T3 countries: Which countries (theoretically... - Thyroid UK

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T3 countries

Which countries (theoretically) sell T3 over the counter? I am thinking Turkey, Greece and Bulgaria? ( I appreciate there may be obstacles particularly July/August when they protect themselves from tourists bulk buying etc)

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I've just purchased 5 packs from turkey for £14. 500 tablets in total.

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Tiromel there called

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Thnak you. Turkey seems to be easier than Greece at the minute.

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I get mine from Thailand.

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Over the counter in Thailand? Thanks.

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Officially, not OTC. The Thai desiccated thyroid products are also not OTC within Thailand.

I have no experience so cannot say what it possible.

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No NDT or T3 is sold OTC in Thailand. I live there and must purchase T3 from Turkey. T3 is not listed on the Thai drug formulary. NDT is manufactured in Thailand but doctors there don't prescribe it so I mail order from manufacturer in Thailand. Haven't seen it in a pharmacy. T4 is the only thyroid hormone prescribed thete and is available OTC. Not sure where the online Thai Cytomel is from.

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I bought two jars of 100 t3 from the chemist in Thailand. The tablets were manufactured in Switzerland.

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Were these the small yellow 100mcg?

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Yes small yellowish.

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Interesting. That's what I got via mail order from Thailand but there was no country of origin on the little bottle. Pills were very difficult to split. I'm now curious if those are the ones that the body builders use in Thailand. I since was able to source Tiromel online so will continue with that. Thanks.

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The pills I received were only labeled Citomel 100 mcg.

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Can you describe the pills themselves?

Shape (I assume round - but flat or "biconvex")?

Size (diameter in millimetres)?

Colour?

Markings - describe both sides?

Coated or uncoated?

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I'm in the US and don't have them with me. Small round biconvex, yellow, unscored, coated, and no markings that I can remember. I'll try one when I get back home next month and see if I can determine any difference to Tiromel (which I think are genuine). By the way they were packaged I wondered if they were the real thing thus didn't try yet. They are only available in 100 mcg...

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t3 Liothyronine Sodium manufactured by .Munster Laboratories Switzerland

I cut them inhalf and they seem to work better than some of the t3 offered in uk.

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Thanks for the description.

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No, from an online store, but it’s shipped from Thailand.

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If shipped from Thailand it is usually that appalling LA Pharma stuff.

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Can I ask why you call is that appalling LA pharma stuff?! Is it second rate? Thanks.

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I haven't seen a good review of it any where

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Wondering the same thing. I’ve been using it and loving it.

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Which one are you using? How long have you been on it?

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LA PHARMA brand. I will Pm you my source.

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Would you be so kind as to PM me your source too please? Tia x

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Would you pm the source as well? Thank you,

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alldaychemist.co.com/produc...

apparently this is $44 and made in Thailand for bodybuilders

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You are not supposed to mention suppliers in a public post. Breaking the rules!

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You might be best removing that link... I'd hate for this whole post to be deleted!

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I have bought in Crete in the past. €1.30 for 100, that was a couple of years ago, Tiromel 25mcg

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They have cracked down now, prescription only...

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Fair enough, it was a couple of years ago.

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I bought from Crete last week with no prescription

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AuntieMandy what brand of t3 did you buy in Crete?

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I think Greece has only one 'brand' and it is Unipharma (the pharmaceutical company).

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Is it NDT or synthetic?

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No it isn't NDT - which is made from pigs' thyroid glands which would be called 'natural'.

T3 is a synthetic replacement but it doesn't need converting (like T4). I was permanently unwell on levo - even a T3/T4 combination didn't work as well (although lots better than levo alone). T3 worked wonders but doesn't do so for everyone. We should be allowed trials of various options as we are not identical machines and some need less and some more. Those who've got Thyroid Hormone Resitance need T3 in larger doses than those that do not.

The pharmaceutical company in Greece is Unipharma and I find it astonishing that the UK T3 is so exorbitant that it was withdrawn (mind you it was a wonderful excuse as more and more patients were asking for a trial of T3 or addition of it. Why the extreme difference in cost?

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It’s uni-pharma

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Thanks. I thought so, but wasn't positive.

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Were you able to buy loads or just one or two packs ? I live in Crete and have to produce a prescription - so am thinking you must have struck lucky :-) Only saying as I do not want everyone thinking they can find T3 easily in Crete !

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A few boxes at a random pharmacy. X

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I go to Bulgaria often and have tried to buy T3 OTC but it is not permitted.

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Oh, that's a shame. Thanks for letting me know. I was thinking it would be, based on a certain well known internet pharmacy that sells it, being based there.

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Selling to people in foreign countries is usually controlled very differently to selling within a country. Further, we have to question whether some of the "Internet pharmacies" are pharmacies at all, in the official sense. I suspect that some are entirely outside the legitimate pharmacy market.

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For clarity, do you mean that T3 is not permitted? Or that you cannot buy T3 without a prescription?

Is levothyroxine available in Bulgaria without a prescription?

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I'm sorry I don't know what the Bulgarian official policy is on either T4 or T3. About 2 years ago I tried to buy T3 in a pharmacy in Sofia, and in a provincial town and was told both times it was not permitted to sell it over the counter.

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Bulgaria does not, at least officially, sell T3. It is neither manufactured, nor imported and endocrinologists don't prescribe it. There are websites where you can order it, unofficially - you get the Greek or the Turkish T3.

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I think that is due to thousands of Greek companies being registered in Bulgaria for more favourable taxation 😊

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The Greek T3 has become very difficult to get, mind you, even on these Bulgarian websites. I heard Uni-Pharma prefer to sell it via bodybuilder websites where the price goes up quite a lot.

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I live in Greece and have a prescription. I think the UniPharma T3 that appears on body building sites is from ill gotten gains ... only my opinion I have no proof !

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Oh, that was what I heard. I´ve never bought from those sites, I hope I won´t have to. I just hope T3 will be possible to find in the future, without a prescription.

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I think you will find they restrict T3 during July/August to curb bulk buying by tourists. Hopefully things will go back to normal later.

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Possibly Cyprus. I'm sure I've read of people (in person) quite recently getting it from both the Greek and the Turkish parts of the island, from a pharmacy, with no prescription. But I have no definite details and I could easily have got the wrong end of the stick.

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My original, 2012 source has been back for a while + friends get for me in the strangest of places. Now I find that x1 Cynomel + x1 Unipharma works well mixed ;-) Who can tell on this hypothyroid merry-go-round... well, not always so merry, eh? xox

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Mexico sells most drugs over the counter... but no opiods or anti biotics . I buy my T3/t4 combination for about $5 a month.

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Curious. We have had another person in Mexico insist that T3 cannot be bought without a prescription. Does it make a difference that it is a combination rather than just T3?

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They are confused.....mine is a combo of t3 and t4.....I don't know if they have t3 by itelf...if they did it would be over the counter. I have always used armour thyroid and the preparation I get in Mexico is very close....it is not natural but the combination is almost the same as Armour and it works good for me. The main thing is to get the t3 if some t4 comes with it no big deal.

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Thank you.

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I've recently been to Mexico and got Cynomel over the counter. However, not easy to come by, had to try several chemists. I think they would have been happy to sell more than 2 bottles at a time, but none seem to stock that many!

Probably not as cheap as the Turkish one, was roughly £8 per bottle with 100 pills.

sfletch43 I assume the combination you mention is Novotiral? It is 100 T4 and 20 T3. I also got some of it, but I think the T3 in it is weaker than Cynomel. At least a few weeks ago tried Novo on its own and symptoms came back with a vengeance! I now mix a 1/4 of it, 1/2 Cynomel and 75 mcg of Levo and feel great with it energy, mood and mentally-wise.

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I was in Mexico in January and asked in 3-4 pharmacies (in Merida and Progreso) for T3 (I think it's Grossman that makes it there.) No one knew what I was talking about.

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Mexico does have t3...it is called triyotex and is 75mcg. I used to use it but like Novotiral better it is 100mcg t4 and 20 mcg t3. Not all pharmacies carry everything...there are pharmacies on every corner and not all have an extensive selection.

The triyotex comes in a capsule so is hard to divide...that is why I switched. Armour 120 mg equals 18 T3 and 80 t4

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How do you feel Armour is working for you?

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I'm finding all these replies very interesting... thanks everyone!

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Spain. Just walk in the chemists. No prob. I do.

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Do you mean T3 or T4 ?

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You can only get EUTHYROX on Spain, T4, if you know any different I would love to know.🤗

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Yes I am aware Spain does not have T3 - hence my question to Patricia who gave the impression you could buy T3 OTC 😊

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Sorry, I didn't see that question when I replied. 🙄😊

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I tried in Spain and couldnt get any. Can you please tell me which area of Spain you can buy over the counter. Thanks.

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Aah. I made a mistake. I buy T4 Eutirox which is levothyroxine.

Sorry. My mistake. This is on Costa del Sol. Any of the coastal towns.

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T3 - none if the above sell T3 presently. At Greece the factory was closed.Bulgaria sells Turkish product. Tiromel It's ment for body building, not Hipo. or Hashi. patients.

I'm on gluten free diet. Eat small and have a brisk walk after each meal.

B 12, selenium and spirulina are included in a daily in take.

Enjoy your weekend's hard work at the Vila.

Good Luck

Rada

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I think the T3 supply in Greece is curtailed during July and August - well it was last year ...

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Tiromel is not just for body builders. Lots of hypo patients use it.

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Thank you. What makes you think that Tiromel is just for body builders? I have just ordered some as I couldn't get uni-pharma. I thought it was simply T3 with the same active ingredients??

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Tiromel is simply T3. I don't know why anyone should think it was for bodybuilders only. It is perfectly good for people with thyroid problems who need T3. I suspect lots of people who need T3 on this forum use Tiromel. I have seen comments that it is weaker than other makes of T3 (I have nothing to compare it to), but in that case people just have to take more.

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A friend of mine has been on Tiromel for the past six months because she could not find a doctor to prescribe T3 for her. It works just fine and is definitely intended to treat hypothyroidism. She takes 25 mcg daily along with 100 mcg of levo and feels so much better than on levo only.

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I live in Scotland have T3 prescribed by my endo. I've often wondered when people are having problems finding sources of T3 if there is any way of ordering from a UK pharmacy. I understand a private prescription may be required but is it not possible to arrange supply this way?

#t3 #supply #t3 supply #liothyronin #liothyronin supply

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Yes, of course it is possible to take a prescription to a pharmacy and get it dispensed.

But the problem, once you have somehow managed to get a prescription, is affording it.

Around £240 for 28 tablets. And some pharmacies will ramp that up even more for private prescriptions.

That is why people with prescriptions are often pointed at some German pharmacies.

thyroiduk.org.uk/tuk/treatm...

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I've recently had the misfortune to discuss the cost of my prescription with a hospital pharmacist. She informed me that a packet of 30 20mcg T3 tabs costs them about £500 and same packet of 5mcg T3 tabs costs them about £2000. Told her to give me more 20mcg in place of 5mcg coz would be much cheaper, said she wasn't allowed to do that. My prescription for 4 months of 75mcg/daily costs about £30,000. Needless to say, I have now had my prescription rescinded and put back on to T4 only......don't worry, I'm fighting the decision.

I would appreciate PM info of any suppliers please.......looks like I'm back to sourcing my own again. Tia x

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Afraid, other than the link I just posted, I do not know any reputable sources.

If you could get a private prescription then you could use the information to purchase from Germany at a very reasonable price.

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That’s crazy. I think I only paid like £50 for 100 of 100 mcg pills.

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I didn't realise the costs involved but also believe there are EU regulations in place to ensure that prices are not wide ranging like this. I know the dispenser at my pharmacy and will ask her what she knows about this.

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The Competition and Markets Authority is, it claims, investigating. Seems to be entirely stalled.

Supplementary statement of objections

On 30 January 2019, the CMA issued a supplementary statement of objections revising certain aspects of its provisional findings in the statement of objections.

Through this supplementary update, the CMA has slightly altered its investigation period, provisionally finding that Advanz Pharma (formerly Concordia) breached UK and EU competition law from at least 1 January 2009 to at least 31 July 2017 by charging excessive and unfair prices for Liothyronine tablets in the UK.

Between January 2009 and July 2017, the price paid by the NHS for liothyronine tablets rose from £15.15 to £258.19, a rise of 1,605%, while production costs remained broadly stable. During that period, Advanz was the only supplier of liothyronine tablets in the UK.

gov.uk/cma-cases/pharmaceut...

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My husband has been researching into this corrupt situation. He sent an email to Advanz Pharma and received this rather interesting reply. Someone is telling porkies!

Thank you for contacting ADVANZ PHARMA. We are sorry to hear about your wife and hope that she is responding well to treatment.

In response to your query about the pricing of Liothyronine, the position is complex and, regrettably, has become distorted in the wider arena. We therefore apologise for the length of our response below but we want to do justice to your questions.

We are a dedicated healthcare company that has been supplying prescription medicines to millions of patients and hospitals around the world for over 50 years. We primarily supply older, complex medicines that have been divested or discontinued by originator companies. They can be difficult to manufacture and can require significant investment to keep them up to date with the latest regulatory requirements, without which they would likely be unavailable. We are committed to ensuring this continued access to high quality, niche established medicines to those customers, including to patients in the UK.

As a business operating in a highly competitive, complex and controlled market, we regularly review the pricing of each of our medicines and any decisions for price increases are reviewed extremely carefully. Prices can go up or down in the market for many reasons, such as increasing regulatory requirements, cost of raw materials, global supply and demand or Government intervention. It should be noted that around 25% of our medicines are sold into the NHS supply chain at prices which are below the cost of manufacture.

The pricing of Liothyronine has been conducted transparently with the Department of Health and Social Care (DHSC) in the UK over a period of 10 years. All our price increases were notified to the DHSC in advance and implemented only after approval from the DHSC. Ultimately, the DHSC has the power to set the price of any medicine in the UK under various NHS Acts and s.28 of Scheme M (an agreement between the DHSC and generic manufacturers, including ourselves). In the case of Liothyronine Tablets, the DHSC never raised any concerns over the price with us.

During the past 10 years, as part of a wider consultation with the MHRA (the UK regulatory body) in relation to thyroid medicines, the company made significant investment in Liothyronine in order to continue to keep it available for patients in the UK, to national quality specifications. The MHRA wants UK thyroid medicines to be manufactured to specifications that are tighter than those in other countries, including in those other European countries where Liothyronine is used. The reason that there is no parallel import of European Liothyronine into the UK is because of this difference in specifications. This investment, over many years, has been a significant contributing factor to the need to increase the price on this medicine.

The UK generics market is highly competitive. In 2017 two other manufacturers launched competing Liothyronine products at similar prices to ours, after investing in developing UK-compliant versions of Liothyronine. Over time, in keeping with UK generic market dynamics, there has been a significant reduction in prices charged by manufacturers which are now markedly lower than the Drug Tariff reimbursement prices set by the DHSC. The Drug Tariff price is set by the DHSC and is paid to pharmacies in order to reimburse them for dispensing medicines: this is ultimately the price charged to local Clinical Commissioning Groups (such as Brighton and Hove NHS Trust). It is unclear to us why the DHSC chooses to set the Drug Tariff price (and as such the cost to the NHS), at approximately double the price that manufacturers sell this product into the supply chain. An independent report by economics consultancy OXERA, this week concluded that the UK generic medicines market is functioning very well and delivers significant savings to the NHS. It also illustrates the point made above, that often prices set by the DHSC in the Drug Tariff are on average double the actual selling prices obtained by the manufacturer. You can view the OXERA report here: ‪https://www.britishgenerics.co.uk/uploads/1561539610_Oxera-study-on-the-supply-of-generic-medicines-in-the-UK-26-June-2019.pdf‬.

The guidelines that have been issued by NHS England to all Clinical Commissioning Groups (“CCGs”) leaves it in the discretion of GP’s and endocrinologists to prescribe liothyronine tablets where appropriate. It is not in any way black-listed. We have been supporting the Thyroid Trust to raise awareness of this matter of patient access, engaging members of the House of Lords and NHS England, and highlighting the need to reduce the DHSC Drug Tariff reimbursement price down towards the level of manufacturer’s actual selling prices.

We trust that this is helpful.

Further to the information you stated regarding treatment with T4 being unsuccessful, as part of our drug safety responsibilities would you kindly advise us if your wife experienced a lack of effect with T4 (Levothyroxine) from our company.

As part of our ongoing effort to continuously improve our level of service, we would be grateful if you could complete this brief feedback survey at the below link.

surveymonkey.com/r/TLXW236

All the information and personal data you will share with us will be protected and kept confidential in line with company SOP and policy and local regulations. The information you provide will be used for the purpose of drug safety surveillance and to enable us to deal with your enquiry appropriately and it may be shared with health authorities. You have a right of access to your personal data which we hold about you.

Yours faithfully

Medical Information Department

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We have seen that reply, or one very similar, in the past.

The investment claims are deeply questionable. Advanz get liothyronine manufactured by a generic manufacturing company. Yet they go on about their investment.

And amazing how they blame the MHRA.

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Yes, it's quite remarkable what the different stories are... someone's lying for sure! Just hope the investigation reveals the truth... eventually!!

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I have just asked the MHRA in what way UK standards are higher than Europe. Without knowing that we cannot assess that part of Advanz' letter.

Might take some time to get a response.

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If you do get a response, please a do let us know. My husband and I would like to reply that their email ideally, but don't feel qualified to challenge their declarations of innocence!

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Thank you all for your interesting response. If NHS England guidelines state that the discretion is left to GPs and Endos whether or not it is appropriate to prescribe Liothyronine for a patient, maybe could someone please point out to me why I have been told that it's the CCG that has refused my prescription?

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You should appeal. I think it's pretty standard for them to deny it on a cost basis to encourage self sourcing, but it should not be denied on the basis of clinical need if you cannot tolerate levothyroxine.

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I just wanted to update people that Greece actually seems relatively easy to buy OTC without prescription. I have two friends on holidays, one of which was able to order eight packets max, but another that won't order in, but gives out two packets a day.

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Where in Greece ? I live in Crete and have to show my prescription. Send me a PM if convenient - thanks. 😊

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I've Pm'd you 😀

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