My last bloods were
serum TSH. 5.15
Serum free T4 15
My GPhad spoken to endocrinology who advised to keep trying more brands but I cannot get past 3-4 days without a severe reaction, constant retching and soul led over in pain, unable to sleep lying down and up in the night continually ill. Anyone else had this reaction? I am extremely worried if I cannot take anything.
Which brand of levothyroxine have you tried
What dose levothyroxine are you starting on
Brands currently available in U.K.
Wockhardt - 25mcg tablets only
Accord - 50mcg and 100mcg tablets only
(also boxed as Almus and Northstar)
Mercury Pharma - 25mcg, 50mcg and 100mcg tablets
(also boxed as Eltroxin)
Lactose free levothyroxine
Teva brand - 25mcg, 50mcg and 100mcg tablets
(also boxed as Northstar 25mcg only)
Teva contains mannitol, upsets many
Mannitol and lactose free
Glenmark - 25mcg, 50mcg and 100mcg tablets
Aristo - 100mcg only
Liquid levothyroxine is another alternative option, usually has to be prescribed by endocrinologist.
I have tried Teva 50 mg mercury pharmacy 25mg. I have had problems with other meds in the past I react the same to anti depressants, HRT, snd cannot take antibiotics on an empty stomach. I have tried taking the mercury pharmacy after food but I was still as ill. I am not exaggerating when I say how poorly I was, my GP told me some people cannot take anti-depressants when I reacted to them, he said they were like poison to the body. Obviously I had a choice with that medication but this is different. I have tried anti nausea with meds in the past to no effect. I am feeling very vulnerable, I think myGP was happy to leave meds a bit as he said my thyroid progression had been very slow since 2007. It had dipped then bounced back a few times. What do you think of my recent results? I am seeing a homeopath to see if that can help.
Dr Ken Blanchard in his writings on treating hypo patients states that some folks need to take levo with food to avoid it upsetting them.
Suggest you try Wockhardt 25mcg on empty stomach at bedtime
Many members find this is the easiest brand to tolerate.
Many people also find it better taking levothyroxine at bedtime. It’s certainly more convenient.
Levothyroxine is not like aspirin, it’s a replacement thyroid hormone, and will take at least 2-4 weeks to start to have any improvements.
Like antidepressants, it can make you feel worse initially, before improving
Depression is extremely common hypothyroid symptom.
Bloods should be retested 6-8 weeks after each dose increase in levothyroxine
Likely to need several further increases in levothyroxine over coming months.
Have you had vitamin D, folate, ferritin and B12 levels tested yet, or thyroid antibodies?
About 90% of primary hypothyroidism is autoimmune thyroid disease, also called Hashimoto’s, usually diagnosed by high thyroid antibodies.
Come back with new post once you get thyroid and vitamin results
Homeopathy can’t do anything for being hypothyroid
What do you think of my recent results?
serum TSH. 5.15
Serum free T4 15
Please add ranges
Was test done early morning, ideally before 9am
No thyroid antibodies tests
What are you historic results
If you have been hypothyroid since 2007 …..that’s a long time
Request GP test adrenal levels too
Cortisol should be tested early morning, before 9am
Bloods were done before 9 am and range as follows TSH serum. Range 0.1-5.0. My result 5.15
Serum free T4 level range 12-23 my result. 15
Historic results
Same ranges
TSH serum 7.68 in March snd and 6.45 in May now 5.15 in June
Serum T4. 13. in March 14 in April. now 15 in June
Also my hair thickening up again.
What were most recent vitamin D, folate, ferritin and B12 results
What vitamin supplements are you currently taking
Have you had thyroid antibodies tested at any test?
antibodies 6,36 range 0.27 - 4.3
That’s an odd range
Is it TPO antibodies?
But shows it’s high and positive
What is TPO
There’s two different antibodies to test for autoimmune thyroid disease (hashimoto’s or Ord’s thyroiditis)
Link about thyroid blood tests
thyroiduk.org/getting-a-dia...
TPO - thyroid peroxidase antibodies
Range is usually - positive if over 34
TG - thyroglobulin antibodies
Range is usually- positive if over 115
But different labs have different ranges
NHS rarely tests TG antibodies unless TPO are positive
I have TPO OF 238 with the range being 0-34
So that’s positive for autoimmune thyroid disease, also called Hashimoto’s
GP should do a coeliac blood test, if not been tested yet
Also ultrasound scan of thyroid can be helpful, too see how badly damaged thyroid is
About 90% of primary hypothyroidism is autoimmune thyroid disease.
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Recommended on here that all thyroid blood tests early morning, ideally before 9am
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
I have had coeliac test which they say is unlikely. Result was 1.9 anything over 30 they say is coeliac but I have been gluten-free for 4 months/ I did include wheat in the week before the test. Why do you not recommend multivitamin if low vitamin an issue? What vitamins do I need?
Why do you not recommend multivitamin if low vitamin an issue? What vitamins do I need?
Post discussing why not multivitamins
healthunlocked.com/thyroidu...
Test folate, ferritin and B12 at least once a year
Test vitamin D twice year when supplementing
Come back with new post once you get results
Vit D and K2 B complex and good multivitamin
Multivitamins are never recommended on here
Most contain iodine not recommended for anyone with autoimmune thyroid disease unless had iodine test even then iodine supplements have to managed extremely carefully by endocrinologist
Test vitamin D, folate, ferritin and B12 and see where you are
I g the hoist you neede iodine for thyroid?
I thought you needed iodine for thyroid?
No….well we need a critical amount
Iodine used to be used to treat hyperthyroid patients….to lower thyroid levels
Hashimoto’s patients need to avoid iodine or be very very careful on amount eaten
drknews.com/iodine-and-hash...
Tirosint is liquid in a capsule in a blister pak to avoid moisture issues
Yes…..but not available in U.K. (currently)
Might possibly be available on private prescription
What happens when you take nothing
I am taking no thyroxine as unable to have GP appt to discuss next step/ will ask for liquid thyroxine.
They are reluctant to prescribe liquid as it’s expensive (£100 a month approx….whereas tablets are £1)
You may find you need to see an endocrinologist to get liquid trial
Many Hashimoto’s patients develop dairy intolerance
McPammy which liquid levothyroxine do you recommend?
How do I know I’m dairy intolerant?
I am on goats cheese and oat milk on the advice of homeopath
I am really concerned if I cannot tolerate the medication- humanbean has frightened me saying I will go mad and die in the next 12 years. I am not in a good place,
GP should refer you to endocrinologist
Meanwhile
Are you avoiding all other dairy ….no butter, checking ingredients lists etc
If strictly dairy free you will need lactose free levothyroxine
Lactose free tablets
Glenmark
if you can find a pharmacy that stocks it (its new)
Ideally starting on 50mcg tablets
Aristo (only available in 100mcg tablets)
You could cut in half to get 50mcg initially to start on
GP would need to give you a new prescription for 100mcg tablets
Teva is lactose free, but has mannitol in it. Many people find they can’t tolerate mannitol
I think liquid levothyroxine is always lactose free
See options here
thyroiduk.org/if-you-are-hy...
Liquid levothyroxine, dose is frequently split as 2 smaller doses…..waking and late afternoon or bedtime
Anxiety is extremely common hypothyroid symptom
Medics tend to associate it with hyperthyroid only
I am not strictly dairy free but have tried to do this, how do I know if I am dairy intolerant?
I will ask for Glenmark from the GP.
What is mannitol?
Mannitol is a different filler used in lots of medications….often instead of lactose
Mannitol changes how gut biome works …..
Caused great problems in France recently….they only have one brand of levothyroxine
Manufacturer changed ingredients, taking lactose out and using mannitol instead
science.org/content/article...
Thyroid patients often have poor gut function and low stomach acid
How does low stomach affect taking Levothyroxine?
We need high stomach acid levels to digest foods, absorb nutrients and also to breakdown levothyroxine
Levothyroxine needs acidic environment
academic.oup.com/edrv/artic...
Low stomach acid extremely common when hypothyroid
Thousands of posts on here about low stomach acid
healthunlocked.com/search/p...
But never assume you have low stomach acid
healthygut.com/4-common-bet...
Web links re low stomach acid and reflux and hypothyroidism
nutritionjersey.com/high-or...
stopthethyroidmadness.com/s...
thyroidpharmacist.com/artic...
How to test your stomach acid levels
healthygut.com/articles/3-t...
meraki-nutrition.co.uk/indi...
Currently no Glenmark in distribution network for distribution.McPammy takes Teva liquid levo, I think. I requested this brand. It is lactose, mannitol and maltitol free.
Don't touch Wockhardt liquid, as full of nasties!
Boots could only access Teva or Wockhardt liquid levo.
Hope that helps.
What is in liquid thyroxine? And what if I can’t tolerate synthetic hormone , what natural one has the least additives? Thanks
You can check each one by following through from my medicines document.
They are all fairly similar but there are differences.
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:
Liquid levothyroxine probably has least excipients
Tablets
Some people react to acacia in some brands
List of ingredients in each tablets or liquid options in U.K. listed here
thyroiduk.org/if-you-are-hy...
(Not as extensive a list as helvella has compiled)
Liquid levothyroxine probably has least excipients
Depends how you measure them!
A tablet could weigh 100 milligrams. A teaspoonful or so of liquid could contain over 50% excipients (other than water) - so 2.5 grams.
As absolute quantity, they could well contain more by weight or volume in a given dose.
True….but we see some members do remarkably well on liquid…when they couldn’t tolerate tablets
it must be easier to absorb somehow
It definitely appears easier to absorb. But at least some find large quantities of glycerol (or whatever other similar substance is used) intolerable - often causing gut issues.
Yes many hashi patients need low sugar
Do you know if anyone on here in U.K. gets Tirosint
A tiny number have mentioned taking Tirosint but I don't recall whether any were getting it supplied, privately or NHS, in the UK.
It's not the fact that glycerol is a sugar. I could eat a teaspoon of sugar, honey, golden syrup etc., but I couldn't tolerate a teaspoon of glycerol when I had a trial of liquid levo prescribed.
'Side Effects
When taken by mouth: Glycerol is possibly safe when used short-term. Side effects might include headaches, dizziness, bloating, nausea, and diarrhea.'
Excipients in levothyroxine oral solution versus levothyroxine tablets – Wockhardt only. Other makes will vary.
The idea that levothyroxine oral solution products have less (or fewer!) excipients than tablets appears to be mis-placed.
Whether we consider the number of excipients. Or the quantities.
Weight
A typical 5ml dose of levothyroxine oral solution would weight around 5 grams.
A typical levothyroxine tablet would weigh around 100 milligrams. (I think many weigh less; a few might weigh more. This is just a typical dose. If you need multiple teaspoonfuls of levothyroxine oral solution, or take multiple tablets, that would have a significant effect.
But that 5 gram dose would inevitably be many times the weight of any conceivable tablet dose.
Number of excipients
Wockhardt Levothyroxine 25micrograms/5ml Oral Solution
Citric acid monohydrate
Sodium methyl parahydroxybenzoate
Sodium propyl parahydroxybenzoate
Propylene glycol
Maltitol, Liquid
Sodium Hydroxide
Hydrochloric Acid
Sodium Hydroxide
Purified Water
A total of nine excipients.
Wockhardt Levothyroxine 25 micrograms Tablets
Lactose
Sucrose fine powder
Maize starch
Magnesium stearate
A total of four excipients. Even if we exclude purified water, there are twice as many excipients in the oral solution.
Documents checked on 2022/07/24
I see now McPammy has replied , and she is on Wockhardt liquid levothyroxine. For some reason I thought it was teva liquid. I was obviously wrong.I checked out the liquid levothyroxine last week as i needed one mannitol, lactose and maltitol free.
I knew Wockhardt didn't fit the bill for me and the Boots pharmacist said it had about everything in it I didn't want.
When I investigate it now I can only see maltitol as an ingredient I want to avoid. Like the Boots pharmacist, I seem to have seen an ingredient list for it that I now can't find.
Whatever we were looking at (and can't find now) also listed xanthan gum.
For those who find mannitol doesn't agree with them, xanthan gum should be avoided. It is derived from the sugar mannose, as is mannitol.
One of the foods where this is commonly used is commercial ice cream.
Thought it might be worth mentioning. It is a stabiliser in food.
Sorry, I didn't mean to frighten you.
I said that people with severe hypothyroidism could end up like that in Victorian times. Nobody in this century would be allowed to get anywhere near that bad.
People can sometimes end up in hospital being given thyroid hormones in a drip if things get very bad, but it is very rare.
All I was trying to impress upon you is that your doctor's suggestion that you don't treat your hypothyroidism was not a good one. Since your TSH is between 5 and 7 and you have positive thyroid antibodies, and your doctor has said there has been little change in your results since 2007 it suggests that you have mild autoimmune hypothyroidism.
Ask your doctor to refer you to someone who tests for allergies. If you've had similar reactions to multiple pills for multiple health problems you need to find out what the problem is, because you might get away with not taking thyroid hormones for a few years but what happens if something much more immediately serious happens e.g. a car accident or a heart attack?
You need to fix this problem if you want to have a good quality of life.
Thank you for your reply, I have always known I have medication problems snd tried to follow a healthy lifestyle to avoid statins, diabetes medication etc. This has really floored me and given me such anxiety I just want a resolution.
I have tried a few brands and I much prefer Wockhardt brand. I was told by Wockhardt customer services that a bottle of 50mcg oral liquid Levothyroxine is £97. A bottle lasts my 2 weeks. So, it’s more like £200 a month. Expensive indeed. It was suggested in writing to my GP from my private only Endocrinologist. My GP prescribed it straight away without any issue. The reason behind it was to reduce excipients and also so I can take 68mcg easily a day. I also split my daily 68mcg dose leaving a few hours apart. This also helps me. I’m also on T3 twice a day. I feel very well (except I recently tested positive for covid 🙄). Took 13 days to test negative! I’m much better now and back to my old energised self thankfully.
Hi❤️
I note your having problems with your thyroid medication, l'm in the same situation in that I'm lactose intolorent and have colitis, as slowdragon said the fillers can affect us, my first lot of T4 contained lactose it took months of me having bad stomach /bowle/ vomiting and awful thyroid blood results for the gp to get me on lactose free T4 but unfortunately I still had the same side affects, the lactose free T4 contained mannitol which still affected me, I finally got on T3 lactose free and felt much better, but T3 is very hard to obtain, I was put bk on T4 lactose free in March 2022 and all my side affects and symptoms have returned, I'm seeing an endo in Aug and I'm going to have a good talk about how this medication is affecting me and my thyroid levels, I'm also going to ask for liquid Thyroxine, as I to can't take certain medication like asprin, antibiotics, anti inflammatory drug, I couldn't even stomach the anti thyroid drugs.. It will be interesting to see what this endo recommends. 🤔🤔🤔
Please let me know how you go on with the endo in August I have found this post helpful.
Hi birkie
Which lactose free levothyroxine are you currently taking?
Aristo?
Glenmark?
Hi slowdragon ❤️
It's flipping teva... 🤦♀️ I was also on teva T3 that was OK on my stomach/bowles but gave me a very bad metallic taste in my mouth, as you may know I came of the T3 teva as my gp said my symptoms were due to it
Symptoms:
Frequency urinating
Server thirst
Bad joint pains / bad bone vibration
Irregular heart beat
Bad headaches
Muscle cramps
Throat pain /throbbing.. ( no thyroid)
Croaky voice
Sweating
She decrease my T3 on theses results.. (TSH.. 0.05...T3..6.6)
Decreased from 40mg to 30mg I then went hypo🤦♀️ it was then I'd had enough and came off T3 ( teva) went on T4 (teva) 50mg to show her it is not the t3 causing the symptoms ( I still have them) makes no difference, so now she as said because of my side effects to the T4 which I had when on it in 2019, I need to see the endocrinologist, but she will not put me bk on the t3.. As you know 2 endocrinologist diagnosed me with primary hyperparathyroidism in 2020..unsurprisingly they are still dragging their heels on this diagnosis 🤦♀️.. I see the endo on the 3rd Aug.. Its a flipping mess slowdragon 😔😔 so she has left me under medicated and by now very hypo.. 😤
Teva T3 doesn’t cause problems
Teva levothyroxine contains mannitol
You’re likely EXTREMELY hypothyroid by now
Insist GP organise retesting of thyroid and vitamin levels and calcium and parathyroid levels BEFORE consultation with endocrinologist
I've been trying to get my gp to see me face to face to discuss this but I've only been given phone appointments, the last was May the one the gp told me to decrease my T4 from 50mg to 25mg until I see the endo, I had a very bad appointment before that with another gp who refused to acknowledge the Parathyroid levels being the cause of my symptoms ( another gp who as no idea what their talking about) PTH... 8.1..PTH 9.5...ranges.. 1.60...6.90.) the only thing I found with the teva T3 was the metallic taste its the same with the T4 to.. But never had any bowle/stomach problems with teva T3... So the gp should really have put me bk on it like I asked, instead of keeping me hypo until I see the endo.. I'm contacting the surgery on Monday because I know that endos like having your up to date bloods when you see them, last one was May 16 with TSH of 6.04 range.. 0.30..4.50..on 50mg can't imagine what it will be now only being on 25mg since May?.. 😔
Come back with new post once you get results
T3 can give a funny metallic taste….it can increase sugar levels …diabetics have to be careful adding T3
Blood results normal?
Latest blood test results
Blood test result: help! 
