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421268

	registered interest
	date	14/10/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hypothyroidism
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what steps they have taken to help patients with undiagnosed hypothyroidism who present clinical signs and symptoms of that condition, but are refused any treatment as their blood test results remain normal.
	tabling member printed	Lord Pendry
	uin	HL2639
	answer	answer is ministerial correction date of answer 27/10/2015 answer text <p>A blood test measuring hormone levels is the only accurate way to find out if there is a thyroid problem.</p><br /><p>Best practice on the identification and management of hypothyroidism has been set out by the Royal College of Physicians (RCP) in its guidance, <em>The Diagnosis and Management of Primary Hypothyroidism</em>, first published in 2008. The guidance, which is attached, was developed on behalf of key organisations, including the British Thyroid Association (BTA), the British Thyroid Foundation (BTF) and the Society for Endocrinology (SOE), and is endorsed by the Royal College of General Practitioners. A copy of the UK Guidelines is attached.</p><br /><p>The RCP guidance sets out that the only validated method of testing thyroid function is through a blood sample, which must include measurement of the levels of thyroid‐stimulating hormone (TSH) and free thyroxine (FT4) in serum, as recommended in the <em>UK Guidelines for the Use of Thyroid Function Tests</em> published by the BTA.</p><br /><p>The RCP guidelines set out that overwhelming evidence supports the use of thyroxine hormone replacement (T4 or tetra-iodothyronine) alone in the treatment of hypothyroidism, with this usually being prescribed as levothyroxine. However, this does not prevent clinicians considering other forms of thyroid hormone replacement if appropriate.</p><p>The guidance remains up-to-date and a statement from the BTA Executive Committee supporting the existing guidelines was published in May 2015 in <em>Clinical Endocrinology</em> and endorsed by the Association for Clinical Biochemistry and Laboratory Medicine, the BTF, the RCP and the SOE. The full statement is attached and available online at:</p><br /><p><a href="http://onlinelibrary.wiley.com/doi/10.1111/cen.12824/full" target="_blank">http://onlinelibrary.wiley.com/doi/10.1111/cen.12824/full</a></p><br /><p>Regarding international guidance and harmonisation on approaches to testing, the existing United Kingdom guidelines have now been supported by new guidance published in the United States of America which draws on the latest research and available evidence on the management of the condition. The USA guidance also includes a section on the ethics of prescribing thyroid hormone combination therapies when the potential long-term harmful effects are not known.</p> answering member printed Lord Prior of Brampton attachment 1 file name Okosieme_et_al-2015-Clinical_Endocrinology.pdf title Clinical Endocrinology paper 2 file name the-diagnosis-and-management-of-primary-hypothyroidism-revised-statement-14-june-2011_2.pdf title Royal College of Physicians guidance 3 file name TFT_guideline_final_version_July_2006.pdf title UK Guidelines Thyroid Function Tests grouped question UIN HL2640 HL2641 HL2642 question first answered 27/10/2015 17:53:42 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	457 label Biography information for Lord Pendry

421269

	registered interest
	date	14/10/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hypothyroidism
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government whether there are any plans to amend the diagnosis of hypothyroidism, which under current guidance is based solely on a blood test.
	tabling member printed	Lord Pendry
	uin	HL2640
	answer	answer is ministerial correction date of answer 27/10/2015 answer text <p>A blood test measuring hormone levels is the only accurate way to find out if there is a thyroid problem.</p><br /><p>Best practice on the identification and management of hypothyroidism has been set out by the Royal College of Physicians (RCP) in its guidance, <em>The Diagnosis and Management of Primary Hypothyroidism</em>, first published in 2008. The guidance, which is attached, was developed on behalf of key organisations, including the British Thyroid Association (BTA), the British Thyroid Foundation (BTF) and the Society for Endocrinology (SOE), and is endorsed by the Royal College of General Practitioners. A copy of the UK Guidelines is attached.</p><br /><p>The RCP guidance sets out that the only validated method of testing thyroid function is through a blood sample, which must include measurement of the levels of thyroid‐stimulating hormone (TSH) and free thyroxine (FT4) in serum, as recommended in the <em>UK Guidelines for the Use of Thyroid Function Tests</em> published by the BTA.</p><br /><p>The RCP guidelines set out that overwhelming evidence supports the use of thyroxine hormone replacement (T4 or tetra-iodothyronine) alone in the treatment of hypothyroidism, with this usually being prescribed as levothyroxine. However, this does not prevent clinicians considering other forms of thyroid hormone replacement if appropriate.</p><p>The guidance remains up-to-date and a statement from the BTA Executive Committee supporting the existing guidelines was published in May 2015 in <em>Clinical Endocrinology</em> and endorsed by the Association for Clinical Biochemistry and Laboratory Medicine, the BTF, the RCP and the SOE. The full statement is attached and available online at:</p><br /><p><a href="http://onlinelibrary.wiley.com/doi/10.1111/cen.12824/full" target="_blank">http://onlinelibrary.wiley.com/doi/10.1111/cen.12824/full</a></p><br /><p>Regarding international guidance and harmonisation on approaches to testing, the existing United Kingdom guidelines have now been supported by new guidance published in the United States of America which draws on the latest research and available evidence on the management of the condition. The USA guidance also includes a section on the ethics of prescribing thyroid hormone combination therapies when the potential long-term harmful effects are not known.</p> answering member printed Lord Prior of Brampton attachment 1 file name Okosieme_et_al-2015-Clinical_Endocrinology.pdf title Clinical Endocrinology paper 2 file name the-diagnosis-and-management-of-primary-hypothyroidism-revised-statement-14-june-2011_2.pdf title Royal College of Physicians guidance 3 file name TFT_guideline_final_version_July_2006.pdf title UK Guidelines Thyroid Function Tests grouped question UIN HL2639 HL2641 HL2642 question first answered 27/10/2015 17:53:42 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	457 label Biography information for Lord Pendry

421270

	registered interest
	date	14/10/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hypothyroidism
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what progress is being made on the initiative to achieve greater harmonisation on approaches to diagnosing hypothyroidism internationally.
	tabling member printed	Lord Pendry
	uin	HL2641
	answer	answer is ministerial correction date of answer 27/10/2015 answer text <p>A blood test measuring hormone levels is the only accurate way to find out if there is a thyroid problem.</p><br /><p>Best practice on the identification and management of hypothyroidism has been set out by the Royal College of Physicians (RCP) in its guidance, <em>The Diagnosis and Management of Primary Hypothyroidism</em>, first published in 2008. The guidance, which is attached, was developed on behalf of key organisations, including the British Thyroid Association (BTA), the British Thyroid Foundation (BTF) and the Society for Endocrinology (SOE), and is endorsed by the Royal College of General Practitioners. A copy of the UK Guidelines is attached.</p><br /><p>The RCP guidance sets out that the only validated method of testing thyroid function is through a blood sample, which must include measurement of the levels of thyroid‐stimulating hormone (TSH) and free thyroxine (FT4) in serum, as recommended in the <em>UK Guidelines for the Use of Thyroid Function Tests</em> published by the BTA.</p><br /><p>The RCP guidelines set out that overwhelming evidence supports the use of thyroxine hormone replacement (T4 or tetra-iodothyronine) alone in the treatment of hypothyroidism, with this usually being prescribed as levothyroxine. However, this does not prevent clinicians considering other forms of thyroid hormone replacement if appropriate.</p><p>The guidance remains up-to-date and a statement from the BTA Executive Committee supporting the existing guidelines was published in May 2015 in <em>Clinical Endocrinology</em> and endorsed by the Association for Clinical Biochemistry and Laboratory Medicine, the BTF, the RCP and the SOE. The full statement is attached and available online at:</p><br /><p><a href="http://onlinelibrary.wiley.com/doi/10.1111/cen.12824/full" target="_blank">http://onlinelibrary.wiley.com/doi/10.1111/cen.12824/full</a></p><br /><p>Regarding international guidance and harmonisation on approaches to testing, the existing United Kingdom guidelines have now been supported by new guidance published in the United States of America which draws on the latest research and available evidence on the management of the condition. The USA guidance also includes a section on the ethics of prescribing thyroid hormone combination therapies when the potential long-term harmful effects are not known.</p> answering member printed Lord Prior of Brampton attachment 1 file name Okosieme_et_al-2015-Clinical_Endocrinology.pdf title Clinical Endocrinology paper 2 file name the-diagnosis-and-management-of-primary-hypothyroidism-revised-statement-14-june-2011_2.pdf title Royal College of Physicians guidance 3 file name TFT_guideline_final_version_July_2006.pdf title UK Guidelines Thyroid Function Tests grouped question UIN HL2639 HL2640 HL2642 question first answered 27/10/2015 17:53:43 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	457 label Biography information for Lord Pendry

421271

	registered interest
	date	14/10/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Hypothyroidism
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government whether there are any plans to amend the treatment of hypothyroidism by including thyroid hormone combination therapies other than treatment by levothyroxine in the standard of care.
	tabling member printed	Lord Pendry
	uin	HL2642
	answer	answer is ministerial correction date of answer 27/10/2015 answer text <p>A blood test measuring hormone levels is the only accurate way to find out if there is a thyroid problem.</p><br /><p>Best practice on the identification and management of hypothyroidism has been set out by the Royal College of Physicians (RCP) in its guidance, <em>The Diagnosis and Management of Primary Hypothyroidism</em>, first published in 2008. The guidance, which is attached, was developed on behalf of key organisations, including the British Thyroid Association (BTA), the British Thyroid Foundation (BTF) and the Society for Endocrinology (SOE), and is endorsed by the Royal College of General Practitioners. A copy of the UK Guidelines is attached.</p><br /><p>The RCP guidance sets out that the only validated method of testing thyroid function is through a blood sample, which must include measurement of the levels of thyroid‐stimulating hormone (TSH) and free thyroxine (FT4) in serum, as recommended in the <em>UK Guidelines for the Use of Thyroid Function Tests</em> published by the BTA.</p><br /><p>The RCP guidelines set out that overwhelming evidence supports the use of thyroxine hormone replacement (T4 or tetra-iodothyronine) alone in the treatment of hypothyroidism, with this usually being prescribed as levothyroxine. However, this does not prevent clinicians considering other forms of thyroid hormone replacement if appropriate.</p><p>The guidance remains up-to-date and a statement from the BTA Executive Committee supporting the existing guidelines was published in May 2015 in <em>Clinical Endocrinology</em> and endorsed by the Association for Clinical Biochemistry and Laboratory Medicine, the BTF, the RCP and the SOE. The full statement is attached and available online at:</p><br /><p><a href="http://onlinelibrary.wiley.com/doi/10.1111/cen.12824/full" target="_blank">http://onlinelibrary.wiley.com/doi/10.1111/cen.12824/full</a></p><br /><p>Regarding international guidance and harmonisation on approaches to testing, the existing United Kingdom guidelines have now been supported by new guidance published in the United States of America which draws on the latest research and available evidence on the management of the condition. The USA guidance also includes a section on the ethics of prescribing thyroid hormone combination therapies when the potential long-term harmful effects are not known.</p> answering member printed Lord Prior of Brampton attachment 1 file name Okosieme_et_al-2015-Clinical_Endocrinology.pdf title Clinical Endocrinology paper 2 file name the-diagnosis-and-management-of-primary-hypothyroidism-revised-statement-14-june-2011_2.pdf title Royal College of Physicians guidance 3 file name TFT_guideline_final_version_July_2006.pdf title UK Guidelines Thyroid Function Tests grouped question UIN HL2639 HL2640 HL2641 question first answered 27/10/2015 17:53:43 answering member 127 label Biography information for Lord Prior of Brampton
	tabling member	457 label Biography information for Lord Pendry