Re: T3 T4 what can GP prescribe

[Guest guest]

·

Thyroxine (T4) - Liothyronine (T3) or Natural Thyroid Extract

i.e. Erfa 'Thyroid', Nature Throid and Westhroid. However, natural thyroid

extract remains unlicensed in the UK and therefore, it is up to the individual

doctor whether or not they are happy to prescribe it for you, but the Medicines

and Healthcare Products Regulatory Agency state that doctors can do this so

long as they are willing to take full responsibility for doing this because

their medical insurance doesn't cover them should anything go wrong.

·

As far as T3 is concerned, a GP will usually refer you to an

endocrinologist before prescribing it, but some are happy to prescribe it

without the need for a referral.

Luv - Sheila

What can british GP's prescribe regarding T3

T4?

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[Guest guest]

HI,

T3 is listed in the BNF (British Nationals Formulary) as liothyronine. I have

copied the entry below for your information. oOme GPs are reluctant to prescribe

as they haven't used it before, if this is the case, it's worth asking your GP

to refer to the BNF to see if they will prescribe a low dose to start with. It

clearly says its for use with Hypoothyroid and that it's more rapidly

metabolised than levothyroxine (t4)

Initially, my GP wrote to the local hospital asking how to dose with combo T4/T3

rather than referring me and I was on both for a while. I am now on T3 only and

on 60mcg a day.

Regards

Nadia

--------------------

REPRODUCED FROM THE BNF WEBSITE: http://www.bnf.org/bnf/index.htm

(YOU CAN REGISTER FOR FREE TO HAVE INTERNET ACCESS TO THE LATEST COPY ONLINE)

6.2.1 Thyroid hormones

Thyroid hormones are used in hypothyroidism (myxoedema), and also in diffuse

non-toxic goitre, Hashimoto's thyroiditis (lymphadenoid goitre), and thyroid

carcinoma. Neonatal hypothyroidism requires prompt treatment for normal

development. Levothyroxine sodium (thyroxine sodium) is the treatment of choice

for maintenance therapy.

In infants and children with congenital hypothyroidism and juvenile myxoedema,

the dose of levothyroxine should be titrated according to clinical response,

growth assessment, and measurements of plasma thyroxine and thyroid-stimulating

hormone. See BNF for Children (section 6.2.1) for suitable dosage regimens.

Liothyronine sodium has a similar action to levothyroxine but is more rapidly

metabolised and has a more rapid effect; 20–25 micrograms is equivalent to 100

micrograms of levothyroxine. Its effects develop after a few hours and disappear

within 24 to 48 hours of discontinuing treatment. It may be used in severe

hypothyroid states when a rapid response is desired.

Liothyronine by intravenous injection is the treatment of choice in hypothyroid

coma. Adjunctive therapy includes intravenous fluids, hydrocortisone, and

treatment of infection; assisted ventilation is often required.

LIOTHYRONINE SODIUM

(L-Tri-iodothyronine sodium)

Additional information interactions (Liothyronine).

Indications see notes above

Cautions see under Levothyroxine Sodium; interactions: Appendix 1 (thyroid

hormones)

Contra-indications see under Levothyroxine Sodium

Pregnancy does not cross the placenta in significant amounts; monitor maternal

thyroid function tests—dosage adjustment may be necessary

Breast-feeding amount too small to affect tests for neonatal hypothyroidism

Side-effects see under Levothyroxine Sodium

Dose

By mouth, initially 10–20 micrograms daily gradually increased to 60 micrograms

daily in 2–3 divided doses; elderly smaller initial doses; child, adult dose

reduced in proportion to body-weight By slow intravenous injection, hypothyroid

coma, 5–20 micrograms repeated every 12 hours or as often as every 4 hours if

necessary; alternatively initially 50 micrograms then 25 micrograms every 8

hours reducing to 25 micrograms twice daily

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