Anyone had a symptom dip after upping levo or changing tablet size?

[CherryPie2]

After my elated post which I was finally upped to 75mg and all the pain I had vanished and energy & brain fog improved, I have taken a dip.

Just wondering if anyone had experienced this?

Upped 75mcg from 50mcg end of March and had been feeling brilliant until 25th May.

What's interesting is this is when I switched from taking 25mcg + 50mcg to make up the prescription to a single 75mcg one. I switched as chemist was giving me a mixed bag of brands and I wanted a common factor for the next few months to track symptoms.

I have light burning in knuckles and ankles (a bit of swelling in the ankles) and arm pain but nothing like before.

25mcg + 50mcg were Teva boxed in Hillcross packaging

75mg were Teva (I've not had previous issues with Teva)

So technically no change in brand so I wouldn't have though that would be the issue?

Review Blood tests are due 24th June (prob just the basic TSH)

[DippyDame]

It's possible that your body is telling you it is ready for a further increase....this is quite normal after it initially enjoys the increase then finds it's still not enough

Your next test will help but only if you test FT4, and if possible FT3, as well as TSH!

[CherryPie2 in reply to DippyDame]

Ah really? So soon?

I honestly felt like a new person (well like my old self) but I was still at 2.14 TSH [Range 0.27-4.2] after 6 weeks on 75mcg. So maybe a way to go as yet.

I think what I will do is get a private test plus nutrients (as I've been supplementing) if the NHS one is just basic. Then can see what's going on.

[DippyDame in reply to CherryPie2]

Yes, a full thyroid test is an excellent idea!

thyroiduk.org/testing/priva...

I don't believe in monitoring by TSH alone, it is not a reliable marker.. as science has shown

bmcendocrdisord.biomedcentr...

Time for a reassessment of the treatment of hypothyroidism

John E. M. Midgley, Anthony D. Toft, Rolf Larisch, Johannes W. Dietrich & Rudolf Hoermann

thyroidpatients.ca/2021/07/...

And yes, the body can respond like that in a fairly short time.

It sounds as if you may need to up your dose again...or the "cocktail" of different brands is causing problems.....or both!

Time will tell....but I suspect you will need to increase your dose to 100mcg.

Post your new labs for advice

[CherryPie2 in reply to DippyDame]

Thank you so much!

[helvella Administrator Thyroid UK]

Hillcross 25 is, as you say, Teva.

BUT Hillcross 50 and 100 are Accord!

So very definitely a change in brand (formulation).

We have also read of members who have changed from, say, two 50 tablets to one 100 - all definitely the same formulation - and found a distinct change.

helvella - Thyroid Hormone Medicines

helvella has created, and tries to maintain, documents containing details of all thyroid hormone medicines in the UK.

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...

[CherryPie2 in reply to helvella]

Oh my goodness! Funnily enough I read through your docs earlier but missed the Accord!

That's what I also wanted to know really if a different combination of same brand has an effect. It's irritating the different contributing factors as if throid wasn't enough of a pain to treat.

So Accord was what I was taking 50mcg in (and have taken Accord no issues before too) but they don't do 75mcg unless I chop in half.

Will have to see what bloods say and they have a think what I do going forward as if 75mg specified they are 100% going to be TEVA from my availability understanding from the chemist.

So bloomin complicated. Great when you are in a thyroid fog.

[helvella Administrator Thyroid UK in reply to CherryPie2]

It is a nightmare. I agree.

Have you got any other tablets left to see what happens if you revert or otherwise change?

[CherryPie2 in reply to helvella]

I only have a box of 25mcg which will be the teva. But I think maybe still worth doing a week on those to see if that's a factor.

I did check the foil backs of the pills and the 25mcg and 50mcg did both have the Teva logo on would they be Accord under TEVA in a Hillcross box as ridiculous as that sounds?

[helvella Administrator Thyroid UK in reply to CherryPie2]

Have you got the boxes?

They will state the PL holder - probably on the side.

If they have changed to Teva, that makes it even worse.

[CherryPie2 in reply to helvella]

25mcg

Levo 25mcg

[CherryPie2 in reply to helvella]

50mcg definitely Teva not got the box but states holder on the back. Had a piece left in my handbag!

50

[helvella Administrator Thyroid UK in reply to CherryPie2]

Thanks - I'll edit my document now.

[CherryPie2 in reply to helvella]

No worries. When you said "If they have changed to Teva, that makes it even worse" what did you mean?

At least it takes one factor out of the puzzle if what's going on for me however, the fact people still report an issue changing tablet size withing the same formula leaves a question mark if it's that or I need an increase.

[helvella Administrator Thyroid UK in reply to CherryPie2]

But that means everyone always needs to check every pack of Hillcross.

If someone gets current it might be Teva. But it appears you could get Accord next week. After all, stock doesn't always change over on an exact date. And they might change back!

[CherryPie2 in reply to helvella]

Oh I see yes. I think we all need medals for this grief!! Thank you for your help (again)