I have been getting liothyronine on a nhs prescription for many years. I could not find a british variety that I could tolerate that was also vegetarian friendly. My gp was very helpful and agreed that I could have a special order prescription. I took American Perigo for three years until there became a supply issue. A couple of years ago I changed to German Thybon Henning, which Tesco order in for me.
I submitted my repeat prescription yesterday. I have just had a telephone call from the pharmacy at my gp surgery. Tesco are unable to supply Thybon Henning. Apparently, Tesco's supplier was audited last week. They were told that being vegetarian is a life choice and not a clinical need and therefore they can not supply me with Thybon Henning!! They ignored the fact that the letter they had from my gp two years ago stated that I needed a gluten free tablet. - At that time I was thought to have a problem with gluten intollerance which was not confirmed.
The pharmacist at my surgery was very helpful and is going to arrange a new letter from the doctor stating that I need the tablet as I am gluten intollerant and omitting the fact that I am vegetarian.
Whilst I am very grateful for her help and understanding, I am shocked that this has happened. Has there been a change in NHS rules? Does anyone know what has sparked this problem? It seems very shortsighted as I believe Thybon Henning is considerably cheaper than uk licenced brands. I've been able to request a vegetarian variety of tablets for years.
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dizzy864
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I have created, and try to maintain, a document containing details of all thyroid hormone medicines in the UK and, in less detail, many others around the world.
There are 3 licensed U.K. brands of T3 - Teva, Mercury Pharma and Morningside Healthcare
All thyroid medications are gluten free
All are suitable for vegetarians
Teva brand T3 is lactose free and suitable for vegans
Currently NHS is paying £72 per 28 tablets 20mcg T3 for Teva, Mercury Pharma or Morningside healthcare
Thybon Henning 20mcg tablets are indeed much cheaper on private prescription at 50p per 20mcg tablet
But Thybon Henning as a “special” off licence product as an NHS prescription ……there’s evidence that in many instances NHS is charged considerably more than the price paid for U.K. brands of T3
Don't forget Roma and Colonis - which are hard capsules. Not vegetarian, but are lactose-free and acacia-free and available in 5, 10 and 20 microgram dosages.
Hi, if they are not vege free then I won't take them,. The thought of eating animals, makes me feel sick. I could not do it.I would have to find an alternative.
Unfortunately, all three brands contain acacia powder, which I can't tolerate. Mercury pharma contains magnesium stearate which can come from pigs or cows or can be synthetic. I contacted Mercury pharma a few years ago. They told me they purchase all forms of it and can not guarantee its vegetarian although it mostly is. Apart from that not being acceptable to me, surely whatever tablets we take should be the same every time we take them?
Sorry but I agree, vegetarianism is very definitely a life choice not a medical need. If you have diagnosed lactose intolerance, then that would be a reason to get prescribed lactose free meds.
I'm fairly sure that all UK thyroid meds are gluten free and always have been. Of course your GP may not realise that, but pharmacists should be aware!
Yes being a vegetarian is a life choice - one I made over forty years ago. Are you saying that I have no right to medicines because I chose not to eat animals?? Should the hundreds of thousands of people in this world who chose to be vegetarian or vegan for moral, ethical or religious reasons be refused medicines? While those who are gluten intolerant should be catered for? What an intolerant world that would be!!
I think the difference is those who are intolerant to gluten or have coeliac disease obtain actual damage to their bodies through consuming gluten whereas although it harms your ideals it will not damage your body to consume animal products. I don’t agree with comparing the two.
Are you saying that I have no right to medicines because I chose not to eat animals??
No of course I'm not saying that. You seem to be trying to pick a fight.
Everyone has a right to medicines that they need.Unfortunately, in this world, many, many people are denied life saving meds for reasons of absolutely no fault of their own, especially in 'developing countries'. To whinge about a microscopic amount of magnesium stearate that might or might not be from an animal is unreasonable in my opinion.
Clearly you are not vegetarian and don't share my principles. I am not "whining" about a small amount of animal product. I am starting, I will not eat animal products. The thought of it not just the eating makes me physically sick. You are entitled to your opinion but I really don't see what developing countries has to do with me being vegetarian. Eating a small amount of an animal is no different to me as a vegetarian to eating roast chicken for Sunday dinner. I find your responses offensive and you are the one trying to pick a fight. It was you who replied to me!!
HiI'm a strict vegetarian, have been for over 50 years but there's a big difference between not being able to tolerate a medication or substance due to an allergy and not wanting to take it based on ethics.
Medication not only sometimes contains animal by products but every one is tested on animals at some point. Which opens up another ethical can of worms.
At the end of the day we are vegetarians through a conscious choice we have decided to make. People who have intolerances don't get a choice. If you won't accept the NHS T3 brands that are available then unfortunately you will have to source your own.
I quite agree it comes down to ethics. If a vegetarian option was not available it would be an extremely difficult choice for me. But vegetarian options are available and at a lower cost so it seems a no brained to me! As it turns out all 3 UK licenced lio brands contain Acacia in some form and I am allergic to that. Teva has included it for years as has Mercury pharma. Morningside, I ve just seen also uses it as a filler.
Are you vegetarian or vegan, I'm a vegetarian but eat a bit of cheese or yoghurt occasionally. I was vegan for a while but struggled tbh with getting enough protein and fat. Ethically I would like to be vegan but practically I can't be.
I ve been a very strict vegetarian for over forty years. I, too would like to be vegan but practically it did not work for me either. I do greatly admire vegans it is a really difficult thing to achieve.
Can't see anything 'shocking' about the statement that vegetarianism is a life choice not a medical need. That would seem to be 'true' . The only thing i find 'shocking' is that somebody who's had T3 free for years from the NHS, thinks they'll get much sympathy from a forum full of people who have been denied the option to try it on the NHS in any form whatsoever (whether it's guaranteed 100% vegetarian, or not)
If you want some guaranteed 100% vegetarian T3 to keep within your perfectly reasonable (but optional) principles , go and buy it.
If nobody makes any , then go and campaign loudly to the manufactures .
But please have the sensitivity to realise there are plenty of other people on here who would happily have your free T3 prescription. even if an ingredient in it might occasionally have an animal source .
I didn't ask for sympathy. I asked a perfectly reasonable question - have the NHS rules changed? Five or six years ago being vegetarian was a good enough reason for having a vegetarian tablet. I have a great deal of sympathy with people on this site who have fought or are fighting to get liothyronine or levothyroxine because I am one of them! Yes I am getting lol iothyronine on an NHS prescription and not everyone does. But that is not my fault. I fort my own battles to get the meds I need.- 3 years of terrible health and wrong diagnoses and treatments to get levo. A 10 year battle to get lio and then a 6 year battle to get the dose increased interspersed with periods of sourcing my own meds. Then the fillers changed and I couldn't tolerate the Acacia that had been added and a further battle to get a special order. Then to find a tablet that I tolerate and am doing well on is discontinued. Another fight to get a new prescription. Again doing well on it only to have it stopped because being vegetarian is not a good enough reason when it wasn't the only reason. Non vegetarians may not understand but for me it's taking away the meds I need. Yes I can source my own but that is an option for us all! But not one any of us should have to do and many of us can't afford to.
Teva. I see that it's not included now. I had Teva for a time a while ago and was fine with it. Then I couldn't tolerate it. I thought it was because Acacia was added. I might be muddling lio with levo though.
When Teva levothyroxine did change formulation, in about 2016 after having been off the market for a few years, their product was emblazoned New Formulation.
I can't think of any other levothyroxine or liothyronine product in the UK that has done that since I have been involved with thyroid issues. To the best of my knowledge, there have been no other reformulations which have added or dropped an ingredient. Some might have changed detailed specifications, and small adjustments to amounts of each, but that is all.
Of course, it could be I have forgotten something.
I'd like to think any future changes would also have New Formulation, or similar, printed on them.
it's pretty clear you can't use vegetarianism as a reason to get the NHS to continue to pay for Thybon, because it's not a medical reason that supports the extra expense. If the issue is about staying on a brand that makes you feel well, when you've tried others that don't, then that's a different question , but you post appeared to be about trying to use vegetarianism as a reason to have it continued , which clearly won't get you anywhere as far as the NHS are concerned.
You would probably have more success if you approached the problem it from the " i get 'x' symptoms on the other brands" point of view, rather than muddying the waters with vegetarianism, which has always been a matter of personal choice not medical need.
I totally understand the unfair difficulty of getting a consistent medication brand in order to feel well, and the stress of having to keep re-assessing sources / brands when something changes either in the ingredients or the availability of supply routes.
But i think you're being unrealistic in expecting the NHS to take vegetarian principles into account if you don't have a medical reason for staying on the same brand that they now have a cheaper alternative for.
I've re-read your original post , and it does read like 'the rights of vegetarians to choose meds' was the issue you were concerned about, and because you'd been allowed Thybon 3 yrs ago, you wondered if the NHS had changed their rules about vegetarianism.
So your post (and it's title) did give the impression that vegetarianism was the only issue.
I suspect it is the case that they have never technically allowed 'vegetarianism' as a reason for prescribing a more expensive medicine ... perhaps you were allowed Thybon 3 yrs ago because of economic reasons such as:
a) we were still in the EU ,
b) and the price of UK T3 to the NHS had not come down to the much lower price it is now.
But things are different now and if you wan to challenge it you will need to use a medical reason.
My original post was simply asking if there had been a change to the nhs rules or guidelines concerning being vegetarian and having vege friendly meds.
I asked this because five or six years ago there was a very clear rule for this and I was prescribed Perigo. A couple of years ago Perigo became unavailable in my area and as a result my doctor had to repeat the same procedure he and I had gone through three or four years earlier. As a result I was able to switch to Thybon Henning. Admittedly along side being vegetarian, I had not been able to tollerate Mercury Pharma or Teva. At that time, I was being tested and I did a trial for gluten intolerance. Although I subsequently found I did not have a problem with gluten. My doctor told me on both ocassions that I was entitled to have vege friendly tablets if they were available, which clearly they were.
I wanted to know why being vegetarian was no longer a good enough reason on it's own. I wondered if something had been introduced or changed in the last couple of years since getting Thybon Henning prescribed.
As things stand at the moment, as I said the pharmacist at my surgery is being very helpful as is the doctor. I have a long history of intollerances to numerous meds and they agree it is important that as I have found a tablet that I can tollerate, I should stick with it.
Incidentally, I think Mercury pharma contains Acacia, which I'm allergic to. I think the reason I get on well with foreign tablets is, due to their stricter tollerance rules. I've read that UK medicines are required to be +/- 10% of stated strengths, whilst the USA and other places it's +/- 5%. I am ultra sensitive to miniscule changes unfortunately. So the more even strengths suits me much better.
I've read that UK medicines are required to be +/- 10% of stated strengths, whilst the USA and other places it's +/- 5%.
Potency requirement for levothyroxine in the UK is 90 to 105%.
Potency requirement for levothyroxine in the USA is 95 to 105%.
I do not know the potency requirement for liothyronine in the UK or the USA.
Potency requirements are not blanket across all medicines.
Perrigo was rebranded and has ended up as Mayne Pharma via some other names. It is available in the USA but would, naturally, be a special import if supplied in the UK.
I was happy on Perigo but then Tesco could not get hold of it. I emailed them and they replied that they did not know when or if it would become available again. I had no choice but to change. I did learn that it was only discontinued for a brief period. As I was happy with Thybon, there seemed no point in changing back to it.
So far as I am aware, the physical continued to be available but would have been re-branded - hence would not be found if someone searched for Perrigo.
Summary of name changes is available in my medicines document:
helvella - Thyroid Hormone Medicines
I have created, and try to maintain, a document containing details of all thyroid hormone medicines in the UK and, in less detail, many others around the world.
I don't think that is the right way to read potency tolerances.
What they really mean is that, if the product is stored under just acceptable conditions (that is, non-optimal), then between original production and expiry date, they must remain with the tolerance.
A modicum of care about storage conditions, and taking them before their expiry date, would see a much narrower real range of potencies. The manufacturers are expected to target 100% as they leave the production line. 105% potency at that point should trigger questions.
This has been an interesting discussion and thread to read, thanks for posting.
Going slightly off-topic for your post but did you ever test your iodine levels prior to being diagnosed with a thyroid problem?
I'm also a long time plant based eater and now vegan for many years but recently discovered that I'm very deficient in iodine. I'm annoyed at myself as I've managed to overlook the importance of iodine being focused on B12 levels instead. My thyroid problems could be iodine induced hypothyroidism but also getting other tests done to confirm.
Just thought I'd mention the iodine issue with you having been a strict vegetarian for many years.
No, I was diagnosed hypo in 1994. I'd been really ill - sleeping twenty hours a day and trying to cope with four children between 4 yrs and 10-yrs. I'd gained three and a half stone. My monthlys were horrendous - lasted eight or nine days and I just poured blood!! I was 39years old. The three doctors I saw were all convince my symptoms were thyroid but refused to treat me as the tests were all "normal". Unfortunately, they had no idea what else could be wrong with me. I was then passed onto a lady doctor who was new to the practice. She told me it was all down to a premature menopause. There was no family history but my doctor was absolutely convinced even though she refused to allow me to have the menopause blood test! The result was that over three years, she prescribed me eleven different HRT tablets and two HRT patches. Each making me more ill than the last. When I refused to try a twelth tablet, she told me that I needed to take uppers as I was depressed. I had to concede that I was - who would not be in my circumstances! I refused and changed doctors. A helpful gyne found nothing wrong with me and told me it was thyroid. He requested I be given levo inspite of four or five "normal" thyroid tests. I later found out that my tests were very borderline and I am one of many people who need levels at the top of the range. Over the years many things have been suggested but iodine was only suggested eighteen months ago by an endo. My gp was very against me taking it. I googled it and found that it can interfere with the absorption of thyroid meds. That was the last thing I needed so I never persued it.Incidentally, years later I went through a very late menopause as expected genetically. I never needed HRT!!
A pity none of the doctors I saw at the time were aware of it!! I was just told repeatedly that it was nothing to worry about. It can't possybe as heavy as I say and once you must be exaggerating with a smirk!!
Yes it sounds like you've had a long time to get an eventual thyroid diagnosis. I'm not taking an iodine supplement as I'm just in the process of getting a possible diagnosis and you have to be guided and follow a protocol.
This last year has been a big learning curve for me as I knew nothing of the importance of the thyroid gland and its effect on our bodily systems.
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