Refusals to Prescribe T3 - is it Ethical?

[smudger1]

Bearing in mind that it is a guideline not a ruling/order issued by the CCG's to stop the prescribing of T3 (liothyronine) I question whether it is ethical for GP's and the like to snatch the opportunity to save money/hit budget targets and allow themselves to be governed purely by a funding agenda without due consideration for the medical repurcussions on their patients.

[helvella Administrator Thyroid UK]

It could be unethical - but I would have some sympathy for a GP who is put under considerable pressure to conform. I'd rather hit the CCG members with the charge of acting unethically than an individual GP who might wish to prescribe.

[shaws Administrator in reply to helvella]

I agree, we all come down on the GPs for not diagnosing us - i.e. TSH has to reach 10. Plus the withdrawal of NDT a few years ago and members having to source their own. Now it is T3. The BTA care not one iota how we the patients feel when the only source of hormone which helps (it isn't fashionable as they probably believe and it isn't all in our minds) us recover.

Who has pursued the GPs in the past who prescribed regardless of TSH like Dr P and Dr Skinner and probably more doctors pressured in the past as they prescribed NDT.

We know there may be some publicity about the withdrawal hopefully shortly.

[smudger1 in reply to helvella]

I agree with you in some instances but not where there are GP's choosing to ignore endo recommendations to prescribe and relaying untruths to their patients.

[shaws Administrator]

This might be helpful if you self-medicate:

web.archive.org/web/2010103...

web.archive.org/web/2010112...

[shaws Administrator]

You can communicate with this journalist who is looking into the matter.

healthunlocked.com/thyroidu...

[smudger1]

Bearing in mind the small amount of training GP's have on thyroid issues I do think it may suit many of them to withdraw T3. This would enable an easy diagnosis based on TSH and how much Levo to prescribe, whereas conversion issues and inactive Levo issues require more thought & knowledge.

[shaws Administrator]

If we are employed by a company, we have to follow their guidelines (we cannot wander in and out or turn up when we want to) and if they circulate what a procedure should now be, we cannot go against their wishes. Members of organisations have to follow changes whether or not they like them. If we, personally, don't agree we can leave and look for another job, but if you are a Professional you usually belong to an Association or even belong to a Union so you still have to follow the decisions which have been made.

For instance if a doctor prescribes a medication for a patient, upon the patient's request, if the patient has a reaction or is rushed to hospital the blame falls on the person who has prescribed.

[SilverAvocado in reply to shaws]

I mostly agree with this. I don't think doctors are trained or resourced to be what we might think a doctor should be

It's obvious that a doctor who hasn't been taught about thyroid would have to put hours into researching to know what we know. And that just doesn't seem to be part of their job.

[marigold22]

There has been a crowd of T3 users writing to every person and body we can think of. Our own CCG, Dept. of Health, Healthwatch, NHS England, etc. If you go to the British Thyroid Association website,

british-thyroid-association...

go to Guidelines at the top, then on left hand side Frequently Asked Questions,

you will see what GPs and Endo's are being told.

[Zephyrbear in reply to marigold22]

I've printed all of those off and will be taking them along to my next endo and GP appointments. To be fair to my GP, she acknowledges that I probably know more about my thyroid condition than she does and is happy to continue with the T3/T4 combo treatment I have been on for the last 7 years while she is permitted to do so. I'm in Wales, although my endo is based in England so I'm not sure how that will work out... In the meantime, I have ensured I have a back-up supply from Greece already stashed!

[Snoddyoddbod]

Fully understand that there are restrictions and budgets to be adhered too but, why offer treatment like RAI and removal when the NHS gps endos etc know they cannot offer the full and corrrect after care.

Surely that is unethical

It's not doing the best for their patients

It's condemning patients to a life of utter misery which surely goes against what they took an oath for in the first place

Aren't they supposed to preserve life not trash it

[shaws Administrator]

Unfortunately, or fortunately for many, levo works. Its those of us for whom it doesn't work who are out on a limb.

Of course specialists should be aware that sometimes human bodies react badly to some of the prescriptions but they don't recognise that with regard to levothyroxine.

As your probably know, some cannot take paracetamol which millions can take without apparent reactions.

[Shelley1954]

A guideline is there to guide it isnt an order and leaves room for individual variance from that guideline if needed. It seems that GP's are just not prepared to vary from it regardless.

[Bluecat101]

Round here Southampton Laboratores ignore any GP request for T3 blood test and dont say they are not doing it either. l get the impression that that is because if it is shown to be necessary then the GP is obligated to prescribe it. (l dont know for sure whether this is so) l am aware the amount a Surgery prescribes on Drugs is recorded and they can be told they are over budget. Expect you know UK is charged the highest price in Europe, and it can be bought in France or Greece for 2-3 Euros

[smudger1 in reply to Bluecat101]

I am currently on T3 from Greece, my endo asked to see the packaging and I showed him the cost, he was stunned!

[helvella Administrator Thyroid UK in reply to smudger1]

Which prompts me to ask: What is this stunned endo going to do to ensure that liothyronine is available at a sensible cost for all who need it in the UK?

[smudger1 in reply to helvella]

Very little I expect, but I do know he is active in the support of prescribing T3, he was one of those commenting on the article recently posted on here.

[Bluecat101 in reply to smudger1]

Good, glad the Endo saw it. A friend was Manager in NHS and can not under- stand why no one ever queries what NHS is charged in any area. For instance l gather WE can buy lxpkt Copy paper up the road - cheaper than the NHS is charged for quantity. l gather the price of T3 was £11/month before the only company that makes it was sold to some 'rip off' enterprise

[Ann-Simpson in reply to smudger1]

Could you please tell me how you import the T3 from Greece? Is it a company who specialises in bringing it into the UK. And does it work in the same way as the T3 we have been used to taking while it was prescribed for us? I am about to start thinking about sourcing T3 in this way as since stopping taking it I am feeling very unwell.