levo brands!

[Judyrabbit]

I have had an underactive thyroid for 20 yrs. for the first 10 yrs I was on Eltroxn and I was great. In 2011 they said I had an allergic reaction towards levo , which I can’t remember but it must have been when they changed me from Eltroxin which they said they couldn’t get anymore, ( prob because of price). Around 2015 they changed the brand again. Around the same time I started to have burning feet which I still have seven yrs later and they can’t find a reason for. Last month they changed the brand again from TEVa to Accord. Since then I have had terrible hip and knee pain and the muscles are tender to touch. My knee is very swollen at the side and back. I was sent to muscular skeletal who said it was arthritis in my knee and gave me exercises to do for 12 weeks. I really don’t think it’s my knee, as I can bend it etc, I think it’s inflammation round the knee. ( I have now arranged for a private mri scan so that I can see if it’s my knee or not) After joining this help group I wondered if it was the meds as I was on 100 mg Accord and 25mg TEVa ! They have different fillers as well. On ordering my new prescription I talked to the chemist who was understanding but said it was difficult to get the two tablets in same brand but she would try. The next day they were able to get the 100mg TEVa agin so I’m back to how I was, brand wise. The dr has not asked me to have a blood test even though the dosage had gone up and the diff b4and so I’m having bloods done for something diff in August so I’m asking for it to be tested then. I will see if the pains etc subside but I would have liked to have tried a comp,etely new brand. Has anybody had any similar experiences to mine please?

[helvella Administrator Thyroid UK]

Many find that they cannot tolerate some makes of levothyroxine.

Lots of information including all UK levothyroxine products here. And a table showing with contain certain ingredients (lactose, mannitol and acacia.)

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/wfhrlmb5983co...

From Google Drive:

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

Apologies if you have already seen my usual reply about burning feet:

Burning Feet

When people post about the feeling of burning, especially of feet, I quite often post this link.

It is getting on a bit but nonetheless it does give an overview of the causes of burning feet.

Burning feet syndrome

racgp.org.au/getattachment/...

racgp.org.au/afp/200312/200...

The following might also be of interest:

Burning Feet

webmd.com/diabetes/burning-...

Riboflavin (vitamin B-2) and health

academic.oup.com/ajcn/artic...

[SeasideSusie Remembering]

Judyrabbit

If it was Goldshield Eltroxin you used to have then it wasn't price that was the problem, it just stopped being manufactured. I had been on that brand for years, it was stipulated on my prescription. My pharmacist asked me to trial Accord instead to see if it suited me, it was fine for me and I've been on that ever since and it's on my record at the pharmacy to only give me that brand.

If you can't get the same brand for both tablet sizes (100 and 25) then ask your GP to prescribe 100s and 50s so that you can stay with the same brand then you can cut the 50s in half or take 100/150 alternate days.

[Judyrabbit in reply to SeasideSusie]

Thank you for your help!

[SlowDragon Administrator]

An alternative is to try Mercury Pharma brand (also now boxed as Eltroxin….but it’s not as good as the old Eltroxin by Goldshield)

Mercury Pharma make 25mcg, 50mcg and 100mcg tablets

Burning feet often low B vitamins

ESSENTIAL To test vitamin D, folate, ferritin and B12 at least annually

What vitamin supplements are you currently taking

Recommended on here that all thyroid blood tests early morning, ideally before 9am and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Bloods should be retested 6-8 weeks after any brand change in levothyroxine

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, 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).

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

Come back with new post once you get thyroid and vitamin results after 6-8 weeks on constant unchanging dose and brand of levothyroxine

[Judyrabbit]

Many thanks. I am on no vitamins as I don’t know what to take as it always says ask dr before taking vitamins but when you can see one you get ni answers . I don’t think I’ve ever had vitamin d tested. Did have b12 prescribed as although it was within limit it was low but then it went too high so don’t take them either. Do have folate and ferritin done.