Thyroid patients receive Liothyronine when needed

Hypothyroid patients who have a clinical need for Liothyronine should be prescribed it without being forced to jump through many hoops and wait many months for it (if they are ever allowed it). It should not be made into a fight which it is now. Clinicians should be able to prescribe according to patient need, not be forced to refuse it when it is needed.

Hypothyroidism is a lifelong condition, and the majority of patients are made well taking Levothyroxine. However a minority do require Liothyronine to be well or to have any decent quality of life.

Norfolk CCGs agreed in June 2018 that Liothyronine could be prescribed by a consultant. It is still not happening in practice - almost all patients are not being allowed prescriptions. 

Norfolk and Waveney need to considerably improve the knowledge of endocrinologists, the treatment of hypothyroid patients, and their health and quality of life, enabling them to lead a full life, lessen the load on primary and secondary care for unnecessary appointments and medications for symptoms which would be resolved with liothyronine, and contribute to the Norfolk economy.

Why the contribution is important

f a patient has a clinical need for liothyronine but is not allowed it, it can lead to them being housebound, unable to work, unable to care for families, unable to contribute to society, and they also end up having tests for conditions they do not have, and being prescribed many drugs to mask the symptoms that liothyronine would cure. It is a false economy to deny liothyronine to patients who need it. It is also not in line with 'duty of care'. 

NHSE, Regional Medicines Optimisation Committee, and British Thyroid Association guidance all say that a minority of patients (approximately 10-15% of hypothyroid patients) need liothyronine. But Norfolk CCGs have still not fully enabled this to happen. 

Clinicians at NNUH do not seem sufficiently knowledgeable in the need for, and use of, Liothyronine. They appear to be diabetic specialists, and none have thyroid disease as a specialism. Norfolk definitely needs thyroid specialists. Thyroid disease appears to be the poor relation alongside diabetes, but thyroid disease, and poor treatment have a devastating effect on patients, and this is for life. Some Norfolk thyroid patients are completely dissatisfied, and have been forced to go private and can ill afford it. Some have to remain ill. 

I ask Norfolk and Waveney Health and Care Partnership to seriously consider this situation and improve matters as stated above. They would be well advised to liaise with Cambridge Addenbrooke's hospital, whose Lead of Endocrinology is Professor Krishna Chatterjee, President of the British Thyroid Association. 

by Aratenaj on August 21, 2019 at 09:33PM

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Comments

  • Posted by DdramaLlama August 22, 2019 at 03:40

    Couldn't agree more with this idea. Thyroid patients need access to the right medication and the right medical specialists to help them recover from how life changing this illness can be. To go from a full active life to struggling to function is devastating to say the least.
  • Posted by Feedback30 August 27, 2019 at 18:38

    Totally agree, NNUH endocrinologists could learn a lot from Addenbrookes about how to treat hypothyroidism. Could NNUH replicate Addenbrookes hypothyroidism policies, as was suggested by NHS England after a review of my care at NNUH endocrinology.
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