I have been using T3 self-funded (tiromel) for the past 3/4 years - I've had it noted on my doctor's record, but never prescribed through a doctor or seen an endo (I almost got there but my doctor at the time withdrew the referral). I currently take 100mcg levo and 8.3 t3 (third of a tiromel tablet) daily, and the difference that little bit of T3 made is phenomenal.
My sourced supply is starting to run low and with the pandemic/Brexit I'm not sure of my capability to source further (though I spot there are some PMs possible for sources so will try those) but I also thought now might be the time for getting an NHS prescription.
From the last time I looked at this at some point within the last year, I remember that Leeds CCG are very strict on their prescribing, and wondered if anyone here had had any success with it? The better armed with Knowledge I am before approaching my doctor, the better chance I have, I think!
Thank you in advance
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queenmabroo
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Before seeing any thyroid specialist endocrinologist get FULL Thyroid and vitamin testing done...privately if necessary
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
If/when also on T3, make sure to take last third or quarter of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test
In your case that’s likely to be half your daily dose.... just a speck of dust
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Thank you so much for the guidelines link, that will be really helpful even in just getting me past the gp and to secondary care.
Yes, I normally take my tests as you describe and usually use medichecks privately, I think my last one was about 9 months ago actually. Though my time perception may have been skewed this year. Thank you for the extra links for tests!
Looking at this advice, it doesn't seem as draconian in discussing T3 use as most such statements from other CCGs. If only there was a constant uniform position throughout the CCGs in the country. If T3's tablet price was as cheap as T4, I think it would be even more encouraging. I am covered by the Leeds CCG so nice to know they aren't total naysayers. I've met one of the doctors who had a few misconceptions but was willing to listen.
SlowDragon added a link from the Leeds CCG website to RMOC Liothyronine prescribing guidance. That is not the final version of RMOC. It should be the final version 2.5 from July 2019. If Leeds are still using the November 2018 version, they are wrong!
Thyroid patient groups had input into the earlier version and the final version is a definite improvement.
I am a little late on replying but I think if you could find a way to do a private test for DIO2 gene polymorphism (it is a genetic variant that stop people converting T4 into T3 properly) you can find this test online (it is a swab) and if you test positive for the variant then your GP may have to prescribe you T3 i may go a long way to convince the NHS hopefully.Take care
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