Hello.
I’ve recently been told to reduce my meds from 100 mcg one night and 75 mcg the next down to 75 mcg every night. My blood test showed the dosage was too high. I’ve been feeling a bit jittery since..it’s only been a week so do you think these symptoms will pass. Any advice would be much appreciated. Thanks Carol
it's common to feel all sort of weirdness going o for the for the first 2/3/4/5/ weeks after any dose change to be honest . and each week can be a bit different as various bits of the body slowly adjust . so unless something feel life threatening it's best to just make a note of how you feel each week for future reference , but otherwise try to ignore how you feel until at least week 6 ... then pay more attention to how it feels from that point on.
Did you feel well on previous dose ?
What were the results [ with lab ranges] that lead to dose reduction ?
free T4..level 23.0 pro/lL (12.0-22.0) above high ref limit
Serum tsh level..0.05 mix/L (0.3-5.5)
Free t3.. level 5.5 pmol/L (3.1-6.8
Also confirm your last dose of Levo before this test was 24 hours.
I was alternating 100 mcg to 75 mcg
Retest after minimum of 8 weeks on new dose
Are both tablets same brand of levothyroxine
Have you had vitamin D, folate, ferritin and B12 levels tested
The tablets were different brands
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
July 2024
Crescent levothyroxine. Dosages: 12.5, 25, 50, 75, 100
(Not yet known if all approved dosages are or will be available).
Excipients: lactose monohydrate, maize starch, croscarmellose sodium, gelatin and magnesium stearate.
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...
How to get Vencamil stocked at your local pharmacy
healthunlocked.com/thyroidu...
Helpful post about different brands
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
not sure how to share my test results
Can levothyroxine work this quickly?
Chest pain from levothyroxine 
Levothyroxine increased 
Levothyroxine - seasonal changes
