75mcg Levothyroxine pills not TEVA!

[Flower7777]

I've been prescribed 75mcg Levo but my local pharmacy says they can only get Teva. They say even if the GP specifies a brand they wouldn't be able to order it. I've called a few pharmacies locally and they say they just order Levothyroxine and get what they are given. How can I get round this as Teva makes me feel ill? Which other manufacturers can I realistically get? And how?! My GP isn't overly helpful so I need to make it easy for him. I don't really want to take 50 + 25 as I'm rubbish at taking pills so want to only take one. Thanks

[SlowDragon Administrator]

until recently Teva was the ONLY brand that made 75mcg tablets

Now there’s Vencamil in 75mcg

Also Crescent available in 75mcg

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 prescription written for Vencamil

healthunlocked.com/thyroidu...

How to get Vencamil stocked at your local pharmacy

healthunlocked.com/thyroidu...

Posts discussing Vencamil

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu....

July 2024

Crescent levothyroxine. Dosages: 12.5, 25, 50, 75, 100

(Not yet known if all approved dosages are or will be available).

Excipients: lactose monohydrate, maize starch, croscarmellose sodium, gelatin and magnesium stearate.

[SlowDragon Administrator]

I don't really want to take 50 + 25 as I'm rubbish at taking pills so want to only take one.

How long have you been on just 75mcg

That’s only one step up from standard starter dose, unless very petite, most people will eventually need at least 100mcg daily

Get FULL thyroid and vitamin testing 2-3 months after each increase

And again 2-3 months later

you need TSH, FT4 and FT3 tested

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

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Only do private testing early Monday or Tuesday morning.

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

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

[Flower7777 in reply to SlowDragon]

I’ve done all that. I went up to 100mcg but it was making me anxious and have heart palpitations. I’m sub clinical. Back down to 75mcg even though that wasn’t enough (TSH was 3.5 on 75mcg). There is an issue that my GP doesn’t think I should be on medication so doesn’t want to help. I saw an endocrinologist privately in the summer who supported me at the time. He is away but his secretary said he said to reduce to 75mcg now. Most of my vitamins are low but he said that shouldn’t matter. He told her my symptoms aren’t related to my thyroid. On 100mcg my TSH was 0.1. T4 was 150% through the range. T3 was 14% through the range. I asked if I was having a problem converting from T4 to T3. He said the T3 test isn’t reliable and I should reduce to 75mcg. In the last few months everything has ached. I’m really stiff. I can’t lie down without it hurting. My shoulder hurts so badly I ended up at minor injuries but they were interested. There have been nights where I have been awake all night as I can’t sleep. I also have psoriatic arthritis so it could be that but I can’t get an appointment with my rheumatologist till June. My GP told me to speak to my endocrinologist and put the phone down. I feel like no one will help right now. My son is freaking out because I can barely move and he thinks there’s something really wrong with me. I’m beginning to wonder the same.

[Flower7777 in reply to Flower7777]

But the good news is that my hair has stopped falling out as much…

[Kerry124 in reply to Flower7777]

That’s terrible to put the phone down on you. I think if you get your vitamins at an optimal level you will feel better Your vitamins need to be optimal so the Levothyroxine will work. I hope this helps you.

[SlowDragon Administrator in reply to Flower7777]

So your hypothyroidism is autoimmune

It’s absolutely ESSENTIAL to test and maintain GOOD vitamin levels for good conversion of Ft4 to Ft3

So first steps are to improve vitamin levels

Most of my vitamins are low

How long ago were these tests done

Please add actual results and ranges

Exactly what vitamin supplements are you taking

You may need to increase dose in smaller steps

Eg 75mcg and 100mcg alternate days

or 100mcg 2 days a week initially

Get a weekly pill dispenser so it’s easy to remember

Retest thyroid levels 6-8 weeks after each dose change or brand change in Levo

Test vitamin D twice year

Test folate, ferritin and B12 at least annually, more frequently if low and working on improving

Aiming for

Vitamin D at least over 80nmol

Folate at top of range

Serum B12 over 500

Active B12 over 70

Ferritin at least over 80

My shoulder hurts so badly I ended up at minor injuries

Sounds like frozen shoulder?

Very common with thyroid

See physio for graded exercise program

[Flower7777 in reply to SlowDragon]

my antibodies were negative but the Endo said he’s sure it’s autoimmune as I also have psoriatic arthritis. I’ve also included results from July before I started on Levo.

Bloods from March

[SlowDragon Administrator in reply to Flower7777]

So B12, folate very low

Vitamin D fairly low

Get vitamin D retested now

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

Suggest you start back on vitamin supplements starting with B12

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement

A week later add a separate vitamin B Complex 

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

In-depth article on different forms of B12

perniciousanemia.org/b12/fo...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

perniciousanemia.org/b12/le...

And why aiming to keep B12 over 500 recommended

perniciousanemia.org/b12/le...

Great reply by @humanbean on B12 here

healthunlocked.com/thyroidu...

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

B vitamins best taken after breakfast

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need 2 per day and/or may need separate methyl folate couple times a week

Post discussing different B complex

healthunlocked.com/thyroidu...

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endocrinenews.endocrine.org...

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 if last test result serum B12 was below 500 or active B12 (private test) under 70

[SlowDragon Administrator in reply to Flower7777]

no ferritin result?

Once you get vitamin D result

Improve and then maintain at least over 80nmol and 100-125nmol may be better

around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly when supplementing

Can test via NHS private testing service

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

NHS Guidelines on dose vitamin D required

panmerseyapc.nhs.uk/media/2...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Recipe ideas

bbc.co.uk/food/articles/mag...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[SlowDragon Administrator in reply to Flower7777]

my antibodies were negative but the Endo said he’s sure it’s autoimmune as I also have psoriatic arthritis.

Agreed

Have you had BOTH TPO and TG antibodies tested

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

NHS only tests TG antibodies if TPO are high

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

Gluten intolerance is often a hidden issue too.

Request coeliac blood test BEFORE considering trial on strictly gluten free diet

[Flower7777 in reply to SlowDragon]

Thanks. I’m taking supplements now so let’s see. There’s no ferritin because I forgot to ask for that one when I was with my GP. He didn’t want to do the ones I had. He said Vit D isn’t relevant so I had to insist. I’ve asked for ferritin but I’m not sure he will be willing to do them all again and I can’t afford to keep buying tests privately. So I’m just hoping things will improve with what I’m doing. If not I have no idea where to go next.

[Flower7777 in reply to SlowDragon]

also, yes to both types of antibodies. I got a test done by Randox. Both negative. There’s no chance my GP will agree to an ultrasound 😂. He doesn’t even think I should be on Levothyroxine!

[Flower7777 in reply to SlowDragon]

could be a frozen shoulder, I’ve had one before. But I’m stiff all over. My back is bad. My fingers are sore. My ribs in general feel sore. When I stand up everything hurts badly for a few seconds. I haven’t get up very slowly and stand still till the pain goes.

[Flower7777]

I started taking vitamin supplements a week ago. No improvement yet…

[SlowDragon Administrator in reply to Flower7777]

Exactly what are you taking

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

[Flower7777 in reply to SlowDragon]

I take my Levothyroxine first thing. Vitamins (wellwomsn gummies for all round (I can’t take big pills or capsules) , also have Vit D & K2, Vit b12) at lunchtime. I’ve bought some folate too. I take sulfasalazine for my arthritis at lunch and dinner.

[SlowDragon Administrator in reply to Flower7777]

How much vitamin D

You need a good quality vitamin B complex, rather than just folate

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need 2 per day and/or may need separate folate couple times a week

Post discussing different B complex

healthunlocked.com/thyroidu...

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endocrinenews.endocrine.org...

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 if last test result serum B12 was below 500 or active B12 (private test) under 70

[bikebabe]

The pharmacist go on what’s available and within the cost envelope as govt hasn’t increased levies. You said you only wanted one pill but you may need to flexible to get the right dose for you. Could you ask your GP for alternative75mcg and improve your vitamins as slow dragon said. If that doesn’t help as much as you need, slowly increase t4 to 87.5 with a pill cutter on a 25mcg tab to help body adjust to higher dose without such overt symptoms. maybe on alternate days - and see how you feel.

[GrannyCe]

I had exactly the same experience. It took persistence and insistence and trying difference pharmacies, but I finally got one to source Vencamil. If you can get the brand you want in 50 + 25, you might want to do that and try again for 75 next time.

[Lulu2607]

Hi Flower7777 I've found my local Boots pharmacy are quite good at sourcing the right brands of levo for you and I always check what's in the bag before leaving the shop . You may need to insist if you have a bad reaction to a particular brand as that is quite serious. I take 50 + 25. It's no big deal and also allows for flexibility as I alternate with a 50 + 12.5. in my current bid to find my ideal dose. I've also found optimal vitamin levels are crucially important if you are to get the best results from the levo. There's a lot to learn but there's lots of advice on this site too.