Medication switching caution?

[Haig]

Hi,
I'm a 41 yr old male with hypothyroidism.  I've been taking Levothyroxine Sodium (generic) .088mg daily for several years.  My health insurance has suggested I try a less costly med.  In the past, I've tried switching to Synthroid (generic) but after a day or two, I experience muddied and disoriented thinking.  I went back to levothyroxine and those symptoms went away.  Now, my health insurance suggests I try "Unithroid" (generic) which is also less costly.  Should I consider this?  I felt lousy under Synthroid but I don't know how different it was from my original med.  Is Unithroid's chemical makeup more closely aligned with Levothyoxine?

I also experience chronic peptic disease (for the last 2 years) for which I take 80 mg of Protonix PPI (generic) each morning and 300 mg of Rantidine each evening.  Lower doses don't help as much.  Yet, I still wake up in the morning with a little discomfort in my gut.  Are you aware of relationships between hypothyroidism and peptic disease?  Are there any treatments you could recommend for peptic disease?  I already try to avoid high acidic foods and alcohol and caffeine.

thanks in advance!

[wlmcdonald]

If Synthroid has been working for you that long, keep taking it. It is a relatively inexpensive drug. I don't know where you live, but in Canada it is about $25.00 for 60 pills and that's without a drug plan. With a drug plan, it's about $8.00. I think the feeling the best you can feel outweighs the cost if your drug plan won't pay. Get a letter from your doctor stating that you have to have Synthroid brand to submit to your health plan.

I have also had GERD for about 20 years and take Losec for it. I find I had to eliminate all citrus juices, spicy food and greasy food to feel better. Don't eat before going to bed. Limit the amount of coffee and soda pop.

I know what you mean by this uncomfortable feeling in you gut in the morning. My naturopath suggested taking DHL (licorice root) it's chewable and works immediately. Tastes very strong though but I am happy with the results. You can get it at a health food store.

[gimel]

TSH is a pituitary hormone that signals to the thyroid glands to increase/decrease thyroid hormone output.  The thyroid glands produce mainly T4, as well as some T3.  Your body usually converts T4 to T3 as needed.  Most T3 in the body is bound up with proteins and not able to affect body functions such as metabolism, etc.  Only the free (unbound) portion of T3 (FT3) is biologically active and it has by far the best correlation to symptoms, so it is good to always include free T3 in any blood testing that you have done.  

[Eliza150]

Ft3 is the active hormone. When your Ft4 is in the upper 1/3 of the range, it should make your Ft3 go up too. There are some that do not convert T4 to T3 very well, so they have to have Cytomel, which is T3. Some take Armour thyroid.

I have also read that taking PPIs or acid reducers continually can cause a decrease in your B12 levels.

[Haig]

Thanks all for the input.  As far as med choice between generic and name brand, I'm curious what experience you've had with convincing an insurance company to change its policy.  My generic thyroid med seems to be working.  My TSH score is in the acceptable range.

As far my peptic disease.  It's not what I'd describe as typical GERD.  I don't ever get reflux.  I just have a discomfort in my stomach when I don't take my meds.  I still get a minor discomfort in the mornings before I eat breakfast but its not life altering.  I do appreciate the comment about my T3 level.  I don't think I've ever had that meaured.  My doctors just look at TSH and if its good, they keep me at my med level.  What's the difference between TSH and T3?

[skeeterknitwit]

I agree with Laura.  Don't let the insurance company bully you.
The cost of generic Levoxyl is about 20 cents a day.  How do they expect to get any less expensive than that?  Name brand is about 40 cents a day.  It's just not worth weeks of feeling unwell to switch to a "cheaper" med.

[stella5349]

Being left undertreated in a hypothyroid state will irratate the problem with acid reflux.

Funny enough, it is NOT the over abundance of acid in the gut - but not having enough.

When hypothyroid your gut slows down and produces LESS acid - but more potent and that is whats causing your discomfort.

Taking anti - blocking acid meds only harms the situation further.It cuts off the little acid you have to digest foods. Eventually food will be hard to digest and cause even more problems. A steady balancing of PH levels needs to be found and getting the system to speed up in function is needed to eliminate this issue.

Some key things to get you balanced again - is to look at your Free t3 thyroid level and make sure that is in the upper ranges. Check your magnesium levels. To heal the gut and get things balanced - consider reading information on acidophillus and digestive enzyme aids to speed the digestive track and to produce more acid along with PH balancing it. Apple cider vinager is a natural aide for that.

If you remain "slow" with hypothyroidism , your gut will not heal and could cause many issues down the road. Your liver could be effected as well.

I was in sheer pain for 2 years with acid issues. I was afraid to almost eat anything b/c I knew it would back up on me and I would be miserable. My throat was raw and I felt horrible.

Getting my system to speed up it's processes of digestive and hormonal functions ridded me of the acid issues. Actually I took in more acid ( lemons) to help me too. It took almost a year to heal - but I am fine now.  

[gimel]

I have gone through acid reflux problems during a period when I slipped back into hypo t while changing meds.  My doctor suggested that I double my dose of Prilosec to see if this fixed the problem.  On that same day I switched to Armour thyroid (T4 and T3).  Interestingly, the next day or so, the acid reflux problem was gone.  I cut back on the Prilosec and the problem did not return.  
I have done some reading on this and found that acid reflux problems are a regular companion of hypo t.  
I think it would be worthwhile for you to post your lab test results and reference ranges and let us comment as to whether you have had the appropriate tests and/or whether your levels seem to be optimum.  It may be that you have never been medicated enough to alleviate your hypo t symptoms.

[laura1967]

Most thyroid drs will tell you to stay away from generic.....don't allow your insurance company to bully you. Most thyroid patients do better with brand names.