Can a pharmacist prescribe thyroid medication?

[sickbucket67]

I don’t think they can but happy to be proved wrong.

I had a blood test for an unrelated issue and the lab found that my thyroid was normal range but completely suboptimal for fertility. The lab said if I want to TTC or get pregnant then I need to have medication.

the backstory of this is that I have had lots of chemical pregnancies and early miscarriages but when I have had my bloods checked (different gp, different area of the uk) I’ve just been told by the GP that it’s normal range and nothing to worry about and I am just unlucky.

I have checked my NHS app and lo and behold- I have always had the ‘suboptimal’ but normal thyroid levels. this was never picked up as a possible ‘cause’ in my investigstions and I was just told everything was normal.

I am lucky enough to have one DC despite the above and I think my family is complete- but a lot of this is due to fear of miscarrying again. Me and dh have decided to try the medication to see if we feel differently when we know that I am healthy and everything is as it should be.

i put in an e-consult at my GPs (basically saying the above) and got a text today to say that the pharmacist will be calling me about my medication tomorrow. I didn’t think they could get prescribe new medication.

Well if the gp has authorised it then the pharmacist can dispense it. On the other hand the gp might be asking the pharmacist to palm you off with the old ‘your levels are within normal range’ spiel.

It just means that the GP has prescribed it (or not) & the pharmacist will discuss it with you.

I’d speak to the pharmacist and if they can’t prescribe, straight back to the GP with another e-consult - Channel your inner terrier. Good luck with TTC if that’s what you decide.

Pharmacists can prescribe if they are independent prescribers (which most GP pharmacists are)

You really need the doctor who told you you need it to be contacting your gp rather then you.

Independent prescriber pharmacists can prescribe within their area of specialty.

Really depends on the practice but I suspect they won't without some input from fertility clinic.

Practice Pharmacists who work in a GP surgery don't dispense.

Often it takes a while to get the levels of treatment correct so they may want to talk to you about blood tests once you have started the medication.

The blood test was ordered by the GP.

The GP took the blood and sent to hospital lab.

The hospital lab told me in my results that if I wish to conceive or become pregnant I will need to be medicated.

But the lab, from the blood test that the GP ordered, has told me I need medication if TTC.

I don’t see how that can be quibbled with? It’s in my blood test results, written in black and white.

Hi @sickbucket67 would you be able to share please what level it was - I'm going to guess this is your TSH? Mine is also in the normal range but we are having fertility problems too so I'm curious if it's the same problem. Thank you.

Edit to add - yes, at my surgery there is a pharmacist who can prescribe. He's great - super knowledgable.

3.4

my lab comments say it should be a maximum of 2.5

I have also gone down a bit of a rabbit hole and many IVF and IUI clinics like it to be 2 or below.

You may struggle to get meds if its under 5, I've been trying for years

I would be very interested to know if your GP prescribes with a TSH of that level. Usually its near impossible to get a GP to prescribe unless you are over range at least twice. My TSH is 6.2, my FT4 (thyroid hormone) is also below range and my GP STILL wouldn't prescribe at that level, despite me suffering awful symptoms.

Maybe I need to lie and tell him I'm TTC.

Won't work for me @DaisyCat33 I'm 55 and have no ovaries!!🙄😂

Oh that's interesting - mine is TSH but too low - around 0.25.

And yes, my IVF clinic say they would like it to be between 1-2 so it's excellent that you've got a GP to listen to you!

It appears to be central endocrinology policy for my area for women who are TTC.

My test results, with the recommendation, had a guide linked about the protocol. TTC and pregnant women are to be medicated if their TSH is >2.5.

I didn’t see the GP for this reason, it was an unrelated matter. The lab flagged everything up and I’ve got from there- it appears to be protocol for my area, but I’ll have to see what they say tomorrow.

@sickbucket67 you're right TSH needs to be under 2.5 when trying to conceive, ideally lower as a pregnancy especially ivf pregnancy tends to cause TSH to increase up. The autoantibodies are also important did they test your thyroid peroxidase and thyroglobulin autoantibodies, if not you should ask them to or arrange your own test through medichecks having high autoantibodies increases the chance of pregnancy loss, it's not felt that people can bring them down but some people believe an off license medication called low dose naltrexone (LDN) will bring them down there is a Facebook group for that medication and hashimotos and another for that medication and preventing miscarriages.

Depends whether the pharmacist is a prescriber or not. As I recall, the current pharmacy students will graduate with a prescribing qualification, not sure about the newly qualified and older pharmacists can do a top up prescribing course.
If employed by the GP surgery, he/she may have been asked to discuss with you and do an assessment and then either prescribe themselves or ask the GP to authorise it.

We have pharmacists in the surgery I worked in. They are actually employed by the health board and placed in surgeries. (Scotland)The 2 band 6/7s have a prescribing qualification which means we can pass on some prescribing to them and saves them seeing us for an appointment. So the GP has probably seen your results and sent it to the pharmacist to action.

Anyone who is qualified as an independent prescriber can prescribe. DH is a paramedic and an independent prescriber and can therefor prescribe, as can certain (prescriber trained) nurses, pharmacists, physios and probably others. Just like doctors they have to work within the limit of their competency.

just an update- pharmacist got back to me. They are stating me with a very low dose of something that begins with L, 8 weeks, then a repeat blood test. Pharmacist thinks that will be enough to get me below 2.5 but he will revisit after the first bloods.

sorry to hear it’s been such a struggle for you ladies.

i originally had the blood test for unexplained weight loss and brain fog, so it will be interesting to see if the medication helps for that.

still not sure about TTC. Honestly think I’m done and just want to enjoy my daughter but at least I can make an informed decision about starting.

Might be Levothyroxin.

That’s the one- didn’t want to attempt to spell it

You are correct