Accord Levothyroxine 100mcg Lot XTC1809

[thyreoidea]

Hi All, I am using the 2nd blister strip out of a particular box of Accord 100mcg Levothyroxine which is actually boxed as Accord. I am only into the 3rd tablet but every morning whilst using this blister strip I get mild indigestion type discomfort low down on the left side which passes on its own just before breakfast which I leave until 1 hour after taking it.

Is this just a coincidence or is it likely that particular blister strip with the same lot number and date as the other one in a pack may be different or is it me and my digestion system, as anyone else experienced something similar to this?

The batch in question is;

Accord 100mcg

Lot: XTC1809

Exp: 09/2026

My dose is 100mcg daily so no other tablet is involved.

[SlowDragon Administrator]

100mcg is a low dose for a bloke

Gutted issues common when on inadequate dose Levo

How much do you weigh in kilo

When were thyroid and vitamin levels lasted tested

Saw you recently prescribed loading dose vitamin D

Are you now taking vitamin D mouth spray and separate magnesium in afternoon or evening (at least 4 hours away from levothyroxine)

What other vitamin supplements are you taking

[RedApple in reply to SlowDragon]

'100mcg is a low dose for a bloke'

Being male does not, of itself, imply anything whatsoever about the amount of replacement thyroid hormone an individual requires. People come in all shapes and sizes!

[helvella in reply to RedApple]

It was years before I needed to increase my own levothyroxine dose above 100 micrograms. Despite being a substantial male! That worked out at well under 1.6 micrograms per kilogram for me. Even now, on a dose of 125, it is still under 1.6 micrograms per kilogram.

There is also an interesting skew that needs to be considered.

If you look at estimating on the basis of 1.6 micrograms per kilogram, you could just look at average (mean) weights of adult males and females, and would see that about 50% of females would need less than 100 or less. But so too would about 10% of males.

However, the lowest weight group from the statistics I used (Health Survey for England, NHS Digital) are those 16 to 24 years old. Who I think would also have the lowest rate of diagnosed hypothyroidism. Hence using the means of the adult population is probably inappropriate.

If you look at each age band separately, the doses required would vary from about 120 to 140 for males. And 100 to 120 for females. The difference between males and females, adjusted to age band, being about 20 micrograms.

That is, not even the next dose up or down (on the basis that doses are rarely adjusted by less than 25 micrograms a day).

But the difference between a person at the lighter and heavier ends of the scale would trounce these calculations based on population averages - even when age-banded.

(Arithmetic is very approximate.)

[thyreoidea in reply to SlowDragon]

My weight at present is around 15 stone 210 lbs or 95.5kg

[RedApple]

' is it likely that particular blister strip with the same lot number and date as the other one in a pack may be different'

Very unlikely that tablets from the same batch could be different.

' I am only into the 3rd tablet '

Too soon to be sure of anything really.

'is it me and my digestion system'

Yes, this is more likely. If this symptom continues for a few more days, then consider other possibilities, such as any recent changes to your diet, any changes to supplements you take. Could even be that your dose of levothyroxine is no longer right for you.

[thyreoidea in reply to RedApple]

Thank you for your reply.

As I have always taken my Levothyroxine early morning and having blood tests mid morning in keep to that routine. My last blood test in March was 0.68 range 0.3 - 4.2

[RedApple in reply to thyreoidea]

TSH 0.68 range 0.3 - 4.2 seems acceptible, although a full test to include FT4 and FT3 would give a clearer picture.

[thyreoidea in reply to RedApple]

Unfortunately never had T3 tested, last time T4 was tested was in 2022

It always states on my records from the NHS pathology lab that if the GP wants T4 tested they have to request it in 5 or 7 days cannot remember which.

T4 17.8. 12.0. - 22.00

TSH 0.21 0.3 - 4.2

[SlowDragon Administrator in reply to thyreoidea]

Obviously it’s essential to test Ft4 and Ft3

[thyreoidea in reply to RedApple]

Thank for replying.

Have an enjoyable Easter.

[SlowDragon Administrator]

Looking at previous posts

You were originally on 150mcg levothyroxine 3 years ago

Reduced to 125mcg

Now on 100mcg

ESSENTIAL to test and maintain GOOD vitamin levels

When dose levothyroxine is reduced lower vitamin levels are more likely

Previous high ferritin levels of over 1000

Were you assessed for haemochromatosis?

Are you still on omeprazole or prednisolone or propranolol

[thyreoidea in reply to SlowDragon]

Thank you for your reply. You are correct, 3 years ago I was taking my 150mcg with my morning cup of tea, breakfast and Omeprazole, all together. When I developed ectopic heartbeats in the first lockdown and without anyone taking it seriously I started to try to work out what could be causing them. I realised that I should have been take the Levo 1 hour on an empty stomach and certainly no where near the Omeprazole.

My TSH went down so managed to reduce dose accordingly.

After my loading dose of Vitamin D my level rose to 72 from 38, I now take 10mcg Boots or Tescos Vitamin D daly at lunchtime.

My ferritin is 205 range 30-400

Magnesium 0.96 Range 0.7 -1.0

My ferritin was very high before I was treated for AIHA Auto immune Haemolytic Anaemia which raises it.

I take Omeprazole when necessary but 4 hours away from Levothyroxine.

[SlowDragon Administrator in reply to thyreoidea]

Suggest you get FULL thyroid and vitamin testing see where your thyroid and vitamin levels are

Last dose levothyroxine should be 24 hours before test

Test ideally before 9am only drinking water between waking and test

Are you taking any B12 or B complex

Vitamin D aim to maintain at least over 80nmol minimum

Are you still taking any steroids? Because on any steroids TSH is especially unreliable

[thyreoidea in reply to SlowDragon]

No steroids at present as have been in remission since 2023 thank heavens.

I only take 5mg of Folic acid once a week to maintain my blood levels, last values in March were;

Folic acid 19.5 >3

B12 464 197 - 771

I have always taken my dose of Levothyroxine early morning before mid morning blood test so have stuck to it. I have been lucky as when diagnosed due to ectopic heartbeats as the only symptom which had disappeared a few days after rearing their head in 2006 before treatment have never had what I can say are any other symptoms that could only be related to my thyroid.

TPO on diagnosis was 539.6 range 0.0 - 30.0

TSH 7.61 0.3 - 4.2

T4 13.8. 12.0 - 22.00

I think I will catrry on taking 10mcg of Vitamin even in the summer months when spending time outdoors to maintain levels and maybe raise them slightly as I wears sunscreen.

[SlowDragon Administrator in reply to thyreoidea]

B12 aim to maintain over 500

Rather than just a folate supplement, a vitamin B complex would also maintain 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.

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.

TSH will be lower mid morning than testing before 9am

Ft4 will be a lot higher if tested after taking levothyroxine

At least test once BEFORE taking morning dose of levothyroxine to see what difference it makes

[thyreoidea in reply to SlowDragon]

Thank you, I will give a go on next blood test if it is close to the last one to compare results.

regarding supplements, as I have a rare blood disorder I try to stay away from anything that I cannot discuss with my haematologist or GP but good to know what to ask about.

Have an enjoyable Easter.

[helvella]

Whatever anyone here has said in reply, always remember that if you suspect an issue with the medicine you are taking, you can, and likely should, file a Yellow Card report.

The MHRA sees all the reports and can apply their processes to decide whether or not they think there is an issue.

It is better to make a well-intentioned report than not do so and possibly see an issue get missed. This applies even if, ultimately, it proves not to be supported by investigation.

[thyreoidea in reply to helvella]

Thank you, will consider it.

Have an enjoyable Easter.