Department of Health

[Summer64]

Had another letter from DOH which I will be responding too as typically doesn't answer my questions. I was prescribed my Liothyronine in secondary care and it should not have been abruptly stopped. Not sure if I can add both pages here so may have to do them separately. I've been trying to find out what NICE actually say about this. So far the only paper I've found doesn't seem to class it as "unsafe or ineffective. Does anyone have anything on this please?

Page two continues in healthunlocked.com/thyroidu...

[SlowDragon Administrator]

British Thyroid Association guidelines say it should not be withdrawn from patients doing well

british-thyroid-association...

Yet, entirely due to costs, thousands of patients have had this essential treatment abruptly withdrawn causing great ill health and distress.

Also increased cost to NHS in other ways, such as needing B12 injections, folic acid, iron and vitamin D supplements on prescription. Referral back to consultants and increase in blood tests

[Clutter]

Summer64,

There are two studies below showing long term use of Liothyronine is safe.

thyroiduk.org.uk/tuk/resear...

ncbi.nlm.nih.gov/pubmed/269...

[Summer64 in reply to Clutter]

Thanks for that but I would like to find the NICE guidelines as that is what the DOH quote. I will include those articles in my reply though.

[helvella in reply to Summer64]

This happens time and again.

There are NO formal NICE guidelines for hypothyroidism.

There are Clinical Knowledge Summaries (CKS) which were inherited by NICE from the NHS. They do not have the standing of full NICE guidelines. They do not have properly developed document management (though rather better than some other organisations).

cks.nice.org.uk/hypothyroidism

Whether the author of the letter understands this or not is another matter.

[Summer64 in reply to helvella]

I shall be responding and make sure she does.

[helvella in reply to Summer64]

I rather thought you might!

[Clutter in reply to Summer64]

Summer64,

NICE CKS on hypothyroidism discusses Levothyroxine and doesn't mention Liothyronine. cks.nice.org.uk/hypothyroid...

There is only mention of Liothyronine in cks.nice.org.uk/#Search?q=L...

[Summer64 in reply to Clutter]

I found something on Liothyronine. I'll see if I can find it again.

[Summer64 in reply to Summer64]

Yes, here it is. bnf.nice.org.uk/drug/liothy... Wasn't the guidelines I was looking for but interesting it does say that side effects are only due to overdose and that we should be tested if our brand is changed.

[helvella in reply to Summer64]

Yet another thing that isn't really NICE!

Published jointly by

BMJ Group London, UK WC1H 9JP Tavistock Square

and

Pharmaceutical Press London, UK E1W 1AW 66-68 East Smithfield

Pharmaceutical Press is the publishing division of the Royal Pharmaceutical Society.

Copyright © BMJ Group and the Royal Pharmaceutical Society of Great Britain 2017.

bnf.nice.org.uk/about/publi...

I wonder what the arrangement is between NICE and BMJ/RPS?

[Clutter]

Summer64,

There is a transcript of NHS England's meeting about the consultation to desprescribe T3 in healthunlocked.com/thyroidu...

[silverfox7]

We know that costs have always been the issue but inept GP's and even Endo's don't help either! I wonder what percentage of people failing on T3 has been down to bad management but that's not taken into consideration? Medics giving it a thumbs down can't have helped.