The great and good from the UK, Europe and USA have come together in a consensus meeting to thrash out possible future assessments and guidelines for the use of T4/3 combination therapy. As we expected it carefully omits any of our work in its conclusions. The whole paper is with Louise Roberts for downloading from her archive. Its clear they are trying to get away with appealing to genetics to solve the problem, whilst holding on to the TSH is test first paradigm. A biased effort but one which could have unhappy consequences if it goes through as it is.
Evidence Based Use of LT4/LT3 Combinations in Treating Hypothyroidism: A Consensus Document
Based on a Joint American Thyroid Association (ATA)/British Thyroid Association (BTA)/ European Thyroid Association (ETA) Symposium held in London, UK and Chicago, USA on Sunday, November 3, 2019
Written by
diogenes
Remembering
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They either are a) ignorant of the existence of our work, b) know of it but don’t understand it or c) know of it, understand it, but ignore it because it confounds their positions.
Diogeneses Thank You so much for your hard work . And hopefully your great work won't be in vain .The biggest problem is that Medical Academia needs to educate present and future Dr's both with T4 /T3/NDT.
Dr's don't bother to to give either T3/NDT to patients since they just don't know how . They are trained with T4 only . There are some Dr's that are independent thinkers care and are out of the *box* those are the Dr's we need to publicise and patronise .
No, not to the general public as far as I know. I got this from one of my colleagues. You have to be a member of the various interested parties to access.
I believe they get Admiral Nelson to look for the evidence.
None of the trials have ever tried to identify cohorts who respond to combination therapy. Nor have they tried to establish what dose of L-T3 is effective.
There has been an invariant assumption that restoring physiological levels of fT3 is required, contrary to patient experience, most patients require higher levels of fT3.
Half the studies have subsituted L-T3 for L-T4 in a 1:4 or 1:5 ratio which reflects relative potency in the serum. These idiots are not even aware of pharmacokinetics, how the different absorption rates and half-lives affect serum levels. The ratio you put in your gob is not the ratio you get in the blood.
How can the exclusion of a large body of recent published research be considered in any way scientifically sound, or ethical? And is the notion of consensus in any way appropriate in scientific discussion?
I despair that they will ever ‘get it’. This is a complete dereliction of their duty as doctors and leaves many of us hypothyroid & unable to function.
Why don’t they ever consult patients who have managed to get their lives back on T3/T4 combo after T4 monotherapy failed miserably for years??? I’d be happy to tell them how effective it has been!
There was a post about the BTF a few days ago so I read all of their web page and about t3 and the Prescribing patterns survey which ended 28 November last year.
There is a report following the findings dated 7/2/2020 which obviously supports the use of t3, where appropriate. It appears to be backed by everyone bar the BTA.
There is a link to the BTA answering GP’s frequently asked questions. This is from December 2016. They clearly state t3 should not be stopped due to cost and if a patient derives benefit from the medication it should be continued. ( mine was stopped around this time after 17 years due to cost)
Does this mean that the survey last year was a waste of time and the guidelines from The BTA will be changed?
From my viewpoint, it is an attempt to produce a guidance document that all (Europe, UK, USA et al) can collectively put out on the T4/T3 combo problem
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t3 & t4 combination therapy - i am so damn tired!!
Combined T4 / T3 therapy Tests
NDT vs T4 T3 combination therapy
Studies on TSH for those on combined T3 T4 therapy 
