Which Levothyroxine Brand?

[Chasing-rainbows]

Hi all,

Finally getting somewhere after going round in circles for months, I now have a prescription for Levo. Is there a brand better suited for people with Cow's Milk intolerance? Do you know whether the lactose in some brands would affect me, or likely to be ok given lactose is the sugar rather the protein which I am intolerant to?

Can you remind me of the best way to take Levo too.

First thing in the morning at least 30 mins before eating or drinking and so many hours away from other supplements I think from memory?

Also, a thank you for all the help and advice previously, I am now doing a strict gluten free diet to try and control the antibodies, I'm keeping a food diary and I'll be starting back on Levo, so finally feeling a bit more optimistic about things. Need to try and find ways to de-stress more too, life can feel very hectic lately which I'm sure doesn't help with the auto immune side of things.

One other thing I am slightly concerned about is my low ferritin level affecting how well I absorb/convert the levo, but my other Iron status tests were all good indicating that I don't need Iron? Any tips here on improving this? I have tried to tolerate Pate but I really can't cope with it. Dark chocolate I've been eating, and I also read that cooking with cast iron skillets can help to raise ferritin levels.

Thanks again guys

[SlowDragon Administrator]

As you are on lactose or dairy free diet……yes, you will need lactose free levothyroxine

GP should add note to all future prescriptions

Teva brand most widely available, but contains mannitol….upsets many people

Some can’t tolerate Teva ….others find it by far best option

There’s now two other lactose free options

Aristo - 100mcg only

Glenmark - just available this week - 25mcg, 50mcg and 100mcg tablets

Not sure it’s easy to find

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

[Chasing-rainbows in reply to SlowDragon]

Dairy free, but it's just an intolerance rather than an allergy so did wonder whether I'd be ok?

What symptoms should I look out for in terms of not tolerating a particular brand, is it tummy upset type side effects? I feel it may end up being trial and error...

[SlowDragon Administrator in reply to Chasing-rainbows]

If you’re on dairy free diet, best to start on lactose free levothyroxine

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.

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...

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

[helvella Administrator in reply to Chasing-rainbows]

Some people who can tolerate dairy foods nonetheless cannot tolerate the lactose in levothyroxine tablets.

I have a few pet ideas why it might be so, but that doesn't matter as much as realising that it is a possibility. And identifying it if it happens to you.

[Chasing-rainbows in reply to helvella]

I've picked up Teva brand from the pharmacy so will start it tomorrow morning. Hoping I don't get any bad side effects from it. Fingers crossed.

[yesendi]

I was switched to the brand name levoxyl because the generic levo was making me really sick do to the lactose in it. I am lactose/gluten intolerant and levoxyl has made a huge difference.