Hi. This is my first ever post on here and one of the issues I’m suffering with an underactive thyroid. I tried Levothyroxine tablets but as I’ve also got digestive issues going on (small intestine bacterial overgrowth, liver problems etc) I couldn’t tolerate them (made the already intolerable all over stinging sensation worse) and I think it’s because of the starch in them. There is actually a liquid version that doesn’t contain starch which I’ve tried to get through my GP to no avail. They hadn’t heard of it and then said it would be too expensive. So my question is has anybody managed to get the liquid version and has anybody heard of Roseway Labs as I think they might be an option as they look like they can provide medications without certain ingredients or fillers? The thing is it might not even work for me, but I want to at least try without having to spend a fortune on a private endocrinologist. Many thanks.
Underactive Thyroid: Hi. This is my first ever... - Thyroid UK
Underactive Thyroid
Many people need to try different brands of levothyroxine
Which brands of levothyroxine have you tried
Standard starter dose of levothyroxine is 50mcg…..but dose should be increased slowly upwards in 25mcg steps until TSH is ALWAYS under 2
Being left under medicated will cause low stomach acid, acid reflux, bloating, SIBO etc
Hi SlowDragon, thanks for getting back to me. I tried 25 mg of Teva.
Standard starter dose of levothyroxine is 50mcg
Starting too low frequently causes more symptoms
Teva brand upsets many people
What were your Thyroid results from BEFORE starting on levothyroxine
When were vitamin D, folate, ferritin and B12 last tested
Thanks for all your info, lots to look into - it seems starting on a higher dose might be an option and I’ll have a look at my blood tests from over the last 18 months. Thanks again.
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 doesn’t make 25mcg tablets
beware 25mcg Northstar is Teva
List of different brands available in U.K.
thyroiduk.org/if-you-are-hy...
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.
New guidelines for GP if you find it difficult/impossible to change brands
healthunlocked.com/thyroidu...
Unlikely to get liquid levothyroxine prescribed by GP ……would need to request referral to thyroid specialist endocrinologist
Thyroid U.K. has list of recommended thyroid specialist endocrinologists
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
Hypothyroidism can cause digestive problems including SIBO. Depending on how hypo you are it might be better to start on 100 mcg to recover quickly, starting at low doses just delays recovery. Even if you need a very low dose like 25 mcg it might be better to take 100 every four days, that way you would only have side effects once every four days. You could also take an antihistamine such as loratadine (hay fever tablet) to deaden any reaction. You may find once your hypothyroidism is treated your digestive symptoms resolve.
Hi Munting, found your post interesting. I have been on 50mcg levo tablets for two years and my TSH was under 2 but recently I started having tummy troubles and severe nausea. Found when I stopped taking tablets the nausea went but my appetite was still poor. As the tablets had lactose in I concluded as I don't tolerate lactose very well I was reacting to that. Eventually persuaded GP to prescribe liquid. I stopped taking any meds for just over a week whilst waiting for liquid levo to come in and my TSH went up up to 4.28. Not sure now reading comments on here if my symptoms were caused by being under medicated or whether I wasn't processing tablets well enough to get the full dose. Anyway now I've got the liquid I'm going to try and stay on it and get my bloods tested again in a couple of months to see how it's going. I will just say that when I first took the liquid it made me feel unwell and anxious so I took half dose for a few days and gradually increased to correct dose and I'm tolerating it well now 🤞. Suggest that if you are able to get the liquid you might want to try and increase it gradually also. Good luck hope you are able to try it and get it sorted soon.
Hi bookworm63. That’s very interesting and am glad things are improving for you. I’m having trouble getting the liquid from my GP; it’s not commonly known and when they looked into it they said it was too expensive. It’s early days yet, but I’ve managed to introduce a small amount of probiotic (by breaking the capsule open and putting the powder into water) and fingers crossed that seems to have helped my mood (I’m very anxious and depressed) and hopefully the stinging. Hope I’m not speaking too soon cos it is early days. I did read somewhere once though that this guy’s Naturopath cured his stomach and therefore his thyroid got better.
Sincerely hope things do improve for you soon Munting. I have difficulty taking probiotics also, good idea of yours to empty some of the tablet into water I've never thought of doing that. I have often wondered if my tummy issues were caused by low thyroid or did my tummy issues cause my thyroid problems? Bit chicken or egg situation 🤔
Well looking back at things I really think mine was stomach first - anxiety/upset over the years, miscarriages, implications during and after giving birth, then a year after my daughter was born I started with IBS. Then menopause kicked in, and around that time I was diagnosed with an hiatus hernia and Barrett’s Oesophagus and was put on Lansoprazole to reduce my stomach acid, which was more than likely already low. Nightmare. My Barrett’s has completely gone now as I got my hernia massaged down by an Osteopath so at least something has gone! I’m also very lucky to have an excellent Naturopath - don’t know what I would do without her.
Hello Munting,
I have antiphospholipid syndrome, ( APS, also sometimes called Hughes syndrome) which is an autoimmune disorder that causes the blood to be in a prothrombotic state, and clot easily. ( including many miscarriages and pregnancy complications- including post delivery.)
As I’m sure you already know, auto immune illnesses love to come in groupings.
One particular triad is APS, Sjögren’s, and Autoimmune thyroiditis, or even a low thyroid minus the targeted antibodies against the thyroid.)
Other ones that can tag along can be Ehler’s Danlos… ( patients herniate easily.)
I have had a lot of personal experience, unfortunately, with APS. I have a little bit of experience with a low thyroid, and a few lovely members here who are also expert patients with APS have helped me tremendously.
I only wonder if you have been checked for APS with your troubles with miscarriages? ( although certainly there may be other reasons for miscarriages other than APS.)
Might be worth asking your doctor?
Greetings,
Kelly
Hi Jonathan1956. Thank you for telling me about the burp test - I think I read about it somewhere but haven’t done it. I did recently do a ‘Burn’ test. I must admit when when my Naturopath wanted me to do it last year I was horrified. Firstly at the name of it, and secondly because I’ve recovered from Barrett’s Oesophagus and didn’t want to cause any irritation. I got desperate recently though and decided to do it - well I needn’t have worried cos it hardly hurt at all. I basically had to take a hydrochloric acid tablet then leave it 5 minutes to see if I felt any warmth, or burning. If I did then my acid was fine, but if I felt nothing then I had to take another and so on and so on. I took all six and didn’t feel a thing so my acid is low. I did feel a slight irritation when I ate after though, but that was all. I think the apple cider vinegar would upset me at the moment, and when I can have it I was thinking of making my own sauerkraut. I hope it’s helping your wife.
Hi KellyInTexas. That’s very interesting. I’ve never heard of antiphospholipid syndrome. My first miscarriage happened within the first few weeks, my second was an ectopic pregnancy, I then had my daughter 🥰, and my last one was classed as a ‘missed’ miscarriage (the baby died in my womb and I had to deliver it), so I suppose they do vary but it’s certainly something I’ll look into.
There is a dedicated forum here on HealthUnlocked:
healthunlocked.com/hughes-s...
You are, of course, welcome here but if they can help, great.
Underactive thyroid
Liquid levoroxine 19 in.. 😞
underactive thyroid 
