Other T3 is available in the UK by special request. I am now on Sandoz. €20 for 30 tablets (25mcg) from Boots. Feeling miles better!

After jumping through a few hoops and finding a pharmacist at Boots that was interested in the T3 issue I have a workaround for the Mercury T3 issue.

My endocrinologist put me on T3. It helped. Levothyroxine didn't work for me. The Mercury pharmacy T3 was an improvement, but I was started on 10mcg per day and was moved gradually to 60mcy per day. The cost was extortionate. I was still tired and not losing weight.

My sister in America was on a different drug and getting a good result. I noticed that the Pfizer T3 was less expensive in America. Began to do research on getting an alternate T3 here in the UK.

The change was actually very simple. It requires a hand written prescription for generic levothyroxine at the 25mcg dose. The pharmacist then writes a request to the health board to use the alternate highlighting the cost savings. Once approved you're all set.

I am now on the German T3 from Sandoz. The cost is about €20 for 30 tablets. (There are 5 mcg tablets available as well, if needed). They are larger firmer scored tablets. Easy to break even without a pill cutter. Most importantly I feel better and I'm losing weight. My energy is better and unlike the Mercury tablets this seems to be a more sustained release formula so I no longer have peaks and troughs of energy.

I have been on the Sandoz for 3 months. I have lost a stone and had new blood tests drawn yesterday.

If anyone is interested in this perhaps their pharmacist can talk to mine and get the ball roling. My pharmacist had to assist the GP with writing the prescription in a way that resulted in the Sandoz prescription as via the automated system the GP can only order the Mercury version. It needs to be handwritten each time the prescription is renewed.

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  • That sounds amazing. Could you private message me the name and details thanks. Does this mean you are paying or the GP is? Could you get it same cost on a private prescription? Wondered who paid as presumably you would pay in pounds to boots?

  • This is an NHS prescription. I pay nothing.

  • You said "generic levothyroxine" do you mean Liothyronine? Clemmie

  • Yes!i meant Liothyronine! Sorry

  • I'm sure everyone knew what you meant but just in case of confusion, I wanted to make sure. Clemmie

  • I was looking up info about liquid thyroxine, so it was on my mind.

  • Lintably,

    GPs have always been able to write prescriptions on a named patient basis to prescribe medications which aren't licensed for UK use. I'm glad yours has found a way to prescribe you T3 without paying the extortionate price for Mercury Pharma.

  • Yes, they have always had the ability, but it's still a struggle to get them to do it. This seems particularly to be the case with Liothyronine as they must make a handwritten prescription and can't see the alternative options in their computer. My GP had to get info from the pharmacist at Boots to sort it out. GPs are unaware that a lower cost and possibly more effective choice is available. Instead they read the NHS advice not to prescribe due to the high cost and don't research further. You need to take info with you to build your case. The fact that the dosage is 25mcg rather than 20mcg per tablet seems to confuse the dosing info they have to hand as well.

  • Lintably,

    Germany and Austria do 20mcg Liothyronine too.

  • There seems to be various doses available in various countries. I was originally requesting 25mcg Pfizer as it appeared to be available. The original named patient prescription was for the Pfizer product. Sandoz 25mcg was substituted. No idea why. Not keen to query it in case the Pfizer gets substituted when I'm having a good response to the Sandoz product.

  • Although cost is an issue, the Sandoz is simoly a much better product as well! There is no comparison to the way I feel. Energy better, weight loss, sleeping better. Hair is fuller, eyebrows growing back. I've lost a stone in 3 months since changing to Sandoz.

  • Hi Lintably

    I am so pleased to hear about how much better you feel it's sounds like you are getting g back to your normal self it must be such a relief !!! 😀 I like you did previously feel absolutely dreadful on Levo it really doesn't suit me my gp has reduced my dose from 50 mcg down to 25mg now she wants me to have a few days off it altogether !!! I am desperate to try an alternative what part of the country do you live in ? Can you private message me which pharmacy so I can go bk to the gp and try and get the wheels in motion 😀 Kind Regards Kazbe x

  • So if i were to ask my Doctor to prescribe T3 or Armour - where would i advise him to 'look up the medication' so he can prescribe it on a 'named basis'. I went to see a private doctor who did not know what i was talking about and when he tried to look up the medication in his 'NHS bible' he said 'if it is not there I cannot prescribe it'. I did not know what to answer to that? I want to appear knowledgable next time - so where would i refer him? Where could he look it up? Is there a definitive handout I could take with me. I felt so stupid last time?

  • Laraline,

    Liothyronine is listed in the British Natural Formulary but many CCGs insist that a NHS endocrinologist recommends its use before a GP prescribes it.

    NDT isn't licensed for UK use so it isn't in the BNF which may be what your GP meant by "NHS bible". NDT is rarely prescribed on the NHS. Most members using NDT have private prescriptions or buy online and self medicate.

  • Thank you - so if I order NDT and self medicate - do I tell my doctor?

  • Laraline,

    That's entirely up to you. I didn't tell my endo I was self medicating T4+T3 until I knew it was working for me.

  • And was he/she ok about it?

  • Laraline,

    I wasn't looking for his approval but he was ok.

  • Thank you I guess what I meant was are we in our rights to order stuff and self medicate?

  • Laraline,

    Legally we are entitled to import thyroid replacement for our own use or that of our household.

    Medically we are entitled to self medicate. If your doctor doesn't approve s/he can ask you to stop and can ultimately discharge a patient who doesn't follow his/her treatment plan.

  • Thank you that is interesting

  • I've just been given a private prescription for Liothyronine 20mg Thybon Henning , could I possibly use that prescription to get this one?

    I'm having trouble been new to private prescriptions & not knowing procedure. Thanks

  • You cannot use a prescription for 20 microgram tablets to get 25microgram tablets. Thybon isn't that expensive, is it?

    You just might find that ordering it from Germany is less expensive than getting a UK pharmacy to get it in. For example, versandapo.de

  • Thank you for your message. Yes, I have now been able to order appreciate all assistance

    Pam

  • Could someone please tell me if I am on Levothyroxine 50 how much T3 would I need to take as well?

  • helvella -

    Thanks for information. However would it be possible to get an English "version" for versandapo.de ?

    Hope it's possible...

  • Their website has the option to work in English.

    On their home page, scroll down to the bottom, towards the bottom left you should see:

    SPRACHE

    With several flags below. Sprache is German for "Language" - click on the Union flag.

  • Many thanks for tip.. will now look it up again. Much appreciated.

  • Perhaps Thyroid UK could write giving this information to all the CCG's as they are the ones trying to stop T3 being prescribed. They can then pass it on to the doctors in their area.

    Could you also please PM me with your pharmacist so I can ask my surgery's pharmacist to speak to them. My blood tests show I need T3 so they are not actually refusing me (at the moment) but they have reduced it.

  • Good work!

    My GP gives me a private prescription (for free) which I send to a pharmacy in Germany. They then send me Henning Thybon, which costs me €30 for 100 x 20mcg tablets.

  • Could you send me details of your pharmacist please? Or they might prefer to provide you with a brief written explanation which you can circulate so they are not bothered by lots of phone calls. My Boots and another pharmacy clearly not aware/not interested by my GP is a dispensing doctor-though I do not live far enough from the surgery to have my drugs dispensed by them, they might break the rules for this. Maybe? As my GP has 2 other patients on T3 and is hoping I can come up with a solution?

  • This is really interesting- could I ask you to send me the details of how it was done too? It will help those of us whose GPs are willing to prescibe liothyronine- but CCGs are trying to stop them. Thanks very much!

  • Hiya, I am planning on seeing my gp as I am getting stressed that they will try and take my T3 from me. If I have issues then please can I message you so I can get info if I need it. Xx

  • This is very interesting. I've been on T3 from Greece for over a year and haven't as yet felt really better. Please message me as it would be good to be able to try a different brand as well as obtaining T3 through my GP

    Thank you very much.

  • I will message people tomorrow as I am just home at nearly midnight tonight.

  • I would also appreciate receiving the info for my GP as an alternative to MP 20mcg plus 5mcg Liothyronine from Boots.

    I also

    Thank you.

  • Hi this sounds very good please could you private inbox the details 😀I'm not doing very well on Levo myself my gp trying to take me off it altogether !!! if I need T3 I need to be able to access it privately as I don't think my gp will prescribe but she will write private prescription ! Thankyou Kazbe 😀

  • Thanks so much for the info! Please PM me too.

  • I feel really bad asking as so many have asked you, but could you send me the details of your Boots Pharmacist as well please.

  • Wow, well done. Now all I have to do is try again to convince my GP to agree to prescribe T3! I am so fed up of feeling so utterly miserable and watching my hair get thinner and thinner. Any suggestions you have to persuade my GP that T3 might be the answer would be gratefully received. What is wrong with NHS UK.

  • Could you please message me with the name of your pharmacist. I presume you have asked your pharmacist if they mind getting calls about this?

  • To everyone asking. I had two different blocks to overcome. My original endocrinologist at Edinburgh Royal infirmary didn't seem to care or want to try new things. Whist he was on holiday a female locum agreed to write the prescription for Named Patient 25mcg Liothyronine . If you have a doctor that refuses to think out of the box, ask for a different doctor.

    Once I had the prescription information from the hospital endo I needed to take that paper to my GP for an actual prescriptione. I took it first to a few pharmacies to see what they could actually order. Several said they would need to research the options, but didn't get back to me. One said that he could order anything except the UK version. As a last resort I took it to my local Boots. He said it shouldn't be a problem but the Pfizer product written on the prescription from the endo might not be available.

    My GP wrote a prescription based on the info from the endo, but left of Pfizer as it was unclear it it could be imported.

    I took this prescription back to Boots. The helpful pharmacist was covering at a different location. The pharmacist on duty indicated an inability to deal with this prescription. I was told to take it to the other Boots to speak with the pharmacist that had been helping me. So, clearly not all pharmacists are willing or able to deal with this.

    The helpful pharmacist ordered a generic 25mcg liothyronine. The Sandoz from Germany was supplied. I had never heard of Sandoz.

    After a few days I noticed a difference in the way I felt. After a few months I feel nearly normal for the first time since 2000.

    The GP wrote the original prescription for only a one month supply. I had to have a telephone consultation to request another handwritten prescription. My doctor was on holiday. The duty doctor called. He was not clued up on what I was actually wanting. He started of with a lecture about the cost of Liothyronine and told me that if I didn't have a prescription from an endo I wouldn't be getting it at all as GPs had been told not to prescribe it. I let him finish the rant. Then explained that the reason I needed a prescription handwritten is because I am now using a Liothyronine that costs only €20 per bottle. He was clearly annoyed that I had ruined his rant. He then screwed up the prescription as he changed it from the endo suggesting I start with 2 per day of the 25mcg tablets and reassess after a few months as it was a decrease from my 3 per day 20mcg UK version. The prescription was written for 3 per day. He also wrote a 3 month supply based on the UK 28 tablet bottle rather than the 30 tablet box that Sandoz supplies. This doctor requested a further confirmation from my endo that this was a valid course of action. VERY strange! Luckily he is not my normal GP. So yet again...you may need to change GP if yours is uncooperative.

    Boots has now been able to work out a system to get the handwritten prescription without me requesting a phone consultation.

    I hesitate to give out the pharmacists name wily nilly as there seems to be a lot of interest in this post. He can help your pharmacist if they are struggling to organise a Named Patient prescription and in getting the approval from the health board. He can't assist in actually getting a Named Patient prescription. There may be other generics available. There should be no reason you can't specifically ask for the Sandoz product instead of a generic to be specified on the prescription as that is what I have in place now.

    It is entirely possible that a GP would prescribe it without seeing an endocrinologist on the NHS as the cost of the Sandoz product is no longer prohibitive. Worth asking.

    If you have a good relationship with your pharmacist you could ask about their ability to deal with Named Patient prescriptions. My GP needed help from the pharmacist to sort out the prescription as the item is not on their computer. It is on the pharmacists computer.

    If you have a prescription and your pharmacist is not able to manage the Named Patient prescription please get in touch. I would suggest that you try your local Boots. If they still can't sort it out, I can then give you my pharmacists name and they can interact as they will be on the same system.

  • Hi there,

    I get named patient basis for 9 years now. My gp writes liothyronine sodium in 25 MCG and I get three months worth. I ask for Cytomel Pfizer from pharmacist.

    Works wonders.

  • Well done and obviously overwhelmed with the responses you are receiving. Those of us who need this drug perhaps have a way round the distress we've been experiencing at the thought we might lose our t3 lifeline. I'm allergic to thyroxine so liothyronine is very important to me.

    So, thank you Lintably 💐 GG

  • Best of luck. Feel free to DM if I can help in any way!

  • Hi Lintably

    Impressive work! I wonder if it might be worth scanning a copy of the handwritten prescription and uploading it on here next time you have one. This might assist willing GPs who just dont know what to write. It might also assist those with GPs who arent willing to think outside the box and just default to 'It is too much effort lets not bother to try', we shouldn't have to spoonfeed but if it gets the job done......

    It might be also be worth asking if the pharmacist is willing to write a short piece from their end of the process to assist unfamiliar/unhelpful pharmacists too.

    This may save your helpful pharmacist cursing your name plus a lot of repetitive phone calls 😁 If the above works I would think TUK also would be happy to have copies for their advice section.. You never know, showing how cheap and easy it is may help in the saving T3 campaign they are fighting.

  • I have no idea how or why the German Sandoz Liothyronine is so different from the UK version. I was initially concerned that it was loaded with filler since it is a far larger tablet (about 4 or 5 times the size of the UK version). It is a much firmer consistency and tastes sweet. It is clearly designed to be easily broken in half.

    I have no idea how the Sandoz product differed from the other German Liothyronine products.

    No idea why it's working so well for me. No idea if any other Liothyronine would work as well for me. Might just be a happy accident that I'vecstumbled onto a medication that my body likes.

    I haven't been able to lose weight in many years. I am also using a vibration plate machine as recommended by another thyroid patient who had success losing weight with the vibration plate. Losing a stone in 3 months is a miracle for me. I hope it doesn't plateau until I reach my ideal weight.

  • This is interesting. I tried searching Sandoz on the internet and it came up as being T4 drug. Do you know what is the full name of the drug - is it Trijodthyronin – Sandoz I believe is T3?

  • "Trijodthyronin Sandoz" with the small 'r' as being a registered trademark is on the box. In smaller letters it says "Wirkstaff Liothyronin (T3)" and "25 Gamma Tabletten".

    There is no translation into other languages on the package insert...just German.

    This link shows the exact product I have. It also shows the individual packets inside the box.

    inter-medis.com/katalog/tri...

  • I have just had a follow up email from Dr Toft. He says that more and more pharmacists are willing to source T3 from other EU suppliers. He also says that he wouldn't be surprised to find that the UK T3 has 'variable potency' as it is a 'common complaint'. He says patients need to raise the high cost and variable potency issues with their MP. He says we should ask our MPs to raise a complaint with the Marketing and Competition Authority. (This is a govt organisation with no direct contact with the general public).

  • I wonder what Boots and other pharmacies charge the NHS for sourcing Sandoz T3 and similar products? Unsure how the pharmacy business works and their agreements with the NHS. It could be they are charging the NHS several times the 20 euro amount to fulfill the prescription. On the other hand there could already be agreed fixed rate charges in place. Just a thought.

  • It certainly is an issue. Don't even know if all pharmacies charge the same for specials like this.

  • Any idea how to find out?

  • Possibly ask the NHSBSA? Use Freedom of Information, if needed, but a simple question might get an answer as to whether there is a standard charge per prescription (or whatever basis it might be on).

    nhsbsa.nhs.uk/

  • Thank you for answer.

  • I have confirmed today that the NHS is being charged £35 for 30 of the 25mcg Sandoz T3...as compared to £258 for only 20 of the 20mcg Mercury T3

  • I have looked up this product. I am very confused. It is headed levothyroxine, but it states liothyronin in where I presume is the ingredients.

    es.sandoz.com/our_products/...

  • You are looking at the wrong product

    This is the Liothyronine

    drugs.com/international/tri...

  • The product I have is German. There are no translations on the package insert. I found this site with the package insert info that translates it to English.

    medikamio.com/de-at/medikam...

  • That page is about bulk levothyroxine powder - as a commodity product to be sold for manufacturing levothyroxine tablets. The reference to liothyronine is identifying that the product could contain a small amount of liothyronine as an impurity or by-product.

    The official standards for levothyroxine allow maybe 1% liothyronine (maximum).

  • Thanks Lintably. I see you have to buy 10 packets for it to be E20 a packet.

    1 package(30 tablets) - 65 €

    2 packages - 40 € per packing

    3 packages - 35 € per packing

    4 packages - 30 € per package

    5 packages-25 € per package

    10 packages - 20 € each For packing

  • I just confirmed with Boots the current price to NHS of my Sandoz product is £35. Initially before it arrived I had been told it would be £20.

    The current price of Mercury is £258

    I take T3 three times per day. The difference is over £660 per month and over £8,000 each year between the two drugs. Eye watering when you think about the money that could be saved across the UK.

  • Hello,

    Could you please let me know where you got this information from? I am trying to find a link to the Sandoz product online. Thank you

  • Today I have written to my MP as suggested by Dr Toft and also written this letter to The Health Secretary.

    Dear Health Secretary,

    I am writing regarding the ongoing situation with Liothyronine (T3) medication for hypothyroidism.

    There are several concerning issues:

    1) there is some sort of single supplier agreement in place that makes it difficult for GPs and Endocrinologists to order other readily available generics at a fraction of the cost without creating a Named Patient prescription. Many doctors are reluctant to use Named Patient prescriptions.

    2) readily available generic Liothyronine ranges in cost between £10-£35. The UK single supplier arrangement instead uses a Mercury Pharma product that is being investigated as part of the investigation into Concordia Pharmaceuticals price gouging. This UK preferred supplier is currently charging £258 for 28 of the 20mcg tablets. Many of the generics are supplied in batches of 30 tablets in 25mcg strength. Hence the UK preferred supplier that is under investigation is producing a less potent product and fewer tablets for an extortionate price. pharmaphorum.com/news/conco...

    3) GPs have been instructed not to prescribe Liothyronine due to the extortionate cost. This leaves patients in need of this hormone in poor health. It is clearly far more sensible to lift the single supplier arrangement and instruct Endocrinologists and GPs to use other less expensive generics as they do with other drugs. A few Endocrinologists are now thinking out of the box and using the Named Patient prescription route to access the generics as a workaround. For instance, I am now on the German Sandoz 25mcg tablets at a cost of £35 for 30 tablets. I require 3 tablets per day. This is a saving of £669 per month. This is more than £8,000 per year just for myself. The savings to the NHS by allowing other generic Liothyronine to be prescribed ASAP is eye watering!

    4) There are also ongoing patient complaints of variations in potency from batch to batch with the UK preferred Mercury Pharma product. Hence not only is it more expensive, it doesn't work very well. That is consistent with my personal experience. Since being changed to the Sandoz product I feel much better! I have lost a stone in 3 months, my energy is much improved, my palpitations have stopped, my hair is thicker, my insomnia is gone. In contrast, the Mercury product seemed to peak very quickly then leave me very tired again. I have been on it for many years and found it utterly impossible to lose weight. Sadly, to achieve this improvement to my health it required finding an endocrinologist willing to write a Named Patient prescription and then a Pharmacist that could pursue the prescription and request permission from the health board to fill the prescription. Many patients are not lucky enough to be able to achieve this and are unwell because of the difficulty in getting a prescription for a low cost effective medication.

    5) An investigation should be started into why the NHS is only authorising the extortionate and less effective variable potency version of Liothyronine.

    I look forward to your prompt attention to this matter. I'm hoping to hear that the restriction against other generics has been lifted and the instruction to GPs and Endocrinologists to not prescribe this essential drug amended.

  • Thank you for this detailed explanation you have obviously been inundated! Never got that chat but than you so much for this. I will go and speak to my pharmacist first then go armed to the GP.

  • Good luck!

  • Could you please PM me too with all the info on the German Liothyronine. My GP has been told to stop prescribing my Liothyronine due to cost. My Endo Doc is trying to sort it all out but i am worried in case they stop it completely. I am on Levo/Lio combo 75/10 mcg. Not sure how to approach my GP about the German Liothyronine. Thank you for posting about this.

  • Hi, has anyone else had noticeable improvements by using Sandoz or any other T3 equivalent rather than the Mercury Pharma one? Why would a tablet of the same dose give such difference results between different manufacturers? Thanks

  • FWIW, I stumbled on this info about Sandoz Thyroxine. It is 12.5% more bioavailable than the Synthroid brand benchmark in the USA.

    If the Liothyronine is also more bioavailable, that is likely why I feel so much better.

    I suspect Mercury Pharma would be the opposite and be less bioavailable than the USA cytomel brand T3. As it is a 20mcg dose rather than 25mcg, perhaps they've not been compared.

    academic.oup.com/jcem/artic...

  • I don't know much about bioavailability. One question, when you switched did you stay on the same dose or do you jump say 60->75?

  • At first they wrote the prescription for 25mcg twice per day and check lab results after 3 months. The original prescrption was written by a locum.

    The GP asked for a letter from my regular endo confirming that I could change. At that stage inexplicably it was increased to 3 times per day. I think this was just carelessness in keeping the 3 times per day schedule.

    Since it saves me the hassle of requesting an increase if I feel under medicated I'm just leaving things as they are. Any extra that I don't take will give me a safety net if Sandoz is withdrawn in the UK in future.

  • Thanks for the info, but I don't totally get it. How much were you on when on the mercury brand. Then now how much are you on, on the Sandoz?

  • Bear in mind the the OLD formulation of Teva was withdrawn from the UK market after they changed the dextrin ingredient. (It looks as if they simply used a slightly different dextrin - not more, not less, not a wholly different ingredient.) This resulted in the tablets failing to deliver their claimed potency to those taking them.

    That single change made a big enough difference to cause a mass of complaints.

    Given that we are all different, our ability to absorb the active ingredient from one formulation could well be different to another formulation.

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