Levothyroxine Dose Raised

[foamfollower]

Just a follow on from my last post. My Levo has been upped from 50 to 75. Re test in 8 weeks. There was no argument either, just used the GP online system at our surgery, explained my symptoms and then had a message from the pharmacy 😁😁😁

[TiggerMe]

👏👏😅

Can you request they test your folate, B12, Vit D and iron levels?

[foamfollower in reply to TiggerMe]

I was going to wait until 8 weeks when they re test my TSH? Also the extra 25 they have given me as a different brand, does it matter?

[TiggerMe in reply to foamfollower]

Some people find they can't tolerate some of the brands, Teva is a bit of a marmite one for sure

[helvella Administrator Thyroid UK in reply to foamfollower]

helvella - Mixing Levothyroxine Formulations

A discussion about mixing (and switching) formulations of levothyroxine.

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

[foamfollower in reply to helvella]

Thank you, will be aware of potential problems 😁😁

[FallingInReverse]

Congratulations!!! So good to hear one good story

And echo Eeyore’s suggestion. You will thank yourself later to have all the key numbers so you can optimize once your Levo gets closer to full replacement dose.

[SlowDragon Administrator]

well done

Also the extra 25 they have given me as a different brand, does it matter?

Which two brands

[foamfollower in reply to SlowDragon]

Accord and Teva.

[SlowDragon Administrator in reply to foamfollower]

See how that is

But if you feel Teva is an issue get more 50mcg Accord prescribed and cut in half to get 25mcg

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, 

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...

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).

And here

pharmacymagazine.co.uk/clin...

Discussed here too

healthunlocked.com/thyroidu...