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Originally published on 11th May 2016 Last updated on 25th June 2020
For those of us living in the UK and using the NHS, prescriptions are free to those in Northern Ireland, Scotland and Wales, but not in England.
However, there are certain people in England who can access free NHS prescriptions for medication, if they fit certain criteria such as having hypothyroidism and being on thyroid medication e.g. Levothyroxine.
Why Do We Get Free Prescriptions?
From digging around the internet, researching files and documents and asking my NHS GP and pharmacist, there isn’t actually one confirmed reason.
There is mostly just forums of people discussing their theories as to why, when we’re put on thyroid medication (most commonly Levothyroxine), that we receive unlimited free prescriptions for life across all medications and prescriptions.
One of my readers got in touch with me to say that although she self-sources her own Natural Desiccated Thyroid medication, she is still allowed her entitlement to free prescriptions. And I personally have my NDT medication (Armour Thyroid) privately prescribed, but am still entitled to my NHS Medical Exemption Certificate too. So it’s not the type of medication that entitles you, but the condition of hypothyroidism itself.
The document ‘Prescription Charges Review Implementing Exemption from Prescription Charges for People with Long Term Conditions’ was some useful reading.
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For those of us living in the UK and using the NHS, prescriptions are free to those in Northern Ireland, Scotland and Wales, but not in England. However, there are certain people in England who can access free NHS prescriptions if they fit certain criteria such as having hypothyroidism and being on thyroid medication e.g. Levothyroxine. I’ve been diagnosed with autoimmune Hypothyroidism since July 2015 and was issued my NHS medical exemption certificate at that time, when started on Levothyroxine. However, I switched to NDT medication just 5 months later (Levo wasn’t helping me) which I started off self-sourcing and then as of July 2019, managed to get privately prescribed (as the NHS very rarely prescribe it). I wasn’t sure if I’d still be entitled to a medical exemption certificate if my meds weren’t prescribed by the NHS, but this year, I was reminded that my original one was expiring and to apply for another. It turns out that it is the condition itself – having Hypothyroidism – which entitles you to the certificate, not the type of medication or where it comes from. This is useful to know and I’ll be updating my blog about it so others are aware too. Ironically, the NHS Medical Exemption Certificate is given because they acknowledge that certain health conditions often then lead on to others. I.e. the NHS acknowledges that those with Hypothyroidism often develop other issues too, such as depression, eczema, hair loss, acid reflux etc. but since being on NDT meds, I haven’t needed anything else because all other issues I had whilst on Levo disappeared. I’m sure thyroid patients would much rather just be prescribed a medication that removes the need for a medical exemption certificate to cover extra conditions?! 🦋💙 ⠀⠀⠀⠀⠀⠀⠀⠀⠀ #theinvisiblehypothyroidism #thyroid #hypothyroidism #underactivethyroid #thyroidadvocate #thyroiddisease #thyroidawareness #hashis #hashimotos #hashimotosdisease #butyoudontlooksick #hashimotosthyroiditis #autoimmune #autoimmunedisease #chronicillness #thyroidhealing #thyroidproblems #thyroidhealth #thyroidwarrior #spoonie #spooniestrong #spooniewarrior #sickandtiredofbeingsickandtired #invisibleillness
Medication For Life
The main recurring reason I found bouncing around the internet is that because it is well-recognised that if you have hypothyroidism, you’ll be taking thyroid medication for life, and that it’s also well-recognised that people often develop many other conditions when they have hypothyroidism, the free prescriptions help with this burden.
And this actually frustrates me a little.
For example, I used to be on many other medications when on Levothyroxine for my hypothyroidism which left my Free T3 levels low, such as antidepressants, acid reflux medication, the combined contraceptive pill for period problems and more.
But once I was on NDT medication and had optimal Free T3 levels, all these other issues ironed out and I don’t require any other regular medications now. Ironically, even though my privately prescribed NDT medication doesn’t affect me being entitled to a Medical Exemption Certificate, I no longer need the free prescriptions because all my other health complaints disappeared when I switched from Levothyroxine to NDT.
It could be possible that having hypothyroidism increases your chances of developing other conditions.
It says in the document ‘Prescription Charges Review Implementing Exemption from Prescription Charges for People with Long Term Conditions’: “As now, exemption should be for the person rather than restricted to the treatment of the condition for which he/she is exempt Currently, patients who are exempt from prescriptions on medical grounds, receive all of their prescriptions free and not just the drugs that relate to the condition for which they are exempt. This is often regarded as unfair. However, it is frequently difficult to determine whether the patient’s current need for treatment is related or not to the index condition, or might exacerbate it. In the interests of practicality, exemption from charges on medical grounds should continue to relate to the person rather than the condition.”
So it’s essentially saying that because hypothyroidism is a lifelong condition, which can be linked to others, we get all medications for free for ease of not being completely sure which other conditions can be related back to it.
The issue of people on lifelong medication not being able to afford it has been in the media several times, so this does sound helpful.
But take for instance all the extra conditions/symptoms I developed while on the wrong medication for my hypothyroidism:
- Anxiety and Depression
- GERD/Acid Reflux
- Eczema and Dermatitis
- Chronic Fatigue Syndrome
- Debilitating Hormonal Migraines
- Leg Cramps and Spasms
- Restless Legs
- Brain Fog
- Menorrhagia (heavy periods)
- Stiff and Painful Joints and Muscles
While it was great that I got the medication for all of the above ‘separate’ conditions for free, I’d have preferred for them to just get my thyroid medication right in the first place, and then I wouldn’t have needed all of them. And it would have also saved the NHS more money… Instead of covering up more and more problems and just treating multiplying issues. The initial cause, low thyroid hormone levels, should have been addressed from the beginning. But the NHS and other conventional medicine services don’t tend to focus on prevention.
Another possibility for why thyroid medication prescriptions are free, is that because your body should produce thyroid hormone naturally in order to live, but doesn’t when you have hypothyroidism. Or at least it is affected. And so it is life threatening in this sense due to the risk of myxoedema coma.
Another theory is that this information may simply be outdated and hasn’t been reviewed for quite some time.
Take the information on the NHS website about medical exemptions for example. It refers to hypothyroidism as myxoedema, a term used to describe severe hypothyroidism, often when it’s so developed, that patients have swelling of the skin and underlying tissue. It can also lead to coma and death.
So our thyroid condition, untreated, could possibly kill us if we go into a myxoedema coma due to the lack of thyroid hormones.
However, most people these days never reach this stage before diagnosis of course, but a lot did a hundred or more years ago.
Patients back then were described as having puffy faces with myxoedema, and once started on medication (natural desiccated thyroid was used widely back then), it went away, along with their other symptoms of hypothyroidism. There are some good before and after photos online. 
Hypothyroidism was widely referred to as ‘myxoedema’ at this time and so the use of this name on the NHS exemption list makes you question how old this information is and when it was last reviewed.
Still, for those who do do well on Levothyroxine, and have their medical exemption certificate, it’s very useful for them to receive their prescriptions for free. To have free medication for life for a life-long condition, is a godsend and not many other countries offer this.
It just makes you wonder why other life-long conditions such as asthma, for example, aren’t on included. Asthma could kill you if left untreated too.
How do you feel about this? Let me know in the comments below.
You can click on the hyperlinks in the above post to learn more and see references to information given, but more reading and references can also be found at:
Rachel Hill is the highly ranked and award-winning thyroid patient advocate, writer, blogger, speaker and author behind The Invisible Hypothyroidism. She has two books: ‘Be Your Own Thyroid Advocate‘ and ‘You, Me and Hypothyroidism‘. Her thyroid advocacy work includes authoring books, writing articles, blogging and speaking on podcasts. Rachel has worked with The National Academy of Hypothyroidism, BBC, The Mighty, Yahoo, MSN, ThyroidChange and more. She is well-recognised as a useful contributor to the thyroid community and has received eight 2020 WEGO Health Award Nominations.