I just wondered what it feels like to be allergic to Levothyroxine or have it not agree with you. I'm increasing slowly from 50 to 75mcg of Levothyroxine (Accord), doing alternate days before a blood test again in 3 weeks. But I feel awful, very low mood, exhausted and itchy. Not sure if to wait it out or get an appt sooner. Should I be feeling better? I did post my results on here before but I can't find them?
Allergic to Levothyroxine : I just wondered... - Thyroid UK
Allergic to Levothyroxine
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Kazzyloulou
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This is your previous post:
healthunlocked.com/thyroidu...
I'm increasing slowly from 50 to 75mcg of Levothyroxine (Accord)
How are you achieving 75mcg, are you cutting a 50mcg Accord tablet in half and adding 50 plus 25mcg?
Sorry, yes the 75 is Teva.....I didn't realise they were different.
How long have you been on just 50mcg levothyroxine
Did you always get Accord brand for 50mcg tablets
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 extra 50mcg Accord tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Glenmark or Aristo (100mcg only) are lactose free and mannitol free. May be difficult to track down Glenmark, not been available very long
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.
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).
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
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...
markvanderpump.co.uk/blog/p...
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)
Have you had vitamin D, folate, ferritin and B12 levels tested
Kazzyloulou
So it's likely the Teva brand is causing you problems, quite common with some members to have adverse reaction to Teva. So on your 75mcg days try taking 1 and a 1/2 of the 50mcg Accord tablets and see if those symptoms disappear. If so refuse Teva in future and put in a yellow card report about your adverse reaction to it. See this post on how to do a yellow card report:
I've been on 50mcg accord for 15 years plus. Latest T4 was 12.6 (9-19.10 range). TSH was 3.19 (0.35-4.94 range). Ferritin 67, I take 2 x Ferrous Fumarate a day. Vit D 84. Cholesterol 6.1. Not had Folate and B12 recently. Last one was B12 856, Folate 5.4. Shall I go back to taking Accord only but still do alternate, same dose until next blood test? Or take 50 plus 1 quarter a day?
Hi Kazzyloulou.
As you didn’t reply directly to SeasideSusie and SlowDragon they probably won’t see you reply, so I’ve tagged them in to this.
Given your most recent TSH and FT4 you’d almost certainly be ok on 75mcg levothyroxine daily—you were clearly under medicated on just 50mcg! But I realise there may be a reason you’re going more slowly with a dose increase? 50mcg is a starter dose and you almost certainly shouldn’t have been left on that dosage for 15 years! Was it your doctor’s idea to only increase by 12.5mcg a day??
If it were me, I’d want to be taking the same amount every day (not least so I didn’t accidentally lose track of which days I was supposed to take extra 🙂). So I’d do the 50mcg plus a quarter (well, being honest and given your ongoing symptoms I’d do 50mcg plus a half and make it 75mcg a day but you probably don’t have enough spare pills to do that).
Your folate is quite low. Would be well worth taking a folate supplement to bump that up a bit—or a Vit B complex with a decent amount of folate in it.
Kazzyloulou
Shall I go back to taking Accord only
That's the only way to find out if Teva is causing the problem.
but still do alternate, same dose until next blood test? Or take 50 plus 1 quarter a day?
That's up to you, either would be fine. Whichever you are comfortable with.
Yes ….1 Accord plus 1/4 tablet every day
After 6-8 weeks…get retested and increase dose to 1 Accord plus half a tablet
Meanwhile request new prescription for extra 50mcg tablets (Accord brand only)
You have been left woefully under medicated for far too long
Need to take increasing dose levothyroxine very slowly after such a long time left hypothyroid