It sounds like maybe the pharmacist is substituting a generic, it may be due to your insurance. You need to ask the pharmacist and be willing to pay the difference.
My pharmacy did this when my doc prescribed Levoxyl. They kept on doing it every time I had a refill too...

So the generic will not be as effective for me?

I don't think the generic is what your doctor ordered. It has all of the "fillers". Sometimes pharmacists don't too much attention and just want to give you what they got...
Tirosint is a name brand with a patent. It is supposed to be cleaner of fillers.I don't believe it's the same thing...
You should call and ask if they have Tirosint.

GL

What can I do since I picked the prescription up? Can I return it and tell them I want the actual prescription of Tirosint? Will they take it back?

When my doctor writes out a prescription for me, she always checks the box that says 'may substitute with generic'... I take levothyroxin which is generic for synthroid.. I've never had any problems with generic meds -- and I like not having to pay what the big pharmacy companies want us to. I've been on 50 mcg since being diagnosed with Hashimotos over 24 years ago -- they've never needed to change the dosage and I'm o.k. with that. Nancee

Tirosint is name brand levothyroxine.

State law and your insurance determines how the Rx is filled.

Since the pharmacy filled your Rx with the generic, that tells me generic substitutions are allowed unless the doctor indicates "dispense as written" on the Rx......and your doctor didn't do that (or the pharmacy made an error).

I suspect pharmacies have policies re return of prescriptions.

And, I'm sure your insurance has a policy re Rx costs. For example, I have a $15 co-pay for generic. If I want the brand-name of a med that's available in generic, my co-pay is $50.

My doctor Rx'd Levoxyl for my very first prescription but did not check "dispense as written" and I didn't ask her to do so.

I knew I was going to get generic levothyroxine and I knew I wanted to try it.

I also knew that success with generics can be achieved as long as the doctor and patient make sure that the same manufacturer's product is supplied each time.

I got Mylan generic - which the ATA (American Thyroid Association) lists as equivalent to Levoxyl in strength and effectiveness.

I did well with Mylan so, I make sure my doctor writes "Mylan Co only" on every levothyroxine refill Rx.....and I save $35/month because it's a generic.

I have been reading a lot today on Levothyroxine and so many people claim to have gained a lot of weight on it. I do not need that. There are also a lot of people who did not improve in terms of energy or overall good moods.

Should I call my doctor AGAIN tomorrow and ask her to call in a new prescription for Tirosint and include Dispense As Written on it, or should I just give this Levothyroxine a try?

I believe that it's NOT levothyroxine that causes people to gain weight but, instead, the inappropriate dose. Same deal with energy and mood issues.

All of these issues occur when hypothyroidism isn't adequately treated.

I think people complain about levothyroxine because that's all their doctors will prescribe for them when they actually need T3 as well....or they "just" need a higher dose of levothyroxine.

People are told "your thyroid is normal" (because their TSH is in the normal range) and they still feel horrible.....levothyroxine gets the blame when it should be the doctor.

As I mentioned earlier, I've been taking Mylan generic levothyroxine...for over 3 years. I've done well with it...my doctor prescribes a high enough dose (along with generic Cytomel) to maintain my FT4/FT3 levels where they need to be to keep me free from thyroid symptoms.

It doesn't matter what med you take - what matters is that your doctor optimizes your levels and keeps them that way.

It seems that most of us have to steer our doctors in the right direction but at least it's better than fighting a brick wall (doctor stuck on TSH :)

Your choice of meds should be your choice.

Should I still be concerned that she wants to start me at 137 mcg? Will I experience heart problems because of the high dose right away instead of working up to that dosage?

Sorry to tell you this but, I really don't know what's appropriate because there are so many unknowns with your history.

I know you said you weren't doing well on 150mcg Synthroid but, we don't know if it's because both your FT4 and FT3 levels were too low.....or if your FT4 level was "good" and your FT3 level indicated the need for T3.

I'd be inclined to think the latter only because you were taking a decent-sized Synthroid dose.

Your labs on Armour showed a LOT of room for improvement but, we don't know what your starting point was in regards to FT4/FT3 levels. We need to know where you've been to properly advise you moving forward.

I'm guessing your doctor was comfortable with 150mcg Synthroid because that was what you were taking before. His/her decision to lower your starting dose of Tirosint to 137mcs makes sense because Tirosint is more effective than Synthroid due to the fact that it doesn't have any fillers.

Effectiveness is very individual-specific.

You probably know that it's not uncommon to have a worsening of symptoms and/or the development of new ones after a dose increase....along with minor improvements (thankfully)

It would probably be helpful if you could remember how you've felt after dose increases so, if you experience a repeat, it wouldn't necessarily be as concerning.

I've been taking replacement for over 3 years now and I developed new-for-me symptoms after getting a belated dose increase. I knew it was possible so, it was easier to deal with. Maybe this can help you.

I had so many symptoms after dose adjustments when my levels were lower (yet still higher than yours) that I got to Googling the symptom and hypothyroidism......and invariably found it on one of "the lists". Of course, I got anything that might be a symptom of a concerning health condition checked out and, luckily, I always tested negative. I think I told you that I have a list of almost 40 different symptoms that I've had at one time or another since I started treatment......and they are all g-o-n-e gone when my levels are optimal.

Just so you know, many people experience *temporary* heart issues after dose adjustments....palps, PAC's, PVC's, BP increase/decrease, heart rate increase/decrease.

Of course, it certainly wouldn't hurt to know that your heart is in good shape and to get a full cardiac workup, if possible.

I'm explaining all that I have because I'm hoping it will help you understand why it's hard to answer some of your questions.....now.

Now that you are getting the right labs done and will hopefully maintain records of them (along with the dose that corresponds to the labs), it will be much easier to help.

And, if you maintain that symptoms journal and are able to share that along with your lab history, you'll get the best possible help.

We can only help make the path smoother moving forward - it's impossible to correct your doctor's past errors.

About a year ago I had a cardiac workup because I was just concerned about symptoms...which in fact are probably hypo symptoms....extreme fatigue,etc. I called the doctor today to see if it was okay to start on the generic of Tirosint, the Levothyroxine, but have not heard back from her....three hours later. To add to it, I don't know if the new symptoms I have are from a few days on levo, or the bug sting/bite that I got a few days ago which I had to go to the urgent care for....it is still hard and warm to the touch and causing my leg some pain. I have an antibiotic for that, so I don't know if the increased leg pain and the stomach ache is the antibiotic or the new thyroid meds.

UGH...does this ever get better??? Thanks for all of your helpful advice. I did start to keep a journal, but it would be helpful to know if what I am describing is because of this new medicine or this new problem with the bug bite.

Based upon the fact that you weren't doing well on 150mcg Synthroid and had horrible labs on Armour (sorry), I suspect your symptoms last year were hypo symptoms. Doctors often seem to be the last to acknowledge this. (I just went through similar with mine).

Sorry to hear about the bug sting/bite. I'd be inclined to think that's the cause of the increased leg pain.....and the antibiotic for the stomach ache.

If they persist after the sting/bite heals, I wouldn't necessarily blame the thyroid meds - they are hormone, after all.

If it's anything related to your thyroid, I'd be more inclined to blame it on the fact that your thyroid hormone levels are moving as a result of changing meds. That can cause many, many symptoms.

And, YES!!!!! It does get better. I am living proof.

As I've mentioned already, my list of symptoms that were caused by either sub-par levels.....or the dose titration process itself is now up to almost 40.

I have NONE of those symptoms when my levels are optimal.

Since my thyroid function remains somewhat erratic, I continue to get labs every 6 wks. so my doctor can adjust my dose (if necessary) so my optimal levels are maintained.

Treating thyroid disease is like treating diabetes - it requires diligence.

I consider it a small price to pay for feeling awesome 99.9% of the time.

I haven't felt good in so many years I wouldn't know what it felt like, but I am sure looking forward to some relief. Friends tell me I am not the same person I used to be.....they are definitely right about that.

I'm wondering if adding Cytomel to the Tirosint (after awhile) might help you. Usually they will lower the T-4 dose somewhat and add Cytomel to it if your labs show you are not converting well and your T-4 is good on it but your FT3 is still low. Slow and steady though, remember. You can't get there too fast and changing meds, doses can cause upsets but you usually have to bear with it for 6 weeks and then see where you're at, it's not a magic pill, that's for sure..

That's true. This is a very complicated disorder to me!