The British Thyroid Association have published some new guidelines for doctors, patients and endocrinologists regarding the prescribing of T3 - New Guidelines from the British Thyroid Association - Switching from Liothyronine (LT-3) to Levothyroxine (LT-4)? - 2016.
These guidelines are telling doctors and endocrinologists that they shouldn't carte blanche stop patients having T3.
Thyroid UK is surprised but pleased that the BTA are realising the plight of some thyroid patients.
If you have been taken off T3 or are in the process of this happening, do take a look at these guidelines. Print them off and take them to your GP or endo for discussion.
Slowly but surely! It's like watching a mule, obstinately with hooves dug in, being slowly pulled along anyhow to a destination it will then say when it gets there, it wanted to get to all along.
If you heard a thump at around 1pm ....that was me falling over!
Seriously, I hope this helps those having trouble with getting T3 prescriptions or who have been told that they can no longer have it due to cost etc..
The change of stance is only the start, however welcome. Now, if we can get TSH testing out of favour, and FT3 substituting for it or in addition, then therapy diagnosis will at last become logical. The evidence for this is now out there in copious amount and it can only be a matter of time before this major hurdle is overcome. But there'll be a lot of mulish behaviour before that is admitted. The fundamental argument against simplistic TSH diagnosis in therapy is now clear, given the fact of different ranges in different conditions.
I've only had a brief glance at this, so someone please correct me if I'm wrong. Isn't this simply saying that those already on T3 can continue to get it prescribed. Which of course is great news for those being told they can no longer have it
Other than that, it still seems to be very strongly stating that T4 is all we need... because there's not enough evidence to prove anything else (i.e. combination or T3 monotherapy) works or is at all necessary. Which is of no help to anyone trying to get desiccated thyroid or T3 prescribed, regardless of cost issues.
However, we recognise that a proportion of patients on L-T4 continue to suffer with symptoms despite adequate biochemical correction and that a carefully audited trial of L-T3 under the supervision of an accredited endocrinologist might be warranted in exceptional cases [3].
Thanks, I know it seems to be better than an absolute and final NO.
How many will in reality, be considered to be 'exceptional cases'? Most especially when a) thyroid patients have to first beg their GP for the referral to an endo (referrals cost money!), b) the endo needs to be sympathetic to the cause and c) the cost of anything other than T4 is relatively astronomical!
Sorry for my cynicism, but I would say it's less than a token gesture really.
We see the figure 15% - or thereabouts - bandied about as the proportion who need something other than levothyroxine-only.
Dragging up every last ounce of optimism, it simply doesn't seem feasible that 15% could ever be talked about, or treated as, exceptional cases. You could increase or reduce that percentage by quite a margin and this comment would still stand.
We seem to have moved on and added to "postcode lottery" a "when seen by a medic who has a clue lottery".
Please let us know if anyone gets a recent, cost-induced T3-withdrawal rescinded and their liothyronine prescription fully reinstated.
I'm as cynical as you RedApple , but then, if we had GPs who were knowledgeable we would not have to be referred to (usually) equally unknowledgeable Endos! They wouldn't have to pay for us then out of their budget (paid for by tax anyway).
Completely shocked and so grateful. I have a prescription review at the end of this month and have just been dreading a fight. Wouldn't we like to know where this came from? lynmynott that is a very reserved heading you gave this post. 'Hallelujah' perhaps? We're clearly all in a state of shock.
well I just stumbled across this... great news, but just days after my review with my endo so I wasn't clued in to discuss with him. Unfortunately, I still seem to be struggling with getting my T3 reinstated... awaiting my bloodwork results from endo hospital appt. I might contact him in the meantime and alert him to this - there was no mention in my clinic session with him, before he writes to my GP.
I will be also arming myself with this next GP appointment...
Will let you know how I get on. Keep your fingers crossed for me!
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ATA New 2014 Treatment Guidelines Reviewed By Mary Shomon
NHS 'guidelines' preventing my GP prescribing for hypothyroidism - help please!
Liothyronin guidelines to Endos
