This website is dedicated to the millions of thyroid patients who are being ignored and left to suffer unnecessarily, and to healthcare practitioners, who want to better serve those patients.

Straight from the Horses Mouth! (UD)

Doctors CAN use thyroid hormones apart from L-T4-only; they can also prescribe unlicensed drugs.

Published on 15th November 2013 00:27 Updated 1st May 2014 Number of Views: 956

Because I could not find the definitive source within the Department of Health for the statements below on the 2 February 2013 I wrote direct to The Rt. Hon Sir Jeremy Hunt MP (Secretary of State for Health in the UK)

Please keep the DoH response safe.

Show it to your GP/Endocrinologist if they insist they cannot prescribe anything other than levothyroxine-only and/or cannot prescribe unlicenced drugs.

Show it to those doctors who state they are not allowed to follow other thyroid guidelines other than the RCP’s policy statement.

Show it to those doctors who claim they are not allowed to diagnose if blood results are within the reference range – and help further their education.

________________________

Dear Jeremy Hunt

I am founder/Chair of Thyroid Patient Advocacy (TPA) www.tpauk.com.

There are no official guidelines for the diagnosis and treatment of hypothyroidism or guidelines for those suffering from peripheral thyroid hormone deficiency and I wondered what the situation is for medical practitioners when all they have as guidance is a policy statement issued by the Royal College of Physicians.

Are doctors allowed to follow guidance/guidelines of their choice whoever has written them and choose guidelines even if they are from a different country? TPA has thousands of members of their Online Thyroid Support Forum many saying their doctor has told them that they are not allowed to diagnose or treat outside of the RCP policy statement. I would be grateful for a definitive answer to this question please.

Kind regards

Sheila Turner (Chair)
_______________________

DEPARTMENT OF HEALTH RESPONSE:
Our ref: DE00000756922

http://tpauk.com/images/bank/jeremy-hunt-2.jpg

Dear Mrs Turner

Thank you for your email of 4 February to Jeremy Hunt about hypothyroidism treatment. I have been asked to reply.

I should explain that the Royal College of Physicians (RCP) and the British Thyroid Association (BTA) are independent of the Government. The Department of Health has no plans to ask the RCP to withdraw its clinical guidelines for the treatment of this medical condition. Nor does the Department have any plans to produce guidance on the diagnosis or treatment of hypothyroidism. UK Guidelines for the use of Thyroid Function Tests are published jointly by the Association for Clinical Biochemistry and the BTA.

Doctors are encouraged not to rely too heavily on the results of blood tests but to use their clinical knowledge and an assessment of the symptoms experienced by individual patients in making a diagnosis for thyroid treatment. Doctors are free to use whatever guidance they feel is appropriate when making a diagnosis. This includes guidance published in other countries.

I should add that under their terms of service GPs are allowed to prescribe any product including any unlicensed product or product not licensed for a particular indication that they consider to be a medicine necessary for the treatment of their patients under the NHS. This is subject to two provisos which are:

– the product is not included in Schedules 1 or 2 of the NHS General Medical Services Contracts (Prescription of Drugs etc) Regulations 2004 otherwise known as the Selected List Scheme; and

– GPs are prepared to justify any challenges to their prescribing by their primary care trust.

It is the responsibility of health professionals to decide on the most appropriate treatment for their patients. If a person has any concerns over their treatment or the drugs they are prescribed they should raise these concerns with their GP or consultant.

I hope this reply is helpful in clarifying the Departments position.

Yours sincerely

Peter Wozniak

Ministerial Correspondence and Public Enquiries

Department of Health

The Secretary of State for Health states doctors can use other thyroid hormones other than levothyroxine-only; they can prescribe unlicensed drugs; they can follow whatever guidelines they wish even if they are from another country.

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Previous comments

Amen!

Charlie Farley,

Well that sounds good.
I will copy it and take it with me when I see Dr Nikookam at King George’s next month.
Although I think my mood has improved thanks to the vitamin Vitamin D and B12 sprays I’ve been taking, my joints are still very painful.
Plus I get quite tired etc, etc.
His registrar previously said I shouldn’t be prescribed it because it was too difficult to work out a safe dose!?
We’ll see. I think the’re just loathe to give it to me and keep saying I’m euthyroid. But surely if I’m euthyroid, I shouldn’t have all these symptoms?

LiliBili,

I don’t get why some lines are highlighted in red. If the DoH was trying to make a point, I missed it

Teabag,

Manchester Royal Infirmary have stopped my Liothyronine as they say my GP should be prescribing this medication.But my GP refuses to do so
as he says the Medical Management Team won’t allow him to to prescribe this drug.I am now under medicated and don’t know what to do about
it. I would like to find a doctor in Manchester who would give me a prescription for Armour Thyroid.Can anybody help.

June Neilson,

ALL of the Clinical Commissioning Groups in Merseyside have adopted the policy of blacklisting NDT such that no doctor in the area is allowed to prescribe it.
Reasons given include the fact that levo is cheaper than NDT, and so it is. BUT it does not get me well. It is allowable for me to be prescribed T3/T4, but the reported cost of T3 is far, far greater than NDT and also is unlikely to give me good health.
Another reason given is that there is overwhelming evidence that levo only should be prescribed, but they seem very unwilling to give me details of it. Hardly surprising as there is no evidence!

John99,

What doctors seem to be missing is that under treating patients will inevitably make them suffer other conditions thus eventually costing the nhs more than if they had been prescribed the right treatment in the first place

PILCHY62,

This does not make sense – I have been on T3 only and NDT, I have just moved back here from overseas . My doctor said he would fill in a funding application for T3. He did this and got a letter a week later saying that I couldn’t have it – based on what I don’t know as no one took a full history or actually examined me. Cytomel is available at a cost of 3.50 Euros in France for a box of 30 25mcg tablets. Why is it £265 here for the same packet?

JM001,

I was given T3 by a.n Endo I was seeing for 7yes. He left and half my t3 was taken off me by an Endo who never saw me. He sat in the next room and made the decision to bring my T3 down from 60 mcg per day to 30 mcg which I Had increased very slowly over a few years. I was forced, like so others to buy T3 online to continue raising to get well. I was living half a life and the hospital refused to try NDT as made in the USA. People who use it there say it works better than any man made horomes as has natural t1, t2, T3, t4 and calcitonin for the bones. I have osteoporosis so NDT would be the best treatment for me but no GP or other Endos will try it and many now won’t try T3 either

Sylviana,