Tablet size is there other options?

[sarahellen]

last question have been really helpful so here is another. I have increased my dose up to 187.5 but have to break a tablet in haalf. Does Levothyroxine come in any smaller sizes than 25? Also does the dose you take depend on your size or how active you are.?

I cant beleive i have found somewhere where i can get answers from peolpe who know what they are talking about, thanks Sarah

[helvella Administrator]

So far as I know, the only tablets available in the UK are 25, 50 and 100. (Even internationally, I don't remember 12.5 mcg tablets. but the US does specialise in lots of tablet sizes allowing many people to have just one tablet a day.)

If you have not yet got one, buy a cheap pill splitter (available in most pharmacies).

Some people do alternate day dosing - e.g. 175 one day, 200 the next. But others find this unacceptable. Indeed people do lots of interesting patterns such as a big drop one day a week, or an extra tablet every so often.

Be aware - 25 mcg tablets are often a different formulation to the 50 and 100 tablets - even with the same branding.

Basic requirement is often calculated based on weight. You have to take into account a lot of other factors including environmental temperature, activity, foods, and so on.

All the best

Rod

[sarahellen in reply to helvella]

thanks Rod thats really helpful.x

[LouiseRoberts]

Hi Sarah

25 is the smallest for Levo, you can get pill cutters though like these:

chemistdirect.co.uk/pillmat...

I have found this information in a BMj article:

Levothyroxine replacement dose is related to body mass; a daily dose of about 1.6 µg levothyroxine/kg body mass is adequate replacement for most adults (equivalent to 100 µg daily or 125 µg daily for an average size woman or man, respectively)

xx

[sarahellen in reply to LouiseRoberts]

thanks for the info have now purchased apill cutter.x

[nanniejan in reply to LouiseRoberts]

They will cut them for you in the chemist if you ask ,but it also comes in liquid form the chemist told me so you could ask next time you see the doctor.

xx Jan xx

[helvella Administrator in reply to LouiseRoberts]

Liquid form, Evotrox, is expensive and is awkward to measure out. It is almost certainly easier to split tablets!

Rod

[nanniejan in reply to LouiseRoberts]

boots told me the cost is nothing and that its easier to measure out than cutting tablets, I cut mine this month I have to cut my T3 into 4 as they only come in 20 mcg and I only take 5 ,and they are hard to cut and like when the chemist do them they are all different sizes,so ask the chemist and make your own mind up !!!

[helvella Administrator in reply to LouiseRoberts]

Well, if you were on 100 mcg a day, then as tablets that would cost around £1.17 for a 28 day supply. As liquid that would be £73.85. Around 63 times the cost.

I rate that as expensive. Anyone disagree?

Sure, the cost doesn't come out of your own pocket if you have the 'free' prescription certificate. But the money does actually come from us.

And as for measuring Evotrox, it is a thick sticky gloop. It is categorically not easy to measure out accurately. You would probably do best with one of the syringes sold for the purpose but in any case you have washing up to do. I guarantee it is quicker to split a tablet than to handle Evotrox and I doubt it is any less accurate. (Though I do admit that some tablets split more readily than others.)

And I would most certainly agree that splitting into four is more difficult. Seems mad to me that we do not have 5 mcg T3 tablets as are available in the US.

Below is a short extract on levothyroxine costs from the BNF:

Tablets, levothyroxine sodium 25 micrograms, net price 28-tab pack = £2.42; 50 micrograms, 28-tab pack = £1.16; 100 micrograms, 28-tab pack = £1.17

Brands include Eltroxin®

Oral solution, levothyroxine sodium 25 micrograms/5 mL, net price 100 mL = £42.75; 50 micrograms/5 mL, 100 mL = £44.90; 100 micrograms/5 mL, 100 mL = £52.75

Brands include Evotrox® (sugar-free)

Rod

[nanniejan in reply to LouiseRoberts]

Well can I say the pharmacist in boots told me the cost is minimal and I can only go with what I have been told by the man I thought should be in the know !!!

[Chippysue in reply to LouiseRoberts]

I member on another forum has been supplied with 5mcg size tablets of T3 in the UK.

This weight to thyroid med dose doesn't sound right to me. I have a friend who is still taking exactly the same amount of thyroid meds i.e. 100mcgs of levothyroxine and 60mcgs of T3 (and is very well) as she did before losing a whopping 8.5 stones!

[helvella Administrator in reply to LouiseRoberts]

Must admit to being surprised at that Suze. The entry in BNF says:

Liothyronine sodium (Goldshield) Prescription-only medicine

Tablets, scored, liothyronine sodium 20 micrograms, net price 28-tab pack = £26.15

And no other dosages. That other person isn't being given special import Cytomel, are they?

If you look around you see people saying anything from 1.6 to around 2.3 mcg of thyroxine per kilogram. This assumes good absorption. And it is sometimes qualified as "per kilogram of lean body mass". If that is true, then losing fat would not imply a significant dose reduction. But it is curious that the authors of the various documents only sometimes say that, meaning, of course, that sometimes they do not.

Further, that is just an indication of the minimum required to provide full replacement. Other factors could increase that requirement,

Rod

[Angela in reply to LouiseRoberts]

i think your right Suze think it depends on how well the thyroid is working ???????????