Leicestershire Health Community
Medicines Formulary
6 Endocrine system
06-02-01 Thyroid hormones

Levothyroxine Sodium Levothyroxine
First Choice
Long half life (about 7 days) so full effects may not be seen for several weeks. Do not monitor or adjust dose more frequently than every 2-3 months

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Liothyronine Sodium
For prescription on specialist advice only. Please see LLR guidance.
For severe hypothyroidism where a rapid response is required. More potent than thyroxine with a more rapid onset and shorter duration (24-48 hours) of action.
Liothyronine 20 micrograms is approximately equivalent to 100 micrograms thyroxine
Randomised trials and meta-analyses show no systematic benefit of combined T4/T3 replacement. It may be used occasionally for initiation only by endocrinologists according to strict criteria and discontinuation if no improvement after 12 months.

Also used by specialists in psychiatry for treatment of depression where other therapies have failed unlicensed use)
Link  Leicestershire Guidance: Treatment of Hypothyroidism with Liothyronine

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Armour Thyroid
Non Formulary

This dried thyroid extract is recommended in a number of populist internet sites and magazine articles. There is no clinical trial evidence of benefit, and this product is not recommended by endocrinologists on either side of the Atlantic.                                                                   

Link  British Thyroid Association Statement: Armour are NOT supported

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