Liquid levothyroxine???knowledgeable, experienced, help required..

[chubi52]

Hi all before I take my first dosage of liquid thyroxine, a couple of questions

1, I take 125mcg daily and its not quite right I tried 150 mcg and was over medicated, therefore will my body absorb 5ml liquid and make me feel optimal? (accord) is my tablets.. (zentiva) is the liquid..

2, this bottle is 100 mls so that's only 20 days, do they give you more bottles to get over the month..

3, can zentiva levothyroxine oral solution be sugar free as this one is not...

Thank you for any advice you may be able to offer me, as this has been a long 2 years of trying to get optimal after being diagnosed as hypothyroid and still not feeling great its wearing me down now

[helvella Administrator Thyroid UK]

You have not told us the strength of the levothyroxine oral solution you have had dispensed. It comes in, I think, five different strengths (listed as dose per 5 mL). Not all companies produce all strengths. I assume you have 125 micrograms per 5 mL?

You will need another prescription for another bottle. Maybe they will prescribe more than one bottle at a time, if they eventually accept it works for you?

I do not understand your question about "sugar free"? The product contains:

It also contains the following inactive ingredients: glycerol, citric acid anhydrous, sodium methyl parahydroxybenzoate (E219), citric acid 10% and purified water.

medicines.org.uk/emc/produc...

No sugar ingredient except that glycerol is (technically) a sugar alcohol, though it is not usually considered as a sugar.

You need to be careful about making comparisons with levothyroxine tablets. A dose of 125 micrograms by tablet will almost certainly result in less being absorbed than the same dose by oral solution. That is, a dose of 125 micrograms, because it would be expected to deliver more levothyroxine than the same dose by tablet, might effectively be an increased dose.

Some people prefer oral syringes for dosing. If used properly, they are more accurate than other approaches. The pharmacy should supply one if there is not one in with the bottle.

There is a whole section about oral solutions in my medicines document:

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.

From Dropbox:

dropbox.com/s/shcwdwpedzr93...

From Google Drive:

drive.google.com/file/d/12N...

[chubi52 in reply to helvella]

Hi thank you for your replyYes it's 125mcg per 5 ml.

There's was a note attached to my prescription for the receptionist to tell me it's not sugar free. So I just wondered why there was a note purposely attached, written by the chemist.. Yes there is a syringe inside... I take my medication at night with nothing else so I'm assuming I will absorb more of this than the tablets? 🙄😁

[helvella Administrator Thyroid UK in reply to chubi52]

Well - in terms of calories, glycerol isn't much different to ordinary sugar!

If you were imagining a liquid sweetened with saccharin or stevia - no, that would be a misapprehension.

The extract below might explain why they are being very clear it is not sugar-free. Though it does not contain any sucrose/glucose.

Maybe changes are being made to Patient Information Leaflets, but they are adding a note in the interim?

Glycerin(e)/glycerol

Glycerin (sometimes spelled glycerine), or glycerol, is a sweet, syrupy liquid that is about 75% as sweet as sucrose. It is chemically categorized as a polyol with 4.32 kcal/g. The FDA classifies glycerin as a Generally Recognized as Safe food additive. As a food additive, glycerin is used in a variety of products, including nutrition or energy bars, because of its ability to retain moisture, and reduced-fat frozen desserts, to prevent formation of ice crystals. Many nutrition bars have > 9 g of glycerin in a single-serving bar.

According to the FDA, synthetic glycerin is produced by the hydrogenolysis of carbohydrates15 and must be included in the grams of total carbohydrate listed in the Nutrition Facts panel. If the label has a statement regarding sugars, the FDA requires the glycerin content per serving to be declared as sugar alcohol.16 Some food manufacturers disagree with the classification of glycerin as a carbohydrate and have been omitting it from their calculations.

The metabolic fate of glycerin has yet to be determined, but it is believed to be converted into glucose primarily via gluconeogenesis.17 The effect of glycerin on blood glucose levels in individuals with diabetes is unknown.

diabetesjournals.org/spectr...

[McPammy]

I take Wockhardt sugar and colouring free liquid Levothyroxine. I much prefer it as my dose is 70mcg a day. I find drawing the liquid up in a syringe you can tailor your dose to suit you really well. I split my dose 35 at noon then a further 35 at 4.30pm. I can’t tolerate a full dose in one hit anymore and don’t know why really.

I much prefer Wockhardt brand to any other I’ve tried. I have it as a named brand on my prescription and it is ordered direct from Wockhardt each prescription. They deliver to my pharmacist at no cost for delivery.

I get 2 bottles for each prescription which lasts me a month. I always put my repeat prescription in as I collect to make sure there is no supply chain issues. This generally works well for me. I don’t need to leave any time before or after food either as it seems to absorb really well. All my blood tests are optimal too.

[helvella Administrator Thyroid UK in reply to McPammy]

I think, perhaps, given the issues about the calorific and potential diabetes issues of glycerol, we might need not to use the term sugar-free?