Switching brands of Thyroxine

[MagicMadge]

Hi there...I'm new to this forum so hello to all fellow sufferers out there.

I've recently been reading about the issues that surround the swapping of brands of thyroxine. I heard about this from a lady in the pharmacy queue and couldn't help but overhear her conversation there. I asked her what it was and from there I've done some research.

I have found increasingly that my levels of tiredness fluctuates somewhat and am seriously wondering if I am one of those patients that are affected by the different brands.

I experience extreme dry and itchy eyes, really bad headaches, tiredness and lethargy and even a strange dry throat that sometimes affects my voice. All these symptoms come and go so they are never with me constantly.

I read on the the UK Gov website about this issue and wondered how to go forward with this and am asking for any advice as to what to do?

I can see that the both my packs of current and the last pack of meds were different brands. I am currently on 75 mg per day having two years ago reduced from 100 mg.

I cannot remember these problems back that far but then again I was only using one brand at a time so it might not have caused so many problems.

Many thanks in advance for your help.

[helvella]

You might care to look at a previous post of mine:

healthunlocked.com/thyroidu...

[SeasideSusie Remembering]

Welcome to the forum MagicMadge.

I am currently on 75 mg per day having two years ago reduced from 100 mg.

Presumably your 75mcg (not mg, big difference ) is made up of two different brands? What are the brands you are currently using? If the 25mcg ones are Teva this brand causes a lot of problems for many members, it seems as though it might be mannitol that is the culprit as they use this instead of lactose (although some members find Teva suits them best).

Do you know the brands you used when you didn't have any reactions?

Why was your dose reduced from 100mcg to 75mcg?

Do you get a print out of your results? This is important so that you can keep a track of your results and you would then know what dose you need to feel well and if your GP wants to reduce from this dose you can discuss what is likely to happen if your dose is lowered.

If your surgery offers online access to results then you can arrange for access to this, if your surgery doesn't offer it then ask the receptionist (never the doctor) for a print out of your results every time you have a test. In the UK we are legally entitled to our results.

Do you know exactly what tests are done each time? A full thyroid panel consists of

TSH

FT4

FT3

and all these are needed to get a full picture of our thyroid status.

Many labs only do TSH if FT4 is in range. If TSH is out of range they should add FT4. Rarely is FT3 done yet it's the FT3 result that tells us if we are overmedicated and need a dose reduction.

TSH is a pituitary hormone not a thyroid hormone (thyroid hormones are FT4 and FT3) and although doctors are taught to just look at TSH and adjust dose by that result this is wrong. It's the FT4 and, more importantly, FT3 that tell us what we need to know.

[MagicMadge in reply to SeasideSusie]

Hi there, thanks for your reply.

Last month I took 50 mcg (thanks btw) of Accord and 25 mcg of Wockhardt. Just opened up a new box of 28 days x 25 mcg of Teva. I'm afraid I cannot remember before this so I have no idea what I was taking without any of the mentioned symptoms 🙄

2 years ago my test showed: TSH was less than 0.02mlU/L. T4 20.7pmol/L. Trio 4.4 pmol/L. I was on 100mcg at this point so Dr reduced dosage to 75mcg. It took about 3 months to get a TSH reading of 0.28mlU/L which was regarded as adequate so no other readings. Last year's test was only for TSH and was 1.12mlU/L. and regarded as adequate. I gather that if your TSH level is ok then they don't test for the other 2 levels! It's very interesting to read what you say.

I always have a pack of 50 and 25 mcg pills from the chemist and invariably they are different brands.

I have been Hypothyroid since the early to mid-90s and gradually my dosage has gone down, although I did have an incidence of Hyperthyroidism in the mid-'00s.

I am off to the Drs on Wednesday for my yearly check up and I also requested a test due to my symptoms. I will ask if they could do the complete check.

[SlowDragon Administrator]

75mcg is only one step up from starter dose

Very likely dose was reduced inappropriately, unless you are extremely petite

Which brand of levothyroxine are you currently taking

Many people find different brands are not interchangeable

If you were taking single 75mcg tablet it would be Teva as they are only brand that makes 75mcg tablets

strongly recommend requesting GP to FULL thyroid test, TSH, Ft4 and Ft3 plus test vitamin D, folate, ferritin and B12

When were vitamin levels last tested

What vitamin supplements are you currently taking

On levothyroxine we MUST have good vitamin levels

ALWAYS test thyroid levels early morning and last dose levothyroxine 24 hours before test

Approx how old are you

what were your results when on 100mcg levothyroxine that caused GP to reduce dose levothyroxine

[MagicMadge in reply to SlowDragon]

Hiya

I have 75mcg dose in two tablets, 25 and 50 and invariably they are not the same. Currently on Accord for 50 and Teva for 25 (just started a new pack)

I am 66 years old and been hypothyroid since early to mid 90's. I have no recollection of my starting dose now I'm afraid.

2 years ago my test showed: TSH was less than 0.02mlU/L. T4 20.7pmol/L. Trio 4.4 pmol/L. I was on 100mcg at this point so Dr reduced dosage to 75mcg. It took about 3 months to get a TSH reading of 0.28mlU/L which was regarded as adequate so no other readings. Last year's test was only for TSH and was 1.12mlU/L. and regarded as adequate.

I have a very healthy and well balanced diet and currently weigh 55 kg and I do have a small frame.

I am off to Drs on Wednesday for a Thyroid test due to my current symptoms so I will certainly ask for a full test.

The fact that I have times when I feel ok, approximately how long does the effect of any change of brand take to have affect?

[SlowDragon Administrator in reply to MagicMadge]

Teva brand levothyroxine upsets many, many people

Accord don’t make 25mcg tablets

You could request increase number of 50mcg tablets prescribed and cut in half to get 25mcg

Request FULL thyroid test including Ft4 and Ft3

Also request vitamin D, folate, ferritin and B12 tested

Ideally test 6-8 weeks after being on constant unchanging dose and brand of levothyroxine

Book early morning test and last dose 24 hours before test

Your weight suggests a daily dose of 88mcg per day you might need SMALL dose increase in levothyroxine

75mcg plus 12.5mcg (half a 25mcg tablet) per day would give 87.5mcg

[1tuppence]

MagicMadge If you care to look at my recent Posts I was asking about different brands of levothyroxine having an effect on me......my own answer has very clearly been a resounding YES.... I am now back on the brand that suited me well for 5 years, and am beginning to reap the benefits of that. Others have commented on those Posts, and you may find something of interest to yourself within them.

Do you remember which brand you were taking when your system was stable? If not, perhaps your pharmacist may have kept a record as to which brands have been supplied to you, and when?