Levothyroxine Increase (Hypothyroid): It’s been... - Thyroid UK

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Levothyroxine Increase (Hypothyroid)

revitalise profile image

It’s been painful and had to keep calling eventually my GP has agreed to increase my dose from 25mcg to 75mcg. I was diagnosed on the 28th June and been on 25 for almost 5 weeks with no improvement in symptoms. She left it upto to me if I wanted to take 100mcg but said likely to get palpitations and cause heart disease. My GP would not go with my Medicheck results only the NHS results. Although, I advised her that their labs are UKCAS accredited. Thanks to everyone who has helped me persevere and push for the higher dose of medication. I don’t know where I would be without this Forum it’s given me the will and tools to continue to get properly medicated and to understand my condition.

Thank you everyone ❤️

17 Replies
SlowDragon profile image
SlowDragonAdministrator

Which brand of levothyroxine are you currently taking

If prescription is for 75mcg tablets, these will be Teva brand, as they are only brand that makes 75mcg tablets.

Teva upsets many people

Increasing too fast can be difficult to tolerate

Suggest you increase to 50mcg for 2-4 weeks, before increasing to 75mcg

Retest 6-8 weeks minimum after increasing to 75mcg

Hi SlowDragonYes I have been given 2 months supply of the Levothyroxine Teva 25mcg last week so I will be using 50mcg which I have now collected and addding my 25mcg until I have used them up. Ok I will start with 50mcg for 2-4 weeks. What are the symptoms of tolerating the 75mcg. Looking forward to feeling semi normal again although I know it will take time. Hopefully, the 50mcg make a difference to my symptoms. The GP I spoke to could not wait to get off the call. I also advised her about the NICE guidelines re: Levothyroxine. Its very sad really that you need to push and push with the NHS to get properly medicated. God love those who just dont have the stamina to do this its almost like they get forgotten about. I was due to have my NHS blood test next week as that would be week 6 - do you think I should still go ahead and have it.

SlowDragon profile image
SlowDragonAdministrator in reply to revitalise

So you are currently taking Teva brand?

Or your avoiding Teva?

Yes I have been taking Teva brand 25mcg since I have been diagnosed for the last 5 weeks.

SlowDragon profile image
SlowDragonAdministrator in reply to revitalise

Well Teva upsets many people

Obviously difficult to know if that includes you, if you started on Teva

Accord or Advanz (Mercury Pharma) often better tolerated

I will just have to monitor how I am over the coming weeks and be aware of any upsets with the Teva brand.

SlowDragon profile image
SlowDragonAdministrator in reply to revitalise

Teva contains mannitol as a filler, which seems to be possible cause of problems. Mannitol changes gut flora.

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 or Aristo are the only lactose free tablets

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

Mercury Pharma make 25mcg, 50mcg and 100mcg tablets

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.

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).

New guidelines for GP if you find it difficult/impossible to change brands

healthunlocked.com/thyroidu...

SeasideSusie profile image
SeasideSusieAdministrator

Revitalise

As has been mentioned in previous replies, standard increases are 25mcg at a time, retesting after 6-8 weeks. I would be wary of jumping from 25mcg to 75mcg.

Watch out for changes of brand. It's best to stick to the same brand if you know that suits you.

Hi SeasideSusieYes the Parmacist has a note on my account to say Levothyroxine Teva Brand only. As I said before I have been digesting all this good advice on this Forum and acting on it. Its early days with me but hopefully the Teva brand will be tolerated moving forward. Will start off on 50mcg from tonight for 2-4 weeks and then increase to 75mcg. Wouldn't you think the GP would advise me of this even leaving it upto me whether to start taking 100mcg which can lead to hyperthyroidism and other complications.

SeasideSusie profile image
SeasideSusieAdministrator in reply to revitalise

revitalise

Wouldn't you think the GP would advise me of this even leaving it upto me whether to start taking 100mcg which can lead to hyperthyroidism and other complications.

Well, to be honest, no, I don't expect anything from GPs any more (and I'm never disappointed!), as far as thyroid is concerned they just don't know enough and they don't care enough to learn about it.

As for leading to hyperthyroidism, it can't. You are hypothyroid, it's physically impossible to become hyperthyroid as the thyroid can't regenerate and suddenly go overactive. What can happen is you can become overmedicated.

Hormones have to be increased slowly and gradually so our bodies get used to them and doctors really ought to know this.

Agree with you totally they dont know enough and dont care enough! Then when we do our own research they are very quick to blast it. I am sure the only reason she gave me the increase was based on the medicheck blood test but when I referred to it she said she was only been guided by NHS results. Grrrrr so why not start me off on more than 25mcg. Infact, only for me pushing to get Thyroid Antibodies tested with another GP at practice I was told by a different GP at practice previously that they would not test until the end of August. So really thankfully I am ahead. The practice I belong to is very large and that comes with advantages and disadvantages.

SlowDragon profile image
SlowDragonAdministrator

If still eating gluten…..Have you had coeliac blood test done yet

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal

Before considering trial on gluten free diet get coeliac blood test done FIRST just to rule it out. Via GP or buy online

lloydspharmacy.com/products...

If you test positive for coeliac, will need to remain on gluten rich diet until endoscopy (officially 6 weeks wait)

If result is negative can consider trialing strictly gluten free diet for 3-6 months. Likely to see benefits. Can take many months for brain fog to lift.

If no obvious improvement, reintroduce gluten see if symptoms get worse.

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

hypothyroidmom.com/how-to-l...

Eliminate Gluten. Even if you don’t have Hashimoto’s. Even if you have “no adverse reactions”. Eliminate gluten. There are no universal rules except this one.

Hi SlowDragonGoing to book the coeliac test today. I am vegetarian and some of my diet is gluten free. However, its def worth getting the test done privately as I feel my GP's are quite negative when I request any tests. Following on from Mondays chat re: Iron Panel GP did not call me back but has put on my notes that I am not anaemic.

SlowDragon profile image
SlowDragonAdministrator in reply to revitalise

So are you lactose intolerant that you are specifically on Teva brand?

You are legally entitled to copies of your iron panel test results

As vegetarian it’s hard to maintain optimal B12, iron and ferritin levels

Teva is just the brand that I was prescribed by GP. I am not lactose intolerant.

SlowDragon profile image
SlowDragonAdministrator

How long have you been vegetarian

Do you always supplement B12 daily

academic.oup.com/nutritionr...

The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3

I have been vegetarian for 37 years. I have been a plasma donor also for many years so my iron levels were always very good. I have never supplemented with B12 just take Vitamin D+ K spray. Will organise that MMA test as well. I have called Viapath on Monday and not heard back so will chase them again today. I was hoping to have it done in St Thomas's.

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