Lactose free Levo

[Dahliasanddaisies]

Good morning,I'm wondering if anyone has experience of switching to lactose free Levothyroxene and it helping with fatigue specifically?

I have always been somewhat dairy/cows milk intolerant. I get all the usual symptoms but over the past few years have discovered what I can manage (butter, hard cheese in small quantities)

I'm currently on Accord and Wockhart. Saw a private Thyroid Clinic last week and she kind of dismissed any importance of changing of brand. They have written me a letter asking my GP to increase my dose to 100mcg - I've got an appointment tomorrow, so I'm wondering whether to bother asking her to put a new brand on my prescription? I tried Teva and it didn't agree with me (allergic reaction).

Thanks all

[SlowDragon Administrator]

Generally only change one thing at a time

If you need increase in dose do that first

Then in 2-3 months consider changing brand

Lactose free brands - currently Teva or Vencamil only

Vencamil (currently 100mcg only) is lactose free and mannitol free. 25mcg and 50mcg tablets hopefully available from summer 2024

March 2023 - Aristo now called Vencamil

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Helpful post about different brands

healthunlocked.com/thyroidu...

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)

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...

[Dahliasanddaisies in reply to SlowDragon]

Yes good point. I'll stick to Accord for now! Thanks 😊