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.
Essential to regularly retest vitamin D, folate, ferritin and B12 and especially as you are also taking PPI Lansoprazole
My medicines document has tables for UK makes of levothyroxine and liothyronine which highlight lactose, acacia and mannitol content.
Links allow you to find out more.
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.
I am also intolerant to acacia powder and always obtained Actavis levo from Boots. I am intolerant to lactose but seem to be fine with the lactose in the levo tabs as it is such a small amount. Actavis is now known as Accord and I have been fine with the Accord. My Gp has specified the brand on my prescription. Helvella’s list is very helpful.
After 2 years of reactions to tablets and with a lot of research and by a process of elimination I worked out that I too am allergic to acacia, probably along with lactose and Mannitol. I was taking 75mcgs with one 50mcg and one 25mcg and realised that I reacted particularly badly to the 25mcg tablet as it has more incipients in it - being a larger pill with less Thyroxine in it. I was worse on Teva, but in the end could not tolerate any of the tablets the pharmacy gave me - always a different brand. I was never offered Aristo. However, having moved house and changing doctors (and making a bit of a fuss) they agreed to put me onto liquid thyroxine, which they don't like to do as it is much more expensive. I have been on it for 6 months and I definitely don't have any intolerance - although the liquid form contains parabens, which I don't like either - but I am feeling much more my old self. Not as easy as taking a pill and a bit of a fiddle measuring it out, but the results are worth it! Perservere with your GP or change doctor.
When someone reports that a particular medicine cannot be obtained by their pharmacy, I always suggest contacting the pharmaceutical company/manufacturer directly.
We have had many occasions when the information given by the pharmacy to the member has not been accurate.
Examples with good outcomes have included:
• There were issues, but they are now, or will very shortly be, resolved;
• There is no issue and it is not clear why the pharmacy said there was;
• The product has a new branding - and is now only available under the new name;
• Give the pharmacist some information and they will be able to get the product.
And examples with bad outcomes:
• The product is no longer available;
• There is an issue that will not be resolved in the time required;
• The product has been recalled.
Quite often, members have found that the pharmaceutical company/manufacturer can and will advise how a pharmacy can obtain stock. At the worst, you can find out from an authoritative source that there really is an issue that will not be resolved. With pharmacies, you will almost always have at least one extra company - the distributor - between the pharmaceutical company/manufacturer and the pharmacy, allowing confusion to enter.
Some pharmaceutical companies/manufacturers have been extremely helpful to members who have contacted them.
The company name is not always the same as the brand name. You can find the company name on the packaging (though in smaller letters and possibly on the back or bottom) and at the bottom of the Patient Information Leaflet. For example, Mercury Pharma is a brand name but the company is Advanz.
Contact details for most, possibly all, UK pharmaceutical companies/manufacturers can be found here:
Acacia should be banned …its poison ! Im in US not sure you can get this manufacture Alvogen (L-Thyroxine tabs 50mcg) does not have Acacia and I have since cleared up my nasal sores, blistering hives and countless other issues from this poison.
My medicines document, linked earlier in this thread, lists all the thyroid hormone medicines which have licences in the UK. (Anything else is vanishingly unlikely to be obtainable.) It even has little tables showing which makes contain acacia, lactose and/or mannitol.
It does seem to be causing an impact on an increasing number of those who need Levothyroxine, and by the time you have worked out what the issue is your in a rite mess.
Sadly I don’t think doctors even understand the issues Acacia does to some of their patients…. My Endo thought I was nutz when I told him my issues and it was a pretty harsh reaction.
Doctors don’t understand any issues around fillers in medication. They usually do think you are bonkers and also a pain for daring to ask to find a medication that doesn’t upset you. Acacia gives me horrendous stomach pains, so as well as avoiding gluten, some dairy, eggs and chicken I have to avoid honey as many jars of honey do not give précise info about the flowers the bees might have visited. Life is full of pitfalls!
Latest TSH is 0.39 I take 125 levo. Vitamins are in range, no deficiencies. In 2019 I was treated for H-pylorie and have been on lanzoprazole ever since, have asked many times about taking lanzoprazole daily and repeatedly told 15mg is fine a day. Asked for a retest for H-pylorie too and was unable to have one . Think it's time to go back to the GP and have a thourough chat.
I didn’t know I was allergic to Acacia until I bought Gold Bond body powder. Where ever i put the powder I had rashes and welts ! I washed my skin and the rash never appeared again. I am also allergic to Melaleuca tree, which both are Australian . I had an Acacia tree in Florida ,but didn’t eat it !!! Having problems since I started a new thyroxine pill. Acacia is a filler, so it’s not listed on ingredients.
Fillers (I prefer the term excipients) are most certainly listed for all licensed medicines in the UK and the USA - and, I am fairly sure, in most "western" countries.
Have a look at my medicines document (linked earlier in this thread). It has links for a huge number of levothyroxine products, and you can see acacia (often acacia powder) listed for quite a number of them.
Hi I have found Wockhardt brand suits me but it does contain lactose and sucrose. It only comes in 25 mg and I need 75mg. Other brands give me really bad side effects.
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