Have been given block and replace . 20 carbimazole ,,, 150mc levo. Don't think its working. Still shaking and insomnia...

Was diagnosed hyper last year and 13 mths into treatment i;m still getting symptoms of shaking and insomnia but my last test 2 months ago said i was just dipping into hypo. Should i take this treatment together, have not seen specialist just GP. I can't cope with these symptoms much longer.

[shaws Administrator]

I would definitely ask for a referral to an Endocrinologist. Someone who has hyper will comment on your treatment.

If you email [e-mail] who has a list of NHS Endos, one of whom may be near you.

[Fruitandnutcase in reply to shaws]

I am very surprised your doctor didn't make an appointment for you to see an endo as soon as you were diagnosed mine did and I was under the impression that GPs didn't treat people who were hyper.

I have just finished block and replace, I started off in November last year on 20 mcg carb immediately I was diagnosed, that was raised to 40 mcg after my four week blood test ( I was notified by letter) My first endo visit was at the end of February when I was started on 50 mcg levo, this was raised steadily over the year until I was taking 75/100mcg on alternate days. I stopped both carb and levo at the beginning of November this year.

Each time my levo was increased I found that after I had been taking my increased dose for five or six weeks I felt the need for more, first time I had palpitations etc and thought I had become hyper again but someone on here said they thought I might need an increase of levo which turned out to be correct, I had actually become underactive before I started on the levo - too long on the 40mcg carb, anyway I got an increase and that was sorted out, next time I felt the need for an increase I was incredibly cold - a real bone chilling cold feeling - it was June and I was still wearing my quilted coat, plus vest, tee shirt, cardigan, gloves and scarf! That was when I moved up to 75/100 alternating and immediately I felt better. Around the end of August when I was away I felt very rough but I was abroad so I just took 100mcg for a couple of extra days for a week or two and that seemed to sort things out then I went back to the regular dose. Next endo visit I was told to stop.

I'm absolutely no expert but 25 mcg levo seems to be a very low dose.

I would ask to see an endo ASAP.

I felt very ill when I was hyper but I felt pretty horrible when I was hypo and then every time my body seemed to need more levo. Neither over or under is pleasant.

Good luck, hope you can get sorted out soon.

[Hidden in reply to Fruitandnutcase]

Sorry I missed the zero.. I'm on 150 Levo.

[Fruitandnutcase in reply to Hidden]

Whew-that's more like it, I never got up that high. Do you know the results of your blood tests and the lab ranges for them?

[Hidden in reply to Fruitandnutcase]

Having seen any of my results. Will ask for a print out next time. Thanks so much

[Hidden in reply to shaws]

Thank you..Will check that out

[Hidden in reply to shaws]

Thank you

[Elh1965]

I have just started block and replace but I'm on 40mgs carb and 50mcs of levo, I've been taking Levo for just over 2 weeks and I've started to feel really anxious again and waking up early. I guess we need to get the dose right to help us to feel better. I would go back to docs if I was you. I hope you feel better soon, it's horrible

[Hidden in reply to Elh1965]

Yes I will go on Monday.Thanks so much for support

[Hidden in reply to Elh1965]

Hi again Elh. Are you feeling any better yet? I'm feeling lousy and still waking up early (4am this morning.) On 20mgs of carb and 50 mcs levo but still think i'm over. My last test was TSH 0.2. Any advice gratefully received.

[Hidden]

I've posted these NICE guidelines before and I'll post them again, GP's are not meant to treat hyperthyroidism, you are meant to be referred to an Endo straight away:

cks.nice.org.uk/hyperthyroi...

Also, if you haven't had a blood test for 2 months and feel unwell you should go and get tested again, 2 months is a long time and your levels could be anywhere.

I can't comment on B&R as I've only ever been on Carbimazole titration method. I've never understood the point of giving 2 drugs when one will do the job just fine on its own, for most people (always exceptions of course).

Hampster