NHS Board decides on the question of deprescribing T3

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NHS England gave its decision at a board meeting this morning about whether liothyronine will be deprescribed by the NHS.

Read a transcript of the meeting 

Liothyronine 

  1. Of those respondents who either agreed or disagreed with the recommendations, only 16% agree that CCGs should be advised that prescribers in primary care should not initiate Liothyronine for any new patients.
  2. The main recurring theme – particularly from patients and organisational bodies – is that this is an effective treatment which can, in the appropriate circumstances contribute to patient wellbeing, quality of life and condition management. The impact on particular cohorts of patients was also highlighted – notably those who are unable to take Levothyroxine -T4, or whose metabolic pathway is impaired in some way.
  3. The joint clinical working group therefore recommended the prescribing of liothyronine for any new patient should be initiated by a consultant endocrinologist in the NHS, and that de-prescribing in ‘all’ patients is not appropriate, as there are recognised exceptions. The recommendation would therefore be changed to advise prescribers to de-prescribe in all appropriate patients.

Thyroid UK is not happy with the word “appropriate”.  They have not explained who would be “appropriate” to remain on T3. The definition of “Appropriate” is very subjective and NHS England should have gone further and explained that patients who do not do well on levothyroxine should be given a trial of T3.

I would like to say a big THANK YOU and WELL DONE to everyone who supported our campaign and who took part in the consultation. Now is the time for patients who have been de-prescribed to go back to their GP/Endocrinologist and show them the NHS England decision and push for having it prescribed again. Patients who are not well on levothyroxine should push for an endocrinologist appointment for a trial of T3!

This doesn’t mean that Thyroid UK will stop campaigning as we really want T3 to be tested as routine in all patients and trials of T3 given more readily. Then, of course, there’s the fight to get the price of T3 reduced!