T3 affects of different manufacturers

[MaryMary]

After many years on Teva 60mcgs daily I am trying to reduce the dose to 55mcgs due to increased bowel activity! The GP prescribed 2x20 Teva, 10 Morningside and 5 Viatris. I feel ok except that I have a burning sensation in my digestive system which would suggest an excipient in the new T3 may be an issue? It’s not like indigestion which I had years ago before the right treatment. Has anyone suffered from this, or knows which excipient is known to cause this?

My plan is to make up the 15 with only one of the 2 new types of tablets to see if I can identify the issue. I don’t believe it’s a question of being under medicated as these are my recent test results (with last T3 taken over 8 hours before). I’ve always had higher results than this without symptoms of being over medicated:

T3 6 (range 3.1 - 6.8)

TSH 0.44 (range 0.27 - 4.2)

All other supplements are the same and I have followed a gluten free diet for about 10 years.

many thanks

Mary Mary

[SlowDragon Administrator]

Morningside contains lactose

Suggest you try just Teva

Cut a 20mcg into 1/2 and 2 x 1/4

Save spare 1/4’s …..every 3 days that gives enough for extra day

[MaryMary in reply to SlowDragon]

Thanks for your quick reply. I did this but GP didn’t think it was accurate enough!

[SlowDragon Administrator in reply to MaryMary]

Well thousands of U.K. patients have to cut 20mcg tablets up to get 5mcg doses

Because 20mcg tablets are MUCH cheaper than other options

current prices

healthunlocked.com/thyroidu...

[MaryMary]

I didn’t understand the logic either!

[helvella]

I suspect that your GP might revise their opinion if they saw how much they cost!

5 - £123.50

10 - £152.44

20 - £42.48

I agree that tablet splitting isn't ideal but sometimes it is a matter of making the most of a bad job.

Viatris contain mannitol.

Current NHS Drug Tariff Liothyronine Prices

Link to a blog post of Monthly NHS Drug Tariff prices for Liothyronine products from January 2023 onwards.

Also includes link to information for Scotland.

helvella.blogspot.com/p/cur...

Last updated 27th August 2023

[MaryMary]

Thanks, is Mannitol known to cause issues with some people?

[MaryMary]

I’ve just Googled Mannitol and I don’t like what I’ve read!! Obviously doses will be much higher for illness than in a 5mcg tablet.

[helvella in reply to MaryMary]

Mannitol has been used for many years and often in relatively massive doses.

But, for some reason, some people seem intolerant to mannitol in at least levothyroxine products. (In the UK, that is the Teva product - though that is also supplied under the Hillcross name.)

Ironically, it could be that for some people, the mannitol versions actually enhance absorption so switching to them has the effect of a small dose increase.

And, possibly, in liothyronine products as well.

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...

[MaryMary]

many thanks