Hyperthyroid Newbie

Hi everyone! Have come here for some advice and support please. I have just been diagnosed as Hyperthyroid (on Wednesday) and have been taking Carbi and Propranolol beta blocker. I am 25 and generally very healthy. I am also 6 months postpartum and breastfeeding. I am scheduled for blood tests on Monday to check for antibodies, but postpartum is the favourite guess at the moment. I was only given one number from my thyroid level test which was 39 (GP then said high normal is 24) could anyone tell me if this is TSH, T3 or T4? Or none of the above? :) I'm very new to all this and have been struggling as I felt so ill but have had my child to look after, breastfeefing does not give much of a break. I am also awaiting an appointment with an endo, who I coincidentally know. I have downloaded Dr Peatfields book as it came recommended, however there is only one chapter on Hyper! Does anyone have experience of nursing on these meds, postpartum Thyroiditis and could anyone explain antibody tests to me please? Thanks so much in advance.

12 Replies

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  • Welcome to the forum, Chloececilia. Pregnancy hormones can dysregulate the thyroid which is why you have an initial diagnosis of post-partum hyperthyroidism. The antibody blood test is to determine whether you have autoimmune hyperthyroid disease (Graves) or post-partum hyperthyroidism which may resolve in a few months.

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

    I should think it is your FT4 which is 39 but I'm surprised your FT3 wasn't tested too. When FT4 is high TSH is usually suppressed <0.03 or even undetectable.

    The Beta blockers will calm your heart rate until Carbimazole regulates your thyroid output. Carbimazole can work quickly so you should have thyroid blood tests every 4 weeks to monitor levels as your dose may need decreasing to prevent you becoming overmedicated and hypothyroid.

    Breast-feeding

    Certain medicines can pass into breast milk and may reach your baby through breast-feeding.

    In the case of Carbimazole:

    women who are taking Carbimazole should not breast-feed

    Before you have your baby you should discuss breast-feeding with your doctor or midwife. They will help you decide what is best for you and your baby based on the benefits and risks associated with this medicine. If you wish to breast-feed you should discuss with your prescriber whether there are any other medicines you could take which would also allow you to breast-feed. You should not stop this medicine without taking advice from your doctor.

    nhs.uk/medicine-guides/page...

    Propylthiouracil (PTU) doesn't cross the milk barrier as readily as Carbimazole and may be a better alternative anti-thyroid drug while you are breastfeeding.

    thyroid.about.com/od/breast...

  • Excellent reply there from Clutter! I have Hyperthyroidism and I would also guess the blood result is Ft4.Has your GP given you this result? It is usual for labs to test TSH first and if out of range to then do Ft4 and Ft3 if you're lucky.I would ask the doctor for the rest of your results, get a print out for your records . Hopefully this is postpartum and will settle down sooner rather than later but the antibody test will determine if it is Graves or not(I have Graves).

    Yes I bet you have felt very unwell as I did but I soon started to feel better after about 2-3 weeks on meds.I am surprised you have been given carb when breastfeeding ! I would get this checked out asap.

    Good luck, ..pipps

  • Thank you so much both and Clutter thanks especially for your detailed reply. She didn't mention which result the 39 was, but I do know they tested more than TSH, they have actually been very attentive and proactive with my diagnosis, it was the doctor who ordered the tests when I went in complaining of side effects from contraception!

    I'm worried about the Carbi and breastfeeding as I had also read the above quote. When the results were in she phoned the endo while I was sitting there to confirm that I was breastfeefing, and he confirmed to her I should have 4x5mg tabs p/day and that then minute amounts would cross the milk. It's hard to question the professional when you are out of your depth, but I will be asking the question on Monday when having blood tested.

    Would the presence of antibodies alone rule out postpartum and indicate something else? Or can there also be antibodies with postpartum?

    After reading more about Carbi and breastfeeding I can't understand why Propyl wasnt the drug prescribed!

    Another note on the result number - when the GP gave me it she said that her's (during her pregnancy) was double that, not sure if that gives any clues!

  • Hi I suppose its possible to have Graves triggered by post partum as there is always a trigger .Graves has a genetic component triggered by an environmental event.Pregnancy, menopause and a viral infection hare amongst those triggers.If you test negative for Graves then there is a good chance your hyperthyroidism is a temporary state, do let us know how you go x

  • Thank you p1pp1ns I will do. I have obviously been through pregnancy but went through a big life event a few months later which was very traumatic. It could go either way! Will keep you updated.

  • Hi all, here are my full results (minus antibodies, pending) for understanding:

    TSH - <0.1

    FT4 - 39.1

    FT3 - 12

    Not sure of the ranges, is FT3 quite high too?

  • Hi everyone, after what seems like an eternity I managed to get something out of the GP receptionist that resembled my antibody results. All she could tell me was that Anti TPO is positive, but no numbers. Does that blow postnatal out of the water? Feeling a bit upset with it all!

  • Hi Chloececilia I was just wondering what happened with you in the end, if you wouldn't mind sharing? I'm going through something very similar right now and it would be great to hear how things turned out with you.

    Is it Graves or postpartum? Do you have to treat it long-term?

    Do you know if the docs would advise getting pregnant again or waiting?

    Thanks a lot! :-)

  • Hi tamz! 

    Sorry to hear you are going through all this just now, but you will see from the forum that you are really not alone! 

    Have you been diagnosed yet? I am yet to come off of my medication (next month) but still have a diagnosis of Hashimoto's thyroiditis which is autoimmune - possibly triggered by pregnancy. This is because I tested anti-TPO positive (Hashimoto's antibodies in my blood). This test should normally be done at the beginning of diagnosis along with a test for Graves antibodies too. (I am negative for these, but it is possible to have both Graves and Hashi's). 

    I have been told that I should be able to have normal (albeit closely monitored) pregnancies and births but I am waiting until I come off medication to see if my thyroid disease goes into remission before trying. I have been told it is likely that it will come back after subsequent pregnancies (anecdotally but not by doctors). Their opinion on that is maybe, maybe not! 

  • Thank you so much Chloececilia! This forum is great.

    I'm just so worried about things going up and down all the time, it's really affecting my moods and my daily life, which isn't easy while being a mother on top of everything else!

    So, from what i understand, you have been on meds for over a year now? And they still can't tell you whether it will be long-term or not?

    But, essentially, even if it isn't long-term, it could come back with each pregnancy....

    So sounds like either way, based on this, I would potentially be dealing with thyroid issues for the next few years because it would either flare up due to more pregnancies, or stay with me because i have an underlying thyroid condition. Unless i'm very lucky and it goes away.

    Until now my endo has kind of been saying, "We'll figure it out by our next appointment" and things just keep getting more and more obscure and weird. Hyper to hypo etc etc

    So im glad to have some kind of inclination of what this journey is going to be like! xxx

     

    PS - any tips on day-to-day management in terms of stress/mood swings while being a mum? Greatly appreciated! x

  • I really, sincerely sympathise with you tamz. Thyroid disease is hard anyway - being a Mother with thyroid disease is HARD. There are lots of Mums on here who can offer a friendly ear and advice - post a question of your own! 

    Do you have your thyroid test results (with ranges?). If you post them in a new thread and a little about your situation we can all help you. 

    When swinging between two phases it's especially difficult and common of Hashimoto's BUT I can't say if it is or not because a) I'm not a doctor and b) symptoms of both hypo and hyper can overlap. With hyperthyroidism you become fatigued very easily also - so I don't think exhaustion is a definitive indicator of either, for example.

    I know you're in a minefield right now, try not to overwhelm yourself with information just yet, drip feed yourself little bits at a time:

    hypothyroidmom.com

    thyroidpharmacist.com

    Both very good links.

    The normal course of treatment for hyperthyroidism is anti-thyroid treatment for 12-18 months to then titrate down (wean off essentially) then come off of medication altogether to see if the thyroid disease goes into remission. Some people stay in remission for years, others months, others weeks, others do not go into remission and will be offered alternative therapies to control the thyroid. 

    Your endo may well be waiting on blood results for antibodies - they don't always tell you exactly what they are collecting blood for. Antibody tests tend to take longer as they are normally sent to an external lab. Mine took about 2 weeks +. 

    You may find as you go along that you will not be volunteered much information from doctors and endos on your disease - you must ask the questions! Take a list, reel them all off, write down the answers you get. 

    If you have been diagnosed hyperthyroid then you can ask for beta-blockers to help with palpitations/anxiety/trembling etc until your anti-thyroid medication takes effect. It works quickly so remember to book in for a blood test approx every 4 weeks.

    Wishing you well x

  • Hi Chloececilia!

    Thank you so much for your helpful comment and useful information. 

    I'll be sure to post here and to check out the forums you suggested, as well as talking to my endo!

    Thanks again and good luck!

    Tamar x

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