Getting private prescriptions on NHS

[seveneleven]

Seeing GP soon to try and push for a diagnosis (rising TSH over time, low T4, now private test showing high antibodies), but I'm also booked into a private thyroid clinic next month. This is mainly because I want things to be managed at least initially by someone who is confident in terms of dosing and understands how thyroid interacts with cortisol, vitamins etc. Also partly because I want to be able to access either T3 or NDT easily should they be needed.

Question is, if NHS GP is on board and accepts diagnosis, could I potentially get T4 via NHS with the recommendation/dosages prescribed by the private doc? Sorry if that sounds confusing...I just want the overall management to be with the private doctor for reasons above, but obviously if I can get anything easily on NHS that would be preferable.

*The private doctor also works for the NHS and does send notes to NHS GP if requested

[Jaydee1507 Administrator]

So long as your GP accepts your diagnosis then you should be able to get your Levothyroxine on the NHS. I see your last TSH was over 6, so so long as you've had a similar test/s on the NHS that will help. Your private doctor also working in the NHS as well as privately will help. The main thing is that your GP needs to accept the diagnsosis.

T3 and NDT are different again, although obviously you won't need either of those perhaps ever or at least for a while. T3 prescription on the NHS has to be started by an NHS Endo for a trial of treatment before GP can take it over. NDT almost never prescribed on the NHS and is expensive.

[seveneleven in reply to Jaydee1507]

Thanks, that's helpful! Recent NHS test was 'just' in range and private test was above. Assuming GP would want to wait it out and test again in a few months to see if it goes above range again in an NHS test, but hoping she'll take in the full picture.

[Jaydee1507 Administrator in reply to seveneleven]

Have your antibodies been tested and come back positive on the NHS? Unfortunately they only test one type (TPOab) and some people are only positive for the other type they don't test - Thyroglobulin antibodies.

[seveneleven in reply to Jaydee1507]

No unfortunately that was on the private test. NHS test was only TSH and T4, standard. I was over 200 for both, which I suppose would help? Hoping GP will request new bloods and agree to also test those antibodies, but almost impossible to get a bloods appointment before 10 at this place, which is probably why my NHS TSH was just within range.

[radd]

seveneleven,

I can’t see any problem getting Levothyroxine on the NHS if your labs evidence you need it, and especially if endo supports medication. 

However, getting T3 on NHS will be more difficult and NDT almost impossible. However, I wouldn't worry about obtaining these until necessity has been proven, and you won't know this for sure until medicating Levothyroxine for some time.

With regard to thyroid antibodies the protocol for conventional medicine is to allow the activity to remain, and the thyroid gland to eventually die whilst replacing deficient hormones. The functional way is to try reducing thyroid gland activity by reducing antibodies and retaining as much gland as possible for as long as possible, so reducing replacement medication. 

Other good management involves monitoring nutrients and iron known to help in thyroid physiology, but totally ignored by doctors.  An excellent read if you are interested in the autoimmune side of the Hashi condition is The Root Cause by Isabella Wentz. Also anything by Datis Kharrizian.

[seveneleven in reply to radd]

Thanks so much radd, that's really helpful info. Yes have been looking at the more functional approach, which makes a lot more sense. I've generally avoided conventional doctors for a while because I just never got anything useful out of it for chronic illnesses. Don't necessarily agree with everything in functional medicine, but the way they test for things and look at full picture seems useful.