Levo side effects?

[TiredMummy]

I feel nauseas about 3 hours after I’ve taken my Levo & this lasts for a few hours & I feel better as the day goes on & it wears off. I’m wondering if this is a common side effect of the medication?

[Lalatoot]

Could be one of the fillers or maybe that your body doesn't like the dose you are on all in one go.You could try a different brand or try splitting your dose into 2 doses.

[TiredMummy in reply to Lalatoot]

Thank you Lalaloot, very sound advice.

[SlowDragon Administrator]

Have you tried taking levothyroxine at bedtime

Or try splitting dose, half waking and half at bedtime

Which brand of levothyroxine are you currently taking

When were vitamin levels last tested

Looking at previous posts you were ordering private blood test

Only do private testing early Monday or Tuesday morning, ideally before 9am and last dose levothyroxine 24 hours before test

As only recently added HRT …..wait 6-8 weeks after any changes like adding HRT or changes in how you take your levothyroxine

Adding HRT frequently results in needing dose increase in levothyroxine

[TiredMummy in reply to SlowDragon]

Hi Slowdragon, I’ve tried night time dosing several times over the years as it’s one of the most logical things to try but alas, my body doesn’t seem to metabolise the thyroxine well during the night & I just wake up feeling severely hypothyroid. I haven’t tried splitting the dose as I thought T4 being a storage hormone should all go in at once. I’m taking Teva as a brand. My private blood test will be done 2nd week July once I’ve been on my new dose for 6 weeks (I was getting the same nausea on the lower dose by the way. The nausea is also accompanied by a headache which also wears off gradually throughout the day. I’ve been on HRT for a few years, the change I’ve made is to my HRT dose recently but again, I get the same nausea & headache 3 hours after taking Levo regardless of what HRT regime I’m on. I think I should just post my results on here in a few weeks time (I’m getting the advanced thyroid test done) and see if that might point towards a dosage split or if that draws a blank, try a different Levo brand as Lalatoot suggests.

For the thyroid test, I’ll have it done on a Mon/Tuesday before 9am & before I take my Levo + fasted so will be at least 24 hours since last Levo dose. I seem to remember I need to stop certain supplements before the test actually? Was it iron and biotin one week before?

[SlowDragon Administrator in reply to TiredMummy]

It’s any supplements that contain biotin need stopping a week before tests as biotin can falsely affect test results

If testing ferritin, stop iron supplements a week before test

Test early morning, fasting and don’t eat iron rich dinner night before test

Personally I was astonished to find it’s much better to split the levothyroxine into two doses, waking and bedtime

[TiredMummy in reply to SlowDragon]

That’s very interesting about the split dosing…..I obviously won’t make any changes until my blood test results but if my levels look ok on the dosage (150mcg) it might be worth trying 100mcg morning & 50mcg at night. I know the 125mcg gives me the same negative effect….so 100mcg in the mornings would be the start point I guess and work down from there e.g 75mcg mornings and 75mcg bedtime as next step. Very interesting & gives me hope if my bloods look ok….!

[SlowDragon Administrator in reply to TiredMummy]

I had been splitting as 100mcg at bedtime and 25mcg waking for about a year

But seeing more and more members saying splitting was an improvement…thought I would try splitting more

I now literally cut 100mcg in half and 25mcg in half ….so taking 62.5mcg waking and 62.5mcg at bedtime

I also split T3 as 3 doses (10mcg waking, 5mcg mid afternoon and 5mcg bedtime)

[TiredMummy in reply to SlowDragon]

I’ll see what my blood test results look like in about 3 weeks time and go from there. If I was to consider switching brands….is there somewhere on this forum that links to a list of ingredients for different Levo brands? I’d like to avoid lactose which led me to TEVA in the first place….

[Lalatoot in reply to TiredMummy]

helvella has a levo brand document in the dropbox. Links are in this post below:healthunlocked.com/thyroidu...

[SlowDragon Administrator in reply to TiredMummy]

Glenmark is new lactose free levothyroxine

Aristo also lactose free but 100mcg tablets only

[TiredMummy in reply to SlowDragon]

Sorry Slowdragon, just coming back again on this split dosing idea. The more I think about it the more I think my nausea is caused by too much thyroid hormone at once and that split dosing is the number one thing for me to try. I had the same nausea but worse for example after taking 75mcg Novothyral and 15mcg T3 all at once in the mornings. This is the medication I was on & felt terrible on before switching to 150mcg TEVA Levothyroxine. I’ve yet to examine the difference in fillers but the nausea was very acute whilst taking the Novothyral & T3 all in one go in the morning. I’m trying Levo only now as previously my blood tests prove that I could convert T3 from T4 (hopefully they still will). I’m suffering quite badly now with the nausea (very debilitating), after taking 150mcg Levothyroxine in the morning. My blood test is next Tuesday morning so only 6 doses to go before my test. But, I’m feeling a bit desperate to try split dosing but presumably this will muck up my blood test results if I tried split dosing now…..? I.e. 100mcg in the mornings & 50mcg at night (appreciate I wouldn’t be able to take the 50mcg the night before the test or the 100mcg until after the test.

[SlowDragon Administrator in reply to TiredMummy]

Ideally hang on until after test …..I know it an feel like forever

Are you lactose intolerant that you’re on Teva?

Teva brand levothyroxine upsets many, many people

It could be the brand upsetting you

Teva contains mannitol as a filler, which seems to be possible cause of problems.

But for some people (usually if lactose intolerant, Teva is by far the best option)

Teva, Glenmark 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).

If you normally take levothyroxine at bedtime/in night …or if splitting dose

...adjust timings temporarily 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

REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex

[crimple]

TiredMummy which brand of Levo do you currently take. Do you always receive the same brand from the pharmacy. A lot of people can't tolerate TEVA, me included.

[McPammy]

I found splitting my Levothyroxine dose helped me. For some reason I couldn’t take my usual daily dose in one hit anymore, I’d feel over medicated after about an hour. Stomach upset and dizzy and also I’d feel very weak. It would wear off after a few hours. I decided to take half my dose late morning and the other half late afternoon. I felt and still feel much better. I take liquid Levothyroxine so it makes life much easier when splitting the dose. And I have no issue with trying to avoid food. Liquid version is much more expensive though. May be worth asking your GP and medication manager at your surgery if you could trial it at the very least. I have Wockhardt brand. I also take T3 Liothyronine which I split twice a day.