Med changed to teva

[Sunnydays11]

Morning everyone, I have been taking 25 levo for 2 months my gp has put it up to 50 chemist changed the brand to teva, I’m getting palpitations most of the day is my dose to high? Can anyone give some advise thanks !

[SeasideSusie Remembering]

Sunnydays11

What brand were you taking before?

[Sunnydays11 in reply to SeasideSusie]

Think it was Workhardt.

[SeasideSusie Remembering in reply to Sunnydays11]

Sunnydays11

It could be one of two things.

1) You may be sensitive to dose increases and need to take it slower, so try 37.5mcg and if you have any Wockhardt left I would be inclined to continue with those and take one and a half tablets daily for now.

2) You may be reacting to Teva brand like many members do (it contains Mannitol instead of lactose and it seems to cause a problem for a lot of people). So you could report your palpitations and ask for a different brand.

[Sunnydays11 in reply to SeasideSusie]

Oh thanks so much is a side effect to mannitol palpitations or headache ?

[SeasideSusie Remembering in reply to Sunnydays11]

Sunnydays11

Members have experienced a variety of side effects so it can't be pinned down to just certain ones. If you're fine on an increased dose of Wockhardt then I'd put in a yellow card report for the Teva

yellowcard.mhra.gov.uk/

[elwins]

I had palpitations when on teva brand think it was the fillers, asked to go back to my normal brand and they stopped. Hope this helps.

[Sunnydays11 in reply to elwins]

Thanks for your help 👍

[SlowDragon Administrator]

Wockhart only make 25mcg tablets

Ask GP to keep the tablets as 25mcg tablets on prescription, but double the number of tablets per month

See if 2 x 25mcg wockhart is fine

If still getting palpitations, reduce dose to 1 tablet plus half tablet daily for few weeks.

Some people are fine increasing dose in 25mcg steps, others need to increase in smaller steps

Many many people react very badly to Teva

Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

Teva, Aristo and Glenmark are the only lactose free tablets

List of different brands available in U.K.

dropbox.com/s/6h3h0qi4eqwi6...

Teva poll

healthunlocked.com/thyroidu...

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

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

Ask GP to test vitamin levels and thyroid antibodies if not been tested yet

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)

[Sunnydays11 in reply to SlowDragon]

Thanks I’ll ask chemist to change med brand 😊

[SlowDragon Administrator in reply to Sunnydays11]

If prescription says 50mcg you won’t be able to get Wockhart

Will need prescription changed to 25mcg x 56 tablets

Alternatively.....many people are fine with Accord or Mercury Pharma brands.

Mercury Pharma available in 25mcg, 50mcg and 100mcg

Accord - only make 50mcg and 100mcg

(also boxed as Almus in Boots, or Northstar in Lloyds - but only 50mcg and 100mcg)

Beware- Northstar 25mcg is Teva