Can you get T3 on prescription in the UK?
T3: Can you get T3 on prescription in the UK? - Thyroid UK
T3
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Foggy73
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shawsAdministrator
It's possible but rare. Some Endocrinologists might. Have chat with your doctor.
Thanks Shaw. I'm having ongoing battles with my GP as I seem to have a minor improvement of symptoms for a few weeks when my Levothyroxine is increased then I go back to fully symptomatic. I wondered if I need T3. I'm having a blood test followed by an appt with my GP to discuss in a couple of weeks time. I'm constantly battling with the "your results are in normal range"!!!
email louise.warvill@thyroiduk.org.uk and ask for a copy of the Pulse Online article by Dr Toft who was President of the BTA. Question 6, highlight and point out to your GP the whereabouts of the TSH he should aim for. Or even some T3 added. Some doctors still ignore this but you can but try.
Most of us feel best with a very low or suppressed TSH. Louise won't be in the office till Monday I believe.
Thanks Shaw. My TSH last month was 0.16mu/L (range 0.30 - 4.20). How do you test that the T3 is actually getting into the cells, as my T3 in the blood is just over halfway in the "normal" range but I'm not convinced that my cells are getting it.
Foggy73, I don't think there is such a test. Halfway through range is normal but if you don't feel good there's no reason not to see whether you feel better with it higher in range either by increasing Levothyroxine or adding some T3 to Levothyroxine.
I suppose if I'm still symptomatic that is the test that it's not getting into the cells. I am going armed with info from this forum when I see my GP.....I am so determined to be listened to i have made a double appt!!
Foggy73, your GP may need an endo recommendation to prescribe T3 but she can increase your Levothyroxine dose to get FT4 top or just over range which should increase FT3.
BUT, if they are a poor converter then taking more Levo will not help. Many people need t3 on its own, or as an addition. Many people do not convert t4 to t3 properly, and hence still feel ill.
"WITHIN NORMAL RANGE"....?????
One of the most beneficial things about having joined this forum is the early recognition that you are not alone, not going mad, not being difficult, not being hypochondriac etc etc.... I have learnt that I am none of these things.....I am just another sufferer of this dreadful THYROID disease. I have also learnt that GP's appear to believe that if you are "within normal range" then you must be ok! which is clearly untrue. for me to feel normal - I think I need to be in the very centre of the 'normal range'. However, GP believes that as I am on the borderline of 'normal range', what on earth am I wingeing about!
If you are lucky ! ! ..
Foggy73 in reply to
I'm not lucky normally as my GP won't even refer me to an Endo!!
in reply to Foggy73
Hello foggy,
I am sorry to hear that you are still symptomatic after medicating on Levothyroxine for so long. However, you have only been on 125mcg Levo for about 3 months and your results from a month ago are:
Serum free T4 = 19.7 (12 - 22 pmol/L)
Serum free T3 = 5.5 (3.10 - 6.80 pmol/L)
Serum TSH = 0.16 (0.30 - 4.20 mu/L)
TSH is below 1.0, T4 is in upper quadrant of range & T3 is over half way through range.
I think your results are really GOOD and that is why your GP is reticent to give you more thyroxine (or T3).
If I had these results and was still symptomatic, I would be considering a conversion problem and how to rectify it, (in order to raise ACTIVE T3 levels and hopefully alleviate symptoms ).
You can have good test results like yours but still feel extremely hypothyroid because T3 isn't get into the cells to become biologically ACTIVE. Your blood test only measures the amount of thyroid hormone circulating in the blood stream and not in the cells.
Low thyroid hormone causes stress on the body and compromises the adrenal glands causing cortisol imbalances. The hypothalamic-pituitary-adrenal (HPA) axis is a complex network of interactions between the hypothalamus, the pituitary and the adrenal glands that regulates things such as temperature, digestion, immune system, mood, sexuality and energy levels.
Inflammatory cytokines caused by high thyroid antibodies (Hashimotos) can disrupt the HPA axis and interfere with the conversion of T4 to T3.
Conversion of T4 to T3 is done by the enzyme 5′ – deiodinase and this is activated by certain minerals, most notably selenium & zinc.
Selenium may be supplemented 100-200mcg but do not supplement zinc without testing levels as it can be dangerous to overload.
T3 doesn’t become active until it’s activated by an enzyme called intestinal sulfatase which is made from healthy gut bacteria.
You have been previously low in thyroid hormone and this is known to encourage low stomach acid (hypochlorhydria) increasing intestinal permeability, inflammation, infection and so causing malabsorption of nutrients, iron and thyroid hormones.
Do you have gut issues?
Inflammation in the gut such as IBS can reduce T3 by raising cortisol.
High cortisol can decrease active T3 levels while increasing levels of reverse T3 which would cause weight gain and hypothyroid symptoms.
A sluggish gall bladder impairs GI function by reducing bile flow and liver detoxification, where T4 converts into T3.
Constipation can impair hormone clearance causing elevated estrogen, which will raise thyroid-binding globulin (TBG) levels, decreasing the amount of free thyroid hormones available to the body.
It isn't all about just adding more thyroid hormone replacement meds because if your body isn't correctly utilising what you already have , you could become toxic from an unused hormone build up.
Flower
Selenium helps synthesis thyroid hormones
ncbi.nlm.nih.gov/pubmed/161...
Selenium reduces antibodies
ncbi.nlm.nih.gov/pubmed/208...
Thyroid-gut connection
chriskresser.com/the-thyroi...
This following link explains the importance of vitamins and where they may be obtained. This forum is supported by the charity ThyroidUK. You do not have to join the charity to benefit from this forum but by doing so you will be supporting the charity and also entitled to various discounts when buying supplements, as detailed in the link below.
thyroiduk.org.uk/tuk/treatm...
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Disclaimer: 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.
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Foggy73 in reply to
Wow thank you Flower, that is very detailed. I'm not aware of any gut problems (I don't get pain). So is there a chance that the T3 is not getting into my cells. Also how long can it take from having abn increase in meds before I notice an improvement......is 3 months not long enough?
in reply to Foggy73
It depends on how long it takes to improve gut health....
Read the Chris Kressler link provided in above answer on thyroid-gut connection.
If you have previously suffered low thyroid hormone and are symptomatic ... I feel sure that some will apply to you.
Flo
Dr. Ray Peat: Coconut oil added to the diet can increase the metabolic rate. Small frequent feedings, each combining some carbohydrate and some protein, such as fruit and cheese, often help to keep the metabolic rate higher. Eating raw carrots can prevent the absorption of estrogen from the intestine, allowing the liver to more effectively regulate metabolism. If a person doesn't lose excess weight on a moderately low calorie diet with adequate protein, it's clear that the metabolic rate is low. The number of calories burned is a good indicator of the metabolic rate. The amount of water lost by evaporation is another rough indicator: For each liter of water evaporated, about 1000 calories are burned.
shond2015 in reply to
What an excellent, interesting and open view. Thank you also for the internet links Flower...I have been using Selenium for 3 months now.... (on and off....but am now going to try to be more consistent with it to gain the benefits.
Foggy73 in reply to
Thank you Flower. I have no gut problems
Look down this link till you come to FT3 and read what Thyroiduk.org say about this test.
I have exactly the same problems as you - initially feel better with each increase and then worse. I pretty much told my GP that I was going to self medicate if she didn't refer me to an Endo. She did and I now get T3 prescribed - the GP writes prescriptions following recommendation from the Endo.
Are you in the UK Kel8? I only ask because it appears it's difficult to get it prescribed here.
I think I am going to threatening my GP with self medication. I wouldn't do it but its worth seeing if she reacts and either refers me to an endocrinologist or if she will prescribe the T3
Yes, I am the UK. My GP couldn't prescribe the T3 without the Endo's instruction. She admitted she wasn't allowed. Never been a problem since though - even when increased to 60mcg a day.
Hope the same tactic works for you!
Thanks Kel8. I'm in East Sussex so I don't know what the Endocrinologists are like here. Sounds like I need to push to see one though if my GP can't offer anything other than T4
I don't believe the Brighton Endo's are any good Foggy73. Not in my experience anyway (going by a letter one of the senior Endo's there wrote in response to a written enquiry from my GP).
I am now waiting for an appointment for an Endo in Kent. The one that ReallyFedUp has praised so highly. Although I am getting impatient now as I have waited 3 months already.
How do you request a referral to a specific Endo, especially outside of your county?
I wrote to my GP. In my case I had the local Endo's letter which I was able to show did not relate to my symptoms and I provided some short links to info to make my case that I was not being optimally treated.
I asked to be referred to a sympathetic Endo. Of course the GP couldn't help with that so she asked me who I wanted to see - I told her (with the help from this forum) and she agreed to make the referral.
in reply to Foggy73
Foggy,
You can choose who ever you would like to consult with on the national health. Ask your GP to refer you through the "choose & book" scheme. It does not have to be an endo within your your own county. I see an endo under the national health in another county who I have chosen. This is not easy as involves travel and the chasing up of test results and prescriptions as correspondence isn't automatically sent through to my GP ( which makes everything very complicated) but I consider this worth while. You can email louse.warvill@thyroiduk.org.uk for a list of sympathetic endos/doctors that members have had positive experiences with. However remember this may involve travel & many of the endos are
private.
Good luck
Flower
My experience was the same as kel8......T3 was prescribed once referred to an Endo and then the GP continued the prescription.
However,I have heard that more and more are not being allowed to prescribe it now.
My own area is OK at the moment but not confident about the future.......One of the reasons I changed to buying NDT apart from feeling better on it!
Foggy73 in reply to
What is NDT?
Thank you reallyfedup123
I know, I have been really lucky. Did have to go private to see him at first but now being transferred to his NHS list.
My gp prescribes it but keeps threatening to stop. I used to just buy it myself because it was easier than having that nonsense held over my head all the time but I can't find it anymore. And I was paying a tiny fraction of what the nhs pays.
Yes,but only if you are allergic to t4 tablets or your results show your not converting, they won't go near armour so my gp had no other option. You have to know your stuff, so you need to educate yourself. I also had a long fight and finally got armour to from endo. If you go in to see them not knowing anything you will get nothing....
i get it on prescription, my dr gave me a one time only prescription when i stopped tollerating NDT, i then brought my own, seen new endo who lowered my dose and prescribes it for me (im using my own to top up)
Pets
..... ... NEVER GIVE UP. .....
List everything and focus on one or just a few things at a time.
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Disclaimer: 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.
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Seriously? Dr. Bergman thinks very highly of him as he states in the thyroid video I often post here. How do you feel about him?
This is the article so if you can give some specifics about where he seems misinformed, I'd be glad to hear them.
Also, he is a PhD. (like my son), they do not have medical degrees. Unfortunately my son can't paint
but is an excellent biomedical researcher. It's different from the actual practice of medicine but is often much deeper in understanding the etiology of disease.
Look, I appreciate your own observations and I possibly neglect looking at personal issues. We have a huge collection of sources here and many different opinions so people can select what they feel will fit in with their own ideologies. Attempting to find any kind of truth in this world is probably a lesson in futility but you are going to have to get specific and refute facts here. Thanks for your warning.
The endos we observe here have got to be worse, however.
Bluepettals2, I agree with you that these people need to be informed/trained better about the wide range of different reactions by sufferers. Its been said, again and again on this forum, that what works for one, may not be working for another.
Our best hope is to write to the British Medical Association about our issues. Infant, if everyone on this forum forwarded to the BMA what they are writing on this forum - one day, someone might actually take us all seriously!
Flower - Just for the record.....I like your level of understanding of the disease, appreciate your common sense approach to dealing with it, but above all, I am impressed with your attitude - your response to Nicolas CR was wonderful: respectful and positive.
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