why don’t people get on with TEVA?

[Gilbo72]

I’m curious as to how people react to TEVA? I have read a few times that a filler can cause problems, but what have you lovely people who have had it experienced?

[Cavapoochonowner]

Hello there,I was given teva 25mcg and I had a terrible upset stomach as if food was going straight through me.I only took it once but because of this site I knew some people couldn't tolerate it so I didn't take it again and now go round pharmacies to get another brand.I had a thyroidectomy in June 2022 and since then I can't tolerate things I used to.Eggs,long life milk,ibuprofen give me terrible cramping stomach,really painful like labour pains.I used to tolerate all these things before my thyroidectomy, so something must have changed.I have Graves disease and was on block and replace before and I think I had teva as part of that with no problem.The thyroidectomy must have changed things for me.Hope this helps.

[Gilbo72 in reply to Cavapoochonowner]

Thank you. That’s interesting. Sorry you are having problems. X

[helvella Administrator Thyroid UK]

Why?

We don't know.

We speculate that it is the mannitol within the formulation. One reason for this suspicion is that a significant number of people have had issues with Merck's levothyroxine products as they have been converted from lactose to mannitol around the world. (Starting in France.)

Merck now issue quite clear guidance in each country explaining that doses might need to be adjusted when patients change to the mannitol version. (This was not done originally.)

Stomach discomfort is a major issue.

If, as suspected, using mannitol results in slightly higher absorption this can require a small reduction in dose. It also implies that mannitol-containing levothyroxine can no longer be regard as exactly equivalent to other products.

However, there is still uncertainty surrounding the Teva issues.

[Gilbo72 in reply to helvella]

helvella , that’s interesting. I have recently been switched to TEVA. From 100mcg x5 days to 75mcg x7 days.

I haven’t really noticed anything untoward. I did wonder if it was slightly stronger. I always have stomach issues anyway. And my hair is always shedding. But I did think I’m slightly itchy more than normal. I was curious to see what other people had experienced. If I was looking for side effects…

[helvella Administrator Thyroid UK in reply to Gilbo72]

Personally, I like the same dose every day - or as nearly as can be achieved. Skipping two days a week does not appeal to me.

Of course, we need to take into account that most other makes contain lactose. So switching from them to Teva both removes lactose (likely a plus) AND adds mannitol. One of those might be a plus and the other a minus but they don't necessarily balance each other out!

[Wua13262348 in reply to helvella]

Funnily enough , came across a test kit mentioned on the internet about half an hour ago from Gettested.co.uk called Intestinal permeability urine assessment test kit. The narrative said it was a test for leaky gut and analyzes urine for clearance of 2 non- metabolized sugars, lactulose and mannitol, which can indicate a leaky gut and malabsorption. Overnight fasting is required.

I had a quick look on the Gettested UK site and don't see the above mentioned test listed. It may have had a name change to the title of the test. It certainly suggests that they do , or have been testing for what is the sugar alcohol mannitol, which is derived from the sugar, mannose.

Thought this might be useful to know for forum members interested in why they react badly to Teva Levo with mannitol if they wanted to test for a possible explanation for why it does not agree with them.

[helvella Administrator Thyroid UK in reply to Wua13262348]

Is this the test?

gettested.co.uk/product/lea...

[Wua13262348 in reply to helvella]

No. I was looking up things on the internet to do with a post today which Jaydee answered, where the forum member had consulted a nutritionalist and the nutritionalist had suggested a long list of tests at great expense. Jaydee thought one of the tests in a long list would be worth doing, as she had done it and found it useful. It was when researching this recommended test and what it did, that a rabbit hole appeared re. a test called "Intestinal Permeability Urine Assessment Test Kit" by gettested.co.uk. I looked their website and it is not listed. Although there is a "leaky Gut" test listed I don't know if this test would test lactulose and mannitol or not. The leaky gut test would appear to be a different test, I think. The "Intestinal Permeability Urine Assessment" only mentioned testing for lactulose and mannitol. It may be that it has been withdrawn, renamed, or included in another test.

The test re. mannitol is not something I , personally wish to pursue. Personally, I have a genetic mutation re. mannose confirmed from an accredited genetics lab in America. They no longer deal with UK residents. I mentioned it in case it was of benefit to other forum members. The easiest way to find out if it is still available , if anyone wants to do the test, would be to ask gettested.co.uk. if they still do the test.

[JenniferW]

I had a weird reaction, it made my energy levels swoop up and down. I would be okayish, but a bit dopy, and then feel really tired and just want to lie down, then back to okayish.

Fortunately I had noticed the brand change and seen posts on here so realised what the problem was after a couple of days when I realised it wasn't just my usual flagging energy due to having rheumatoid arthritis.

[Forestgarden]

I've had no problem with it. Its definitely an individual thing. I just wish my pharmacist would stick to one brand and not switch it every time!

[crimple]

Gilbo72 I reacted badly to Teva over ten years ago. I thought I was developing a stomach ulcer. I changed to what is now Accord, which I believe does contain mannitol.

TEVA does also contain acacia powder as a filler and I think it was that that caused me issues. @ helvella document on meds will show which are lactose free etc. Acacia powder is used as a filler in other thyroid meds.

Whilst I am lactose free, I use lactose free milk and cream but eat "normal" yoghurt and hard cheese without issues, so not concerned about lactose in thyroid meds.

[helvella Administrator Thyroid UK in reply to crimple]

Ten years ago, the Teva levothyroxine product of the time was a wholly different formulation which was withdrawn due to failing to deliver the claimed potency. With Teva branded levothyroxine not being marketed for several years.

The only current UK levothyroxine to contain mannitol is Teva.

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...