Anyone using 12.5mcg tablets of Levothyroxine.

[arTistapple]

Further to an earlier post a few hours ago. I really would like to just start T3 again but I have been refused an NHS prescription. Long story.

Working my way towards 87.5mcgs Levo but now involved in making an appeal to NHS endo. I can’t wait for a reply for my appeal for months as my heart is struggling - hence the need to increase to 87.5mcg. Normal dose was 100mcg before adjustment for expected T3 prescription, which is not going to happen.

I would not need to ask but both my 100mcg and 25mcg pills are too crumbly, attempting to split them. It’s interfering with the precision of the dose. I would never have thought with Levo, the dose had to be so precise (and absolutely the same every day, which can’t be done splitting the blooming things) but I suspect my body is well aware of this hit or miss situation and making my symptoms (heart) worse.

Anyone using 12.5mcg pills of Levo?

I need some 12.5mcg pills. How difficult are these to get on prescription? If I contact my GP today any idea how long pharmacy might take to provide?

[jimh111]

We store around 10 days worth of T4 in our blood so any variation in splitting a 25 mcg tablet is negligible. Also, bear in mind that our T4 and T3 levels fluctuate a little on a daily basis due to tome of day, weather, diet etc.

[arTistapple in reply to jimh111]

Thanks jimh11. I really thought this was the case but something ‘not nice’ is happening. I was originally on 100mcg. Endo suggested a 25 to 50% reduction and he would supply a T3 prescription. I took him at face value and started to drop my Levo in anticipation of said T3 prescription, which he then changed his mind about. A right mess but much of it my own fault.

So I dropped it 25% for six weeks and blood tests showed increase in TSH, modest reduction in T4 and tiny but all important reduction in T3. Unsurprising. By this time I had finally had word - no treatment. So I have been climbing back towards 100 mcg. Six weeks on 75mcgs and then six weeks on 81.25mcgs. Today (now 12 weeks from original change) commenced to 87.5mcg but pills are so crumbly.

Probably just generally taking too little TH overall is the problem, plus the cold weather too.

It might be any of your suggestions. However I am having heart issues. If the NHS was not in such a state I should be able to phone and make an appointment and get help but it’s just not possible. It’s an emergency as far as I am concerned but …..

What a bloody system!

[DippyDame in reply to arTistapple]

Bear in mind the heart needs a great deal of T3.....

[arTistapple in reply to DippyDame]

I know this to be a fact. My chosen endo knows this and his own research proves it but I still can’t have it. There is just no sense in medics. I know I am in a precarious position. Frankly they are wetting themselves because of the perceived danger they think I am in. When I feel terrible I am wetting myself too. I understand heart stuff can be a real emergency (I had an MI years ago) but I still think they should be looking at the thyroid side of things as important and central. Whereas it’s purely a side issue, no more, for every single doctor I have spoken to about it. Endocrinology (or hypothyroidism at least) is not considered important at all. Unfortunately I think they are more concerned about their own careers than any patient. NoThis endo is none too keen to be ‘tested’ by my case. Anyway I am attempting an appeal. I need to keep going until I can get a reply. Then I know he truly has washed his hands of me.

[Lulu2607]

Hi arTistapple . I use 12.5 mcg. I take 50 and 12.5 as prescribed by the clinical pharmacist. It's a recent adjustment from my 75mcg dose (50 and 25 mcg). I use Boots for my prescriptions and they get it for me from a bigger store as it's not always easily available. It's Teva brand but has been OK. I'm due the first blood test to check my new dose but the pharmacist was adamant that 12.5 mcg tablets are better than splitting 25s or alternate day dosing and I agree. So yes, short answer is they are available but seem to be Teva. I don't know about alternative brands if you don't like Teva.

[arTistapple in reply to Lulu2607]

I have never had Teva but I don’t think excipients are a problem for me. Yes what you are doing is so much more convenient AND your experience of the difficulty of getting 12.5mcgs is kind of what I expected. I have just split my pills today but honestly I am not sure I trust my ‘memory’ to be sure which is half a 100mcg and half a 25mcg by the time they are in the box a pile of crumbs!

Thanks Lulu, your input is appreciated.

[tattybogle]

it might help a bit if you get get 2x 50mcg prescribed instead of 1x100 ?

you'd still have to cut a 25mcg , but it would significantly reduce the variations from inaccurate splitting of 100's. Gp should be willing if you say you feel better when splitting dose . Gp's wording on my prescription is "Levothyroxine 50mcg tablets ONE to be taken TWICE each day"

[Sparklingsunshine in reply to tattybogle]

I'm prescribed 200mcg a day but since sourcing T3 dont take that much. I use Accord brand only. My old pharmacy has a lot of issues sourcing the 100mcg, this was a couple of years ago, but had no issues getting hold of 50mcg. So I got my GP to change to 50mcg 4 times daily.

I've since changed pharmacies but haven't bothered asking if 100mcg is still an issue so have kept up with the old dosage instructions. When I saw a GP a few months ago he did query it a bit but didnt protest. 50mcg does make it easier to take lower doses.

[arTistapple in reply to tattybogle]

Crikey I have got it pronto tatty! Not quite to your suggestion but it’s done anyway. Thanks for your suggestion. My brain fog often means I don’t see the wood for the trees. That’s why the Forum is so necessary. Somebody is on the ball when you/me/whomever can’t be.

[Hedgeree]

Hi arTistapple,

Not sure how easy they are to get but Vencamil brand of levothyroxine are now doing a 25mcg size tablet. helvella posted about it the other day. I'll search for the post and link to it for you.

healthunlocked.com/thyroidu...

Edited!! It's a 25mcg tablet and not 12 sorry about that! They would be easy to split in half.

[helvella Administrator in reply to Hedgeree]

I need to see this for myself, but I believe that all the Vencamil dosages are in the same physical form - tablets with a dividing line.

In some countries (but NOT the UK), the official documentation for them explains that you can break them by applying the pressure from your thumb - with the tablet on a smooth, flat surface. And they break very cleanly and easily.

If that is acceptable (despite MHRA not agreeing), we effectively have the potential for 12.5 and 37.5 half-tablets. (Dividing 50 and 100 might help in terms of convenience but they do not add to the dosages available.)

This gives scope for novel combinations such as 50 + 37.5 to give 87.5.

[arTistapple in reply to helvella]

I noticed the 25mcg pills I have do have a split. It’s helpful but perhaps still not always accurate (certainly into quarters). I have a bigger problem with the 100mcg pills with no split in them. I thought with TH the splits were just there for identification only. Anyway good to know. Thanks helvella.

[helvella Administrator in reply to arTistapple]

The official position in the UK is that dividing lines are for identification only unless the Patient Information Leaflet EXPRESSLY says they can be split.

However, my comment applies ONLY to Vencamil. Not Thybon Henning or any of the others with dividing lines.

(I strongly suspect that dividing lines were very often intended to allow splitting. But that someone actually tested and found that they often gave inaccurate/uneven doses. And this is particularly important when more than one tablet is split - such as a pharmacy splitting 28 tablets. The person could take them in any order. If you are doing your own each day, it isn't going to be much of an issue. Losses are the key concern to me - crumbs flying off!)

[GlowCoach Administrator in reply to arTistapple]

Accuracy when splitting Levo isnt as critical as with T3.

If you take a few mcgs more one dy and a few less the next its not an issue, just important to hoover up the crumbs!

[arTistapple in reply to Hedgeree]

Thanks Hedgeree. It’s support for me and pretty blooming important when feeling particularly vulnerable.