New to this fun game!

[QuiltingGoddess]

So today I go to have my staples removed following my thyroid removal last week, I’ve been given 100mg thyroxine which I’m switching from daytime dosing to night time today.

I’m finding that my blood pressure is going haywire! I have a heart problem which is kept in check by two lots of tablets which both act by lowering my blood pressure. Now this started from a normal level a number of years ago so I had to get used to a bp of around 110/60 . No problem, but in the last week it has averaged much less than that and I’m continually light headed.

I have been advised to stop the heart meds, but that will eventually lead to my heart function decreasing.

I need to be educated about the dos and don’t. Foods, meds and supplements.

Any tips or tricks would be muchly appreciated.

We don’t all have to reinvent the wheel!

[SlowDragon Administrator]

Welcome to the forum

What’s the reason for thyroidectomy?

Are you based in U.K.

Approx age and approx weight in kilo?

Which brand of levothyroxine have you been started on

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

Always test early morning and last dose levothyroxine 24 hours before test

Many people find taking levothyroxine at bedtime more convenient…..possibly more effective

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

Always get TSH, Ft4 and Ft3 tested.

If in U.K. likely to need to test privately.

NHS rarely tests more than TSH

Have you had vitamin D, folate, B12 and ferritin levels tested

If not get GP to test these now

What vitamin supplements are you currently taking

[QuiltingGoddess in reply to SlowDragon]

Thanks for your reply.

I had my thyroid removed as a nodule was displacing my trachea.

I’m moving back to the UK from Portugal at the end of this month.

I’m 65 and 69 kg

The box says Eutirox - it’s Portuguese

I have good level of Vit D 41.6 ng/mL - I have that tested as part of my cancer checkups (I’m clear).

Not tested for B 12 or ferritin

I have had the TSH (0.70mUI/L) Ft3 (0.93 ng/mL) and Ft4 (6.1 -that u with a tail -g/dL) tested on occasions and obviously recently with the investigations re the surgery, levels ok.

I take a load of supplements:- multi vits, vit B complex, gentle iron, glucosamine, calcium, magnesium, echinacea, vit D3, omega 3 and starflower oil.

I’m off to the GP this morning (before the staple removal this afternoon) and will take the list of tests you suggested in an earlier post.

Thanks for your help!

[SlowDragon Administrator in reply to QuiltingGoddess]

Multivitamins not recommended on here generally and especially if they contain iodine

You will see many members supplement vitamin B complex

Important to stop this 3-5 days before blood test as contains biotin and biotin is used in lots of lab testing equipment, so can give false results

you may find you need slight dose adjustment in levothyroxine once all vitamins are optimal

Request GP test folate , B12 and iron panel including ferritin

U.K. levothyroxine brands

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

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

Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz 

Accord only make 50mcg and 100mcg tablets 

Accord is also boxed as Almus via Boots, and currently Northstar 50mcg and 100mcg via Lloyds ....but Accord  doesn’t make 25mcg tablets

beware 25mcg Northstar is Teva

Northstar is however being phased out this month so probably already no longer available

 Many patients do NOT get on well with Teva brand of Levothyroxine. Teva is lactose free.

But Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome 

But for some people (usually if lactose intolerant, Teva is by far the best option)

Aristo (currently 100mcg only) is lactose free and mannitol free. Not currently widely available

Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets 

 

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.

Government guidelines for GP in support of patients 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).

[QuiltingGoddess in reply to SlowDragon]

Many thanks for that!