Avoid prescribing desiccated (natural) thyroid extract

[helvella]

The NHS England Specialist Pharmacy Service advice re desiccated thyroid has been updated.

Doesn't make much difference! But in case you are interested or need to know, it is linked below.

Note that it does NOT say desiccated thyroid cannot prescribed.

It still contains this bizarre sentence:

Commercially available DTE products are derived from cleaned, dried and powdered pig thyroid glands formulated into doses called ‘‘grains’’.

Which to me reads as 'Janet and John - Off we go to the pharmacy'. I mean, we still have numerous medicines which are dosed in milligram equivalents of grains - such as some aspirin and paracetamol products. When you see 325 (five grains) rather than 300 or 350.

And many other questionable statements and assertions.

Avoid prescribing desiccated (natural) thyroid extract

Published 20 January 2022 · Last updated 12 October 2023 · See all updates

Levothyroxine is the standard of care for treating hypothyroidism. Desiccated or natural thyroid extracts (DTE) are not routinely recommended.

Update history

12 October 2023 RMOC guidance removed and updated NHS England guidance

20 January 2022 Published

Rest of paper here:

sps.nhs.uk/articles/review-...

[Tythrop]

Do they have reson why we should avoid... .Do they give evidence to support their reasons ...no.I guess not

[helvella Administrator in reply to Tythrop]

Follow the link and they identify three areas of concern:

Licensed status

Lack of evidence

Safety concerns

[Zephyrbear]

Did anyone else hear the Janet and John bit in Terry Wogan’s voice? 😂🤣😂

[Feuerfrei in reply to Zephyrbear]

🤣🤣🤣 no, but I do now! Thanks for that.

[radd in reply to Zephyrbear]

Oh helvella , is that what you sound like? I like Terry Wogan's voice 😁

[Lily905]

Thank for the Update. So the NHS are still saying - One Size Fits All "Levothyroxine is the standard of care for treating hypothyroidism. Desiccated or natural thyroid extracts (DTE) are not routinely recommended"

[helvella Administrator in reply to Lily905]

Yes - no real change.

[Lily905 in reply to helvella]

Exactly. Individualized Care & Medication Plans for Everybody Except Thyroid Patients

[TaraJR]

The word 'routinely' is crucial - regarding NDT and T3.

It doesn't mean do not prescribe, it means not as a first-line treatment. Sadly, drs and ICBs don't (or choose not) to interpret this correctly. Patient groups have emphasised this with NHSE but they don't accept that the language could be clearer

[helvella Administrator in reply to TaraJR]

Absolutely!

[Hidden in reply to TaraJR]

My health authority flatly refuses to prescribe anything other than Levothyroxine. It is a blanket refusal to all in our area to be prescribed NDT and T3. The head of endocrinology has stated it. They strongly believe it is nothing but witch doctor medication, and feel those that take it through self medication are putting their lives at risk, me being one of them 🙄😣

[TaraJR in reply to Hidden]

Which area (ICB) are you in?

[Hidden in reply to TaraJR]

I will PM it to you

[serenfach]

Lack of evidence - oh, there is plenty of evidence - decades of evidence before they manufactured Levo. People took NDT and did not die.

Safety concerns - thousands took NDT and had normal lives. They still do. Ignore that though.

Licensed status - ah, here is the truth. They cannot make money from it. Just imagine if they managed to make NDT with a spot of Vit D in it, called it something like "the ultimate thyroid tablet" and charged the same as Levo. There would be queues round the block!