Have you suffered a reaction to a brand of Levothyroxine?

[Spottyskin]

How many have had a reaction to Northstar Teva and Northstar Accord Tablets and Teva Liquid Levothyroxine? I suffer from itchy spots and hives from head,neck and back after a period of 6/8 weeks from start of taking to 5months. Full in Bio

[helvella Administrator Thyroid UK]

Just so that you know all the thyroid hormone products available, I'll add a link here:

helvella - Thyroid Hormone Medicines

I have created, and try to maintain, a document containing details of all thyroid hormone medicines in the UK and, in less detail, many others around the world.

dropbox.com/s/shcwdwpedzr93...

I encourage everyone to report ALL side effects and bad experiences with ALL medicines including vaccines and diagnostic testing kits. In the UK, use the Yellow Card reporting system to inform the MHRA about any medicine issue you experience - or even suspect.

If in doubt, shout!

This post says more.

🟨 Making Yellow Card Reports 🟨

healthunlocked.com/thyroidu...

There are other routes outside the UK. For example the USA's FDA has a reporting mechanism. Within the EU, the European Medicines Agency handles reports for centrally licensed products - each country handles its own for nationally licensed products.

[SlowDragon Administrator]

Thousands of thyroid patients react badly to Teva levothyroxine tablets

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, or Aristo (100mcg only) 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 Accord doesn’t make 25mcg tablets

beware 25mcg Northstar is Teva

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

Posts that mention Teva

healthunlocked.com/search/p...

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

gov.uk/drug-safety-update/l...

If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient. If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.

healthunlocked.com/thyroidu...

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).

[Spottyskin in reply to SlowDragon]

Thanks for this, I have been researching on manufacturers and the excipients within the Levothyroxine makeup. I have seen a dermatologist who say you will never know what your body will not tolerate in the makeup. I am trying to get my doctors to prescribe Roseway as they have the least excipients in the meds. It is a minefield never had a reaction to any meds before or products I have used.

[SlowDragon Administrator]

Hives is extremely common with autoimmune thyroid disease (hashimoto’s) and usually improves when adequately treated

How much levothyroxine are you currently taking

What were your most recent thyroid and vitamin results

Acne/spots often low B12 or other B vitamins

Bloods should be retested 6-8 weeks after any 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 with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.

Presumably you have Hashimoto’s ?

When were vitamin levels last tested

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 all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

Please add most recent results and ranges

[Spottyskin in reply to SlowDragon]

I had Cancer and a complete Thyroidectomy in two stages last year. I have a scan on the 20 of this month and bloods to check TFTs and Thyroglobulin then Consultant 18 October for results.My Cancer Hurthle Cell Carcinoma. I was in 125mcg they wanted to reduce this in April as TSH was 0.02 and free thyroxine was 29 and upper limit is 20. Tried 100mcg but extremely tired do went to alternate days if 100 then 125. Worked well. When I was changed to liquid the and the spots came back I reduced to 100mcg to see if that would make a difference to the spots and itching it hasn't but I am 0K on the lower dose.

[SlowDragon Administrator in reply to Spottyskin]

So just testing TSH and Ft4 is completely inadequate

Essential to regularly retest folate, ferritin and B12 at least annually

Vitamin D test twice when supplements

Many people find they need to supplement to maintain optimal vitamin levels when on levothyroxine

Come back with new post once you get results

Only test after minimum 6-8 weeks on constant unchanging dose and brand of levothyroxine

[Spottyskin]

Thanks Will Do

[SlowDragon Administrator in reply to Spottyskin]

So….been on 100mcg 3 months

What are your most recent thyroid and vitamin results