Banning T3 - what do you do next ? : I’m in a... - Thyroid UK

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Banning T3 - what do you do next ?

20 Replies

I’m in a private health scheme where I can claim costs back for Dental optical They have a doctors line which you can contact if you need further assistance with medical needs I’ve just had a consultation with one of the doctors regarding my endocrinologist stopping prescribing in T3 in hope that I could probably get a private prescription.

I explained my situation saying that I’ve recently had blood tests I don’t know the results as yet but I should get them through the post soon I suspect they’re okay because I’ve not heard anything, my T3 has been stopped and we don’t have a treatment plan in place. I’ve expressed my concern about stopping T3 because it’s the only drug that helps me. He said there is no evidence that T3 works this is why they’re stopping prescribing it he carried on stating that no doctor will prescribe T3 anymore and it’s really down to the endocrinologist if the blood test comes back in range then it’s down to them to prescribe it if they feel the need to but in usual circumstances T3 is not to be used

I told him that I’d been on T3 for a long time and that it clearly does work it’s the active hormone so how can we say that it doesn’t work when it’s T4 that’s the dormant hormone ?

I’m really surprised to be honest with you that they can do this I was hoping that I could probably get a prescription written through this doctor but obviously not.

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20 Replies
fuchsia-pink profile image
fuchsia-pink

no doctor will prescribe T3 anymore and it’s really down to the endocrinologist

I think the private doc is right in that T3 meds are endo-only in the UK - but once the endo has prescribed them (and some still do!), the prescription is usually "transferred" to the NHS GP - and the GP cannot then unilaterally stop the prescriptions.

So why has your endo stopped your T3 meds? If s/he's being unhelpful, can you get an NHS referral to another? - you can get a list of T3-friendly endos from Dionne at Thyroid UK - tukadmin@thyroiduk.org - or try a sep post asking for recommendations near-ish to you.

Or can you see a private endo on your private health scheme to get a private prescription? Or pay for a private endo to access the private prescription? Again DIonne does a list of well-rated private endos

Good luck x

helvella profile image
helvellaAdministratorThyroid UK in reply to fuchsia-pink

I can't think of any formal requirement outside NHS guidelines and similar documents from the NHS and NHS-related organisations which precludes prescribing T3. (Even then, it would be necessary to check the NHS information from all four nations as they might well not be entirely consistent.)

The obvious source would be the British National Formulary which categorically says nothing like "there is no evidence that T3 works". It actually says:

Due to the uncertainty around the long-term adverse effects and the insufficient evidence of benefit over levothyroxine monotherapy, the use of natural thyroid extract is not recommended. Liothyronine (either alone or in combination with levothyroxine) is not routinely recommended for the same reasons. NHS England's specialist pharmacy service have produced guidance on the prescribing of liothyronine, for further information see: sps.nhs.uk/articles/updated... .

bnf.nice.org.uk/treatment-s...

That link refers to an NHS Specialist Pharmacy Service document:

NHS England guidance states that prescribers in primary care should not initiate liothyronine (L-T3) for any new patient, and that individuals currently prescribed liothyronine should be reviewed by a consultant NHS endocrinologist with consideration given to switching to levothyroxine (L-T4) where clinically appropriate. Prescriptions for individuals receiving liothyronine should continue until that review has taken place.

The majority of patients suffering from hypothyroidism can be treated effectively with levothyroxine alone, but liothyronine is perceived to be an important medicine for a small proportion of patients in order to maintain health and well being. The prescribing of liothyronine is only supported if initiated by, or considered appropriate following a review by, an NHS consultant endocrinologist. The withdrawal or adjustment of liothyronine treatment should also only be undertaken by, or with the oversight of, an NHS consultant endocrinologist. Where General Practitioners (GPs) are involved in such treatment changes this should be with NHS consultant endocrinologist support. This advice applies to both liothyronine monotherapy and combination therapy with levothyroxine.

As noted by the British Thyroid Association (BTA) Executive Committee (1), ‘clinicians have an ethical responsibility to adhere to the highest professional standards of good medical practice rooted in sound evidence. This includes not prescribing potentially harmful therapies without proven advantages over existing treatments’. Also ‘If a decision is made to embark on a trial of L-T4/L-T3 combination therapy in patients who have unambiguously not benefited from L-T4 then this should be reached following an open and balanced discussion of the uncertain benefits, likely risks of over-replacement and lack of long-term safety data. Such patients should be supervised by accredited endocrinologists with documentation of agreement after fully informed and understood discussion of the risks and potential adverse consequences. Many clinicians may not agree that a trial of L-T4/L-T3 combination therapy is warranted in these circumstances and their clinical judgement must be recognised as being valid given the current understanding of the science and evidence of the treatments’.

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

Wherein they confuse NHS policy and professional ethics. And ignore Northern Ireland, Scotland and Wales.

Also note that the guidance repeatedly uses the word "should" - not "must". The interests of the patient absolutely MUST be paramount. Which surely would require the insurance doctor to check directly with an endocrinologist and not make a decision without doing so.

in reply to helvella

Thank you for this think I’m going to copy this info and send off an email to the CCG along with supporting evidence I’m one of those people who cannot take T4 . Worth a try isn’t it

helvella profile image
helvellaAdministratorThyroid UK in reply to

Certainly is - if you don't try, you might end up kicking yourself.

Best of luck.

in reply to helvella

Thank you 😊

shaws profile image
shawsAdministrator in reply to

It seems like we're the suffragettes nowadays - but fighting to get a thyroid hormone that restores life and health. We cannot even trial options.

in reply to shaws

It’s about time these people stopped and thought about what there actually doing what keeps going round my head is the T3 is the active hormone T4 is not , for those minority - very small number ( his words not mine ) of people who can’t convert they have to have evidence of not been able to tolerate T4 . The evidence is crystal clear that lots of people can’t tolerate T4 banning it should be classed as negligence surely . It’s a lifeline for many of us . Like taking a diabetic off insulin , or stopping oxygen from a dependant . It should no be happening . I’m on one 😢

Thanks for your reply , my endocrinologist has been giving me T3 for a while . The GP Have fulfilled my prescription up until March this year then they stopped , took Liothyronine off my repeat prescription and handed the care of prescribing back to my endocrinologist at the hospital . I had to have a second opinion from another endo at a different hospital who requested blood tests to check liver function thyroid function cortisol etc . I have not heard anything back since but I did speak to my regular endo secretary last week who informed me that the hospital will no longer supply me with my Liothyronine as it’s not on their formulary .

in reply to

I'm so cross for you.

It is an absolute outrage that they stopped your prescription with no notice.

It's so scary to be at the mercy of doctors why aren't interested in quality of life.

in reply to

It’s not the first time this has happened to me . 4 years ago I had the same thing happened, we moved out of the area and GP was happy to prescribe it after endocrinologist had seen me . This time round he’s not willing to prescribe future T3 .

shaws profile image
shawsAdministrator in reply to

He might well have been reprimanded by those 'higher up the ladder' and he may be afraid he'll lose his licence. Where is that special vocation - why did they become doctors or endocrinologists?

shaws profile image
shawsAdministrator

I think that your doctor is 'passing the buck' as he no longer wants to prescribe due to the cost.

I am another person who knows that, for me, T3 has been a revelation in that my health and vitality have recovered.

It is not up to medical people who do not have have a dysfunctional thyroid gland to insist that the majority of patients who're hypothyroid recover on levothyroxine alone.

There are always exceptional reasons that some patients cannot recover on levothyroxine alone and especially if they felt much better and symptom-free on T3 they can see no reason why they cannot continue on the one that suited them.

Also those who had NDT prescribed - that was withdrawn without any warning and these decisions are made by people who don't have dysfunctional thyroid glands and work on theories alone.

My body does not function on levothyroxine. I am far more unwell upon it than with a TSH of 100. T3 has done me a service by restoring my health and well-being and I thought that was the purpose for doctors i.e. to help patients be symptom-free and able to carry on their lives as they did before developing a dysfunctional thyroid gland.

They have no idea how some people can suffer due to medical professionals jumping onto a wagon full of myths. Who do they want to keep 'happy' and symptom-free?

The only people to decide what suits them is the patient themselves who swallows the medications. If we don't feel any better why do the professional insist? It doesn't make any sense.

in reply to shaws

Exactly , I agree . I’m still preparing my email to the CCG . I’ve had enough of been in their target list - 2nd time now 😐

shaws profile image
shawsAdministrator in reply to

I doubt that other people who have medical conditions have to jump through the hoops that hypo people do.

Why is there such ignorance in the medical profession when people who have dysfunctional thyroid glands seem to do better from 1892 and before blood tests were introduced? (Dr John Lowe said it was just to improve Big Pharma's profits that they developed them).

LindaC profile image
LindaC

WHAT!? "He said there is no evidence that T3 works this is why they’re stopping prescribing it he carried on stating that no doctor will prescribe T3 anymore and it’s really down to the endocrinologist if the blood test comes back in range then it’s down to them to prescribe it if they feel the need to but in usual circumstances T3 is not to be used."

NDT, T3 aka - anything that works for those who desperately need something other than T4! Wow! They'd been up for doing this for a while... I was even UN_diagnosed to ensure that my Armour T - NHS prescribed for 5+ years [but I also use T3].

This is the ultimate abuse of power - 'unconstitutional' against their NHS Constitution where 'patient choice' is meant to be respected. This is not mere choice, it is vital for some and someone needs to find out who exactly has been taking and ratifying these decisions and/or be a Judicial Review or something... to curtail these abuses. 🦋

in reply to LindaC

I know , it’s criminal 😢

LindaC profile image
LindaC in reply to

Bordering something akin to genocide, if this continues! I've just posted on this!

shaws profile image
shawsAdministrator in reply to LindaC

Lies, Lies and more Lies. If they state often enough that neither NDTs or T3s do not help - lets have their thyroid glands removed before they make the final decision!!!

Of course, we wont allow prescriptions for any other thyroid hormone replacement. I'm sure after a few weeks they would have a 'change of thought' about treating those who've hypo.

Do we really have to 'chain ourselves around the BTA or Parliament?????

LindaC profile image
LindaC in reply to shaws

Most of the 'Good Guys' have been seen off; any younger ones being waayyy too scared to even question... these days, who is questioning? We're left, largely, with the Spiv-World of Medicine... the equivalent of 'used pizza salesmen'. Yes shaws, "Lies, Lies and more Lies' - dressed up in that 'Emperor's Shabby Suit' - 'Nothing on Offer' and with only those afflicted actually grasping what's going on... by taking away NDT/T3, no one WILL [have sufficient wit about them to] BE ABLE TO COMPLAIN. Some eventually becoming bedridden like many CFS/ME people, generally equally ignored!?

How did it get to be quite so bad, become this dreadful? When Dr S started his World Register, I recall it being said that it may end up with legal action being brought?? Without something of that nature happening - although they 'ALL P in the same pot' - who can tell what would happen? In a semi-'sane' world, this current lot would be 'whipped in disgrace' and drummed out of town, never to pratice again. The amazing work of Dr Lowe - ignored by 'the powers that be' - should have been THE clincher. There are others... equally dismissed and sneered at, just like so many hypothyroid patients. (I'm not ignoring hyperthyroidees - far from it - huge abuses going on there too!)

shaws profile image
shawsAdministrator

You made me laugh with your phrase:-

"Spiv-World of Medicine... the equivalent of 'used pizza salesmen'.- and I think it was Dr L who stated that it was due to corruption (i.e. doctors (in USA) paid to use blood tests alone when first introducing levothyroxine) which has become the No.1 worldwide I think.

That's the reason to, I believe, why NDT was withdrawn - again dismissing patients' worries when they had been well upon NDTs or T3 as it, too, was alleviating symptoms and - mainly women who've enough physical health problems during their lives as it is. How can (supposed to be) experts know more than the sufferers?

Do we have to become suffragetes to make the medical professionals see 'sense' instead of 'non-sense'.

Dr Skinner wasn't afraid to stand up as one who didn't agree with the guidelines but, unfortunately, he died of a heart attack. The majority of his faithful clients and staff believe it was due to the constant strain of appearing before the GMC and always found to be doing nothing wrong.

Dr Barry Peatfield surrendered his licence as he, too, couldn't avoid the strain of being chased for doing as he was taught as a young trainee. I was very fortunate to consult with both of these gentlemen and it was a privilege.

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