converting from Thyroid s to Levo and liothyronine please help.

[dizzy1979]

hi guys, after many years of going round and round with my nhs endo she has finally agreed to a trial of t3, as I refused to go back on t4 only. I have just received the conversion she has suggested, and wondered if anyone could offer any help/advice/input. I currently take two tablets of thyroid s daily, once in the morning and once at night.

Is the suggested conversion correct? And would I take in the same way as I currently take my thyroid s ?

[greygoose]

That sounds very reasonable. Yes, take it the same way as you have been taking Thyroid S, assuming that you were taing it on an empty stomach - two hours after food or one hour before - and well away from other medication/supplements.

[dizzy1979 in reply to greygoose]

Thank you for your reply. I was quite surprised by her conversion too, thought it seemed to generous. I don’t really want to swap if I’m honest Bu my weight gain is out of control and I don’t feel as optimum as I once did. So I will play her game and try the swap.

Should I split the dose of t4 as well as t3? Or just take the t4 in one go and then split the t3?

[SlowDragon Administrator in reply to dizzy1979]

I would initially split the levothyroxine and T3

Which brand of levothyroxine and which brand of T3

Best to avoid Teva brand levothyroxine unless lactose intolerant. Teva levothyroxine contains mannitol and upsets many people

Teva is the ONLY brand that makes 75mcg levothyroxine tablets

So request 25mcg and 50mcg if wanting to avoid Teva

Mercury Pharma make 25mcg, 50mcg and 100mcg

Accord only make 50mcg and 100mcg

Accord also boxed as Almus via Boots or Northstar via Lloyds

Beware Northstar 25mcg is Teva

Teva T3 is not a problem.

Other T3 brands on NHS are

Morningside healthcare and Mercury Pharma

Don’t accept T3 capsules as they can’t be split

healthunlocked.com/thyroidu...

[dizzy1979 in reply to SlowDragon]

Thank you so much, that’s really helpful. I have asked for the prescription to be printed rather then sent to my usual online pharmacy so I can go in store and speak to the pharmacist to see what options/brands are available to me before committing. I will use your helpful guide. Thank you again x

[SlowDragon Administrator in reply to dizzy1979]

Many people find Levothyroxine brands are not interchangeable.

Glenmark or Aristo (100mcg only) are lactose free and mannitol free ….but not widely available

Most easily available (and often most easily tolerated) are Mercury Pharma or Accord

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

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

[Brightness14]

That sounds about right. Why are you changing to levo and T3 doesn't Thyroid s suit you?

[dizzy1979 in reply to Brightness14]

I feel better on thyroid s then levo, but the endo is insistent that I can continue with thyroid s as they don’t know what’s in it .. and she can’t give me NDT. So I am going through the motions to prove that I do not do well with levo, to prove a point. If I manage to get in a good place then fab, because thyroid s is getting more expensive every time I order. I will give them 6-12 months to try and get me in a good place. I am not optimistic. But I have been going round in circles for the past 3 years with this endo and I know I am fortunate that she has agreed to t3, so won’t look a gift horse in the mouth. I did try self sourced t3 a while ago with levo but honestly I didn’t give it much time. I am 43, pretty sure I’m peri, and gaining weight daily. I need to change something so going to give it a go 🙏🏻

[Brightness14]

Thanks for explaining and good luck.