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spoonking profile image
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can gps prescribe t3 without been seen by a endo?

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spoonking
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Clutter profile image
Clutter

Spoonking, GPs can prescribe T3 without an endo recommending it, but most won't. Medical training and UK thyroid guidelines state that Levothyroxine is the standard treatment for hypothyroidism so many GPs think it's dangerous stuff which will cause osteoporosis and atrial fibrillation. NHS T3 is very expensive and many CCGs will have instructed GP practices not to prescribe it without an endo recommendation.

If you post your recent thyroid blood results with the lab ref ranges (the figures in brackets after your results) and say what dose and medication you are taking members will advise whether you are optimally medicated.

If you don't have FT3 results you can order a private test from Blue Horizon or Genova via thyroiduk.org.uk/tuk/testin...

Deb_g profile image
Deb_g in reply to Clutter

Hi Clutter,

Hope you don't mind me jumping in on this discussion but do you think that taking T3 long term is dangerous?

I self medicate with T3 after seeing Dr p and have felt great for 5 years after 15 years of hell

I've been to the GP today for my telling off- she's saying my T3 is far too high at 35 when the range should be up to 6 and she says I've killed my thyroid ( I've only got half anyway) - if she saw these results she would be treating someone for hyper- even though I said I don't feel hyper in any way- oh that's because your body has got used to it-----and while she can't tell me to stop self medicating she pointed out that the T3 is causing other health problems.

She says I can expect to have a heart attack or stroke any day soon and she would like me to have a bone density test as T3 causes osteoporosis - ( I've broken a bone in my hand- which must have been a gift for her!)

She would like me to stop taking the T3 to give my thyroid chance to recover?!?!? I've written to Dr P for further advice, but after 5 years I think I prob need to go back and see him again.

I have moved GP once already due to my thyroid

Clutter profile image
Clutter in reply to Deb_g

Deb-g, A pity your GP spouts such rubbish, of course Levothyroxine &/or T3 don't destroy the thyroid. There is a 20 year safety review into Liothyronine in the link below.

endocrine-abstracts.org/ea/...

I do agree with your GP that you are very overmedicated, whether or not you feel it. FT3 35 long term significantly increases your risk of developing atrial fibrillation and osteoporosis. It's generally recommended that FT3 remains within range. I don't see why you should completely stop taking T3, just reduce it substantially.

_______________________________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

Deb_g profile image
Deb_g in reply to Clutter

Thank you for your reply- I've had a bone density test which is showing low density- not yet osteoporosis - so I'm going to have a big fight with GP

In the meantime, I have halved my T3 intake

Unfortunately Dr P is poorly so I'm struggling for 1-1 support so in very grateful for your help

shaws profile image
shawsAdministrator

Yes, but many are reluctant. If you email louise.warvill@thyroiduk.org and ask for a copy of Dr Toft's Pulse online article. Question 6 may be helpful for your GP.

galathea profile image
galathea

Mine did about 10 years ago. It was after I bought some off the Internet... I went to him, told him I felt better and asked to to prescribe it or I was going to source some more for myself. He was horrified and wrote out a prescription

Later, when that doc retired I was given a new doctor who tried to stop the t3. I insisted on being sent to an endo who decided I had best stay on t3 as it was a placebo which was working well for me.....

Yeah..... Whatever..... :-).

G

MacG profile image
MacG

Yes, I too have been prescribed T3 by my GP. Have read in various places, however, that "treatment should only be instituted by accredited internists/endocrinologists"

This is from a research paper that I was looking at this morning: A very useful read on LT4/LT3 combination therapy.

thyroiduk.org.uk/tuk/guidel...

Ditto in an article in PULSE online which is very much used by GPs

"Combination LT4 and L-T3 treatment should be reserved for use by specialist endocrinologists, and discontinued if no improvement is experienced after three months". Mark Vanderpump was the author of this article.

pulsetoday.co.uk/clinical/t...

I just love the title! "Tricky ten minutes - ‘You say my thyroxine dose is correct but I still feel terrible"

Mmmm - I wonder where I have heard that before?

The "received wisdom" that a lot of GPs will be acting upon is in articles such as these.

I think we probably know what trainee doctors are told about treatment protocols.

In the USA, they leave the medication prescribing to the specialist.. the GP

just does not have the knowledge..the job of the GP is to decide what expert

the patient needs to see. The GP usually has strict guidelines about what she/he

can do for you and they refer the rest out ..most are not familiar with how and

why your endo prescribes what she/he does..the other reason that you want

only your endo to prescribe is that if something goes wrong with you, explaining

it to the ER doctors that you took it on yourself will make you feel criminal...

been there, did that but not for thyroid.. Good luck.

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