So, my endo is telling my GP to prescribe T3 and T4 combo. But, although my GP is prescribing it for me, he is upset at the cost and his parting shot at my last appointment, literally as I left his office, was, "there is no evidence that liothyronine offers any benefits"
Can anyone suggest a succinct and convincing document that I can print out and take to show him at my next appointment?
Thanks in advance.
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AndiRiley
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Its an all too familiar story unfortunately! My GP was happy to give me a little T3 but when i recently asked for an increase she was about to sign off the prescription until she saw the cost and that was that...referral to Endo and she mentioned something about not having any scientific evidence that it was helpful!! You would think the very fact that we feel better and go and see them less often would be evidence enough! Cant help you with any documents but hope others might be along soon who can.
It doesn't appear to be the lack of evidence which is bothering your GP but the cost of Liothyronine.
I discussed several studies on the benefits of T4+T3 with my endo but he found them "not sufficiently robust" or "too American". Despite the lack of robust evidence on the benefits he prescribed it either because of the noticeable improvement in my health having self medicated for 6 months, or because he didn't want me buying it on the internet.
Yes, EXACT same situation re endo/gp, same spluttering re cost. Endo wrote gp a slightly sneering letter implying he didn't see the problem.
Is this any good to you? ncbi.nlm.nih.gov/pmc/articl... The conclusion is that most people do brilliantly well on levo alone, but what are the odds your gp is going to refer you for genetic testing to see if you're one of the many or one of the few?
It isn't that there's 'no' evidence, it's that they pick and choose to suit their budget.
Might be worth pointing out to GP, it is not the actual costs of the drug that is the issue.
It is the extortionate immoral profit, being extracted from tax payers, due to NHS incompetence on regulation of price paid for drugs from a monopoly supplier.
Lol, my gp and I had that convo. He was a bit taken aback when I said I could buy it myself for £60 for almost a year's worth. (That came back and bit me in the @rse when my supply dried up.)
Thank you eljii for that list of links. I have made my eyes sore from reading, but there is some new-to-me info there about preripheral conversion and DI02 ( I'm heterozygous ) I did find one document which is a single page long that I will take to give to my GP.
As a first learning point; it does look like serum FT3 needs to be higher in range than FT4 because of the suppressive effect of thyroxine on the effect of the D2 enzyme. I need to re-read that ( very long ) article again.
Oh dear I fear I may well be having the same convo with my doc, once I get the letter from my Endo advising a dose of t3 be added. oh the fun.. I've managed to get my own in the mean time. I really can't afford the cost of the private prescription he gave me
I am in the process of trying to get my Gp to change my T3 prescription over to Cytomel, the American version as I am so fed up with getting British T3 which not only costs the NHS a bomb but also does not work reliably and some batches are faulty. I think the American tablets are coming in at roughly a quarter the cost of the British ones so why aren't the NHS using these? The British medication is now affecting my quality of life and I am so fed up with having to put up with batches of medication that simply do not work. I have sent in numerous "yellow cards" for this medication but nothing seemed to work until I sent a rant email to the manufacturers. Since then I've had a flurry of E-mails back but no actual answers.
To rub salt in the wound I managed to buy T3 while in Greece on holiday over the counter for just over £1 a box of 30 tablets! As I take T3 only I am acutely aware a couple of hours after I taking a faulty tablet and the hypo symptoms start to return again.
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