Medication for hypothyroidism
Hypothyroidism
"a term used to describe an under-active thyroid gland" can be manufactured by one company but distributed by another company, which means the name on the package might not be the same as the PIL information. The information below will state when medication for hypothyroidism is the same product from different companies (e.g. Northstar distribute a Teva 25mcg tablet and Accord own Actavis and Almus). This can be confusing but if you note down the ingredients for the product that suits you, you will always know which generic (non-branded) is best for you.
Some of the Patient Information Leaflets (PIL) have been obtained from the MHRA website.
Feedback on medication for hypothyroidism
Be aware that we have received feedback from people who are finding they have adverse reactions when they are given a different brand of levothyroxine
Levothyroxine
"a synthetic thyroid hormone commonly given to treat an under-active thyroid. It is also known as L-thyroxine" . We are also aware of at least two countries (France and New Zealand) where, as a result of pressure from thyroid patients and support organisations, the prescribing of specific brands has been stopped.
On checking it seems that lactose has been replaced by mannitol in some brands of medication for hypothyroidism and it appears that this may be what is causing the adverse reactions in some people.
If this happens to you, check the Patient Information Leaflet (PIL) first to see whether the ingredients in the new brand are different from your previous brand of medication for hypothyroidism. If so, ask your pharmacy to give you your usual brand and see if this helps.
You should always try to be aware of whether you have been given the same brand as usual and always check the PIL as the box may say one company but the PIL may say a different one.
If the new brand causes adverse reactions and it contains mannitol, then please fill out an MHRA (The Medicines and Healthcare products Regulatory Agency) Yellow Card as this informs the MHRA of any adverse effects in medication for hypothyroidism. If they receive a lot about one particular medication, they will investigate.
We have received comments from a couple of people who have used oral
Oral
"relating to the mouth" medications for hypothyroidism (both branded and compounded) that it didn’t seem to absorb as well as tablets. If this has happened to you, do let us know.
Levothyroxine sodium plus one filler (see below) – filler should be discussed with your doctor.
Notes
All the capsules are gelatin capsules and may contain a variety of fillers (see below) although they may not all be available. The doctor must write on the prescription the strength, quantity and which filler. The pharmacist must hold an account with Ethypharm.
· lactose · avicel cellulose · calcium
Calcium
"a mineral found in many foods. The body needs calcium to maintain strong bones and to carry out many important functions. Almost all calcium is stored in bones and teeth, where it supports their structure and hardness" carbonate · mannitol · calcium phosphate · calcium carbonate
Levothyroxine, olive oil, silica gel, cellulose, vitamin E acetate
Notes
A prescription medication that must state strength per ml of T4. 30mls of medication will have the required dosage calibrated to a 1ml dose. The shelf life is 30 days and the medication does not need to be refrigerated
The half-life of T3 is one to two days, so you would get the maximum benefit of this after two to three days and the duration of effectiveness is up to three days after stopping T3.
This only comes in 20mcg tablets, which generally need to be cut in half or quartered for use with thyroxine
Thyroxine
"the main hormone secreted into the bloodstream by the thyroid gland. It is the inactive form"
Liothyronine, olive oil, silica gel, cellulose, vitamin E acetate
Notes
A prescription medication that must state strength per ml of T3. 30mls of medication will have the required dosage calibrated to a 1ml dose. The shelf life is 30 days and the medication does not need to be refrigerated
Comes in 5mcg tablets, which some people find much easier. Pfizer has taken over King Pharmaceuticals. Note: We have been unable to confirm if King Pharmaceuticals have a TSE certificate which is required for import into the UK
Synthetic combinations are not generally available on the NHS in the UK unless you can persuade your GP to prescribe on a “named patient” basis. These may be available from a private doctor (although they usually prefer the natural thyroid). This product would be suitable for people who are allergic to pork and therefore can’t take any of the natural thyroid hormone products.
Roseway
Manufacturer
Roseway
Product Name
Compounded Levothyroxine plus Liothyronine Thyroid Suspension (Lactose-Free)
Levothyroxine, liothyronine, olive oil, silica gel, cellulose, vitamin E acetate
Notes
A prescription medication that must state strength per ml of T4 and/or T3. 30mls of medication will have the required dosage calibrated to a 1ml dose. The shelf life is 30 days and the medication does not need to be refrigerated
Thyroid tablets, USP (38 mcg levothyroxine (T4) and 9 mcg liothyronine (T3) per 60mg (1 grain) of thyroid), calcium stearate, dextrose, microcrystalline cellulose, sodium starch glycolate, opadry white
Details
Armour contains approximately 38mcg T4 and 9mcg T3 plus an X factor (something not yet understood). This means that patients taking Armour Thyroid are automatically getting T3 immediately into the system
Thyroid USP, colloidal silicon dioxide, dicalcium phosphate, lactose monohydrate*, magnesium stearate, microcrystalline cellulose, croscarmellose sodium, stearic acid, opadry II 85F19316 clear. * Present in a traceable amount as part of Thyroid USP (diluent).
Details
Nature-Throid® (Thyroid USP) tablets, micro-coated, easy to swallow with a reduced odour, for oral use are natural preparations derived from porcine thyroid glands (T3 liothyronine is approximately four times as potent as T4 levothyroxine on a microgram for microgram basis). They provide 38 mcg levothyroxine (T4) and 9 mcg liothyronine (T3) for each 65 mg (1 Grain) of the labelled content of thyroid
Thyroid USP, inulin, medium-chain triglycerides
Triglycerides
"a type of fat (lipid) found in your blood" , lactose monohydrate* *Present in a traceable amount as part of Thyroid USP (diluent)
Details
WP Thyroid tablets are natural preparations derived from porcine thyroid glands. (T3 liothyronine is approximately four times as potent as T4 levothyroxine on a microgram for microgram basis.) They provide 38 mcg levothyroxine (T4) and 9 mcg liothyronine (T3) for each 65 mg (1 Grain) of the labelled content of thyroid
38 mcg levothyroxine (T4) and 9 mcg liothyronine (T3) per grain of thyroid (or per 60 mg of the labelled amount of thyroid), calcium stearate, dextrose (agglomerated), mineral oil
Thyroid tablets, USP (35 mcg levothyroxine (T4) and 8 mcg liothyronine (T3) per 60mg (1 grain) of thyroid), desiccated thyroid containing lactose, derived from porcine thyroid glands, cornstarch, magnesium stearate, sugar, talc
Details
Gluten
Gluten
"a mixture of two proteins present in cereal grains, especially wheat, which is responsible for the elastic texture of dough" , paraben, sulfite and tartrazine-free
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