Levothyroxine manufacturers

[normannippy]

I am being given MercuryPharma 50 micro grams and Teva 25 micrograms to make up my daily dose. People on this site have suggested that manufacturers matter so is a mixture unwise? Thank you.

[Sparklingsunshine]

HiTeva is a marmite brand, people either seem to love it or hate it, its lactose free, which is important if you're lactose intolerant but one of the fillers they use, Mannitol, causes issues for some people.

I have Accord as a named brand as I don't get on with the others, when I was on 75mcg, the pharmacist at my surgery suggested 100mcg one day and 50mcg the next, making an average of 75mcg. Which is easier than splitting tablets. How do you feel on Teva?

[normannippy in reply to Sparklingsunshine]

I don’t know how long I have been taking it for to be honest. I am having digestive problems and thinning hair but I don’t know if there is a connection.

[mrs44mac]

Hi I use Mercury Pharma and was prescribed 125 daily like you I took the advice and tried to keep the same brand it was easy to get the 100 but now have trouble locating the 25 after trying every chemist I decided to use any other brand for the 25 (not Teva I don't like it) and so far have had no adverse effects. Hope this helps

[normannippy in reply to mrs44mac]

Why didn’t you like Teva?

[mrs44mac in reply to normannippy]

Just trial and error with different brands and found I didn't feel good using Teva

[normannippy in reply to mrs44mac]

Could you be a bit more specific?

[helvella Administrator]

If you do OK, mixing makes isn't such an issue. But if you start to find problems, it is difficult to know which product is causing the issue.

You can see what products are supplied in the UK 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...

[SlowDragon Administrator]

How long have you only been on 75mcg levothyroxine

That’s only one step up from starter dose

It could be Teva upsetting you…..but digestive gut issues and hair loss suggests under medicated

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

ALWAYS test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Ask GP to test iron, ferritin, vitamin D, folate and B12 NOW

On levothyroxine it’s essential to have GOOD vitamin levels

Important to test vitamin levels at least annually

What vitamin supplements are you currently taking

Have you had TPO and TG thyroid antibodies tested to confirm cause is autoimmune thyroid disease.

[SlowDragon Administrator]

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, 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 only make 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.

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

[normannippy]

Thank you for your very detailed and helpful reply. I have been on this dose for many years. I suspect that I have not been tested adequately because of Covid these last two years.I decided to take vitamin D because it is said to be advisable for everyone to do so and I had been taking it with my Levothyroxine so I will space them out now. Thank you.

I have never had a conversation about vitamins or minerals with my doctor or, in fact, any conversation about my condition at all . I will take your kind advice and ask for blood tests if possible!

Thank you again