Reply from Department of Health re email flooding of PM's email. I expect everyone has had more or less the same reply

Thank you for your emails of 8 and 20 June to David Cameron about thyroid testing and treatment. As the matter you raise concerns the NHS, your emails have been forwarded to the Department of Health and I have been asked to reply.

I was sorry to read about your ill health.

The Royal College of General Practitioners (RCGP) curriculum sets out the skills, attitudes and knowledge required to practise as a GP for a career of continuing professional development. GP trainees are systematically assessed against this curriculum and, to be licensed as an independently practising GP, must successfully complete their training placements and pass the assessment for Membership of the RCGP, which consists of an applied knowledge test examination, a clinical skills assessment – a mock-surgery examination – and a series of assessments carried out in the workplace by trained supervisors. Hypothyroidism is a common condition encountered in the community and, therefore, its diagnosis and management is incorporated in all of these assessments.

GPs are required to demonstrate knowledge and skills in the diagnosis and management of hypothyroidism relevant to their role as generalist, community-based doctors. However, the diagnosis of hypothyroidism is often challenging and the RCGP is continually looking at ways of improving the training and education of GPs.

The vast majority of patients, once diagnosed with hypothyroidism, can achieve successful management of their condition with a synthetic hormone replacement treatment.

Best practice on the identification and management of hypothyroidism has been provided in the Royal College of Physicians’ (RCP’s) guidance ‘The diagnosis and management of primary hypothyroidism’. This document was developed on behalf of organisations such as the British Thyroid Association, British Thyroid Foundation and Society for Endocrinology, and is endorsed by the RCGP.

The guidance states that overwhelming evidence supports the use of thyroxine T4 hormone replacement alone in the treatment of hypothyroidism. This is usually prescribed as levothyroxine (Thyroxine) tablets. The guidance does not recommend prescribing additional T3 hormone in any presently available form. However, this does not prevent clinicians considering other forms of thyroid hormone replacement if appropriate.

The RCP’s ‘The diagnosis and management of primary hypothyroidism’ also makes clear that the only validated method of testing thyroid function is on blood, which must include a measurement of the thyroid stimulating hormone and free thyroxine in serum. The guidance does recognise that different methods used for testing blood can give differing results, and the RCP highlights its support for an international initiative for greater harmonisation of reference ranges, and of the units used in expressing the results of thyroid function tests.

I hope this reply is helpful.

Yours sincerely,

Peter Hawkins

Ministerial Correspondence and Public Enquiries

Department of Health

8 Replies

  • Topaz, Unfortunately the guidelines state that Levothyroxine (T4) is the only therapy required for hypothyroidism and despite being a guideline many GP practices take this as being written in stone.The DoH letter seems to have missed the bit about taking clinical symptoms into consideration with blood test results, as do many doctors it would appear.

  • I totally agree

  • This is why we need people to sign the petition about research into T3/NDT. They need to know how many people are dissatisfied with T4 only treatment!

    We need to sign and share the petition! :)

  • Thanks Louise, I have signed the petition and shared. Lets hope it brings the desired result.

  • First I had a letter and then an e-mail - same as above - all gobbledygook ! All talk and NO action !

  • I keep re-reading this reply from The Department of Health and quite frankly it is making me feel sick and disgusted! Have they ever heard of T3 and do they know what it actually does? What sort of training are our GPs being given in this regard?

    When I brought T3 into the conversation with my GP he said not to go down that road or I'd lose him!! That at least finally arrived at " Hand me over to an Endo time",who thankfully knew about such things,ordered an FT3 test and prescribed T3 because of a question mark over conversion.

    I have already signed and passed on the petition and I applaud all that is being done by others in that direction,but I really really fear for all those who need something other than T4 to help them regain their health,if we have to wait for thousands more to sign our petition before we are listened to.

    The Book " Understanding Thyroid Disorders " by Dr.Antony Toft is issued by the British Medical Association and on pages 46-47 refers to the possibility that some patients may need the addition of T3 known as Liothyronine.Perhaps Peter Hawkins needs a copy.

    Is there anything else we can do to make ourselves heard?


  • There are ample clinical test figures, there is no need for any other studies into the use of T3 or NDT, both were used for over 100 years and are safe, effective and useful. We should NOT succumb to the 'oh, we'll test again' mentality, we should be printing off stuff and taking it to GP's to read, they are required BY LAW as well as NHS guidelines to keep up with tests and papers.

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