Mannitol in Vitaris.

[Ebx_design]

Hi,Has anyone had reactions to the mannitol in Vitaris brand liothyronine? First time I've tried it, and I am lucky to usually be OK with pretty much every other T3 brand I've had but this has given me a super dry mouth, seemingly unquenchable thirst and excessive loo visits (I'm assuming due to the mannitol in it used as a filler, which is a diuretic).

I'm not taking a lot just under one tab a day atm, but still these symptoms. Am considering putting in a yellow card. Is Vitaris one of the cheaper brands available to the nhs? I'd never heard of it until I received it in my prescription this month. 🤔

Thanks

Ebx

[helvella Administrator Thyroid UK]

Viatris is the Sigmapharm product.

No, it is not a cheaper product. £147.14 per 28 tablets - 20 micrograms.

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 Northern Ireland and Scotland. (Wales' data is based on England.)

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

Last updated 26th April 2024

Link to dm+d:

dmd-browser.nhsbsa.nhs.uk/a...

Please very much DO put in a Yellow Card report.

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...

Screenshot of product in dm+d

[Ebx_design in reply to helvella]

Thank you. From what I've read mannitol occurs naturally in some foods and in other places but, I'm guessing this is just a larger 'dose' albelt sypposedly benign. I tend not to react to much (at all), so this one is interesting. What I have thought though, is one other change I made a few weeks ago was starting to take creatine... I've googled this too and some people report diuretic symptoms. But I'm quite sure that it's the T3, the dry mouth and thirst especially seem to arise only a short time after I take my morning Vitaris dose. And this is a recent thing (a few days), while I've been on creatine for a few weeks now.

helvella That's odd that it's not even that cheap - I imagine it's all they had available. So anyway, today I called my endo secretary and asked for a note to be added to my file saying not Vitaris please. Will see if that actually happens. I still have 2.5 months of the stuff left, and while I can scrabble about and patch with other brands I don't want to waste it. A shame at that price too!

Thanks for your thoughts on the yellow card, reassuring to know I'm not exaggerating by submitting one.

[helvella Administrator Thyroid UK in reply to Ebx_design]

Honestly, the MHRA can sort out the reports they get. Never hold back.

What is so very odd is that many of us tolerate mannitol perfectly well in numerous other things. But put it with thyroid hormone and BANG! Something goes wrong. Pure guesswork - but definitely needs to be researched and understood.

I found even 12.5 microgram Teva levothyroxine with mannitol caused me issues - plus 100 of something else.

[Ebx_design in reply to helvella]

Yeah, I'm only taking 15mcg of Vitaris in the morning (another brand at two intervals pm owing to quantities required). I didn't think it's that much, but, I definitely don't feel great.

[Gymbuni]

I am not hundred percent sure but I think this is the same as Sigma Pharma T3 just under a different brand name, I can not tolerate medication with mannitol in so you have my sympathy. My pharmacy know I can’t have Sigma Pharma, I’m dreading being given Vitaris.

Have you got any other brand of T3 you can use.

I would yellow card it, if it was me and I was sure as I could be it is the T3 making you feel like this.

I hope you feel better soon.

[Ebx_design in reply to Gymbuni]

Gymbuni thank you. Can I ask, what symptoms / reactions you had to mannitol? And perhaps I'm making assumptions, but your name suggests you might be a gym goer.... Ever taken creatine and experienced a bad reaction to it?

I'm 98% sure it's the Vitaris, but always good to hear other people's two-penneth.

Best, ebx

[Gymbuni in reply to Ebx_design]

I used to go to the gym regularly for light exercise yoga, aqua etc, but sadly I have been under medicated on my thyroid meds for quite sometime and haven’t had the energy or inclination to go, I should perhaps change my name to couch potato!

The mannitol made me have stomach issues, bloating, cramps, stomach pains, headaches and just a general feeling of malaise and feeling out of sorts, and even more undermedicated. It also made my constipation worse, we are all different so my symptoms will probably vary to yours.

I have never taken creatine, so I can’t really offer any advice on that.

[Ebx_design]

Yeah, I feel pretty rubbish in a general way alongside these specific dry mouth thirst issues. I simply can't understand why they choose to use such reactive things for fillers. Honestly, why not use something that's actually neutral. It makes it so hard to tell if it's the new med or the fillers causing the issues! X

[helvella Administrator Thyroid UK in reply to Ebx_design]

That's how we all feel.

But what? Most substances that are already used in medicines wouldn't suit everyone. And the fewer substances that are used, the more difficult to find an alternative if you are one of the unlucky ones. After all, some who are lactose intolerant are really happy some lactose-free products are available.