Meeting of the Parliament 04 December 2018
The Public Petitions Committee has been considering PE1463 since 2012. I only recently became the convener of the committee, but it is my privilege to speak to the report, which contains the understanding that the committee has accumulated over a long period.
I acknowledge a number of people who assisted in the committee’s consideration of the petition, including the petitioners, Sandra Whyte, Marian Dyer and Lorraine Cleaver; the many individuals who took time to submit evidence to the committee, many of whom are struggling with the condition; and organisations such as the British Thyroid Association, Thyroid UK and the Society for Endocrinology, which provided oral and written evidence.
Thyroid disease is known to affect millions of people, predominantly women, throughout the world. The female-to-male ratio is up to 20:1, which makes the disorder predominantly, although not exclusively, a women’s disorder.
The petition is drafted in broad terms to cover all adrenal and thyroid disorders, but the petitioners explained in evidence to the committee that it is focused on a particular subset of hypothyroid patients. As the petitioners explained to the committee:
“By definition, primary hypothyroidism is a problem within the thyroid gland, but the condition that we are talking about is not within the thyroid gland. It is about the hormone that comes from the thyroid gland that becomes inactive.”
They told the committee:
“the condition that we are talking about”
is
“a conversion failure of the inactive T4 thyroid hormone to cross over into the active T3 hormone.”—[Official Report, Public Petitions Committee, 5 February 2013; c 1057, 1056.]
The Public Petitions Committee’s scrutiny has therefore focused on a subset of thyroid and adrenal diseases—that is, hypothyroidism—with a focus on patients who continue to experience symptoms while undergoing the recommended standard treatment.
I will set the scene by providing some medical detail of the issues that were considered in the context of the petition. Hypothyroidism is a condition in which the thyroid gland produces insufficient amounts of thyroxine, a hormone that is important for regulating the body’s metabolism. A healthy thyroid gland normally produces the hormones triiodothyronine—or T3, which is much easier to say—and thyroxine, or T4. Low levels of thyroxine can result in symptoms such as tiredness, weight gain and depression.
Testing for hypothyroidism occurs mainly in primary care when patients present with symptoms. Once diagnosed, hypothyroidism is usually treated in primary care with a prescription of thyroxine, or T4, tablets—usually levothyroxine, which is the standard treatment. Levothyroxine is a thyroid medicine that replaces a hormone that is normally produced by the thyroid gland to regulate the body’s energy and metabolism. It is given when the thyroid does not produce enough of the hormone on its own. Patients then undergo monitoring, to ensure that their levels of thyroid stimulating hormone—TSH—and T4 are within normal limits.
Thyroid conditions can have a significant impact on the lives of the people in whom they are diagnosed. Although the majority of patients with hypothyroidism will get a diagnosis and be treated successfully through the standard treatment and testing regimes, that is not the case for a proportion of patients.