T3 costs: hi, I know Thyroid UK are doing their... - Thyroid UK

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T3 costs

Essexlil profile image
46 Replies

hi, I know Thyroid UK are doing their best to get us treated fairly. I’ve just been given a private prescription for a 3 month trial of T3.

I know the price has reduced, but I’m still shocked by the unfairness involved: I’ve had to pay £300 for three months supply at our local pharmacy but 20 minutes up the road in Suffolk it’s included on the NHS. Where I live mid Essex won’t allow it on NHS. If I find I’m suited to it or I need an increase this expense can’t be sustained as my husband and I are pensioners.

I’ve read the parliamentary reports regarding this - how is it still allowed? Talk about rip off Britain - a box of T3 can be bought in Greece for under 3euros over the counter! I know the company in the UK charging extortionate prices for T3 were fined, but they still charge approx £65 a box for it and the rest is VAT 🤬and chemist charges. How is this allowed if it’s under 3 euros in Greece?

I don’t know how this unfairness is allowed to continue but there doesn’t seem a way around it - my consultant joked maybe move house - it’s just so wrong!

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Essexlil
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46 Replies
SeasideSusie profile image
SeasideSusieRemembering

How many have you got for that price?

Did you ask for your prescription to be made out for Thybon Henning 20mcg (mentioned frequently on the forum)? You could have sent that to one of about 3 pharmacies on TUK's list and the price is around £60ish for 100 tablets.

thyroiduk.org/if-you-are-hy...

I think it's Smartway, Chemist4U or Roseway Labs who do it at around this price, someone will correct me if I'm wrong.

Essexlil profile image
Essexlil in reply toSeasideSusie

hi, no didn’t think! That’s a lot cheaper! I’ve got 10mcg £65 for 28 😩then VAT and pharmacy charges! Is Thybon Henning the make? Thank you I’ll make a note and save money next time!

SeasideSusie profile image
SeasideSusieRemembering in reply toEssexlil

Yes, Thybon Henning is the brand name. Comes in 20mcg tablets which you can cut into two if necessary .

SlowDragon profile image
SlowDragonAdministrator in reply toEssexlil

Ask endocrinologist to change prescription for 20mcg x 100mcg tablets next time

then ring email online pharmacies here

thyroiduk.org/if-you-are-hy...

Do you currently take 10mcg as 2 x 5mcg ?

Easy to cut 20mcg into 1/4’s (5mcg) with sharp craft scalpel …mop up any crumbs with damp finger

Essexlil profile image
Essexlil in reply toSlowDragon

I take 10mcg one tablet each morning with 50 mcg levo

SlowDragon profile image
SlowDragonAdministrator in reply toEssexlil

I take 10mcg one tablet each morning with 50 mcg levo

Is this what you’re currently taking…..or what endocrinologist wants you to change to

Previously you were taking 100mcg levothyroxine?

Reducing by 50mcg may be too much

Have you worked on improving very low B12 and folate

Have you tried, or are you now on gluten free/dairy free diet

Essexlil profile image
Essexlil in reply toSlowDragon

hi, I’m takingB12 and bloods have improved. No haven’t tried gluten/dairy free diet. Just started 50 mcg levo and 10 mcg t3

in reply toSeasideSusie

Essexlil I was recently charged 50p per 20mcg tablet plus £8.99 delivery so 90 tablets cost me £53.99 from Chemist4U.

Essexlil profile image
Essexlil in reply to

thanks for that info - cheaper than I paid locally so I’ll look into that if I need more

SlowDragon profile image
SlowDragonAdministrator

What dose and brand do you get

Thybon Henning is far cheaper than U.K. brands at 50-60p per 20mcg tablet…..sold in boxes of 100

U.K. licensed brand prices

healthunlocked.com/thyroidu...

Essexlil profile image
Essexlil in reply toSlowDragon

hi, not sure if manufacturer box just says Roma Pharmaceuticals Ltd. Marketing Authorisation Holder. They’re 10 mcg tablets just 28 in box 🥲

SlowDragon profile image
SlowDragonAdministrator in reply toEssexlil

They are capsules

You can’t easily split capsules

Cost is £65 per 28 tablets to NHS

What were you taking before…..or is this your first prescription?

Essexlil profile image
Essexlil in reply toSlowDragon

yes my first prescription - yes £65 for 28 tablets but then they add VAT and pharmacy charges - £292.50 for three months

SlowDragon profile image
SlowDragonAdministrator in reply toEssexlil

Well you can’t possibly start on 10mcg all in one go

Can you take it back to pharmacy and explain you are going to need tablets as capsules can’t be split

Adding T3 has to be done extremely SLOWLY

5mcg max initially …..

Many people start on 2.5mcg initially….and assuming that’s ok …..add 2nd 2.5mcg mid afternoon

After 4-5 days at that ….then increase morning dose to 5mcg ……and after few days increase afternoon dose to 5mcg

Retest in 6-8 weeks time

Essexlil profile image
Essexlil in reply toSlowDragon

oh I didn’t realise - ivebeen off levo completely for three months as he said my antibodies were very low and he didn’t think I needed it. Three months later I’d put on half a stone and had xanthelasmas forming on my eyelids. My three month later bloods proved I needed treatment so he’s put me straight back on levo with T3 added. I was on 100 mcg levo so now I’m on 50 mcg levo taken in the morning with 10 mcg T3. Only started T3 today and levo yesterday

in reply toEssexlil

My jaw hit the floor reading this. This is appalling.

Theres so much to unpack. First of all - withdrawing medication for 3 months?! Just to prove need. They'd never bloody do it to a diabetic. It's sadistic.

Second, dropping from 100 to 50 is way too big a drop in one go (and likely unnecessary) and adding in 10mcg T3 is going to be a rough ride.

When I first started taking NDT, which is thought to be 'gentler' on the system, I was taking 0.5 grain a day which translates to 4.5mcg T3. I was having huge anxiety, including waking up in the night and having to literally 'shake it off' like a dog. It was a very rough ride to start with.

Just be prepared for things to get tough if you're sticking with 10mcg all at once. I came through it but it was awful.

Essexlil profile image
Essexlil in reply to

oh no this sounds bad. To be fair I was hoping he’d give me T3 when I said levo seemed to make me put on weight and I hadn’t before I took it. He seemed to think levo wasn’t helping me at all and so when he suggested stopping it I thought I’d give it a go - Wrong decision but he did say to c9me back if I felt unwell. I saw it through as I didn’t actually feel any worse, just fat and bloated, just to prove to myself that I needed medication or if not I’d be free of it as my bones have been affected and he said they’d be better without levo.

in reply toEssexlil

Do you have any test results from before you stopped taking levo?

Essexlil profile image
Essexlil in reply to

hi yes just sent to slowdragon

SlowDragon profile image
SlowDragonAdministrator in reply toEssexlil

good grief

I am lost for words

If you haven’t been on any Levo for 3 months…..vitamin levels likely collapsed too

Presumably you have had TSH, Ft4 and Ft3 plus vitamin D, folate, ferritin and B12 tested after 3 months on no levothyroxine

What were TSH, Ft4 and Ft3 on 100mcg levothyroxine

Did you always get same brand levothyroxine

Quite likely only needed dose tweaking and optimal vitamin levels

Essexlil profile image
Essexlil in reply toSlowDragon

hi, test results taken on 9th Feb before stopping levo:

TSH 0.07 mlU/L (0.27-4.2)

Free T4 19.2 pmol/L (12.0-22)

Serum free triiodothyronine 3.9 pmol/L (3.1-6.8)

Test results after 3 months with no levo taken on 4th July

TSH 9.31 (0.27-4.2)

Free T4 11.4 (12-22)

Free triiodothyronine 3.9 (3.1-6.8)

Luckily I’ve been taking B12 recently and my bloods had improved, and I’ve been taking D3 and magnesium. Under NHS guidelines they were all ok.

SlowDragon profile image
SlowDragonAdministrator in reply toEssexlil

Luckily I’ve been taking B12 recently and my bloods had improved, and I’ve been taking D3 and magnesium. Under NHS guidelines they were all ok.

Can you add actual vitamin results

FT4: 19.2 pmol/l (Range 12 - 22)

Ft4 is 72.00% through range

FT3: 3.9 pmol/l (Range 3.1 - 6.8)

Ft3 only 21.62% through range

Assuming test was done early morning and last dose levothyroxine 24 hours before test…..and all four vitamins at OPTIMAL levels……shows poor conversion

Ideally you would do at least 2-3 months back on 100mcg and getting vitamins optimal BEFORE considering adding T3

Essexlil profile image
Essexlil in reply toSlowDragon

hi, thank you for looking at these for me:

Feb 23 before stopping levo

Vitamin D3 97.3 nmol/L >75 nmol/L optimal

Folate 4.5 ug/L <3 suggestive of deficiency

B12 224 pg/mL (197.0-771.0)

Ferritin 259 ng/mL (13-150)

July 23 prior to re-start with levo and T3 added

Vitamin D3 79.9 nmol/L

Folate 7.0 ug/L

B12 331 pg/mL

Ferritin 236 ng/mL

See what you think - I’m on 2nd day of T3 and reduced levo today

SlowDragon profile image
SlowDragonAdministrator in reply toEssexlil

Higher ferritin is completely normal after menopause

Range actually changes to 13-600

B12 and folate both far too low on both tests

For good conversion of Ft4 to Ft3 we must have OPTIMAL vitamin levels

Many (most?) patients on thyroid replacement need to supplement vitamin B complex continuously

Initially you will need to start on a separate B12 supplement, before adding a vitamin B complex a week later

Low B12 symptoms

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and add a separate vitamin B Complex after a week

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)

Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

Other options

healthunlocked.com/thyroidu....

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 until B12 is over 500

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

Essexlil profile image
Essexlil in reply toSlowDragon

oh I had no idea that ferritin changed after menopause - mine isn’t abnormal after all then! I taking B12 so the July tests were a bit better. I’ll start in Bcomplex + folate - thank you for all of your help! I really appreciate your advice and took it re Alendronic acid - started on D3 and magnesium instead of Alendronic acid and when I saw endo he agreed completely and said Alendronic acid would’ve done me no good at all but D3 and magnesium and daily walk were perfect!

SlowDragon profile image
SlowDragonAdministrator in reply toEssexlil

healthunlocked.com/thyroidu...

We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes: 

Males 16-60: 30-400 ug/L

Female's: 16-60: 30-150

Both >60: 30-650 

The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘

Essexlil profile image
Essexlil in reply toSlowDragon

that’s an eye opener for me as I’ve always thought I’m way out of range given blood test ranges - good to know thanks!

Essexlil profile image
Essexlil in reply toSlowDragon

hi, yes always Mercury Pharma

Liz-H profile image
Liz-H

it’s terrible!

I’m having the same battle myself , how they differentiate what’s too expensive is beyond me

Essexlil profile image
Essexlil in reply toLiz-H

I know and knowing if we lived 20 mins up the road is so unfair!

SlowDragon profile image
SlowDragonAdministrator

Helpful website to show you CAN be prescribed T3 on NHS in Essex …..but need an NHS endocrinologist to say you have clinical need

Typically 6 prescriptions per person per year

North East Essex

797 prescriptions in last year

openprescribing.net/analyse...

West Essex

199 prescriptions in last year

openprescribing.net/analyse...

Mid Essex

263 prescriptions in last year

openprescribing.net/analyse...

Liothyronine guidelines

Has to be prescribed via hospital pharmacy

midandsouthessexformulary.n...

Contact your MP too

braintreeandwithamtimes.co....

Essexlil profile image
Essexlil in reply toSlowDragon

hi that’s really interesting - I’m with mid Essex but have had to see endo privately and my GP told me he wasn’t allowed to prescribe T3 if she referred me on NHS 😡

SlowDragon profile image
SlowDragonAdministrator in reply toEssexlil

if you transfer to see him via NHS he could then write to GP and request they take over care and cost of prescription

endocrinologist might need to do individual funding request on your behalf if GP is difficult

Essexlil profile image
Essexlil in reply toSlowDragon

thanks I’ll look into this - in the meantime I’ve written to our MP complaining bitterly and pointing out how the problem still exists

tattybogle profile image
tattybogle in reply toEssexlil

Looking at the mid essex formulary that TaraJR gave link to below , your GP is correct in that 'they' can't prescribe T3 to new patients ..

it is coded RED which in this area means "Hospital Only Medication" ....but NHS Endo in that area can prescribe it and continue prescribing it , as long as they do an IFR (individual funding request)

" New Patients:

To initiate an IFR is required. New patient prescribing should remain with the hospital specialist. Primary care prescribers should not initiate for any new patient"

an IFR is probably a lot of paper work, so Endo probably won't want to be bothered with it if they can get away with fobbing you off . so you may have to be extremely persistent.

Essexlil profile image
Essexlil in reply totattybogle

hi thank you both for this information - I understand now how it could be possible, however I don’t think he’ll be willing to do it as he must know about this but didn’t offer, agreeing how unfair my predicament is. He prescribe T3 for a family member who lives in Suffolk but she has no problem as they have provided it on NHS for her. Her GP sends her back to endo if things become unbalanced on her bloods - they won’t help with that apparently.

TaraJR profile image
TaraJR

T3 CAN be prescribed in your area. They've been telling porky pies.

midandsouthessexformulary.n...

If you're on Facebook, do join us on ITT Improve Thyroid Treatment Group. We have template letters and details of all the parliamentary statements and national guidance that ICBs and drs should be following

Essexlil profile image
Essexlil in reply toTaraJR

ok thank you I’ll join this on facebook

Whiterose profile image
Whiterose

Dorset formulary won't allow G.P's to prescribe it here. So have given up and no longer take levothyroxine. I gradually reduced it. I feel much better.

SlowDragon profile image
SlowDragonAdministrator in reply toWhiterose

Whiterose

Extremely common to initially feel better stopping levothyroxine

Strongly recommend getting FULL Thyroid and vitamin testing 6-8 weeks after any dose change or brand change in levothyroxine

Whiterose profile image
Whiterose in reply toSlowDragon

Hi Slow Dragon. GP's will only test for TSH. In April this year my TSH Level was 8.5 (Range 0.3-5.5) But they included Serum Free T4 this was 10.8 (10-22.0) This month July they only tested TSH which was 8.9 Range (0.3-5.5) and not Serum Free T4 I have forgotten the name of the companies that do the blood tests & vits etc. Many thanks.

SlowDragon profile image
SlowDragonAdministrator in reply toWhiterose

please write this as a new post

On levothyroxine TSH should always be below 2

Most people when adequately treated will have TSH around or below 2

You must be extremely under medicated

Presumably you had 25mcg dose increase after these results

Bloods should be retested by GP after 6-8 weeks

ALWAYS book early morning test, around 9am latest, only drink water between waking and test and last dose levothyroxine 24 hours before test

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/wp-content/up...

Tips on how to do DIY finger prick test

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Essexlil profile image
Essexlil in reply toWhiterose

oh so unfair

TaraJR profile image
TaraJR in reply toWhiterose

But Dorset has a shared care agreement for consultants/GPs prescribing T3, so they are letting some patients have it. Worth asking again?

nhsdorset.nhs.uk/Downloads/...

Essexlil profile image
Essexlil in reply toTaraJR

hi I asked GP and she said she can’t provide it on NHS 🤬I’ve written to MP

Essexlil profile image
Essexlil

ok thank you I’ve taken note to look that up

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