This is repackaged Accord – formerly Actavis. ❗

—————————————————————

🔹 Teva – (marketing authorisation holder)

🏭 PLIVA Croatia Ltd (manufacturer)

  12.5  PL 00289/1971

  25  PL 00289/1972

  50  PL 00289/0038

  75  PL 00289/1973

  100  PL 00289/0039

—————————————————————

🔹 Wockhardt – (marketing authorisation holder)

🏭 CP Pharmaceuticals Ltd (manufacturer)

🥛 contains lactose

  25  PL 29831/0130

➖➖➖➖➖➖➖➖➖➖➖➖➖➖

🔹 – identifies marketing authorisation holder.

🔸 – identifies ‘own label supplier’ products.

🏭 – identifies manufacturers (where known).

❗ – Take particular note of the actual product which varies by dosage.

—————————————————————

Numbers refer to tablet dosages in micrograms.

Only products which definitely contain lactose are identified (🥛 contains lactose). Please check other products. Where products are ‘own label supplier’, check the marketing authorisation holder.

If there is anything inaccurate in this information, please let me know by Private Message:

healthunlocked.com/user/hel...

➖➖➖➖➖➖➖➖➖➖➖➖➖➖

This document is updated whenever I am aware of any changes or enhancements are needed. Please check the Last updated date. The current version is available as a PDF here:

dropbox.com/s/6h3h0qi4eqwi6...

[Marz]

You posted two years ago and I replied with some suggestions for further tests which may help you. You didn't reply so am wondering if you managed to have them done.

To find your earlier posts click onto daftbat1987 and all will be revealed ..