My thyroid problem has returned

[Abmonster]

I had treatment on carbimazole for a year and was in and out for consultation appointments at hospital and got discharged when I was well again. I have the graves disease and now it has returned and they say my blood test results are normal but I am at a loss because I am extremely tired, still get cramps and feel my heart still fluttering a bit sometimes. The doctor gave me more blood tests for other things the other day on Friday but if my results come back normal I know they will send me away and say it's nothing. What do I do if they come back normal?

[Hennerton]

What were the tests done recently? When you get results post them here with the reference ranges for advice. You may be low in iron, which will cause tiredness and other symptoms and is common after being hyper and on Carbimazole. Possibly they are testing that and I hope Vit D, B12, folate and ferritin. All necessary for feeling well.

[Abmonster]

For calcium levels, diabetes, anemia and colieac/gluten.

[shaws Administrator]

This is for your information. It is an extract from Pulse Online mag for doctors.

5 Patients with hyperthyroidism often ask for advice on drug treatment versus radioiodine therapy. Can you summarise the pros and cons of each?

The three treatments for hyperthyroidism of Graves’ disease – antithyroid drugs, iodine-131 and surgery – are effective but none is perfect.

Iodine-131 will almost certainly cause hypothyroidism, usually within the first year of treatment, as will surgery, given the move towards total rather than subtotal thyroidectomy.

There is no consensus among endocrinologists about the correct dose of thyroid hormone replacement so patients may prefer to opt for long-term treatment with carbimazole. Standard practice is that carbimazole is given for 18 months in those destined to have just one episode of hyperthyroidism lasting a few months.

But there’s no reason why carbimazole shouldn’t be used for many years in those who do relapse. Any adverse effects such as urticarial rash or agranulocytosis will have occurred within a few weeks of starting the first course.

Iodine-131 treatment for toxic multinodular goitre is the most appropriate choice as hypothyroidism is uncommon. Surgery would be reserved for those with very large goitres and mediastinal compression.

Once hyperthyroidism has developed in a patient with a multinodular goitre, it will not remit and any antithyroid therapy would have to be lifelong.

[Hidden]

First of all, try not to jump ahead to a bad place! As you are a known Graves' sufferer, and as Graves very often recurs when treatment is stopped (I had 4 or 5 years before it recurred, after treatment with Carbimazole) it would be plain daft if that wasn't the first thing your doctor thought of when you present with the same symptoms. Even though the doctors people on this site tend to encounter are well known for chronic daftism... But should your doc miss the signs you need to be firm and make sure you draw his/her attention to them. Take a list of symptoms, perhaps alongside a list of symptoms you experienced before. And, if you're remotely worried about the consultation, take someone with you. All this is to ensure that you don't leave the surgery until you have had your say and have worked out with the doc what is to be done about your symptoms. Fingers x-ed it all goes fine!

[Abmonster]

I will do all this. Thanks. I don't feel well at all today now I've done a days work again, I just feel completely drained, slightly sickly last night and keep getting hot and sticky. Hence, how am I going to cope with my band practise tonight! I always scrape through somehow.

[Abmonster]

I haven't been on this site for ages but I have been feeling a lot better than I was. My blood test results came back all normal apart from my iron levels which were a bit low, I have another blood test for this after my one I have just had for my thyroid in a few days. Thank you for the help.