Why is it so difficult to convince doctors to prescribe T3?

I understand cutting costs on the NHS, but if the patient is paying, then why are they still so resistant to even let you try it? I really don't get it. I've had responses from "it's a placebo" (!) to "some people feel better on it, some feel worse". Ok, but if SOME people feel better, then maybe it will work for me too?...

Anyone have any idea why this is?


12 Replies

  • There seem to be a host of reasons.

    If they are not familiar with T3 because they won't (or as some are now saying, can't) prescribe it on the NHS, then I imagine many are therefore unwilling to do so even privately. Their experience likely doesn't include how to commence treatment, convert from T4-only, establish a decent long-term dosing regime, identify problems with dosing, etc.

    The current orthodoxy says that most patients do fine on T4 only. But it really doesn't give any direction to go if T4 doesn't make the patient well. It appears to suggest that if T4 alone doesn't work then something other than thyroid is the problem. But I find it difficult to recall many people who have ever had that other problem identified and treated! Sure - there have been the commonly associated problems like B12 deficiency and adrenal issues.

    They are unwilling to become targets for being "up in front of the GMC" by crossing the lines which are in the usual guidelines.

    They don't understand some of the fundamentals of thyroid hormones and how they work.

    After the recent T3 shortage, perhaps they worry that if they start someone on T3 they will become responsible for somehow sourcing T3 in another shortage situation?


  • T4 alone has not worked for me. It looks like I have a pituitory tumour. I was told that if T4 is not working there is either a pituitory issue or it's kidneys. Symptoms for chronic kidney disease are similar to thyroid symptoms. Luckily my kidneys are fine.

  • A tough decision - perhaps refer, privately, to an independant endo or blood pathology lab - more expensive but worth a peace of mind? The matter of T3 and T4 is known - not - should not be - a matter of economics. (It is an issue of health-care.)

  • I think the answer is very simple. Their guidelines have put them in a box with levothyroxine being the only treatment, and they are too scared or unwilling to think outside that box. Jane x

  • I agree- the success of T3 is not well known and tricky to manage- but the risk of practice managers,PCTs or insurers getting narky over it is high with current guidelines, if any exist at all.

    All hidden behind mixed processes of one sort or another,inc bossy labs..

    Part of the medical mystique -and.don't others pay...

  • I want to try it too but my surgery only cares about tsh

  • Thank you very much for all your answers! That question's been bugging me for a while. It's frustrating.


  • My doctor wouldn't have prescribed T3 because she admitted she didn't know enough about how to monitor it, it was well out of her comfort zone. However, she was happy to prescribe it on the NHS with an endo's recommendation. Presumably this takes the responsibility out of her hands.

  • Hi another Ana who spells her name like mine. My doctors completely refuse to consider anything but T4 and the fact that I don't feel well on it must be something else like age, chronic fatigue, stress, diabetes etc not the thyroid medication. Ana

  • My doctor said exactly the same!

  • The reason is that in the British Thyroid Association's guidelines they have statements re T4/T3, T3 and Natural Dessicated Thyroid Hormones which Dr Lowe stated are false statements by them and he produced and sent a Rebuttal to them and despite three requests, they didn't reply. The BTA appear to ignore the many of us who do not do well on levothyroxine only, or who maybe undermedicated with no chance of feeling well. Is it because the majority are females? We are rarely offered an alternative or are forced to go private. Some do not have the wherewithal to do this.




  • Will the Scots petition work it's way through to these BTA guidelines.

    I really hope so! There's a lot of inbuilt resistance to change there...

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