Liothyronine CMA fine company

[rick2525]

I noticed in the media on the 29th July that the Competion and Market Authority had found the company Pharma Allianz guilty of excess charging the NHS for this very important medication. They were fined £100 million pounds for breach of unfair practice. This may have been covered already on this website which I missed so sorry if I'm going over old ground. Does this ruling mean that this med will be more readily available (and affordable)by the CCG .l asked my GP last year when I was struggling with my hypo symptoms to be told there isn't a gp or endo in our area would prescribe this. I am assuming this was down to cost. I am asking this for all the people on here who struggle to obtain this med.

[helvella Administrator]

There have been a number of recent posts about this issue including discussion of future availability and pricing.

The principle company was Advanz. There is a pharmaceutical company Alliance - part of Walgreen Boots Alliance - which was NOT involved. And Allianz is a financial services company.

You can find many of the posts from a search on "CMA":

healthunlocked.com/thyroidu...

[SlowDragon Administrator]

Price has dropped considerably already down from £268 to £101 per 28 tablets 20mcg T3

Liothyronine (T3) can only be initially prescribed via endocrinologist

Before considering adding T3 you will need FULL thyroid and vitamin testing

How much levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

Bloods should be retested 6-8 weeks after constant unchanging dose and brand of levothyroxine

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 with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

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)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Email Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private

[e-mail]

Roughly where in U.K. are you

[rick2525 in reply to SlowDragon]

Thanks for reply. I've posted results on here before and you have been really helpful with advice. I am currently on 125 mcg levo and have been for 3 months. Symptoms have improved after a recent dip a month ago. GP wants me to stabilise on current dosage to see how I go. I took advice on here re Gluten free and have been GF for 8 months. What advice could you give for coming off GF ? Is this possible? If so do I need to do it gradually. I am not coeliac as test was negative.

[SlowDragon Administrator in reply to rick2525]

If you have seen benefits being gluten free it’s likely you need to remain so

Before considering eating gluten again, get FULL thyroid and vitamin testing done via Medichecks or Blue horizon

See if Ft3 has improved and vitamins, or TPO antibodies reduced

Then try eating gluten…see what happens

If you need to be gluten free, likely to need addition of T3 prescribed alongside levothyroxine

[SlowDragon Administrator in reply to rick2525]

Looking at previous posts, your weight suggests that you might need further increase in levothyroxine

How long since you last tested Levels

[rick2525 in reply to SlowDragon]

Hi. I was tested on the 12th July. I always get a private test done when GP test because GP will only test TSH and Free T4 as usual. So when go for blood test I take my private test tube with me and ask the nurse to fill test tube for me up to 600 line which they kindly do.

GP/NHS Results

Type Result Normal Range

TSH 0.53 0.27-4.2

Free T4 21.3 10-21

Private Blood Test

Type Result Normal Range

TSH 0.59 0.27-4.2

Free T4 19.7 10-22

Free T3 4.6 3.1-6.8

Vit D 79 50-200

Folate 7.3 2.9-14.5

Ferritin 138 30-400

CRP 0.8 0-5

Vit B12 Active & TGA & TPA the company failed to produce a result as previously stated on here.

[SlowDragon Administrator in reply to rick2525]

High thyroid antibodies already confirmed in previous tests

So you know that you have Hashimoto’s and gluten free diet frequently necessary

Only one adrenal gland

Have you had 5 point saliva cortisol and DHEA testing via Regenerus?

regeneruslabs.com/products/...

cdn.shopify.com/s/files/1/0...

EXACTLY what vitamin supplements are you currently taking

[SlowDragon Administrator in reply to rick2525]

TSH 0.59 (0.27-4.2)

Free T4 19.7 (12-22)

Free T3 4.6 (3.1-6.8)

These tests show poor conversion

Ft4 is 77% through range

Ft3 only 41% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

Vitamin D might be better at least around 100nmol

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

[rick2525 in reply to rick2525]

Hi SD This is the answer to the questions . My Cortisol test done via GP was 375 nmol/l normal range 140-690.Yes I am Hashi and my readings of Antibodies taken 15th May were:

TGA 331 (normal range 0win-115)

TPA 345 (normal range 0-34)

Vit B Active 131 (normal range 25-165) taken 15/5 also

I am currently taking Vit D 25ug (1000 iu daily. In winter i was taking double but pharmacist recommended reduction for summer months.

Vit B 10 ug daily and I stopped taking a week before blood test. Since I was put on 125mcg Levo 12 weeks ago my symptoms improved considerably for 6 weeks then they worsened for a period of approx 10 days which was when I asked your opinion and you suggested blood test(re 18th July) results shown on previous email in this thread. After the 10 days my symptoms are improved and remain so. So discussed all this with GP on 15th July who advised to stay on current Levo to stabilise. I said to her my weight suggests I could increase but her concern is it may make me Hyper looking at Free T4. My GP at last test did Cholesterol and noticed this was raised from previous 5.5 to 6. I am not on meds for it and Dr didnt suggest it. She trusts I will take evasive action to reduce pastry and fat intake (not easy when wife bakes!!) But in last 3 weeks I have reduced fats and lost 5 lbs in weight. Will try to continue sensibly. Can people go from GF to "normal " again in your opinion.

[pffft2017]

About time something was done. Would be great if the NHS did allow GPs to now prescribe liothyronine willy-nilly, but even at a hundred quid it's still exorbitant compared to the cost of levothyroxine. I went to about 15 different surgeries and a private endo before I managed to wrangle some T3. Don't take no for an answer.

[helvella Administrator in reply to pffft2017]

It would be even better if GPs knew when to prescribe liothyronine. And how much.

Of course, the patients who really understand might be OK, but most would probably like to be able to discuss sensibly with a professional who does actually understand.

[pffft2017 in reply to helvella]

I was referred to a so-called endocrinologist in 2019 which I guessed ( correctly ) was a ruse to get me off lio and back on the cheap thyroxine. Told the GP that I was adamant I would not see him if he didn't prescribe T3 so no appointment was made but the letter of advice he sent to my GP made no mention of checking my adrenals and it turned out he wasn't even a qualified endo but a GP with an interest in endocrinology. Have never had an ACTH test yet.

You guys have forgotten more than most GPs will ever know.

[rick2525 in reply to pffft2017]

Thank you for your reply. I agree £100 per prescription is still extortionate. Hopefully this will reduce in time. I have been underactive for a year and increase in levo gradually. It is a rough journey to be on but hoping last levo dose will stabilise my symptoms. I explored the T3 route with GP just in case I need to find a source. At the moment it's a case of 🤞that Levo works. It should not be that patients have so much difficulty in being prescribed T3 or even trialled on it.