Teva T3 doesn’t agree

[Karunablue]

I was given Teva recently and I hadn’t realised and now I feel ill. Achy and tired. Bloated. Headache. This happened before which is why I told pharmacist. They said they can’t get hold of Mercury or Morningside. Has anyone else had this experience?

[Buddy195 Administrator]

I’ve had a bad reaction to Roma Liothyronine (although others tolerate this well) so my GP has agreed to write ‘Morningside only’ on my T3 script (& I already have ‘no Teva’ on my Levothyroxine one!) Its definitely worth reporting adverse symptoms to your GP and getting your prescription updated to suit your needs. Sometimes you may need to take your prescription to a different pharmacist if there are supply issues.

[Karunablue in reply to Buddy195]

thanks so much for your response. Whilst a difficult process it’s helpful to know your experience 🙏

[Starmen in reply to Karunablue]

I also have No Teva notice at my GP and local pharmacy. I left a note with the receptionist to pass to gp explaining the reactions I had and fortunately the practice agreed to this.

[SlowDragon Administrator]

Request GP/endo add note to all future prescriptions that says

“No Teva liothyronine “ or “ Morningside or Mercury Pharma Liothyronine only “

It has to be written correctly so that pharmacy can get paid correctly

Government guidelines for GP in support of patients if you find levothyroxine difficult/impossible to change brands 

Same should apply to liothyronine

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).

Important to write prescription correctly

How to specify brand levothyroxine

[Karunablue in reply to SlowDragon]

again very helpful indeed. I will speak with my GP tomorrow and ask for help with this. The pharmacist has been really helpful. They just said their supplier doesn’t have morningside or Mercury available

[SlowDragon Administrator in reply to Karunablue]

You may need to try numerous different pharmacies before finding one

Small independent pharmacies often more flexible

[ETHEL103 in reply to SlowDragon]

Hi.I had a conversation yesterday and M.Ed changes were talked about.The pharmacist at our surgery says they're should be no difference in different meds and said Teva are the best actually because the are good for celiac and lactose intolerance.I told him they don't agree with me and even though there is a plain instruction no Teva I still get them sometimes.Very frustrating.Also he wouldn't up my levo from 25mg as I'm just within limits 4.88 tsh.The ft4 and ft3 also in range .Had a lengthy conversation with him and he read my 2 page typed letter with interest.He even said he looked at Thyroid UK and found it interesting. Thought it was to much to aim for below 2 tsh.So here I am no change.

[SlowDragon Administrator in reply to ETHEL103]

he wouldn't up my levo from 25mg as I'm just within limits 4.88 tsh.The ft4 and ft3 also in range 

Totally unacceptable

On levothyroxine TSH should ALWAYS be below 2. Most people when adequately treated will have TSH around or below 1

Make an appointment with a GP and insist on 25mcg dose increase in levothyroxine

Bloods retested 6-8 weeks time

[ETHEL103 in reply to SlowDragon]

Hi again.He said my bloods would be tested in 3 months then see a gp if necessary.Which I will do then.Only emergency appointments are done at our surgery so it's the mad scramble at 8.30 on the day.Doubt if my thyroid issue would be classed as an emergency but will post again in 3 months.Thankyou for your helpful replies.

[SlowDragon Administrator in reply to ETHEL103]

Make a phone or face to face appointment with GP and take in copies of your MMH test results and that previous NHS test TSH was over 5

healthunlocked.com/thyroidu....

in December test, your TSH (Thyroid Stimulating Hormone) level was :TSH 5.53 (0.3-4.8)

meanwhile working on improving your low vitamin levels should help improve symptoms and should increase TSH so that you can get levothyroxine dose increase

healthunlocked.com/thyroidu....

Alternatively see endocrinologist privately

Email Thyroid U.K. for list of thyroid specialist endocrinologists and doctors

Endocrinologist who will instruct GP to increase levothyroxine dose slowly upwards and to maintain TSH around 1 maximum

[e-mail]

[SlowDragon Administrator in reply to ETHEL103]

The pharmacist at our surgery says they're should be no difference in different meds and said Teva are the best actually because the are good for celiac and lactose intolerance.

Pharmacist is clueless

ALL levothyroxine is suitable for anyone with gluten intolerance as they are all gluten free

Yes many people do need lactose free levothyroxine, but many people can’t tolerate mannitol in Teva at all

Only Aristo brand is lactose free and mannitol free

Government have issued guidelines in support of patients that many, many people find different brands are not interchangeable

[Debimmm]

Yes, I had an awful time on Teva, I was seeing double and the optician reported my eye muscles had dropped to my GP at the same time I developed Trigeminal neuralgia ( the suicide disease) which meant I had to have an MRI etc… all because I had a reaction to the fillers in Teva. My prescription now like the others commenting says “No Teva”.

Do report to your Drs so it goes on file.

Myself I prefer Morningside but happy on Mercury Pharma.

[Rita-D]

I can’t tolerate Teva it gives me irritable bowel symptoms. I can only tolerate Mercury Pharma. It’s written I. My prescription but I still have trouble getting it. I always ask the pharmacy prior to handing the script over if they have Mercury. If not, I go elsewhere.

Advanz are the parent company and their Levothyroxine has the same ingredients so try asking for that. Boots have been very good, ordering in for me if they don’t have it in stock. Do make sure you report your symptoms under the Yellow card scheme.

Yellowcard.mhra.gov.uk

[notatortoise]

I’ve been on Morningside 10 mcg for two years with no side effects. I also had problems getting Morningside recently. Firstly pharmacy said they were out of stock, then that they were too expensive to prescribe. Tried Teva, Roma, Viatris - all had bad side effects. Eventually GP pharmacist agreed to source 20mcg Morningside that are a cheap as Roma and I pill cut these. They now write Morningside on my prescription.

[mandy-white]

I also can't take roma or teva liothryronine.

[helvella Administrator Thyroid UK]

Please, everyone who has issues with specific medicines, make a Yellow Card report.

This system is our only real way of ensuring that the MHRA, the manufacturers, indeed the whole UK healthcare system, records these issues. And hopefully, in time, responds to them.

(I appreciate some readers might already have done so.)

🟨 Making Yellow Card Reports 🟨

healthunlocked.com/thyroidu...

mandy-white

notatortoise

Rita-D

Debimmm

[Karunablue in reply to helvella]

thanks I did this last night. It feels so important

[mandy-white in reply to helvella]

How do I make a yellow card report please ?

[helvella Administrator Thyroid UK in reply to mandy-white]

There is a link just below 🟨 Making Yellow Card Reports 🟨 in my earlier reply. Click on that and follow through the steps.

[mandy-white in reply to helvella]

Thank you

[HashimotoSandy]

Yes I can't have Teva either xx

[Susieibbo301]

Yes I have had an issue with getting Morningside T3 recently and so have been prescribed Viatris 5 mcg. Feeling unwell now after a couple of days. Headache in the morning and muscle aches and worse fatigue. Only T3 only. I will go back to the chemist and tell them this and then with the next order ask the GP to change back to 'Morningside Only.'

[Karunablue in reply to Susieibbo301]

sorry to hear Susie. I’ve just spoken with a pharmacist who says the issue is cost. They only get up to £59 per prescription and Morningside is currently £152 🥴🥴

[helvella Administrator Thyroid UK in reply to Susieibbo301]

Can you tell us what details are on the Viatris product?

I rather assume that it is a USA product.

[Karunablue in reply to helvella]

sorry what is Viatris?

[helvella Administrator Thyroid UK in reply to Karunablue]

From Susieibbo301 reply!

Viatris 5 mcg

Viatris is a company formed by the merger of Upjohn and Mylan!

[susieibbo1 in reply to helvella]

Sigmapharma International Ltd. Dublin but I think it is US. It has cornstarch gelatine and mannitol and something else in it. Susieibbo301

[helvella Administrator Thyroid UK in reply to susieibbo1]

I've got Sigmapharm (both UK/Ireland and USA products) in my documents.

[susieibbo1 in reply to susieibbo1]

also calcium sulfate dihydrate and magnesium stearate

[Susieibbo301 in reply to Susieibbo301]

Helvella

Can you give me your link to the medecine information. So sorry have lost it. Susieibbo301

[helvella Administrator Thyroid UK in reply to Susieibbo301]

You can always go to my profile which links to the blog and all the documents.

helvella's medicines documents (UK and Rest of the World) can be found here:

helvella - Thyroid Hormone Medicines

helvella has created, and tries to maintain, documents containing details of all thyroid hormone medicines in the UK and, in less detail, many others around the world.

This link takes you to a page which has direct links to the documents from Dropbox and Google Drive, and QR codes to make it easy to access from phones.

helvella.blogspot.com/p/hel...

[Karunablue]

after all that I rang the same pharmacy to see if they’d managed to get a replacement. A box of Morningside had come through and I was so relieved if rather confused after them saying they didn’t offer that.

Thanks so much everyone it’s so helpful to be able to share on this forum 🙏♥️

[Agapanthus]

This is a bit of a late reply.....I yellow carded Teva Liothyronine about 5 years ago, and they came back to me after testing it, to say it was OK. Not to me it wasn't!!

I moved a year ago, and Boots began to give Teva to me here, as they said they couldn't get Mercury Pharma until I objected and they gave me Morningside T3.

I can't be sure, but Morningside has transformed my life. I was OKish on MP, but after a period of exhaustion from stress/bereavement/moving, I am now at the allotment 12 hrs a week. I had a diagnosis of ME/CFS before. I have No Teva - Morningside only on my prescription.

Now I can't get Morningside either, and I am beside myself trying to get a replacement. I am terrified that I am going to be back to how I was on Teva - which feels like brain injury. I see here that it's the Mannitol in it probably doing this. I took Omeprazole briefly last week and had similar symptoms, only worse. I couldn't even remember the name of my road, which is scary. Boots are trying to get me Advanz (which I think is Mercury Pharma), or Accord to try, but I have heard nothing in a week of waiting.

[helvella Administrator Thyroid UK in reply to Agapanthus]

Am very glad you did a Yellow Card.

Teva levothyroxine does contain mannitol.

But Teva liothyronine does not contain mannitol.

I can only assume that people are getting confused and not checking?

I keep posting the information about medicines - my UK documents have a matrixes of which medicines contain mannitol.

Accord's own formulation of liothyronine appears never to have been released. They do, though, act as distributors of the Morningside product(s).

I suggest you contact the companies involved (e.g. Morningside) and ask them what is happening.

helvella's medicines documents (UK and Rest of the World) can be found here:

helvella - Thyroid Hormone Medicines

helvella has created, and tries to maintain, documents containing details of all thyroid hormone medicines in the UK and, in less detail, many others around the world.

This link takes you to a page which has direct links to the documents from Dropbox and Google Drive, and QR codes to make it easy to access from phones.

The UK document contains up-to-date versions of the Summary Matrix for tablets, oral solutions and liothyronine available in the UK.

helvella.blogspot.com/p/hel...

[Agapanthus in reply to helvella]

Thank you helvella . OK not Mannitol then in Teva Liothyronine. I wonder what it is, that is affecting me, and seemingly a lot of other people.

I did actually ring up Morningside the other day, and was told that their Liothyronine was freely available at Lloyds pharmacies. Of course a lot of them have closed down this year, but I found one within reach but the pharmacist there said he couldn't obtain Morningside, though he was being extremely helpful to me in trying to obtain other makes of T3.

Happily, I went into Boots to see what was happening to my order, having left it with them a week. Usually I get alerts but hadn't so assumed there was a problem for them trying to access anything that wasn't Teva or Morningside.

However, to my amazement there was a bag waiting for me, and it was Mercury Pharma which I had for over 10 yrs at my previous address, via Boots. I was told when I moved here that they couldn't get hold of it and I assumed it had gone out of production. Hopefully, they haven't changed their ingredients, as I was OK on that, though I think Morningside was even better. If I don't get dementia/brain injury type symptoms, I will be happy though!