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.
Sheila Turner (Chair)
DEPARTMENT OF HEALTH RESPONSE:
Our ref: DE00000756922
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.
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.