Tirosint

[Mostew]

Just wondering if anyone has tried tirosint in uk. Are gps willing to prescribe it ?

I’ve had a sort of clamped feeling in my head and face , trying to find out why . Wonder if it’s Teva which I take cos of no lactose .....

x

[SlowDragon Administrator]

How much levothyroxine are you now taking

5 months ago only on 50mcg starter dose

What were your most recent thyroid and vitamin results and ranges

guidelines on dose levothyroxine by weight

Even if we don’t start on full replacement dose, most people need to increase levothyroxine 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...

[Mostew in reply to SlowDragon]

Thanks for quick response.

Started taking 75 mcg every other day. Thyroid and vitamin levels ok . I do take vit d , c and fish oil ...

I’m very sensitive to additives and would like to explore if ingredients are problem first .

[SlowDragon Administrator in reply to Mostew]

Bloods should be retested 6-8 weeks after each dose increase

What was most recent blood test results before dose was increased?

Have you had vitamin levels tested recently.

[Mostew in reply to SlowDragon]

Vitamin and blood tests fine . That’s why I wonder why I have funny head

[helvella Administrator Thyroid UK]

It might just about be possible to get Tirosint prescribed. But you'll need a well-informed medic, probably a consultant, to push it through.

Many assume Tirosint is a USA product. It isn't. It comes from Switzerland.

ibsagroup.com/

[Mostew in reply to helvella]

Thanks . Sounds like Another battle !!!

[hipolion]

I've been taking it for a few years from an international online pharmacy -Germany with prescription but I not living in UK. They order it directly from Lugano where it is produced.

[Cheverin in reply to hipolion]

Hi could you share the name of the online pharmacy? Or send me a message with that information?

Many thanks!