The Dark Ages of Thyroid Treatment in The UK

We have a dark and insidious situation developing in the UK.

It is also happening in some other countries. 

In the UK, there is a shift against the prescribing of T3 by many endocrinologists and doctors. Many of our funding areas (Clinical Commission Groups, or CCGs, in the UK), are giving directives to not prescribe T3. In some cases, patients who are well on T3 are having it taken away from them.

All this is happening just as we appear to have more and more pieces of medical research that begin to show that T3 (Liothyronine) is necessary for some thyroid patients.

Just as the evidence is mounting for the life-changing benefits of adding T3 to a patients T4 medication, or using natural desiccated thyroid (NDT), or on occasion using T3-Only, it is becoming harder to have it prescribed.

It is so clear to me from my own case, and from working with thousands of thyroid patients, that T3 is absolutely essential to have as an option.

I have seen transformations from decades of ill health to good health and vitality through the use of T3. There are many research studies now that now explain why this should be and support the need for T3.

In the UK a big driving factor is the cost of T3. Our health service has allowed the price of their supplier of T3 to rise. I think at the last count the price has risen over several years to around 6000% of its original level. The price of T3 in other countries is significantly lower and quite affordable. The price of 100 tablets of UK T3 was £856 in November 2018 (£239.76 for 28 tablets). This is compared to around 30 Euros for 100 German Thybon T3, and only 2 Euros per 100 for Turkish Tiromel T3! No wonder T3 is seen as a problem! The solution that is being employed is to stop the prescriptions of many patients who have remained well on T3, but who were sick previously on T4 medication!

This just seems a draconian and frankly, stupid solution!

The Car Analogy

The analogy I have been using when I speak about this problem is one based in the automotive industry.

Imagine that a car manufacturer had a brake disc supplier who had increased the prices of the discs by several hundred per cent over some years.

Do we think the car company would have ignored this? No!

Do we think the car company would have decided to just remove the brake discs from the design of their cars?

Do we think they would have sent their cars off the end of  the production line without brake discs, simply because the discs were too expensive now?

No! No! No!

At the first sight of a problem with pricing, they would have:

  1. Negotiated with the supplier.
  2. Second sourced at least one new supplier who could supply an equivalent brake disc.
  3. Looked at second sourcing a cheaper brake disc, even if they had to design the surrounding braking system to work with the cheaper component.

They would not have chosen to be a victim of the supplier, and when the price got out of control, simply shipped the cars with no brake discs!  

I have no idea why our health service has not taken a firm and early action on the cost issue and got far cheaper alternative sources! It seems woefully negligent.

The Dark Ages of Thyroid Treatment

If the current situation did not feel like a violation of human rights or abuse, I would say it was surreal and almost ridiculous. It is a situation that I find hard to believe is happening.

When I first released the Recovering with T3 book, I felt that I was part of a movement that was ushering in a new era of enlightened thyroid treatment. I even thought that I would be contacted by lots of interested endocrinologists, who would want to find out more about my experience and my safe protocol for using T3! Sadly, I was naive.

Instead of moving forwards, we are moving backwards.

In the old days, there was just clinical judgement and natural desiccated thyroid. I think now we are probably in the worst period of thyroid treatment that has ever existed, since the early days when natural desiccated thyroid (NDT) was the only option. We are in the dark ages of thyroid treatment in the UK.

Endocrinologists are holding onto the mistaken beliefs that their use of thyroid blood tests, and the wide population reference ranges are the best way to go about assessing the efficacy of thyroid treatment. They cling on the mistaken views that TSH and FT4 are the only laboratory tests that they need to look at to manage treatment. They put these lab test results at the forefront of their focus rather than the patients’ symptoms.

In the old days of NDT therapy, thyroid medication was adjusted according to symptoms. These were the best days for thyroid patients. We ought to have just moved forward from those days, with improved diagnosis and treatment through the correct application of lab testing, and by the use of T4 and T3 medications, and in some cases T3 monotherapy (T3-Only) for those few that need it. But this has not happened.

Endocrinologists are treating thyroid patients by using the WRONG TEST – TSH. They are also mistaken that FT4 and FT3 levels just need to be somewhere within the reference ranges. They are not focused mainly on the patients’ symptoms.

It has got so much worse.

Most endocrinologists and doctors are simply looking at TSH result, or perhaps FT4 and FT3 as well, and deciding that patients are adequately treated because their results simply lay within the population ranges.

We are moving backwards, as clinical judgement is taking second place to lab test results. Only Levothyroxine (T4, Synthroid) is being offered to the majority. I think it is probably the worst period of thyroid treatment that has ever existed. 

I think so many doctors and endocrinologists have been indoctrinated at their medical schools to believe the false paradigm of T4-Only, TSH-centric and lab test-driven thyroid treatment. It is hard for them to see past this failed model, and actually pay any attention to the new research, or to the many patients who have recovered their health with the help of T3 containing medication.

Do I have any optimism left? Well, a little. If it has got as bad as this, surely there must be a backlash at some point? The research is clearly much stronger now and supports the case for T3 far more clearly than ever before. The large numbers of patients who remain well on T3 but were not on T4 medication ought to be enough of a case on its own.

I try to stay hopeful, although it is hard to.

We are not unique within the UK. It is happening in other countries. 

Many groups are uniting to try to fight against this. Fighting to get back to the light, from the Dark Ages.

It is also time for those endocrinologists and doctors who know that T3 is needed sometimes in combination with T4 (and very occasionally T3-Only) to stand up and speak against what is happening, and against the pressure to not prescribe T3 at all. They need to unite with the patient groups and help fight back against the wrong-doing that is currently happening.

Uniting seems the only way to tackle the situation.

Good luck to all involved in this.

Best wishes,


Paul Robinson

Paul Robinson is a British author and thyroid patient advocate. The focus of his books and work is on helping patients recover from hypothyroidism. Paul has accumulated a wealth of knowledge on thyroid and adrenal dysfunction and their treatment. His three books cover all of this.

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