Prescription from private endo: I saw a private... - Thyroid UK

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Prescription from private endo

Alex_p profile image
21 Replies

I saw a private endo yesterday and he said I should continue taking 100mcg levo but split the 20mcg liothyronine in 2. I cannot do that with what I’m currently taking (Novothyral) so he gave me a prescription and said he would send a letter to my GP. My question is: how likely is my GP to prescribe liothyronine through NHS? And if he refuses to, where can I get it from with the prescription from the endo?

The endo mentioned Thybon as being cheaper, but is it ok compared to other T3 brands?

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21 Replies
shaws profile image
shawsAdministrator

Your doctor should prescribe what the expert stated.

One of TUK's Advisers, expert in the use of Liothyronine (T3) would never prescribe levothyroxine (T4). He also prescribed NDTs (natural dessicated thyroid hormones) now removed in the UK leaving many people upset.

Dr Lowe was a scientist/researcher/doctor. He himself took T3 once daily (in the middle of the night) so that he was able to carry on his scientific work and healing patients. He stated that one dose of T3 'saturated' all of our T3 receptor cells and that dose could last up to three days but we daily dose with T3.

I have trialled that myself - took T3 on day one, none of day 2 or 3 and I felt fine.

He also prescribed NDTs (natural dessicated thyroid hormones) - the original replacement from 1892 and withdrawn in the UK some months ago (for some unknown reason).

The link below you may find helpful:-

drlowe.com/thyroidscience/l...

I must also state that thousands seem to be o.k. on T4 alone but they wont be searching the internet.

Alex_p profile image
Alex_p in reply to shaws

I’ve been reading about NDT and would like to try it if the split T3 dose doesn’t work. Are you saying no endo will prescribe it now if it’s no longer available in the UK?

FancyPants54 profile image
FancyPants54

It will depend entirely on your GP if they will prescribe T3 from a private endo. I've not even asked mine yet because I'm not on a stable dose. If I can find a stable dose and start to show that it's doing me good, I will go and ask as they do prescribe the other things the endo recommends. But for now I buy the T3.

Thybon Henning is a good T3. German made. You can use your private prescription at rosewaylabs.com, but when I filled my recent prescription they were out of stock and not too clear when they would have more. They may well have more now. They had put the price up to 60p per 20mcg tablet (that are easy to cut into half and quarters with a pill cutter). So last time I used chemist-4-u.com who had the stock I needed and were still charging 50p per 20mcg tablet. You can use anyone you fancy with a private prescription. Although with T3 not everyone has it.

I would get started on the T3 first and see how you go before you try getting it from your GP.

Alex_p profile image
Alex_p in reply to FancyPants54

I’m already taking a combination of T4 and T3 and feeling a lot better than on T4 only. I’ll try to split the T3 for 4 weeks and re-evaluate with the endo after. But I suppose that if the GP will agree to the T3 prescription, he’ll also agree to any other recommended dose suggested by the endo.

greygoose profile image
greygoose

Why can't you just cut the Novothyral tablet in half and take it that way? Or did he mean reduce your T3 to 10?

Alex_p profile image
Alex_p in reply to greygoose

Novothyral is 100mcg T4 and 20mcg T3. I want to take 10mcg T3 in the morning and 10mcg in the afternoon, without changing how I take the T4.

greygoose profile image
greygoose in reply to Alex_p

I doubt it makes much difference how you take your T4, it's a storage hormone. Have you been taking Novothyral for long? Have you been well on it? One doesn't always have to split the dose of T3. I take 62.5 mcg T3 all in one go, and it suits me fine. :)

Alex_p profile image
Alex_p in reply to greygoose

I’ve been taking it since December and for a while I’ve felt great. Now the tiredness has come back usually in the afternoon so the doctor suggested I split the T3 dose. The plan is to try that for 4 weeks and see how it goes.

greygoose profile image
greygoose in reply to Alex_p

When hypo symptoms start to creep back in, it normally means you need an increase in dose. But, even that's not easy when taking Novothyral.

Gingernut44 profile image
Gingernut44

Your Endo is probably thinking your GP will prescribe your 100 mcg Levothyroxine. You’ll be very fortunate to get your GP to prescribe T3 that’s why your Endo has given you a private prescription. Why not try splitting your Novothyrol in half to see if it makes any difference to your pm fatigue first, that will save you a lot of hassle if it works. Quite a few people split their Levo when splitting their T3. I certainly wouldn’t rule it out.

Alex_p profile image
Alex_p in reply to Gingernut44

How would that work? I'm guessing I would need to not eat for 3-4 hours before the second dose? And would I get the same dose of T4 and T3 with each half? I'm thinking that the T4 and T3 are not distributed on the whole pill...

Gingernut44 profile image
Gingernut44 in reply to Alex_p

I think you would only need to leave 2 hours after eating or you could take your second dose an hour before lunch. As 10 mcg T3 is about the same price (or thereabouts) as the 20/25 mcg tablets, most people on T3 actually break their tablets in half or quarters to save money- they are very expensive. I just think that it would be worth trying splitting your Novothyral for a couple of weeks to see for sure if splitting is going to solve your afternoon slump. You’re still going to have the issue of timing your second dose with just taking the T3 element if you swap to a combination of separate T4/T3 tablets. Nothing is simple in the world of hypo ☹️ Whatever you choose, I wish you luck.

Alex_p profile image
Alex_p in reply to Gingernut44

Thanks for the answer. I guess it doesn’t hurt trying that, I usually don’t eat between breakfast and lunch anyway and could fit the second half an hour before lunch.

Gingernut44 profile image
Gingernut44 in reply to Alex_p

Go for it, you have nothing to lose by trying. It could be that the ratio of T4/T3 in Novothyral is not good for you. Did you have a blood test done before your Endo suggested splitting your T3 dose?

Alex_p profile image
Alex_p in reply to Gingernut44

I did. My TSH is <0.01 (range 0.27-4.2), FT3 5.3 (range 3.1-6.8) and FT4 14 (range 12-22). The endo was reluctant to add more T3 because of the low TSH - which he said will cause issues long term. I would like my FT3 to be closer to 6, that was actually the reason I went to see him but I've agreed to try this splitting method for 6 weeks.

Gingernut44 profile image
Gingernut44 in reply to Alex_p

Well, I’m no expert but I would want my FT4 much higher in range than where yours sits. Having a higher FT4 may well bring your FT3 up a bit. From those results, I would say the ratio in Novothyral isn’t the best for you.Perhaps SeasideSusie and/or SlowDragon would be better at helping you.

SeasideSusie profile image
SeasideSusieRemembering in reply to Alex_p

Alex_p

My TSH is <0.01 (range 0.27-4.2), FT3 5.3 (range 3.1-6.8) and FT4 14 (range 12-22).

I agree with Gingernut44 I am on Levo plus T3 and I wouldn't be able to function with your FT4 level, I need mine over half way through range (around 60-70%) and fairly well balanced with FT3 but everyone is different, some are fine with a low FT4.

If those were my results I'd be increasing Levo.

This is where separate Levo and T3 can be better, you adjust the dose of each one to suit. With a combined tablet you're stuck with that ratio and may never be able to get to your optimal combination.

If you're going to stick with Novothyral I'd be inclined to add a small dose of Levo to improve your FT4 level which should, depending on how much natural conversion you have, also improve your FT3 level.

Alex_p profile image
Alex_p in reply to SeasideSusie

Thank you for the suggestion. But increasing the levo would lower my TSH even further, isn't that right? I'm not too concerned about my TSH being too low, I need to keep it suppressed anyway because of thyroid cancer, but I have a feeling my endo would say that it's too low.

SeasideSusie profile image
SeasideSusieRemembering in reply to Alex_p

Thank you for the suggestion. But increasing the levo would lower my TSH even further, isn't that right?

Possibly but the result will look the same because the testing equipment doesn't measure lower than 0.01 hence the result of <0.01

Alex_p profile image
Alex_p in reply to SeasideSusie

Haha you're right. I also have some Accord 50mcg levo, would it be ok to combine the brands? And how much levo should I add?

SeasideSusie profile image
SeasideSusieRemembering in reply to Alex_p

Some people are fine mixing brands, give it a try. Accord seem to be generally well tolerated by many members. I would quarter your 50mcg tablets and start with adding just 12.5mcg Levo, retest after 8 weeks to see what's happened. You can always add a bit more if you feel the need.

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