Lactose Intollerance?

[Wrayofsunshine]

Hi there, was diagnosed autoimmune hypothyroidism in January, initially given 25mcg levothyroxine (teva brand), upped to 50mcg in early March as 25mcg had done nothing. I cut dairy and gluten out of my diet in early Jan just before diagnosis. When my dose was increased I was given a different brand of levothyroxine Accord and noticed straight away that I was getting tummy pain a few hours after taking levo. I had enough teva 25mcg to take 2 tablet for a while to let my tummy settle down but whenever I've taken the Accord tablet again I've had tummy pain. Im aware teva is lactose free while Accord contains lactose. Decided yesterday before getting in touch with GP to see what would happen if I had dairy again so had a glass of milk. Slight tummy pain a few hours after, by the evening it was much worse and my tummy is still really sore bloated and gassy today. Im also very achy and more tired than usual. Highly suspect this means I'm lactose intollerant. Does anyone have advice on how to approach this with the GP? Do they test for lactose intollerance or will they specify lactose free on my symptoms etc? Be super grateful for any advice, it's so hard getting to even speak to a doctor, want to do my homework in advance so the appointment isn't wasted! Thank you so much!

[helvella Administrator Thyroid UK]

There is a strong tendency to insist that the "tiny" amount of lactose in a tablet isn't enough to cause an issue - even in those with proved lactose intolerance.

To some extent this might be true.

People who are lactose intolerant can sometimes consume other medicines which contain lactose without any significant issue, but there seems to be something particularly special about levothyroxine and taking lactose containing levothyroxine. It appears worse than consuming the equivalent amount of lactose in other circumstances. This has not been adequately explained, but it is widely shown by personal experiences as written up by members here. I am not lactose intolerant. Yet I prefer levothyroxine products which are lactose free. In the UK, at the moment, in addition to Teva, about which you know, we also have Aristo. However, Aristo is only available in 100 microgram tablets at present.

If you look at the Summary of Product Characteristics documents for lactose-containing products, you will see something like this:

Excipient with known effect

Lactose 48.86mg per tablet

medicines.org.uk/emc/produc...

(That is for Advanz Pharma Eltroxin 100 microgram levothyroxine tablets.)

The simple fact that it is listed separately like this indicates there is a known issue.

[SlowDragon Administrator]

Just state to GP that you are lactose intolerant and therefore need lactose free Levothyroxine

If you find Teva is ok that’s great as is widely available

Request GP specify Teva brand on all future prescriptions

[Regenallotment]

I had the exact same reaction to Accord (from Teva) and to lactose in HRT before hypo DX. I actually found my pharmacist to be more helpful than the GP, the surgery did reissue my prescription (I had returned the Levo to the pharmacy) and the pharmacist sorted me out with Teva again. She has been super helpful and helped me get Aristo for a trial. I have fewer gastro issues but feel it doesn’t absorb so well and have a hunch it under perfoms compared to the Teva, I’m about to test bloods again so we shall see what that shows. Keep on at the GP for increases if you are symptomatic 8 weeks after each raise, it took me 8 months but now on 125mcg it’s definitely getting better. 🌱🦋🌱

[Wrayofsunshine]

Thanks you all so much for the above. Will try and get an appointment with the GP and see how things go.