Dear Dr.

You previously told me that you would not be prepared to prescribe thyroid extract (Armour thyroid) for me in view of the difficulty in ensuring adequate quality control for this preparation. I have been investigating the question regarding potency problems with Armour thyroid and into the question of ‘quality control’ of this product. This question was passed directly to the Medicines and Healthcare Products Regulatory Agency (MHRA) and a letter from Graham Matthews (Pharmaceutical Assessor, Defective Medicines Report Centre) of the MHRA has been received setting out details about the prescribing of this particular product.

I am attaching a copy of this letter for your information, and you will see that they state very clearly that adequate quality control for Armour Thyroid is assured through the Food and Drugs Administration (FDA) and that it is standardised to the specifications required by the United States Pharmacopoeia (USP) As there appears to be concern by some medical practitioners who express doubt about the stability of liothyronine (T3) and levothyroxine (T4) in natural desiccated porcine thyroid extract. I am enclosing a document made up of extracts from the Monograph on Armour Thyroid showing that batch to batch consistency and stability of T4 and T3 in Armour thyroid is well within the USP reference ranges and this is consistent.

I am also enclosing copy of a letter sent by Thyroid Patient Advocacy UK to all UK endocrinologists and this letter gives answers to the many questions doctors have raised regarding the prescribing of natural desiccated porcine thyroid.

My local Primary Care Trust has agreed that they will fund this medicine should you feel that a trial of Armour Thyroid could be beneficial for me and I enclose a copy of their letter of agreement. An article and correspondence in the Thyroid UK Newsletter for April 2004 stated that in a discussion between MHRA and Idis, the onus is on Idis, as importer and supplier, to prove that Armour thyroid is being supplied for the permitted indication, and a spokesperson for Idis has agreed that doctors now only need to write on the prescription ‘required to treat hypothyroidism’. If there are any problems concerning this, please contact the MHRA or Idis World Medicines direct.

Would you please arrange a meeting with your partners to discuss this and write to me (sae enclosed) to let me know your decision as soon as possible?

I hope that with this new information, you will now feel in a better position to give me a trial of natural Armour Thyroid extract.

I look forward to your reply.

Yours sincerely