Hi can anyone advise.I'm taking levothyroxine 50mg almus brand.
It has caused severe abdominal bloating. My stomach is full of gas and it is uncomfortable like someone has inflated my stomach full of air which is causing my back to spasm..
I was advised on previous post it may be due to undermedicated as I have only been taking levo for 10 weeks.
I increased from 25mg to 50mg 1 week ago but the stomach bloating is too much and I have to recline back due to discomfort. Passing wind constantly isn't reducing it neither lol.
What do I do? Surely this is an intolerance?
I have no known intolerance but I was diagnosed with hashimotos 4 months ago. Previous to taking this medication I didn't have this issue. It started wheb starting levo and has got worse with increasing dose
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Salkas
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This is very familiar, Almus (same thing as Accord) contains lactose and it does the same to me.
Lactose free brands are Teva and Vencamil
Teva also contains mannitol which affects some and not others. It’s my second choice. I get on best with Vencamil.
Definitely report symptoms to GP and ask to have lactose free named brand on your prescription, you will need to check your prescription at the desk every time you pick it up, pharmacists seem to think we can all take anything and it’s all the same. It absolutely isn’t and even the Government’s own guidelines say this. Just keep politely repeating I can’t take that, if they say they can’t get it… it’s distributed by Alliance one of the biggest wholesalers and there is no supply problem.
Consider dairy free if you aren’t already see if you improve.
Your description of symptoms is exactly how I was before I cut out dairy.It seems amazing but within a few days of being dairy free I was much more comfortable and my abdomen was visibly flatter.
Try it. You have nothing to lose and everything to gain.
Some people may be fine with very low amounts of lactose, others not so. It's individual as to what works for you.
I'm still taking Accord Levo that contains lactose but am just about to collect some Vencamil Levo. I still have some lingering niggles so am hoping that completely lactose free will resolve those.
It can actually be a reaction to the excipients (fillers) in the levothyroxine medicine, which can be a common cause, as we all react differently to medicines. Have you considered taking a different brand of levothyroxine so you can compare if it is the generic brand or something else (before cutting out important food groups from your diet!)?
I had similar problems with a generic levo medication and I though I was all over sudden lactose intolerant - but I was not and it was actually the brand of levothyroxine that caused the stomach upset, bloating etc. and also made me feel hypothyroid.
If it is a reaction to the medicine, you should also report your reactions and symptoms via the yellow card scheme to the MHRA, so the manufacturer of the medicine can be made aware of the side effects. This can then be incorporated in the label of the medicine at the next update, hence important to report it.
I agree that any reaction could be as a result of sensitivity to excipients.
However, lactose intolerance is extremely common. The older a person gets, the more likely they are to develop this. We are very unusual in the animal world in that we are the only mammals that, as adults, regularly consume the milk of another species.
(before cutting out important food groups from your diet!)
Sorry but this is a very sweeping statement. How is one supposed to discover if something will help otherwise? Dairy may be one of the major food groups but dairy alternatives offer very similar levels of vitamins and minerals so you are not removing the important nutrients from your diet, just the bits that could possibly be causing issues. If there is no relief after replacing dairy then you probably don't have lactose intolerance and it's due to some other cause. It's a very simple experiment.
I also agree that the yellow card scheme is important but it's also important to report things accurately not just because you think it may be the meds you're taking. A bit of fact finding before rushing to report is key.
The amount of lactose in each tablet varies but can be almost 66 milligrams.
My UK medicines document has the amounts in all UK thyroid hormone tablets. (In the past few years, the MHRA has required this information to be included in Patient Information Leaflets and I think this applies across the EU as well.)
Obviously, it is necessary to consider all dosages and all other medicine in order to find out how much lactose you will be taking in! I suspect that some who are taking multiple medicines could actually be consuming quite a bit.
But I do not think that lactose in levothyroxine medicines is quite as simple and obvious as this implies. People who have no other lactose issue seem to have problems with levothyroxine that contains lactose. Speaking for myself, I have consistently preferred lactose-free levothyroxine despite not even bothering to look at things like paracetamol tablets. And consuming significant quantities of dairy products - cheese, yogurt, etc.
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 injectables and descriptions of tablet markings which allow identification. Latest updates include all declared ingredients for all UK products and links to Patient Information Leaflets, Dictionary of Medicines and Devices (dm+d), etc. PLUS how to write prescriptions in Appendix F.
Also includes links for anti-thyroid medicines (but not product details).
I didn't realise that there was that much lactose in levo, or indeed other medicines. I defer to the expert on that one 🙂
I was working on the simplistic view that removing the majority of lactose from your diet has to have some effect.
Personally, one cup of coffee with a tablespoon of milk in it affects me negatively for at least 48 hours 🤢 (I know from experience after hubby accidentally did this one morning and I drank it without realising as I was half asleep)
I find it really interesting how people react differently to different things.
I agree that lactose intolerance is common in older people and on the increase and it should be looked into - however lactose intolerance is NOT dairy intolerance and sadly these two are often used interchangeably, and that is a 'sweeping statement'. An intolerance also means that you may be okay with very small amounts of lactose in your diet such as hard cheeses and yoghurts and would not have to miss out on dairy completely. I am sorry, but I do find it irresponsible to suggest to someone to give up on dairy BEFORE they try to find other solutions in the first instance. And if it worked for you, it may not work for others.
Salkas stated, that she was fine with dairy before she started her medication. Is it likely that it is the small amount of lactose in the medication (although she has dairy otherwise) or could it be that the medicine she is taking could have caused her upset due to an excipient she may not tolerate; and the fact that the problems actually increased when she upped the dose would point in that direction. So the logical thing to try first would be to see if it IS the medication and then see if it could be something else.
With regards to the yellow card scheme, my suggestion was that if she thinks that it could be the medication, she should report it. I know many people don't bother, but if you even suspect that it could be the medication, you are encouraged to report it (please see the yellow card website). The MHRA will go through the reports and make a decision which ones would be important. And if many people report a suspected side effect, it shows a pattern that can be further investigated.
I agree that lactose intolerance is common in older people and on the increase and it should be looked into - however lactose intolerance is NOT dairy intolerance and sadly these two are often used interchangeably
Totally agree.
An intolerance also means that you may be okay with very small amounts of lactose in your diet such as hard cheeses and yoghurts and would not have to miss out on dairy completely.
Again, I agree. This is the reason I said that OP may be ok with the amounts in the Levo that he's taking. (I don't feel I'm "missing out" on dairy)
I am sorry, but I do find it irresponsible to suggest to someone to give up on dairy BEFORE they try to find other solutions in the first instance.
Simplest and quickest thing to try rather than having to battle to get a GP appointment to alter medication. Hardly irresponsible if you're trying to help yourself feel better.
And if it worked for you, it may not work for others
Another statement I agree with. It was a suggestion, not an instruction to Salkas.
Salkas stated, that she was fine with dairy before she started her medication
As was I. My intolerance, and I DO have it, started after beginning Levo.
Is it likely that it is the small amount of lactose in the medication (although she has dairy otherwise) or could it be that the medicine she is taking could have caused her upset due to an excipient she may not tolerate;
Who knows that answer? Until you stop consuming whatever it is that doesn't agree with you, you won't know.
and the fact that the problems actually increased when she upped the dose would point in that direction.
May not be strictly true. Increasing the amount of Levo may not necessarily increase the amount of excipients in the tablets. (Will leave that to helvella.)
So the logical thing to try first would be to see if it IS the medication and then see if it could be something else.
As I said earlier, it's quicker and easier to experiment yourself rather than wait weeks for a GP appointment. If nothing changes, then you have something to tell the GP that is relevant when you DO manage to get an appointment.
I'm not looking to get into an argument, I'm trying to explain to Salkas my experience and to suggest something that may help him. I thought that's what people did on this forum. Shared experience and all that🙂
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