Do different types/makes of thyroxine make a difference

[janedudman]

Does anyone know if you can respond differently to different makes of thyroxine. Is there any difference between them? Can one type suit and another not?

[shaws Administrator]

I think (and am not medically qualified) that there can be differences in their levothyroxines.

We can only judge if we begin to have symptoms that we didn't have previously.

[SlowDragon Administrator]

Absolutely.

Which brand of levothyroxine do you normally get

Many people find Levothyroxine brands are not interchangeable.

Many patients do NOT get on well with Teva brand of Levothyroxine. 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

But for some people (usually if lactose intolerant, Teva is by far the best option)

Teva, Aristo and Glenmark are the only lactose free tablets

Most easily available (and often most easily tolerated) are Mercury Pharma or Accord

Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but Accord doesn’t make 25mcg tablets

beware 25mcg Northstar is Teva

List of different brands available in U.K.

thyroiduk.org/medications-f...

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

REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex

[janedudman in reply to SlowDragon]

Teva now but has also had Wockhardt and Mercury Pharma in the past as well as Teva. I now realise the pharmacy change it all the time but hadn't given it any thought. It used to be always Mercury Pharma which seemed fine, no ill effects. This is for my daughter aged 18 who is generally peeed off with the whole thing.

[SlowDragon Administrator in reply to janedudman]

Teva seriously upsets many people

You can specify one particular brand on prescription....or have note added (for example) to say “no Teva brand “

[janedudman in reply to SlowDragon]

That is incredibly helpful thankyou. So this requires very careful monitoring.

[Simplyred57 in reply to janedudman]

Ask your GP to put the brand that suits you on your prescription, mine did now my local pharmacy orders mercury pharma for me , Teva made me very unwell .

[elwins]

I find that Teva does not suit me, Boots are very good and put no Teva on my records, they only supply what suits me. Doctors surgery also noted my records.