The local hospital pharmacy have finally got the go ahead from the medical drug commission to dispense my T3 on the NHS after having it in their possession for SIX months!!
When I spoke to the hospital pharmacist on the phone she told me she doesn’t know what brand she can get hold of as there is a shortage on the NHS . Firstly is this true?
Secondly and most importantly, I’m on 10mg twice a day, but she told me that she might only be able to get me 20mg Liothyronine tablets that are UNABLE to be broken in half.
Her solution was that I dissolve the 20mg pill in 20ml of water and suck 10ml up with a measuring syringe to take 10ml!
Then I discard the rest of the liquid and do that again in the evening ( in othe words waste half the pill each time!)
IS THAT EVEN A THING???
can T3 be dissolved?
what a waste of half a dose each day!
I know that you can do that with Omeprazole as that’s how we administer to babies, but does it compromise the T3?
Do any of you do that?
I would be so grateful to you all as ever for your knowledge and wisdom.
Many thanks x
Written by
AuntieMandy
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I’ll let someone who knows what they’re talking about respond to this but every single post i ever see on this forum about the NHS I despair. Every. Single. Time. They just never get it right.
That pharmacy have been terrible since the beginning. I told the pharmacist that Thybon Henning comes in breakable 20mcg tablets and that I know the NHS use that brand often. She didn’t have a clue what I taking about and made me spell it. Sad and disheartening when you know more then them 🙄
I’m so sad to say I’m not even surprised. I once had to explain to my GP why a ft3 test would be relevant for me as a hashi’s patient on T4. It’s like none of these people do any kind of independent thought.
Someone did mention this the other day but I'm forgetting the details now. I mean it sounds like a lovely idea, thought up by a scientist locked in their lab 24/7 never going out for fresh air and sunlight. WTAF! 😆
Some pills are definitely more dense and harder to cut that others. I'll let the experts comment and you can take their advise but really I had to LOL! What is the NHS coming to?
Liothyronine is lipophilic and generally does not dissolve in water. However, 20 mcg is a tiny amount and will just about dissolve in a cup of water. The only study I've ever seen did this in water at 36 centigrade. The drug companies dreamt up this method as a means of wasting tablets and pushing up profits.
Just break the tablets into two, it doesn't matter if the halves aren't equal.
Agreed. I’ve done that with Thybonn, Cytomel and Uni Pharma too in the past. I just wanted to see what the consensus was on here incase she gives me a brand that I’ve not had, that has tiny tablets that crumble to oblivion when broken. Also wanted to be armed before I have to deal with it and possibly take further action on it. Thanks so much.
"Unable" is the wrong wording. It is not a supported option. But they can physically be split.
However, there are also 10 microgram (and 5 microgram) tablets and capsules by Roma.
10 microgram capsules are currently priced at £65 for 28.
5 and 20 microgram capsules are £55.
The prescription would have to be revised to "capsules" from "tablets". Which is hardly an earth-shatteringly difficult change to make.
(10 microgram tablets are massively more expensive.)
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. It is sectioned by UK - rest of the world, and by T4, T3, desiccated thyroid, etc.
And do keep up to date. I edit it frequently- sometimes trivially, sometimes extensively. If your copy is more than a few weeks old, please download it again. (You must download - not just view in a browser- for the Table of Contents to work.)
The ridiculous advice by pharmaceutical companies to dissolve in water was invented as a way to increase usage/wastage after 1000’s of NHS patients had their T3 prescription stopped when price charged to NHS went up 6000%
Ignore it
The cheapest and most flexible option by far is to get 20mcg tablets and cut into 1/4 tablet for 5mcg and in half for 10mcg
Get a pill cutter or sharp craft scalpel
Cut tablets in half or 1/4’s
Store remainder in pill dispenser and mop up any crumbs with damp finger
Generally best to start on only 5mcg initially for first week or two…..before adding 2nd 5mcg dose mid-late afternoon
Retest thyroid levels 6-8 weeks after adding 2nd 5mcg dose
ALWAYS test thyroid levels early morning, ideally just before 9am and last dose levothyroxine 24 hours before test
Last 5mcg dose T3 approx 8-12 hours before test
What are your most recent TSH, Ft4 and Ft3
Have you been advised to lower levothyroxine, if yes….by how much?
Are vitamin D, folate, ferritin and B12 levels optimal
SlowDragon ive been self sourcing for 5 years already. Was taking uni pharma T3 25mg and wanted nhs to fund. Their Endo has recommended with my last bloods that i cut down to 20mg a day. (Last bloods in my last post) if I don’t feel good he will allow me to go back up.
No one would take back to the pharmacy .. it would just be chucked down the sink. Not great for the hormone content of our water supply!
I cut T3 tablets all the time and have no problems....just cut 1 tablet to obtain the portions you need then store the remaining bits in a little lidded pot/ jar and use next time.
I use a cheap simple cutter, whack it on the "lid" after the pil is placed in position ...any slight discrepancy in size won't matter so long as all of the pill is eventually consumed. Job done
I've used several more expensive versions but found this the best.....sometimes also available in Boots ( not sure that I'm allowed to say this!!)
Liothyronine is hydrophobic, so very little dissolves in water but 20 mcg is a tiny amount and so may just about dissolve at room temperature. The only evidence I’ve seen is at 37 centigrade pubchem.ncbi.nlm.nih.gov/co... .
I complained to the MHRA but they just echoed the manufacturer’s claim about it having sufficient solubility to dissolve 20 mcg. They gave no evidence. The MHRA is pretty useless unless you happen to be the Prime Minister and so have the clout to get them to do something.
Split the tablets, snap them into pieces like I do or use one of the recommended pill cutters. I would try to avoid capsules as tablets give you more flexibility.
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