NEW NDT ADTHYZA

[Brightness14]

I am not sure if anyone has heard of the latest NDT. It is free of the following, Gluten, Lactose, Corn, Dyes, and Latex.

The main drawback is the fact that it contains, guess what, Mannitol.

[Alanna012]

What benefit does mannitol provide in the manufacturing? What are the alternatives?

[helvella Administrator in reply to Alanna012]

Apparently it is good for physical characteristics - allowing sharp definition of tablets, a clean break, doesn't pick up water from humid air - avoids the lactose intolerance issues, and is readily available.

Possibly ironically, some companies use it despite it being significantly more expensive than lactose. So it clearly isn't simply getting the cheapest possible ingredients.

And, in general, mannitol appears well-tolerated. Even in doses hugely greater than would ever be used in a thyroid hormone tablet.

Detailed research into why some of us find it causes problems, and specifically in levothyroxine and liothyronine products, hasn't been done, so far as I know.

[Zazbag in reply to helvella]

I've always used Teva levo which also contains mannitol and it hasn't caused me any issues despite my having lots of other intolerances (gluten, dairy and egg).

[Alanna012 in reply to Zazbag]

It's good to hear someone speak positively about TEVA levo. I'm afraid some people avoid it straight out of the bat because of hearing about the issues, which are legitimate, but won't be the same for everyone and it is (in my opinion) a stronger levo than some of the other brands (although, disclaimer, they're all supposed to be the same in potency for whatever standardised dose)

[helvella Administrator in reply to Alanna012]

I agree.

Potency is controlled (within the rather wide range of 90 to 105%). But the amount we actually absorb isn't. If makes vary in how much we as individuals absorb then it is very reasonable to suggest one make feels stronger (or weaker!) than another.

We have had quite a number say they get on better with Teva than any other UK product. (At least, better than any they have tried.)

So far, I haven't seen any rationale we could use to predict whether any individual would find Teva better or worse than any other formulation.

Speaking entirely personally, I find Aristo my preferred product. And also found two other German makes (L-Thyroxin Henning and Aliud) both of which are lactose-free and mannitol-free were also fine. But did not like Teva - even in a tiny dosage to make up my full dose.

[Alanna012 in reply to helvella]

I'm now on Almus, which took some getting used to. The problem with Teva I have found it that it seems to be the first to run out in my local pharmacy. Kept happening every few months. It's different from the other brands and a straight switch has always been impossible for me. I have felt truly awful. I had a period of trying T3 only, then made the switch because again it wasn't available.

Almus is good. But I don't feel it's as potent as the Teva but is ok taking with the T3.

[Brightness14 in reply to helvella]

That's interesting, I wonder why when it was added to Merek Levo here in France it badly affected patients. As you know Merek were fined over 6 million euros because of it.

Something sounds odd to me but it did happen here. Maybe it was the fact that it wasn't put onto the sheet to inform people, although over 3000 patients here had been awarded money by the court as well as the huge fine.

[helvella Administrator in reply to Brightness14]

It was actually done at the request of the French medicine/health people!

I think they were responding to questions over lactose including lactose intolerance and product expiry issues.

And everyone seemed content to see testing of the mannitol product to be on a virtual handful of healthy volunteers.

More than anything else, it seems to have been the lack of warning, the lack of options, that caused the whole thing to explode.

The PIL (or whatever it is called) did list ingredients correctly. But I think nothing drew anyone's attention to that. Nothing obvious on the packaging.

Since then, Merck have issued warnings in countries around the world as they have switched over. They say that patients might need to adjust their doses, The packaging changes are very clear.

Not defending Merck because they did get it very wrong, But blame lies elsewhere as well.

[Brightness14 in reply to helvella]

Interesting, probably, here they are good at getting things wrong. Thank you.

[pennyannie]

Yes - I think it is not freely available if you haven't a prescription !!

[Alanna012 in reply to pennyannie]

For now...lets see over time. Technically none of the others are either. They can't be unaware of the huge demand abroad. We can but hope.

[Brightness14 in reply to pennyannie]

Time will tell I only had the detail this morning it's made in the US so would need FDA approval anyway. As for a prescription I would think so.

[adin]

Hi, it would be interesting if someone found and uses it to tell us about the product....

[Brightness14]

Yes it would but we are all different what suits one doesn't suit another. I know the NDT Thyroid s suited me for years but Armour never suited me. It's very interesting to hear the results from patients I agree.

[Hidden]

Thanks for the post, Brightness14.

Something that may also be relevant?

"T4: Only 41% is absorbed when given in a gelatin capsule as opposed to a 74% absorption when given with an albumin carrier."

dailymed.nlm.nih.gov/dailym...

[Brightness14]

I never knew that there was a gelatin capsule for only T4. Thanks

[helvella Administrator in reply to Brightness14]

I don't think the information necessarily relates to a real product - anywhere. In context, it could well be from research.

It also appears potentially misleading as the Tirosint gel caps are claimed to have very good absorption - usually at least 80% and possibly close to 100%. However, they are very different in that the levothyroxine is already in a solution.

[Brightness14]

The information was on Dr Westin Childs site and apparently people have been using it for over one year now. I did goggled it, there are plenty of pictures of it too. I think that it is a real product but who knows sometime the thyroid information is a mystery.

Thank you for the information. I don't have a problem with absorption, just the opposite in fact that's why I can't take Armour or T3. I think that a lot of people with thyroid problems also have gut problems to, but not me my gut works fine.

I would imagine that the gel caps are good absorption too.