Two brands of levo?

[Obsdian]

So, I have been on 50mcg almus... Finally they have increased it to 75... But they've given me 25mcg tablets that are Wockhardt.

Is it going to cause me issues using two brands to make up the 75mcg?

[SlowDragon Administrator]

Try it and see

Many people prefer Wockhardt. Its generally very well tolerated

[Obsdian in reply to SlowDragon]

Thank you. Felt a bit panicky as I felt like I have enough problems without possible other ones.

It's reasonable, though, for me to request they only prescribe my levo as one brand in the future, right?

[SlowDragon Administrator in reply to Obsdian]

Almus is Accord brand boxed for Boots

Accord only make 50mcg and 100mcg

Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz

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)

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...

[Obsdian in reply to SlowDragon]

Thank you. I am dairy free but not even considering changing to a lactose free levo until my more major problems are solved.

Your info is veru helpful!

[helvella Administrator Thyroid UK]

helvella - Mixing Levothyroxine Formulations

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

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

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. There is now a specific world desiccated thyroid document.

I highly recommend viewing on a computer screen, or a decent sized tablet, rather than a phone. Even I find it less than satisfactory trying to view them on my phone.

helvella - Thyroid Hormone Medicines - UK

The UK document contains up-to-date versions of the Summary Matrixes for levothyroxine tablets, oral solutions and also liothyronine available in the UK. Includes descriptions of tablet markings which allow identification. Latest updates include all declared ingredients for all UK products and links to Patient Information Leaflets, etc.

dropbox.com/s/bo2jzxucgp9hl...

helvella - World Desiccated Thyroid

Contains details of all known desiccated thyroid products.

dropbox.com/scl/fi/gx6dmz5i...

helvella - Thyroid Hormone Medicines - RotW

Contains details of all levothyroxine, liothyronine and combination products - excluding desiccated thyroid products. Details available vary by country and manufacturer.

The link below takes you to a blog page which has direct links to the documents from Dropbox and QR codes to make it easy to access from phones. You will have to scroll down or up to find the link to the document you want.

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

[Obsdian in reply to helvella]

Thank you, will read all that this evening

[helvella Administrator Thyroid UK in reply to Obsdian]

Don't blame me if you fall asleep after a few minutes...

[Obsdian in reply to helvella]

That's a lot to think on, but also makes me think maybe I shouldn't think on it and just see how it goes. Keeping track of medication sounds like a good idea.

[helvella Administrator Thyroid UK in reply to Obsdian]

Provided you avoid the most obvious and worst mistakes, there is a lot to be said for seeing what happens.

In particular, it is often a good idea to try something by choice - before you are forced to do so by circumstance. For example, switch to a new make while you still have some of the old make. That way, you can revert if it is unacceptably bad.

It also reduces the time and effort you put into thinking and re-thinking the issues. Often, despite the best of intentions, fruitlessly.

Much easier for me to say than for you to do!

[Obsdian in reply to helvella]

Yes, I struggled for a long time just to get this dose increase and they definitely don't allow me to get a new prescription of anything early.

[Obsdian]

A side question. Is there any way to find out if I am lactose intolerant or if its the cassein and whey (proteins) that affect me.

I cut out dairy in December because I figured out I was intolerant... But didn't know until recently that my levo has lactose. Far as I can tell taking my pill isn't having any noticeable effect... Soooo wary to mess with anything by insisting on a lactose free version.

[helvella Administrator Thyroid UK in reply to Obsdian]

There won't be any casein or whey proteins in pharmaceutical lactose. It is extremely pure.

Lactose tolerance is difficult. I am convinced that there is something about levothyroxine PLUS lactose which is different to just lactose. Many can tolerate lactose in lots of other products but not in levothyroxine tablets.