Found this while trying to see the name of the Consultant within Hywel Dda (West Wales). There does not appear to be one... This could be a reason why the waiting list is so long...
It is not my FOI. Anyway this makes interesting reading. Take some blood pressure pills or grab a duster before reading - may as well dust up there when you hit the roof!
"Many endocrinologists may not agree that a trial of levothyroxine/liothyronine combination therapy is warranted in these circumstances and their clinical judgement is valid given the current understanding of the science and evidence of the treatments.”
Copied from the FOI response
Is it just me .... this sound like gobblygook avoiding a straight answer!!
If the evidence is sound why don't they agree?
For "may not agree" I read, they have no indepth understanding of how interpret the available labs and clinical evidence. If they did they would come to the same conclusion ( i.e agree) as to the treatment required for any individual
But....don't dare question their valid judgement because it's based on their understanding of the science and evidence of treatments
Note the words " their understanding"! Not "the" understanding.
Well guys... if your personal understanding is flawed ( as it often appears to be) then your judgement will also be flawed.
And heaven help the patient!
This sounds to me as if their judgement is based on personal opinion rather than on science.
I agree. "‘Medicines Identified as Low Priority" says it all. They targetted idocaine plasters, tadalafil once daily preparations, liothyronine and doxazosin modified release tablets.
Lidocaine patches can be bought over the counter. Tadalafil is a medicine used to treat erection problems of which there are many alternatives, some can be bought over the counter, and doxazosin is a blood pressure medicine with many alternatives. Stuffing liothyronine in with these seems deliberate - there is no alternative apart from NDT which they dismiss.
The research they quote is also fairly old, and of course, they only read the research which cements their ideas.
I wonder who did the FOI - I have been making a fuss about the non testing of T3 here, so it appears someone else is too!
That particular phrase I have highlighted for myself too but for me the utter power emanating from the phrase is truly spooky. We all know there is much evidence opposing this view. However the view held in this FOI @serenfach has highlighted, is held so powerfully no-one can refute it. The power is held in very few hands. Every time I see this sort of reference I have to remind myself we live in an allegedly free country. Endocrinology and the BTA and the NHS mostly comes over as promoting a benign dictatorship but it’s clearly a dictatorship all the same. Please see very recent Facebook posts from the BTA elsewhere on the forum. Apparently there are approx 791 endocrinologists in England alone. Say half but probably more, with very little thyroid input as many will be fully employed diabetes specialists. There are 120,000 ish unsatisfied thyroid patients on this forum alone. It leaves an awful lot of people’s lives in their uncontested hands. Using the full 791 endocrinologists it means 152 of each, of their patients, are unsatisfied - if the patients manage to get as far as seeing an endocrinologist at all! If there are only 350 thyroid specialists (as opposed to diabetes) the number doubles to 300 dissatisfied patients each etc etc. However, remember the power they hold over GPs, the gatekeepers. Through the endocrinologists ‘clinical judgement’ and power, the GPs too stop patients getting the proper care. I am aware it’s a very rough estimate, so don’t catch me out on that - just highlighting raw figures. Dissatisfied patients don’t always find the forum. Dissatisfied patients don’t always complain. Dissatisfied patients are often too ill to worry about complaining.
Or even T4 on many occasions! Off course if the patient is “stable”, obviously in the doctor’s opinion, then off course TSH will cover it - especially if T3 is not monitored either.
Ooh, I’m so glad I’m in the other side of Wales to you! Although my endos are over the border in England, NHS Wales have provided me with Liothyronine since 2011 when my old endo prescribed it for me. It’s gotten to the stage now where I am in charge of my own thyroid treatment as, over the years, I have educated myself here, through books and online to the point where the doctors now accept I probably know more about the thyroid than they do and they leave me alone.
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