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Trouble Switching between Generic Levothyroxine Brands

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Q. I have taken levothyroxine for several years but my insurance keeps changing the brand (from Synthroid to Levothroid to several generics). I have had progressively deteriorating hypothyroid symptoms (weight gain, fatigue, muddled thinking, high cholesterol, low sex drive, constipation, brittle nails and painful joints).

Where can I find the information I need to convince my doctor I need a better approach? I did well on Armour Thyroid years ago when I was first diagnosed, but my current doctor doesn't like it.

A. Although the FDA has approved many generic levothyroxine products as bioidentical to Synthroid or Levothroid, physicians and patients report that not all generic products seem to be identical to each other.

A person taking generic levothyroxine might need to have the dose re-calibrated every time a different generic was dispensed. Because this requires blood tests and a doctor visit, the insurance company's savings from the generic could be wiped out.

We are sending you our Guide to Thyroid Hormones, with a discussion of Armour Thyroid as well as the finer points of adjusting the dose of levothyroxine. After shortages that had many patients frantic, the company that makes Armour Thyroid reports that it is once again shipping common dosages.

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I used thyroid meds since the early 1960's; had used synthetics with little success; then I got Armour; wonderfully effective; then, when I could not get it any more I was put onto synthroid; arggggggg. Hair loss; weight gain; thin nails; dry skin; tiredness; morning hoarseness and the last tsh showed normal; my doctor will not put me back on the REformulated ARMOUR.

We pay for brand name Rx out of pocket; I asked the pharmacist if I would be able to get a month of generic and a month of synthroid and alternate daily... etc. to save money (SINCE THE GOVERNMENT SAYS generics are identical; LOL) she said an emphatic, "NO!" then said something like, "They are not abc" or something like that a-c something like that; I asked her what she meant and she said that generic thyroid meds do not work the same as synthroid and they are not compatible and she refused to let me get both and do that to save money; she was emphatic about the fact that they are not the same and did not work the same... hmmmmmm. I hate synthroid but to try to get back on ARMOUR means blood tests every two months for a long time and that costs $$$$$$$$! we pay for office calls.

PEOPLE'S PHARMACY RESPONSE: FDA HAS APPROVED THE GENERICS AS "BIOEQUIVALENT" BUT MOST HEALTH CARE PROVIDERS DON'T CONSIDER THEM COMPLETELY INTERCHANGEABLE. YOU COULD USE THE GENERIC LEVOTHYROXINE COMPLETELY, BUT YOU WOULD NEED TO HAVE THE DOSE ADJUSTED WHEN YOU STARTED AND YOU WOULD NEED TO STAY ON THE SAME GENERIC AND NOT SWITCH MANUFACTURERS.

I take synthroid and have also had weight gain, hair loss, constipation, etc., etc.
What is "Armour"? I've never heard of it.

PEOPLE'S PHARMACY RESPONSE: ARMOUR THYROID IS DRIED THYROID GLAND FROM PIGS.

My mom has been through hell with her thyroid meds, to the point where she sometimes thinks she'd rather just give up and die. One month you CAN get one manufacturer, the next you CANNOT. Switching is like a roller-coaster ride. And the doctors just keep parroting that old "they are all the same" line. As if they care!

By the way, generics and brand-name drugs are definitely NOT THE SAME in all cases. How many people have to die to prove this? But just tell your insurance company you've had trouble with a generic, and the call-center representative (who apparently thinks she/he is a physician) will treat you like you're stupid or crazy.

Thanks for letting me vent; no one at any medical facility or insurance office will!

I switched from Synthroid, after about 25 years, to a generic levothyroxine. My pharmacist had long been telling me that it would save money and would work as well. So I decided to give it a try. (For the record, I am a 66 year old woman, and my overall health is, knock on wood, excellent.)

Generic levothyroxine definitely didn't work anywhere near as well as Synthroid. And considering the effects of lousy thyroid replacement, it wasn't worth saving a few dollars on a prescription. What's any amount of money when you feel crappy?

I gave it about eight months or so, and the progressively worsening effects were, to put it mildly, awful. Near the end of this experiment, I was tired all the time, and it was an effort to do anything. I had lost a great deal of hair, my finger nails and toenails split and chipped, and my leg muscles were weak and sometimes had fine tremors. I felt almost as ill as I had when I was first diagnosed with Graves' disease.

So I returned to Synthroid. I have a wonderful primary care doctor. After a few weeks, I was myself again. I've returned to doing all the usual things in my life, feeling my normal energy and interest and happiness.

My advice to anyone on thyroid replacement meds who has problems with what you're taking: trust your feelings and experience, and if you don't have a doctor who listens, cares, and responds with help, find another doctor.

Your doctor won't allow you to have it, or won't put you back on the more effective and always superior Armour Thyroid? My advice? That doctor is ignorant. Get rid of that co-opted doctor and find one who knows about the superior effectiveness of Armour. They are out there and there are more and more of them who bother to educate themselves about Armour Thyroid.

Most doctors are governed by the faulty ethical attitude, "It is easier for me (us) if everyone is on the same drugs" = doctors first (screw the patients), not the more ethical, "whatever is the most effective for each patient" = patients first!!

YOU know what is most effective for you and your body (because you LIVE in it), not the doctor. Demand it! Doctors typically base their negative attitude about Armour Thyroid on only ONE single really shoddy historical report from 60 years ago about the inability to control dosages in Armour Thyroid. That report and the tests conducted at the time are severely outdated and should be deleted/destroyed, as they are dangerously irrelevant and incorrect. Not to mention the FACT that Armour Thyroid is manufactured by pharmaceutical company, Forest Laboratories, the SAME company that manufactures synthetics, Levothroid and Thyrolar, so how uncontrolled can Armour BE today?

Would like more info on Synthroid - been taking it for years. With regular blood tests (every 3months) Dosage changed as needed.

BRAVO, PK - you spelled it out correctly. If your doc is ignorant and will not listen
(which is most of them in the HMO's), find another one and interview them and how they feel about listening and trying new things. And, for heavens sake, inform yourselves about meds, illnesses and be aware of changes in your body.

I am 70 now and am proud to say I take NO MEDS at all, lots of vit. and minerals and occasionally aspirin or aleve for headaches, when I eat something that has sneakily MSG or other junk added to foods. I do read labels before buying anything, and yes, it takes time, but so does sitting for 2 hours in a dr's office, waiting for an audience with his highness the doc.

I have read/studied up on nutrition, meds and side effects since 1975 and until Medicare always went to holistic MD's. Chiropractors know more about natural remedies and supplements than the majority of MD's.

My 89 year old mother has required thyroid medication for about 60 years, since her thyroidectomy. She has been prescribed various generic thyroid medications by her current primary care doctor over the past several years. When I took her to her endocrinologist for a checkup about two years ago, he was adamant that she not receive any generic! In fact he had a sign on his examining room wall stating why generics were inferior. His position is that generics are not the same as Levoxyl, the brand her wants her to take. He writes her scripts making it clear that no generic is permitted.

I, too, need to find a doctor who will put me back on Armour Thyroid. I was diagnosed in the '60's, taken off Armour when I changed doctors and he said Synthroid was easier. BIG MISTAKE! Same problems, big loss of hair, split nails, tired, weight gain, joint problems with replacements, etc. A neurologist, who was testing me for nerve damage, told me a lot of my problems were due to the thyroid problems and the Synthroid.

I got on the internet and read the same thing. At least I was able to get my present doctor to write an exception letter to my insurance company to allow the Synthroid. It is criminal that insurance companies can dictate what your treatment should be. Of course, if you die they don't have to pay any more.

I have been on Synthroid and generic brands (depends on insurance) for several years and my doctor informed me that my body "got used to it" and has lost it's effectiveness. I now also take Cytromel with my Synthroid.
I did better with the Synthroid/Cytromel and have gained 8 pounds with the generic Synthroid and generic Cytromel.
Hope this helps.

what is the amount of cranberry juice to help with urinary tract infection?

Generics are not the same as name brands. It took me several tries but I am finally feeling back to normal. I am back on name brands of Celexa ($140.00 a month) and Synthroid ($30.00 a month). It's killing me financially. You would think the Pharma companies would lower the costs to encourage sales. Just saying

I know I'm late to the show here, but I will chime in. Many generic drugs are bio-equivalent (work the same in the body) to brand drugs and thus are deemed to be interchangeable. Thyroid medications generally, are not. The only manufacture which is AB equivalent (or bio-equivalent, and works the same in the body) with all brand levothyroxine medications is the Mylan brand. Other brands are not interchangeable.

Almost all clinical pharmacists will recommend that you stay on whatever brand/generic manufacture of levothyroxine you start out on. There is a term called the therapeutic window, and this means that slight variations of a dose of medication can have substantial effects on the body. Since not all brands are AB equivalent, you should try to stay on the brand that you started out on as long as your blood work comes back good. Don't let physicians tell you otherwise who may have been coerced by pharmaceutical reps.

A little over one month ago I was switched from levothyroid to levothyroxine - I have developed pain - aching and nerve sensitivity - in primarily my right knee and leg with occasional discomfort in my left leg also. I also have developed a sensitivity to sugar - moderate amounts - makes me sick to my stomach (not nausea) - also I have started shaking when nervous in social situations. my doctor feels there is no relation with the thyroid medication changes and my symptoms - do you feel there could be. Thank you JC

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