different Brand

[Peggymae-18]

why does my Brand change on Levothyroxine. I feel I am much Better with Accord brand than Teva and Aristo any ideas. My doctors and pharmacy have got a note only Accord brand given . The pharmacy is saying that they cannot get Accord brand. I just feel like I don’t want to take another brand and feel unwell again .

[helvella Administrator]

Whereas I feel better on Aristo, less good on Accord and Advanz, and bad on Teva!

Pointing at lactose content seems feasible as an explanation for some of us, but clearly doesn't explain all issues.

You could try a Boots - they usually dispense Almus which is Accord product.

And always consider contacting Accord!

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...

[Peggymae-18 in reply to helvella]

Thankyou so much I will try boots chemist.

[Sparklingsunshine in reply to Peggymae-18]

I think Lloyds also dispense their own brand, Northstar, which is made by Accord. Accord suits me, I got fobbed off with some Mercury last week, which was promptly returned.

[helvella Administrator in reply to Sparklingsunshine]

Not any longer. Northstar has gone.

Lloyds pharmacies (and at least some if not all who have replaced Lloyds) tend to dispense Accord.

[Sparklingsunshine in reply to helvella]

Oh ok thanks for that. I didnt know😆

[helvella Administrator in reply to Sparklingsunshine]

I've given more detail in my medicines document.

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...

Screenshot of helvella's UK medicines document showing NorthStar

[SlowDragon Administrator]

Many people find Levothyroxine brands are not interchangeable.

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, 

If pharmacy can’t give you brand of levothyroxine you need take prescription elsewhere

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 

Lactose free brands - currently Teva or Vencamil only

Teva makes 25mcg, 50mcg, 75mcg and 100mcg

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 

Teva is the only brand that makes 75mcg tablet.

So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

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.

March 2023 - Aristo now called Vencamil

healthunlocked.com/thyroidu...

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).

Discussed here too

healthunlocked.com/thyroidu...

[SlowDragon Administrator]

Once you get back on Accord/Almus recommend you get FULL thyroid and vitamin testing 6-8 weeks later

Vitamin levels need testing at least annually

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/wp-content/up...

Tips on how to do DIY finger prick test

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[SlowDragon Administrator]

How GP should write prescription

How to specify brand of levothyroxine on prescription

[Anthea55]

As I understand it, pharmacies take whatever their wholesalers send them. Unfortunately wholesalers don't seem to be aware that different brands of levothyroxine affect people differently, due to them containing different excipients. Excipients are defined as 'inactive substances'. Many of us find that some of the 'inactive' substances are definitely 'active', such as lactose for people who are intolerant to dairy.

So unless your prescription specifies the brand you want, then you will just receive whatever is flavour of the month.

Once you know which brand you want (you do), make sure that the brand name is written on the prescription. Check what brand has been issued before you leave the pharmacy; it's easier to get it changed if you haven't taken it away. You can ask for your prescription back and take it somewhere else.

[birkie in reply to Anthea55]

Hi Anthea55❤️

This is a big problem for me I live in such a small town don't have very good pharmacy's,.. Both tesco's and morrissons pharmacy's can't obtain T3 lactose free so I can't get it there.. boots (which may be closing, I've heard rumours to this effect😔) one family run pharmacy which is very small and they only supply T4, T3 as I was told was to hard to obtain for me so I moved to boots which couldn't source my T3 either (T3 lactose free) we have a 24 hour pharmacy which I'm with now, but have given me different brands because of what they get in, I've told them many times I'm lactose intolerant and have colitis so need to keep on the same T3 (although this T3 Roma is giving me so many stomach and bowle issues I've now had to come off, it not good as I have no thyroid 😢.

I'm still trying to get a gp appointment about this, since going on T3 Roma last Oct my usless gp will not put it on repeat prescription, and has not ever put down I'm lactose intolerant, in a meeting with him on this issue he told me there was not enough lactose in the tablets to cause any effect.. I pointed out, that may be the case if only taking one or 2 tablets then never taking them again.. However I take 3 tablets spilt.. 10mg, 10mg, 5mg everyday year after year so the lactose can surely effect the gut.

I've only been offered teva which was bad, and now Roma although Roma as increased my T3 the gut issues are unbearable who wants constant cramps along with inflammation (pain, looking like I'm pregnant) and horrible runy, muddy stools, as I say I've had to come off them, today I feel OK no bowle or stomach problems, feel normal again.

I know it won't last tho I know I'll go hypo😢 but at least I won't have all the problems with the stomach and bowle, really gets to me tho just how little gps ect care about thyroid illness and us who suffer through it😭

[Anthea55 in reply to birkie]

Another thought for getting meds, birkie, Thyroid UK has a list of pharmacies. Go to this page

thyroiduk.org/if-you-are-hy...

Some of these will dispense NHS prescriptions. It's mentioned under the pharmacy name. Ring several of them to see if they can help.

Do you get prescriptions which have several items on them? What I mean is does it have levothyroxine and liothyronine on the same page, so you need to find a pharmacy which will have both? I insist that I have separate prescriptions for different items. I can get my levo at my local pharmacy or sometimes at Tesco, but I get my lio online. That helps.

Hope you can get sorted.

[birkie in reply to Anthea55]

Hi Anthea55❤️

I'm on T3 only as T4 never restored my T3 to a good level being 1.05.. (Range.. 3.10..6.80) at one point, I've gone back on the Roma at 20mg although this still gives me the gut issues which as now returned😢 the 25mg seems worse😢

I don't want to be on this anymore, not T3, just the Roma brand I've been on teva which was worse, I just couldn't stomach it🤮 plus I had a serve headache's every morning like I'd drank 2 bottles of wine... I don't drink!

My only problem is getting a gp appointment it's impossible I've been trying for a month 😠 I need to see the gp because she said after my colonoscopy if theres no sign of cancer I would need to see the endocrinologist as she the gp cannot advise on T3 drugs.

I'd need to speak to a competent endocrinologist who knows about how fillers/lactose can effect patients with ongoing bowle disease.

The endos I've spoken to don't believe this is a thing, and I would like them to see what I'm passing, been on roma since Oct last year and my gp as yet to put it through as a repeat prescription 😠 the pharmacy keeps asking me why it's not on repeat, I've told the prescription staff plenty times to inform my gp of this.. Deaf ears comes to mind🙄 but as I say I don't want to stay on this (Roma) any longer.

I've not been able to go out mainly because I'm back on the roma diarrhea ect, but I will be stopping it this week and going to my gp armed with the pictures of what I'm passing, going to show it to the receptionist (hope she's just about to have lunch🤮😂) to see if that will do anything in me seeing a gp I just can't go on any longer 😢

[crimple]

Peggymae-18 I always have Accord tablets. I cannot tolerate TEVA because of the acacia powder filler used.