GP happy to prescribe me NDT but does not know how to prescribe as never done so...

[JaneyG]

Hi sympathetic friends!! I need some advice. My very lovely and open minded Dr who has supported me through my personal journey of none NHS Thyroid related treatment (including seeing Dr B Peatfield Durrant)...Is happy to support my next step - to move from Thyroxine to NDT - he is willing to prescribe but as it's obviously not in his book of licensed medicines, he is unsure how to go about it. Any advice I could take back to him would be great? I live in Hampshire GU51

[Hidden]

Congratulations! Here's hoping you're now on your way to feeling normal, or at least nearly normal again.

This page here on STTM includes some approaches: stopthethyroidmadness.com/n...

Some people reduce T4 and add NDT but others drop Levo altogether from day 1 and build up.

I'm sure others will drop by with their experiences, but my OH simply switched and has never looked back.

[Clutter]

Janey, you need 1 grain for every 75mcg Levothyroxine you take. You don't need to taper off Levothyroxine, just switch to 1 grain for a week or two before increasing 1/2 grain every week/10 days until symptoms resolve.

Ask your GP to prescribe 1-3 grains to therapeutic requirement so you can titrate as required. NDT is supplied 100 to a bottle so your GP should prescribe 100 or 200 at a time to ensure you get fresh unopened NDT and not opened and possibly stale gear.

Named patient prescribing info here thyroiduk.org.uk/tuk/treatm...

[JaneyG in reply to Clutter]

Hi all - thanks so very much for your advice... This forum is just priceless, it's really helpful positive knowledgable advice- thankyou !! : o )

[waveylines]

He won't be able to write it in grains though -he will probably write you a prescription for the active ingredients that are in the brand that you go onto ( levothyroxine and liothioine -arrggh spelling!) . So i would download the page from Thyroid Uk as it shows the active contents of each NDT tablet Most are the same but Erfa has a slightly different T4/T3 balance:-

thyroiduk.org.uk/tuk/treatm...

He will write your prescription in micrograms -not grains so the chemist can understand it. He may need to write the brand at the top of the prescription. Lloyds Pharamcy can order it in for you -so I would contact your local pharmacist as a first port of call. Thyroid Uk explains on their sources page what you might need written on additionally if you order from other uk sources.

Personally I use Lloyds Pharmacy as they collect the repeat prescriptions and order the stock in so I don't have to think ahead. What I did was to contact the pharmacist and I downloaded the info from the link I have sent you. I also downloaded the info on the particular brand I wanted from the manufacturers ( including the T4/T3 content of each strength/grain of tablet -they liked this) and met with the pharmacist to discuss. He then liaised with the Gp and told him what to write on the prescription -it was then ordered in from their central supplies ( Lloyds have a specialist prescription department that your pharmacist will talk to) -the process took about three weeks in total -but was great once set up.

Well done -sounds like a lovely GP. Just be aware that the GP will be prescribing on 'a named patient basis'. This means that your GP is not insured under the usual NHS and he/she takes full responsibility for the consequences of prescribing. It also sadly means that your GP can withdraw their consent if they change their minds -this has happened twice to me now -so you might find it a wise move to have a backstack of the NDT you choose in case this happens to you..... Feel free to Pm me if you have any further questions

[JaneyG]

That's what he will need to know - perfect - thankyou !!

[JaneyG]

My doctors has a Lloyds chemist attached to it - that is so so helpful thankyou. I will PM you if I need any more help if that's ok with you? Thankyou for the offer & all your helpful advice... Feel like I am getting there.....!!

[JaneyG]

Hi there fellow Thyroidees..

I have recently had a full Thyroid - Plus test by Genova through my nutritionist..unfortunately she is not able to advise on results as not qualified to do so..

Before I go to my GP I wonder if an administrator or someone could give me an idea of what my results mean:

I am currently on 50 of T4 & 50 T3.....thinking of changing to NDT but want to know what these results may indicate..

Total Thyroxine (T4) 44.0

TSH 0.004

FT4 8.29

Free T3 23.10

FT4:FT3 Ratio 0.4

rT3 0.21

Thyroglobulin (TG) 20.0

Peroxidase 10.0

I believe my rT3 is pretty good but everything else seems High or Low

I have never had my underlying autoimmune disease addressed...Would my TG & TPO reflect this?

I wold be so grateful if someone cold shed some light on this for me..

Thanks very much Jane

[humanbean]

Genova always supply the reference ranges. Could we have those too, please. It isn't really possible to interpret results without them.

We need to know whereabouts in the range your results are lying.