Legalities of prescribing Armour - help please!

[jane17]

Am due to be put on medication for Hypo as TSH levels have just hit 10. Have started to feel really bad recently particularly with sore, sensitive, itchy, blurry eyes (eyesight has deteriorated quite rapidly in just last six months and am now having to wear glasses) and frequent rather than occasional flare ups of rheumatoid arthritis. Also have problems with low stomach acid and digestive issues. Contracted a virus in the 1980s which left me with ME and have had periodic flare ups of that over the years. In fact, a lot of what I am feeling now is similar to the ME symptoms I originally had for some five years and occasionally since. As I have a history of a very sensitive immune system and react to many things including certain drugs, I feel I would prefer (after much research) to take natural desiccated medication such as Armour or Nature Throid. Speaking with a pharmacist today to see if the pharmacy can obtain either of these before suggesting them to my doctor, I was told that legally every doctor has to first prescribe synthetic levothyroxine to a person diagnosed with Hypo and then can only prescribe Armour or Nature Throid if the levothyroxine doesn't appear to be working. Are there people out there who have had different experiences or has everyone found this to be the case? It would be so helpful to me to know this before seeing my doctor. Many Thanks.

[helvella Administrator Thyroid UK]

I am neither a lawyer nor a medically trained person! (So I am obviously ideally suited to answering your question. )

That is certainly NOT how I understand things.

What is required is that the doctor believes that any treatment - with desiccated thyroid or anything else - is in your interests. It would be usual to try levothyroxine and only change to something else if that did not work sufficiently well. But that is very much a matter of following usual processes and not a "must under all circumstances".

I cannot for one moment imagine a House of Commons discussing this as a legal issue! It can only be a matter of adherence to guidelines. There are no NICE guidelines. Any guidelines are indeed simply lines that guide - they do not in and of themselves have any force of law.

I suggest your pharmacist could not produce any documentation to support their assertion.

Pretty much any pharmacy in the country can supply desiccated thyroid - they would need an account with IDIS or another specialist importer, but that is all.

Your problem will be finding a doctor who will prescribe desiccated thyroid! Even though I believe it to be legal.

You might find Good Medical Practice 2013 can be interpreted in interesting ways:

gmc-uk.org/guidance/good_me...

Rod

[jane17 in reply to helvella]

Thanks so much, Rod, for such a prompt and very informative reply. I had not heard or read anything like that before on forums and thought it didn't quite ring true in terms of 'legally not permitted'. Despite not being a lawyer (or a medic), in my opinion, you did a great job of answering the question. In relation to finding a doctor willing to prescribe desiccated thyroid meds, I guess I'll just have to put on the Armour and get ready for battle.....

[hooper]

Hi jane17! My first choice of medication would have been natural dessicated thyroid but I was never offered a choice when I was diagnosed. I don't really get on with levothyroxine, but despite requesting a trial of either natural dessicated thyroid or T3 I have been unsuccessful in attaining either. Others however have been successful in getting it prescribed for them though usually because they don't get on with levo or because they can pay privately for it. Some are lucky enough to find a doctor who is more open-minded and ready to accommodate. Good luck to you!

Jen x

[jane17 in reply to hooper]

Hi Jen,

Thanks so much for your kind reply and best wishes! I have just returned from seeing my Doctor and ready to argue my case for Armour - only to find that my TSH level had dropped from 10 to 5 in three months after having climbed steadily from 1-10 over a just under two year period! Upon which the doctor said "I'm really happy with the way it's going so no need for medication currently". That amazed me as I had been feeling really bad. So what had happened in that 3 month period? I had been taking Dynamic Health liquid vitamin C since December approx 330 mgs/I teaspoon before every meal which had really helped with my digestive /malabsorption problems. I reason that it provided not only a natural form of acid with meals, thereby aiding digestion and absorption of vitamins/minerals, etc, but also helped in strengthening the immune system. I was unable to tolerate Vit C before in tablet form and had scanned the internet for a 'good', relatively inexpensive liquid version. At the same time, I ordered and started taking Biocare liquid Vit B12 drops and Ferroglobin liquid containing iron, other B Vits and iodine (low dose). Have to mention that previous blood tests had shown B Vit, D Vit and iron levels OK but was not convinced they were getting through to cell level/being taken up by cells where they were needed. So am now back to the possible ME virus trigger where my original ME symptoms read like a Hypothyroid symptoms checklist (which no-one had ever mentioned to me and I did not know until 2 years ago). Am very interested in possible connections between the two (in some cases) and virus effects on the body in general but this is not the place to raise the issue under this question heading. Think I will make another posting at some time with a relevant title.

Back to your own issues. I am so sorry you have had bad experiences and been denied what you want (and probably need). Having had some really 'unhelpful' doctors in the past, the one I have now is really nice, listens to what I have to say and takes my concerns and questions seriously. Where, sometimes, prescribed medications have not helped me and ones that I have researched and found have helped me, he acknowledges this and his attitude is - if it is working, continue using it. I think that, based on what Rod and NBob have said, my doctor would probably have prescribed Armour or Nature Thyroid if I had presented a good case. What reason does your doctor give for denying you an alternative when synthetic levo has not been working for you and there are natural alternatives known to work for so many? This makes me really angry where some doctors are unwilling to take on board alternative ways of thinking (especially those known to work) rather than fobbing patients off with the "I'm the expert, you'll have to take what I say and put up with it" syndrome. Bottom line - Who is the expert in knowing what our body is telling us/how we are feeling on a day to day, symptom to symptom basis?

Warm Regards.

[NBob]

Rod is right.

A GP can prescribe any medicine if s/he thinks it is in the patients best interests. The GP has to be able to justify prescribing any medicines that are not in the British National Formulary. but can still do it. A GP does not have to prescribe medicine levothyroxine before Armour.

[jane17 in reply to NBob]

Many thanks, NBob. Both Rod's and your own very helpful comments have been 'filed away' in case I suffer a long-term rebound in the future - which is quite possible!

Best Regards to you both.

[shaws Administrator]

If you have a sensitivity, both Naturethroid and Westhroid are hypoallergenic. This is an excerpt from Dr Lowe

When patients have reported to me that they've had allergic reactions to Armour, I've recommended that they ask their prescribing clinicians to switch them to Nature-Throid. This product, produced and marketed by RLC Labs, is different from other prescription desiccated thyroid products. The difference is that it contains binding ingredients that are hypoallergenic, such as microcrystalline cellulose. Patients who have switched to Nature-Throid have maintained the benefits they got from switching from Synthroid to Armour, but in addition, they've freed themselves from their allergic reactions to Armour.

web.archive.org/web/2010122...

nature-throid.com/

rlclabs.com/

[Heloise]

here are a number of misconceptions about Armour Thyroid, which we would like to rectify, as it is important that all medical practitioners are given the correct information.

1. Medical Practitioners believe they cannot prescribe Armour – UNTRUE

Armour Thyroid is the brand name of natural, desiccated porcine thyroid extract. Armour is authorised by the FDA as medicine that is standardised to the specification of the USP. The MHRA has not objected to the importation of Armour thyroid, as it is an FDA authorised prescription medicine, standardised to the USP and is for the treatment of patients with thyroid disease, for whom the UK licensed thyroxine is unsuitable. Consequently it can be prescribed to patients who need it, subject to it being prescribed by a doctor.

excerpt from stopthethyroidmadness.com/u...