DIfference Between Sandoz Produced Levothyroxine and Synthroid

[arndins]

Hello,

I have Hashimoto's Disease and currently take 75 mcg of levothyroxine. I have been taking the Sandoz version of this drug for almost a year, and my current TSH level is 2.25, while my T4 and T3 are both normal. I feel substantially better than I did last year; I have more energy and seem less tired during the day, and I can even skip evening naps, too, without detriment!

However, over the last 3 months, my pharmacy has attempted to switch my generic levothyroxine to another manufacturer three times without telling me. Luckily, I caught it each time, and was able to get the Sandoz from another location. My preferred pharmacy has essentially told me that they don't expect to carry the Sandoz product much longer. I don't want to have to deal with this every time I get a refill...

After telling my problems to my endo, he gave me a Synthroid script with "DAW" on it to avoid future generic problems.

I have read that the Sandoz version of levothyroxine is about 12% more "bioavailable" than Synthroid, on average.

1. I have to get retested in 6-8 weeks anyway after switching to the Synthroid, but do you expect my TSH to rise due to this alleged bioavailability issue?

2. If so, do you think that the 88 mcg version of Synthroid is the actual equivalent of the 75 mcg pill from Sandoz? If that's the case, should I request my new script for my established dose of 75 mcg be changed to the 88 mcg dosage even before trying the Synthroid?

[thyroid man]

i'm starting to think maybe i just needed a higher dose the same time i switched. cause now it feels like 75mcg  is not enough.

[Melmike]

Interestingly, for what it's worth, my endo recently told me that the Sandoz levothyroxine's bioavailability and consistency of same are the worst of all the T4s on the market, and he says Synthroid is the best.  An internist told me that a few years ago, too.  

[thyroid man]

i switched from 50mcg of levoxyl to synthroid on my own and got tested after a few months and tsh was 5.9. so now im on 75mcg of synthroid and thyroid is normal. i have also tried the sandoz levothyroxine in 50mcg and that kept it normal. i also dont seem to feel as well on the synthroid even though my tsh was normal. i'm going to stick with the synthroid a little longer if i don't feel well soon i'm switching back to levoxyl .

[Mark Lupo, M.D.]

The key is to stick with one manufacturer -- would change at same dose, then retest to see if it is working as well or if the dose needs to change.  On the other hand, with a TSH of 2.25, it would be probably fine to try the Synthroid 88 initially.