I have been taking Euthyrox levothyroxine 25mcg for more than 3 years than switched to Mercury Pharma levothyroxine 25cmg in June 2020, now Boots (where I pick up my repeat prescription) decided to switch again, without giving me a choice or notice to Teva levothyroxine 25mcg.
On Euthyrox: I was feeling decent, steady heart rate and normal life. Downside: very dry skin, occasional eczema patches.
On MP Levothyroxine (for the past 5 months): Initially well for the first 2 weeks then chaotic for the past months with a heart rate that fluctuated from 135 to 44 (usually and while on Euthyrox is 65 -68), constipation, insomnia (I usually have it but it was agraveted), itchiness, hair loss.
On Teva: should I start taking them or request another brand? I am quite scared, I ended up with really bad heart palpitations a few times when either the 75mcg was not working for me or a few days after I changed the brand.
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JosephineSmith
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Or is this 25mcg tablet alongside 100mcg or 50mcg?
Most of these symptoms could be due to being under medicated
50mcg levothyroxine is the standard starter dose levothyroxine and most people will need to increase dose slowly upwards until on something around 1.6mcg per kilo of your weight....rare to be less than 100mcg per day, unless very petite
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....or if left under medicated
Ask GP to test vitamin levels
Low vitamins tend to lower TSH
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)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Yes, I've been only taking 25mcg for the past 4 years. I have started with 75mcg which sent me to the ER with a bad arrhythmia then the dr. adjusted my dose since I am petite (46kg).
The latest blood test I did in February 2020 with my GP indicates normal values of TSH, T4, Serum Ferritin, Vitamin D and B12 - back then I was still on Euthyrox which my mum used to send from Greece (where I was first diagnosed) - I still had a few boxes before the pandemic started; Unfortunately I couldn't receive them anymore nor find them here and I had to replace them with Mercury Pharma levothyroxine in June, whilst still in lockdown. In July I started feeling unwell like my heart was about to explode, had a phone consultation with my GP which sent me to the same day emergency appointments at the Hospital for some extra blood tests and EKG - surprisingly, they told me blood tests are fine - even though I still feel unwell on the MP Levothyroxine: insomnia, constipation, sometime dizziness, fluctuations of heart rate from 135 to 44 within minutes (normal one for me is 65-68), very dry and itching skin.
I feel like I should try another medication, yet I am scared after reading the symptoms of other patients on Teva levothyroxine and after my experience with MP so far.
Is there other brand of levothyroxine that you might have heard good things about and that I should look into?
So, even when very petite, 25mcg is almost certainly going to be too low a dose
Guidelines on dose by your weight is roughly 75mcg levothyroxine per day
Strongly recommend getting FULL thyroid and vitamin testing done to see EXACTLY what’s what
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......and/or if especially if been under medicated for long time
Ask GP to test vitamin levels or test privately
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)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
If been very under medicated (or undiagnosed) for a long time it can be extremely difficult to increase dose levothyroxine up. Often has to be done extremely slowly
I will insist to redo the blood test as advised (had them done and they always come back with the comment that I am under adequate thyroxine replacement). I always asked my GP if I should take my pill or not before blood test as I always go in the early morning before eating or drinking and they told me I should, therefore I am going to try taking it after the blood tests, not before.
I also saw that Euthyrox and Teva have similar components except acacia - which I don't know if I am allergic to.
Extremely rare for any GP to be aware of relevance of when test
Extremely unlikely to get more than just TSH tested.
Strongly recommend getting hold of previous test results
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.
Vitamin D 51nmol/L (50 - 300 nmol/L) ; it was 17nmol/L in October 2019 (which is abnormal) and I followed a course of 3 months high dose Vitamin D treatment - these are the results after the treatment.
Suggest you start by adding vitamin D mouth spray with vitamin K2
Look at adding magnesium supplement in 2 weeks.
Calm vitality magnesium powder is cheap and easy to use. Must be four hours away from levothyroxine. Best taken afternoon or evening. Starting on low dose as too much can cause diarrhoea.
Ferritin low, but not low enough for GP to test for anaemia
Never supplement iron without doing full iron panel test for anaemia first
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
I have edited my blood tests to add normal range values in brackets.
I had vitamin D deficiency in October last year and followed a treatment for 3 months. I then been advised to take a dose of vitamin D every day which caused dizziness and confusion, therefore I stopped taking them.
I did had my blood test done in hospital at the ER in July as well, unfortunately St Helier London did not sent the results to my GP in order for me to be able to see them.
Ideally you would get full testing for Pernicious Anaemia before starting any B vitamins, but highly unlikely GP will agree and it’s most likely B12 is low due to under medicated (unless you have family members with pernicious anaemia)
There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms,
Patients with AITD have a high prevalence of B12 deficiency and particularly of pernicious anemia. The evaluation of B12 deficiency can be simplified by measuring fasting serum gastrin and, if elevated, referring the patient for gastroscopy.
Levothyroxine can decrease serum homocysteine level partly; still its combination with folic acid empowers the effect. Combination therapy declines serum homocysteine level more successfully.
Assuming GP won’t test
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.
This can help keep all B vitamins in balance and will help improve B12 levels too
Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)
Or Thorne Basic B is another option that contain folate, but is large capsule
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
With such low B12 result taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
Was this test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Assuming yes....
Ft4 is only 31% through range
Aiming to increase dose levothyroxine slowly up
Normally in 25mcg steps
Some people need to increase much more slowly
Aiming for Ft4 at least 60% through range
So if currently taking 25mcg .....adding 12.5mcg (cut 25mcg tablet in half) every day .....or even 1/4 tablet extra per day
After any dose increase wait 6-8 weeks before next increase.
Common to feel worse weeks 4-6 weeks after each dose increase as rest of metabolism catches up
Looking to eventually get to 75mcg approx per day
Retest FULL thyroid and vitamin levels 6-8 weeks after you have got slowly up to 50mcg
Daily vitamin C helps support adrenals
Levothyroxine doesn’t “top up” failing thyroid it replaces it, hence why it’s important to be taking high enough dose levothyroxine
The problem is the size of tablet I have found. 25mcg tablets often come as TEVA. I have received 25mcg TEVA from Boots before, luckily only one pack. I was too scared to try it having read about reactions on here!
I now get the surgery to put no TEVA on my prescription . Last time in Boots the girl tried to put TEVA in my prescription and when I pointed this out she went back to the shelves and got another brand of 25mcg instead. So you can get others.
Thank you for your reply Shaws. Unfortunately I cannot find Euthyrox in UK and Mercury Pharma levothyroxine was not that great for me (been taking MP for the past 5 months).
Could you please let me know what brand are you using at the moment and if it is the adequate one for you?
I no longer take levothyroxine. I've been taking T3 only for a number of years now. It has resolved all of my symptoms. Most people, as their dose of levo is raised, find that they do o.k. Some need T4/T3 combination. Others T3 only but it is difficult to get prescribed, except if an Endocrinologist does.
The aim is a TSH of 1 or lower but the majority of GPs seem to think that if it is 'somewhere' in the range that we're on sufficient and don't increase.
If you look under "polls" you will see that Teva is the Marmite brand: lots of people don't get on with it [it's lactose-free and has mannitol as a filler instead]; other people absolutely prefer it [esp if lactose-intolerant] and others - like me - can take it or leave it.
You won't know which camp you're in until you try it
If it doesn't suit, "yellow card" it and have "not Teva" put on the actual prescription. You'll still need to check before you leave the pharmacy that they haven't sneakily given it to you anyway ... and may find it easier to get 50s prescribed and cut them in half with a pill cutter.
Thank you for your reply. You are right, I can't find out before I try. However, I am bit sceptical after reading about reactions here. Most of them don't seem to have got along with Teva levothyroxine.
I was hoping to see more of the good feedback since I am quite unwell on MP so far.
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.
❗ – Take particular note of the actual product which varies by dosage.
🟢 PIL – Patient Information Leaflet
🟣 SPC – Summary of Product Characteristics document
🟢🟣 Single document combining typical PIL and SPC information
—————————————————————
Only products which definitely contain lactose are identified (🥛 contains lactose). Please always check other products. Where products are ‘own label supplier’, check the marketing authorisation holder for the specific product.
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