Excipients that irritate gut?

[GreenTealSeal_]

I know mannitol is a big one and interestingly looking back at the last year I feel like things worsened further when I was switched to this and I def had more gut issues. But maybe this was just cos the dose was higher and the higher the dose the worse I struggle with side effects.

Are there any problematic excipients known in liquid levo? This was pretty bad for me too but in a different way (it felt like burning in my throat and stomach everytime I took it)

Any other excipients that need to be looked out for?

Was just wondering if my histamine issues are linked to something in the excipients upsetting me and throwing off my gut function.

Do NHS offer specially compounded levo if you have issues?

Can you specify a brand? Gp said before they could not do that.

Thanks

GTS

[helvella Administrator]

The ingredients of all the liquid products are very similar to each other - though some members do find they're different in tolerability.

The big problem with excipients is that mostly we are into guesswork. We can be convinced that a particular excipient is a problem but later realise it was something else! To make it personal, I do not believe I have lactose intolerance, but definitely prefer lactose-free levothyroxine! But I don't know with any certainty why this is the case.

The main excipients suspected in UK tablet formulations are lactose, mannitol and acacia. But that does NOT mean everything else is beyond suspicion.

All except Aristo Vencamil and Glenmark contain at least one of these. And Glenmark is currently unavailable.

My UK document lists every excipient in every UK formulation.

Makes can be specified. See Appendix F of my UK document. But it takes effort. Theoretically it should be easier to specify the two "brands" - Eltroxin and Vencamil - because they should be listed in the prescribing systems. Specifying any of the generics might require the surgery to add them to their prescribing systems. (Assuming hand-written are not possible.)

Specials are possible. But there are issues of costs and very short life (typically an official Use by of 28 days). And getting any doctor to believe you need one.

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The UK document contains up-to-date versions of the Summary Matrixes for levothyroxine tablets, oral solutions and liothyronine available in the UK. Includes injectables and descriptions of tablet markings which allow identification. Latest updates include all declared ingredients for all UK-licensed products and links to Patient Information Leaflets, Dictionary of Medicines and Devices (dm+d), British National Formulary, NHS Drug Tariff, etc. PLUS how to write prescriptions in Appendix F.

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helvella - Excipients

Details of excipients are in my Excipients document. This includes all excipients identified in UK-licensed thyroid hormone medicines.

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