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Not-So-Nice "NICE" Guidelines Released in the UK

In the UK, the National Institute for Health and Care Excellence (NICE) has issued guidance that is NOT especially nice for thyroid patients who rely on natural desiccated thyroid (NDT) drugs. The new NICE guidelines on "Thyroid disease assessment and management, published at the British Medical Journal, read:

Natural thyroid extract is not recommended and liothyronine (alone or in combination with levothyroxine) is not routinely recommended for treating people with primary hypothyroidism

This is no surprise, as many physicians in the UK -- as well as the UK's National Health Service -- have discouraged use of NDT in recent years, refusing some hypothyroid patients the treatment that works best for them. This bias -- and the new NICE guidelines -- appear to be based on outdated information about the use of NDT, and a lack of understanding of the need for T3 treatment thyroid in some hypothyroid patients.

There guidelines are being subject to some strong pushback by physicians and patients. For example, in responses to the British Medical Journal, one endocrinologist wrote: "_The treatment of thyroid disease still has many controversies and uncertainties. Until these are resolved, the onus on professionals is to regard patient choice and opinion and to have an open mind on treatments that may not be recommended or accepted by experts._"

I highly recommend you read the several pages of responses from doctors, patients, and advocates from the UK and around the world. You'll find all the responses at the BMJ site at


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