The management of primary hypothyroidism with Levothyroxine (L-T4) is usually simple, effective and safe, and most patients report improved well-being once they have started treatment. However, medical professionals recognise that a proportion of individuals continue to suffer with symptoms despite apparently having thyroid function tests falling within the normal range.

For patients who have clearly not derived benefit from L-T4, endocrinologists (thyroid specialists) sometimes decide to begin a trial of L-T4/liothyronine (L-T3) combination therapy. Such patients should be supervised by accredited endocrinologists after a fully informed and understood discussion of the risks and potential adverse consequences.

We are aware that a number of patients have been advised by their GPs that L-T3 is no longer available for the treatment of hypothyroidism and that they should use L-T4 as an alternative treatment. We understand that this is as a direct result of the sharp increase in price of L-T3, which the NHS does not believe is sustainable. 

Factsheets for patients and GPs

The recent non-availability of L-T3 has caused considerable concern and we therefore feel that some clear advice would be helpful. We have prepared this frequently asked questions (FAQ) factsheet for patients who are on treatment with L-T3 and are concerned that they may be required to switch to L-T4.  The BTA has produced a similar FAQ sheet for GPs which you can print off and take with you to an appointment if you believe it would be useful. 

November 2019 - T3 Prescribing Patterns Survey

This survey has now closed. Thank you to everyone who answered it. To read the report of the results of this survey follow this link.

To help us understand more about the patterns of liothyronine (T3) patterns in England since NHS England clarified its guidance in July 2019 please complete this short survey by midnight on 19 November.

July 2019 - Updated RMOC Guidance - Prescribing of Liothyronine

The Regional Medicines Optimisation Committee (RMOC) have clarified the guidance issued to Clinical Commissioning Groups (CCGs) on the prescribing of liothyronine. This updated guidance was published in July 2019 and can be found on this link.

October 2018 - Liothyronine Dossier

To address the problems caused by this issue UK thyroid patient groups have worked in partnership with the British Thyroid Association (BTA). In 2018, at the request of the Department of Health, they produced and published the Liothyronine Dossier which was presented to NHS England.

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