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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

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

114517

registered interest
date	05/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Ovarian Hyperstimulation Syndrome
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, further to the Written Answer by the Parliamentary Under-Secretary of State for Public Health, Jane Ellison, on 12 September (HC Deb, col 750W), whether data regarding the cohort of patients that may develop ovarian hyperstimulation syndrome as described in the journals Human Fertility (volume 10, issue 3, pages 183–7) or Fertility and Sterility (volume 101, issue 4, pages 967–973) were shared with the Human Fertilisation and Embryology Authority (HFEA); and what assessment the HFEA has made of those studies.
tabling member printed	Lord Alton of Liverpool
uin	HL2690
answer	answer is ministerial correction date of answer 18/11/2014 answer text <p>The Human Fertilisation and Embryology Authority (HFEA) has advised that, with regard to the Human Fertility journal article, it has nothing to add to the answers given to the noble Lord on 22 October 2008 (Official Report WA110), 9 July 2012 (Official Report, cols. WA 202-3) and 8 January 2013 (WA23). Data regarding the cohort of patients described in Fertility and Sterility (volume 101, issue 4, pages 967–973) were not shared with the HFEA. However, the HFEA has access to the published article.</p><p> </p><p> </p><p> </p><p>It would be for clinicians and professional bodies to decide on the evidence required to predict the cohort of patients that may develop ovarian hyperstimulation syndrome and to treat symptoms in accordance with guidelines.</p><p> </p><p> </p><p> </p><p>As outlined in the answer given on 23 Jan 2013 (Official Report WA217), the HFEA would refer to evidence based guidelines, produced by the National Institute for Health and Care Excellence, on these matters.</p><p> </p> answering member printed Earl Howe grouped question UIN HL2640 question first answered 18/11/2014 12:39:40 answering member 2000 label Biography information for Earl Howe
tabling member	738 label Biography information for Lord Alton of Liverpool