As per title, I collected my script earlier today, saw the packaging was different, and didn't really think much of it - because it seems to happen quite a lot with my other meds - until I popped out some pills to put into my dispenser. They're much larger than what I'm used to, so did a quick Google and found the main difference is that Wockhardt contains lactose and Teva contains mannitol. Never heard of the latter before, so did a search and WOW, there's a lot of controversial stuff about it online (from the major issues in France, to the UK government outright banning it and then reinstating it a few years ago).
I'm aware that everyone reacts differently to different meds, but just wondering if I should go back to my pharmacist and ask for the old brand or give this one a go? Some have reported actually feeling better on it - something I've never really noticed on Wockhardt (I don't feel better, but I don't feel worse, either). I've just had a lot of crap with medications not agreeing with me over the years, and I'm headed down under for a 2 week break in January and don't want to be feeling worse than I currently do because of Teva. My kidney function isn't great (currently around 70) and as mannitol is sold as a diuretic, I'm actually a bit concerned I may start losing too much water. There's also the issue with palpitations due to salt/mineral imbalances, and as I already have a heart issue...
Thoughts? Advice?
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NotAllWhoWonder
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Many people dont get on with Teva brand but equally there are others that love it. Its very marmite.
In future your GP can write the brand of Levo you prefer in the first line of the prescription so you always get the same brand you prefer. Either that or switch to Vencamil which again is written in a way they can only give you that brand. Its lactose & mannitol free which suits many.
Have you tested key vitamin levels and now supplementing to optimal levels?
Been on the 25mcg for about a year now. Getting vitamin levels tested, etc, from my GP is a PITA, but everything last time I managed to get it done was "within range". Went for bloods last week to check TSH (even though I asked for it, they apparently don't do T4 unless TSH is an issue, and definitely won't ever do T3 because of the cost).
What exactly were your last test results and ranges BEFORE starting on Levo
And at last test
Standard STARTER dose Levo is 50mcg
Having been left on only half the standard starter dose vitamin levels likely low
Low vitamin levels will tend to lower TSH, making it harder to get dose Levo increases
Guidelines of dose Levo by weight
approx how much do you weigh in kilo
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)
Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day. This may be increased gradually over a few weeks to between 100 micrograms and 200 micrograms taken once a day.
Some people need a bit less than guidelines, some a bit more
TSH should be under 2 as an absolute maximum when on levothyroxine
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
25mcgs is just a starter dose. If you're male then likely you need far more than that.
Theres a rough calculation to work out approx how much you might need.
1.6 x weight in kilos = approx final dose of Levo.
Suggest you push your GP for an increase on a 'trial' basis which often goes down better. You can point out that the calculation I have given is used as a guide in the NICE guidelines.
If one GP refuses then dont give up, keep trying different GPs.
Always book blood test for 9am or earlier when TSH is highest. Fast before the test and take Levo that day AFTER he test, to allow 24hrs between last dose of Levo & test. Stop any biotin comtaining supplement 4-7 days before the test.
Do you have a copy of the vitamin results? You are legally entitled to a printed copy of your results, ask at GP reception. In England you can get the NHS app and ask for permission to see your blood results on that by asking at GP’s reception.
Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...
There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
Only do private tests on a Monday or Tuesday to avoid postal delays.
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Monitor My Health (NHS private test service) offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12
Post discussing how biotin can affect test results
Right, so I've decided I'm probably going to have to go for private blood tests to get everything I need to make an informed decision. This one (onedaytests.com/products/ul... looks quite decent so will start there.
Re: Teva, should I just see how I get on with it?
Edit: and where to after my blood work, as the general consensus appears to be that the NHS is clueless?
You can use the code HEALTHY10 for One day tests to get 10% off that price.
Follow the preparation instructions carefully for a finger prick test.
See how you go ith the Teva. You should know within a few weeks if its having any adverse effects. That said, you are likely very hypo on only 25mcgs Levo so unwanted effects sometimes can be related to being hypo.
Good morning, just thought I would send a quick reply as I was changed from Accord to Teva a few months ago and they do not agree with me at all. The palpitations have been debilitating along with headaches and dizzy spells. I have stopped taking them and currently waiting to pick up a new prescription for Accord. As soon as I stopped taking them, the palpitations subsided so it must have been the medication. Just thought I would share my experience but obviously everybody is different.
To be honest with you, it must have been a few weeks as I didn’t connect everything to the change of medication until fairly recently. I knew I hadn’t felt well for a few months with the palpitations etc but I read something on this forum about Teva and it all made sense. I spoke to the pharmacist on Monday about changing brand and explained what side-effects I’m having and she confirmed that a lot of people have said the same thing. I have now reported my issues on the yellow card website, as advised on this site. Good luck with everything, hope you get sorted.
Recently I was given Teva instead of my normal Accord. I took them briefly and did not feel good. I went back to the pharmacy which is inside my doctor's surgery and just asked to go back to Accord. They did this immediately and made a note on my record to keep me on Accord. I feel fine now.
Only been a few hours, but no adverse side effects on Teva (yet), so fingers crossed. Of course, could be a while before any present, but so far so good?
Question regarding dosage changes: recall reading here that TSH is not the be all and end all for determining whether or not my dosage needs to change, and that the main ones are FT3 and FT4. Problem is that GPs tend to only use TSH, so if my TSH reading comes back as "within range", but my private blood work shows that FT3 and FT4 aren't, do I just tell my GP and hope he does the right thing?
Also, re: TSH as the measure for dosage, I found this today, which assumes that's correct:
In my previous post, I mention going off levo because I suddenly started feeling crap, and bloods revealed my TSH was 0.19, and the link I posted saying the "goal" is between 0.5 and 2.5. I of course started taking it again because I felt I was going to do my self a disservice over the long run if I didn't. But, just how easy is it to overmedicate? I know it's a not a medicine, but no other word fits.
That approach of making TSH more important than EVERYTHING else is why we have so many problems.
There are at least dozens of reasons TSH doesn't always reflect how well we are. And this:
In most patients on thyroxine replacement, the goal TSH level is between 0.5 to 2.5 mU/L.
Is terrible. It gets read as every person having a TSH anywhere between 0.5 and 2.5 is fine. Whereas the difference between TSH at, say, 1.0 and even 2.0 can be significant.
That’s generally been my experience with the NHS to date, actually. Was dead tired all the time, and went for bloods to check my ferritin, around the same time as they first did my thyroid. Reading was in the 20’s (NHS guideline is >30 is “normal”). Took some OTC iron supplements and it went to the mid-30’s, and I still felt flat, but they just left it at that because I was “within range”. I’m a cardiac patient so my ferritin needs to be >100, but I struggle to get it that high, most likely because my thyroid is borked.
So, the NHS will, for just about everything, try and get you “within range” (which can be HUGE, using ferritin as an example it’s 30-300), and then that’s it.
Personally I'd be going back to mention concerns. But the best way is to get your GP to specify brand. I've been on Wockhardt all the way from 25 to the 75mcg I now take daily. So I take 3X 35mcg every day because Wockhardt only make that dose for levothyroxine.
Update: started feeling quite out of it and weird all of Thursday, so rang the pharmacy on Friday morning and she gladly swapped out the Teva for Wockhardt, and also put a note on my file to make it my preferred brand.
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Question to those of you on Euthyrox
Can't decide which brand to continue with. Started with Wockhardt, followed by Actavis
New levothyroxin making me sick
Side effects of Teva brand
