Can a psychiatrist prescribe NDT or T3 in the UK??

[ThyroidObsessed]

Was wondering if this can happen, as I'm now at a loss after being stable on levothyroxine for 10 years but the last 2 years have been hell with my levels all over the place and no endo gives a shit, apart from one who left the hospital to go back to his own country! 😣...

I don't suffer physically apart from chest pain sometimes (hearts been checked and fine) i suffer mentally and been told to see a psychiatrist I'm wondering if they see that my levels are dodgy they may prescribe NDT or T3?? 🤔

[shaws Administrator]

I think you most probably need T3 added to T4. This is an excerpt and we do know T3 has risen astronomically over the past couple of years:-

T3 therapy is much more expensive than levothyroxine (T4) therapy

(one T3 tablet is approximately 100 times more expensive than one

levothyroxine tablet). It used to be much cheaper so I don't know how the extraordinary rise occurred.

So that's the reason they've withdrawn T3 from those patients that need it to get well. Previous to that they withdrew NDT through misinformation despite it being in use since 1892.

It would appear that if we don't recover on levothyroxine we may be damned to illhealth and all of the consequences of being undertreated.

[MaisieGray]

At it's most general, in the UK an authorised practitioner can prescribe what they chose to, if they believe it is necessary & beneficial for their patient. Authorised practitioners are either independent prescribers, or supplementary prescribers. The former are healthcare professionals who are responsible for assessing your health & making clinical decisions about how to manage your condition, including prescribing medication; and therefore include GPs, Hospital Doctors, Dentists (for oral conditions), Prescriber Pharmacists etc. I would doubt NDT would be a go to med, but certainly psychiatrists are using T3 for their patients with depression. A 2017 literature review for instance, over 50 yrs, found that "liothyronine is an efficacious enhancement and augmentation strategy for depression in combination with antidepressants, primarily tricyclic antidepressants and selective serotonin reuptake inhibitors" and concluded that "with appropriate baseline and follow-up safety monitoring, liothyronine augmentation can be a safe and effective treatment for unipolar depression". So a psychiatrist is likely to be considering the affect of your thyroid condition on your psychological health and prescribing accordingly, rather than considering your thyroid condition directly.

[SlowDragon Administrator]

If you have recent blood test results that show low FT3 take these along

As a secondary specialist, a psychiatrist can prescribe T3

[SlowDragon Administrator]

This is recent NHS England guidelines- see psychiatrist section

sps.nhs.uk/wp-content/uploa...

[beh1]

Liothyronine is sometimes used in ‘treatment resistant depression’. I was put on liothyronine by a psychiatrist and it has gradually reduced my body pain and improved mood. Obviously most of my issues were that the levothyroxine was an inadequate treatment for me. So, accept the offer of seeing a psychiatrist and ask for a trial of liothyronine to help your mood. Good luck.

[LAHs]

Excuse, this is a little off topic. I don't know if you ever got a TV program called Frasier in the UK. It was about two psychiatrist brothers ( Niles and Frasier) and an English home help (Daphne). Anyway, Niles was in love with Daphne and desperately wanted her to spend the night with him. She was agreeable , things got very romantic until just at the last minute she says she had forgotten her thyroid tablets and so she had to dash home. Niles was devastated and when he told his brother, Frasier, about his bad luck Frasier tells him," Oh Niles, did you forget you do have a medical license, why didn't you just write her a prescription!"

So if you believe the TV show, yes a psychiatrist can write medical prescriptions.