Hyper again

[pingpong]

Bloods back. Confirm hyper again (Graves 2008 diagnosed). Lymphocyte count 0.9 (1-4).

Adjusted calcium sounds good at 2.19 (2.1 - 2.6). B12 457 ng/L (200 - 900) - I guess midway is acceptable?

Folate 24.0 ug/L (2 - 17). Vitamin D 74 nmol (75 - 200) - I do get lots of exercise and am always outside!

Free T3 10.4 pmol/L (3.5 - 6.5), Free T4 24.0 pmol/L (9 - 24), TSH 0.03 mu/L (0.35 - 5.0).

When the bloods were taken I had just come off Levo at 25 mcg but was still on Carbimazole at 15mg. I have now upped my Carbimazole to 25 mg but i suppose I should go as high as 40 mcg but definitely no Levo. I have definitely lost muscle tone over the last few weeks and have palpitations and bad sweats.

I am, however, not feeling too bad. It always seems to be around January time when things go wayward. I was on 100 mcg Levo and 40 mg Carbimazole block and replace this time last when when my endo reduced my Levo to 50mcg and three months later the carb. to 20mg but I began to feel hyper and reduced to 25mcg Levo and 15 mg Carb. Then felt even more hyper and stopped the Levo. Shall I increase carb. to 40mg and see how I go? I certainly knew last time when I needed Levo.

[shaws Administrator]

I'm sorry you are having a problem again. Someone who has Graves will respond.

[Joy333]

Hi pingpong,

Is your Gp and endo supporting you with your dosage changes? I've never been on block and replace, I'm on titration method, carbimazole only since may 2011. I would be concerned if you upped your dose to 40mg as carbimazole alone is very powerful and you would be at risk of going hypo very quickly as your t4 levels are within but at the top of the reference range.

[Silver_Fairy]

Block and replace didnt work for me, and I felt really ill while on it. After I stopped and relapsed I decided to try Carbimazole on its own. I went from 40mg which was way too much (but it was what I had been put on just after diagnosis) and I dropped 5-10mg after every blood test. I am now on 2.5mg every four days.

I dont understand why the Endo dropped your dose of both. Normally, you are put on quite a high dose of Carbimazole because they worry about the effect on the heart. They then put you on Levo and raise or drop that side of it until the ranges look normal. You then stay on the course for 12 - 18 months before stopping both at the same time and seeing if you have gone into remission.