Update on levothyroxine brand

[Sunflower1-]

So after speaking to the pharmacist she is going to write on my prescription Teva if possible -i was told a brand cannot be stated as Teva Only due to what the pharmacy has in stock at that time-but I'm sure I have read if a person on levothyroxine is having side effects from certain brands that a brand can be named on the prescription,I could be wrong .I have narrowed it down to the fact I get tummy issues with lactose,so if Teva isn't given to me this time are there any other brands that do not contain lactose? Surely having tummy issues due to medication would be a cause not to prescribe it,it just doesn't make sense to me.

[Obsdian]

Your GP can write the brand name and lactose free in the first line of the prescription and the pharmacist has to order that one. Mine does, sometimes it takes up to two weeks to order so my GP writes the prescription with that in mind.

If lactose bothers you it's not reasonable to expect you to have it in your medication.

Vencamil also doesn't have lactose

[Sunflower1- in reply to Obsdian]

Yes im definitely going to speak to the doctor about it,as I dread finding out what I've been given,thinking to myself am I going to be going back and forth to the toilet for the next month or not(sorry if that sounds gross but thats the way it is).I would much rather no where I stand and be happy in my regime.Its funny that you replied because before I posted my post I replied to something you had written about hrt and how it can effect the thyroid and I think that's what im experiencing after an increase in gel estrogen.

[Obsdian in reply to Sunflower1-]

I am dairy free too and have the same lactose issues.

[Sunflower1- in reply to Obsdian]

Yes I gild the days I have milk,say oats in a morning that my stomach turns constantly and I have a lot more wind(sorry again).Do you think I could have broader issues?I do not eat cheese anyway or yogurt,the actual only dairy in my diet is milk and not all the time as I often just gave my oats with water now as I put lots of fruit and nuts with it so the milk isn't needed,come to think of it my mum only ever gave my goats milk,i thought it was due to my asthma (that's what she said( but I know as a child I had numerous allergy tests and numerous allergies to food,lots of E numbers ,animals /fur/dust but i don't actually know now everything i was allergic to,im wondering if I should retest myself or if there are tests you can buy.Do you know of any tests I could buy?

[Obsdian in reply to Sunflower1-]

I didn't have dairy consistently so that made it take me a few months to realize I had become intolerant. My symptoms were diarrhea, inhumane intestinal gurgling, and an crazy amount of wind. I decided to try eliminating it completely and after a month found that a lot of my muscle pains and random cramps went away too. That made it feel worth it for me.

To me, trying to eliminate it for 30 days is the easier test. If it doesn't solve your issues look into the other suspects.

I don't know of allergy tests you can buy but that doesn't mean they don't exist. I found the GP not willing to test allergies as they used to as well.

[Sunflower1- in reply to Obsdian]

Im going to try eliminating it which won't be hard as it's just the milk,then go from there but I've got a feeling I'm exactly like you.Can I ask what did you do when you realised hrt was causing issues with your levothyroxine/thyroid -did you just use less?and if so did it improve?thank you for all your help by the way.

[Obsdian in reply to Sunflower1-]

I just happened to have been trying out medichecks tests more often and discovered it that way. So, it's been a bit more preventative for me instead. I have been leaving a sort of safe gap if I want to change my hrt, so I am not necessarily aiming for my tsh and t4 to be where I want them as I know sometimes ao need to lowery hrt and that might make t4 rise and tsh drop.

Online I read you should retest thyroid hormones 6 weeks after adjusting hrt.

[Jingley in reply to Sunflower1-]

If you want to eliminate milk totally, make sure you read the backs of any pre-prepared foods you buy. There's milk in lots of things you wouldn't think. 😲 Even some breads.

I was the same as Obsdian with the gurgling and wind. I only had an upset tum if I had a dairy heavy meal. I was one of the smaller percentage people who had constipation rather than diarrhea.

[Joant24 in reply to Sunflower1-]

I am similar to you and use lactose free milk readily available in all large supermarkets, Arla make the best one.

[SlowDragon Ambassador]

Lactose free brands - currently Vencamil or Teva ONLY

GP should write on all future prescriptions

Lactose free levothyroxine only

Vencamil is lactose free and mannitol free. originally only available as 100mcg only, but 25mcg, 50mcg and 75mcg tablets became available Sept 2024

Prior to March 2023 Vencamil was called Aristo

Vencamil often very well tolerated/best option for many people

How to get Vencamil stocked at your local pharmacy

healthunlocked.com/thyroidu...

Posts discussing Vencamil

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu....

Teva makes 12.5mcg 25mcg, 50mcg, 75mcg and 100mcg

Many patients do NOT get on well with Teva brand of Levothyroxine ….but others like yourself find it the best option

Teva is lactose free, but contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol can upset some people, it changes gut biome

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

healthunlocked.com/thyroidu...

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you always need TSH, FT4 and FT3 tested together

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

[Sunflower1- in reply to SlowDragon]

Thank you so much for all the information you have provided.So with what you have said I should really be talking to the doctor and not the pharmacist?I usually talk to her over a phone consultation as it is often easier/quicker to speak to her rather than a doctor and she has the ability to change it add new medications if needed and I often do not feel as rushed when talking to her so I can explain myself better- and I find her knowledge on the thyroid is exceptional,I'm not saying the doctor is not knowledgeable it's just that she is the only one who has ever talked about T3,reverse, antibodies ect ect and the fact that doctors do not test these ,and all sorts of other information,it's like talking to say yourself but someone in person if you know what i mean.So I've got to order my prescription in a week and if the pharmacy ignore what is written then i should make an appointment with my doctor.

[SlowDragon Ambassador in reply to Sunflower1-]

Print out the government guidelines to show them

And then discuss with pharmacist - request all future prescriptions state LACTOSE FREE levothyroxine only

If she can’t do that, then send polite message (email or letter) to GP requesting they add note to all future prescriptions

[helvella Administrator]

My UK document has a section on how to write prescriptions (Appendix F). And details the ingredients of all UK thyroid hormone medicines.

Writing "Lactose-free" is probably not much good as most doctors and pharmacists would not know which products contain lactose, and which do not.

helvella - Thyroid Hormone Medicines - UK

The UK document contains:

Up-to-date versions of the Summary Matrixes for levothyroxine tablets, oral solutions and liothyronine available in the UK. These include declared ingredients for all UK-licensed products.

Details of every dosage of each medicine include PL numbers, PIP numbers, tablet markings, product history and links to:

Patient Information Leaflets

Summary of Product Characteristics

Product Assessment Reports

Dictionary of Medicines and Devices (dm+d) entry and current prices

Document has links to:

British National Formulary

NHS Drug Tariff, etc.

PLUS how to write prescriptions in Appendix F.

Also includes links for anti-thyroid medicines (but not product details).

Direct link to PDF:

📄 dropbox.com/s/bo2jzxucgp9hl...

Blog last updated 02/02/2025 - documents are regularly updated

Link to blog:

helvella.blogspot.com/p/hel...