Concierge endocrinology · UK
Private hypothyroidism treatment, by a consultant endocrinologist.
Levothyroxine done properly — the right starting dose, the right monitoring, the right TSH target for your life stage — and an honest conversation about T3 if you want one.
Why patients choose us
- 01
A consultant endocrinologist, not a script mill
A named endocrinologist who understands TSH, free T4, TPO antibodies and the difference between primary and central hypothyroidism.
- 02
Levothyroxine done properly, T3 discussed honestly
The right starting dose, the right titration, the right monitoring — and a straight answer about liothyronine if you ask.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private hypothyroidism treatment costs in the UK.
Indicative ranges across our partner clinics. Send the details and we quote firm figures — including whether NHS shared care is realistic for you.
In short
Initial endocrinology consultation in our network: £250–£400, with a plan the same day.
| Service | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Initial endocrinology consultation | £250–£400 | 45–60 min | Same visit |
| Follow-up review (with TFTs) | £150–£250 | 20–30 min | Same visit |
| Thyroid function tests (TSH, free T4, T3) | £60–£120 | 5 min draw | Same day |
| TPO antibody test | £40–£80 | 5 min draw | Same day |
| Levothyroxine private prescription (monthly) | £8–£20 | — | Same day |
| Liothyronine (T3) private prescription (monthly) | £150–£700 | — | Same day |
NHS levothyroxine on a GP prescription costs roughly £1 to £2 per month once shared care is in place. Private prescriptions are only needed if your GP declines shared care, or if you choose T3 or NDT — neither of which is routinely NHS-funded.
The problem
The right diagnosis, the right dose, the right monitoring.
Hypothyroidism looks simple on paper — one tablet a day — and it usually is. The mistakes happen in the details: subclinical cases treated in the wrong direction, central hypothyroidism missed, TSH targets set too loose, and pregnancy dose changes made too late.
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Told it is “just borderline”?
Subclinical hypothyroidism deserves a proper decision, not a shrug — treat, monitor or investigate further. We help you choose.
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Still tired on levothyroxine?
Sometimes it is the dose. Often it is anaemia, low vitamin D, coeliac or sleep. Sometimes it really is a T3 conversation. We separate them.
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Pregnant or planning?
TSH under 2.5, a 25 to 30 per cent dose increase on confirmation, monthly TFTs — get this right early and outcomes are excellent.
The journey
From enquiry to steady state — what happens, in order.
One endocrinologist from first message to stable dose — including the six-to-eight-week TSH recheck.
Phase 1 · Before your appointment
Concierge, off-stage for you
Phase 2 · On the day
An hour with your endocrinologist
Phase 3 · After
Titration and shared care
- 01
Before
You tell us what is going on
A short, confidential form. Symptoms, recent TFTs if you have them, whether you are pregnant or planning pregnancy, and current medication.
- 02
Before
We come back with a recommendation
Within one working day: the right endocrinologist, whether bloods are needed first, an indicative price. If your GP can manage this on NHS, we say so.
- 03
Before
We arrange the appointment
Usually within one to two weeks. Any recent TSH, free T4, TPO antibody and cortisol results are gathered and shared with the team.
- 04
On the day
Consultation and diagnosis
A proper hour with the endocrinologist. History, examination, and a plan — primary or central, overt or subclinical, treat now or observe.
- 05
On the day
Levothyroxine started
A tailored starting dose — lower if you are elderly or have heart disease. Written instructions on when to take it and what interferes with absorption.
- 06
On the day
Prescription and plan home the same day
A private prescription (or a letter to your GP for NHS repeats), and a clear timeline for the first TSH recheck.
- 07
After
Retest at six to eight weeks, then annually
TSH is rechecked six to eight weeks after every dose change, then yearly once stable. Dose is titrated to symptoms and TSH target.
Typical end-to-end: 1–2 weeks from enquiry to consultation. Time to stable dose: 3–6 months.
When to treat
When treatment is the right step — and when to wait.
The situations that lead most patients to a levothyroxine prescription, plus the one red flag that means A&E rather than a clinic booking.
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Hashimoto’s thyroiditis
Autoimmune destruction of the thyroid — the commonest UK cause, confirmed by TPO antibodies and treated with levothyroxine for life.
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Post-radioiodine hypothyroidism
After radioactive iodine for Graves’ or a toxic nodule — full replacement is usually needed within months.
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Post-surgical hypothyroidism
After total or partial thyroidectomy — replacement starts immediately, often at full weight-based dose.
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Subclinical hypothyroidism
TSH between 4 and 10 with normal free T4 — treat if TSH is over 10, if you are pregnant or planning, if TPO positive, or if symptomatic.
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Central (pituitary) hypothyroidism
Low free T4 with a low or inappropriately normal TSH — cortisol must be checked first, never start levothyroxine before adrenal insufficiency is excluded or replaced.
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Drug-induced hypothyroidism
Amiodarone, lithium, interferon and some cancer immunotherapies can cause it — treatment and dose depend on the drug.
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Pregnancy and pre-conception
Aim TSH under 2.5 before conception and in the first trimester; increase levothyroxine by 25 to 30 per cent as soon as pregnancy is confirmed.
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Red flag: myxoedema coma
Severe hypothyroidism with hypothermia, drowsiness and low blood pressure is a medical emergency — 999 or A&E, not a clinic booking.
Treatment options
Levothyroxine is the answer for almost everyone.
The options on the table — and which fits which patient. NICE NG145 sets the ground rules; your endocrinologist tailors within them.
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Levothyroxine (LT4) — standard
The evidence-based first-line treatment. A once-daily tablet, on an empty stomach, 30 to 60 minutes before food, calcium, iron or coffee.
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Levothyroxine — brand switch
Some patients notice differences between Wockhardt, Teva, Mercury Pharma and Advanz. NICE 2021 supports staying on a brand that suits you if a switch causes symptoms.
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Liothyronine (T3, Cytomel)
Not routinely recommended by NICE NG145. Considered for selected patients with persistent symptoms on adequate levothyroxine, under an endocrinologist.
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Combination LT4 + T3
A small subset of patients report better wellbeing on combination therapy. Trialled cautiously, monitored closely, and stopped if TSH suppresses.
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Natural desiccated thyroid (NDT)
Porcine-derived (Armour Thyroid, ERFA). Not routinely prescribed on the NHS or by most UK endocrinologists — available privately for specific patients.
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Pregnancy dosing
Dose is increased by 25 to 30 per cent as soon as pregnancy is confirmed, with monthly TFTs in the first half and specialist obstetric endocrine care thereafter.
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Cardiac-cautious start
In the elderly or in known ischaemic heart disease, we start at 25 micrograms and titrate slowly to avoid provoking angina or a cardiac event.
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Central hypothyroidism protocol
Cortisol is checked and replaced first if needed. Dose is titrated to free T4 in the upper half of the normal range — TSH is unreliable here.
Our vetted UK network
A small panel of endocrinologists, we picked them.
Consultant endocrinologists across London, Manchester, Birmingham and Edinburgh. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every endocrinologist in our network.
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Consultant endocrinologists, not GPs with an interest
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Comfortable prescribing T3 or NDT for the right patient — and honest when they are not indicated
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Experience with pregnancy, post-surgical and post-radioiodine cases
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Willing to share care with your NHS GP for repeat prescriptions
Safety and monitoring
What to expect on treatment — honestly.
Levothyroxine is safe, cheap and effective. The things worth getting right are timing, interactions, retesting at six to eight weeks, and knowing what to do the moment you confirm a pregnancy.
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Take it on an empty stomach
Levothyroxine works best 30 to 60 minutes before food, coffee, calcium, iron, PPIs or biotin — all of which reduce absorption.
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Retest TSH at six to eight weeks
Every dose change is followed by a TSH recheck at six to eight weeks. Retesting sooner gives a misleading picture — the pituitary takes time to catch up.
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Aim for a TSH that suits your life
Roughly 0.5 to 2.5 if you are planning pregnancy or newly diagnosed and young; 0.5 to 4 if you are older; upper half of normal free T4 in central hypothyroidism.
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Interactions matter
Calcium, iron, PPIs, statins, oestrogen, anticonvulsants and rifampicin all affect thyroid replacement — take them at a different time, or expect a dose change.
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Pregnancy needs a dose increase
The moment you confirm pregnancy, increase levothyroxine by 25 to 30 per cent and contact us — do not wait for the next appointment.
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Cardiac starts are cautious
In the elderly or with known heart disease, we start at 25 micrograms and step up slowly. Rushing risks angina or a heart attack.
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T3 is rarely the answer to fatigue
When TFTs are normal on adequate levothyroxine, persistent tiredness is more often anaemia, low vitamin D, coeliac, sleep or mood — we screen for these before reaching for T3.
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Do not stop suddenly
Levothyroxine is lifelong for most causes. Stopping abruptly returns you to hypothyroidism within weeks and, at worst, provokes myxoedema.
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Red flags
Severe drowsiness, hypothermia, low blood pressure or new chest pain on treatment are not normal — 999 or A&E the same day.
Reading your clinic letter
Your clinic letter in four parts. Read the last one first.
Whichever endocrinologist you see, the letter that goes to you and your GP keeps to the same shape.
A quiet reminder
Endocrine language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the letter before your review, just ask.
- 01 Header
Diagnosis and cause
Primary or central, overt or subclinical, and the underlying cause — Hashimoto’s, post-RAI, post-surgical, drug-induced or congenital.
- 02 Technique
Starting dose and target TSH
The starting dose in micrograms, why that dose was chosen, and the TSH range we are aiming for based on your age, cardiac status and pregnancy plans.
- 03 Findings
Antibodies, cortisol and comorbidities
TPO antibody result, cortisol if central hypothyroidism was suspected, and other autoimmune conditions to screen for (coeliac, B12, adrenal).
- 04 Impression
Monitoring plan and shared care
Read this first: when to retest, when to review, and whether your GP will take over repeat prescriptions on the NHS.
Recognised by major UK insurers
Endocrinology consultations and TFTs are usually covered by UK PMI. Levothyroxine on repeat, and T3 or NDT prescriptions, are typically self-pay. We confirm cover before booking.
Frequently asked
Everything we get asked about hypothyroidism treatment.
Quick answers on diagnosis, dosing, cost, pregnancy, T3, and how NHS and private care fit together.
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How is hypothyroidism diagnosed in the UK?
A raised TSH with a low free T4 confirms primary overt hypothyroidism. A raised TSH with a normal free T4 is subclinical. A low free T4 with a normal or low TSH points to central (pituitary) hypothyroidism — this needs a cortisol check before starting treatment. TPO antibodies confirm Hashimoto’s.
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Do I have to take levothyroxine for life?
For most causes — Hashimoto’s, post-radioiodine, post-surgical, congenital — yes. A small number of drug-induced or transient thyroiditis cases recover. Your endocrinologist will tell you which category you fall into.
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When should I take my levothyroxine?
On an empty stomach, 30 to 60 minutes before food, coffee, calcium, iron, PPIs or biotin supplements. Many people take it first thing with a glass of water; some take it at bedtime, at least three hours after their last meal.
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What TSH should I be aiming for?
Roughly 0.5 to 2.5 if you are young, newly diagnosed or planning pregnancy. Under 2.5 in the first trimester of pregnancy. 0.5 to 4 if you are older or have heart disease. In central hypothyroidism the target is free T4 in the upper half of normal, because TSH is unreliable.
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How much does private hypothyroidism treatment cost in the UK?
Roughly £250 to £400 for the initial endocrinology consultation and £150 to £250 for follow-ups. TFTs are £60 to £120, TPO antibodies £40 to £80. A private levothyroxine prescription runs £8 to £20 a month; liothyronine (T3) is £150 to £700 a month depending on brand.
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Should I be on T3 as well as levothyroxine?
NICE NG145 does not routinely recommend combination therapy. It is considered for a small number of patients with persistent symptoms despite biochemically adequate levothyroxine, once other causes of fatigue — anaemia, low vitamin D, coeliac, sleep, mood — have been excluded. It should only be initiated by an endocrinologist.
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What happens to my dose in pregnancy?
Increase your levothyroxine by 25 to 30 per cent as soon as you confirm pregnancy — do not wait for an appointment. Contact us the same day. TFTs are checked monthly in the first half of pregnancy, then per specialist obstetric endocrine advice. The dose usually returns to pre-pregnancy after delivery.
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Can I use the NHS and see you privately too?
Yes, this is the commonest arrangement. Your private endocrinologist sets the diagnosis, dose and monitoring plan, then writes to your NHS GP so repeats and yearly TFTs stay on the NHS — the private levothyroxine prescription is only needed if your GP declines shared care.
Related pages
Looking for something else?
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Hyperthyroidism treatment
Carbimazole, radioiodine and thyroidectomy compared.
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Hypothyroidism (condition)
The underactive thyroid explained — symptoms, causes, tests.
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All tests & procedures
Every test and procedure we arrange.
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Blood tests
TSH, free T4, TPO antibodies and beyond.
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