block and replace

[frian]

I don't know anything about block and replace I have graves and as I have posted have problems when reducing meds how does BR work and who do they give it to

[HIFL]

There's a good explanation of BR here: tiredthyroid.com/graves.html

[Fruitandnutcase]

I was on block and replace. I have Graves. First of all I was given 20mcg Carbimazole for a month then had a blood tests after a month and was contacted by my endo to increase the dose to 40mcg a day. I took that for two months ( it took three months for my appointment to come through even though I was really hyper) After two months on 40 I had more bloods done and was hypo when I got to see the endo

I was started on Levothyroxine that day, 25mcg a day, still with the 40 carbimazole. Had bloods done after six weeks and had my Levo increased, this went on with my levo being increased until I was taking 75/100 levo on alternate days plus the Carbimazole. Eventually I was told to stop both drugs. Just like that, one day you are taking carb and levo - next day you're not.

I found that after a few weeks I began to need my levo increased, first time my doctor gave me amitryptiline to stop the palpitations I was getting ( it felt like being hyper again but it wasn't) but next time it happened my doctor raised my levo herself.

I think they can give it to anyone, I had B&R because that is how my hospital treat their hyper patients. Other people only have Carbimazole and they titrate it downwards until they are better.

Some people can't take carbimazole - I was lucky. It can affect your white blood count in which case it has to be stopped immediately. If you have problems with carbimazole to can be offered PTU which (I think) works in a similar way.

I've been told that should i relapse I will be given RAI. I've decided that I won't! I was lucky and generally felt wel

On B&R and should I relapse I want another round, in fact I wiuld like to stay on it as long as possible. Ovbiously if I wasn't able to I would have to reconsider but that's my plan at the moment.

My pharmacist told me to take vitamin C with the carb which I did - 1000mcg +zinc.

Good luck, I hope you get sorted out soon.

[frian in reply to Fruitandnutcase]

many thanks for explaining B&R I now feel I have a lot more understanding which will help me make any decisions when I need to

[Silver_Fairy]

You are first given quite a high dose of Carbimazole (40-60mg) then after a month or so they will add in Thyroxine until your bloods level out.

I ended up on 40mg of Carbimazole and 125mcg of Levo for 18 mths (sometimes they do 12 mths) The medication was then stopped dead, to see if I went into remission. Unfortunately within a month I started to get symptoms back so I then asked to go onto Carbimazole alone and titrated my dose from 40mg down to 2.5mg 3 to 4 times a week. I did this slowly over a couple of years, dropping 5mg every 2-3 months.

I never felt well all the time on B&R, in fact I felt really, unwell! On Carb alone I have felt better as the dose dropped. I am now off the Carb completely and will be tested in 6 months time (or earlier if I feel it necessary) to see if I am still in remission.

I refused to have RAI (as I have Thyroid Eye Disease) or to have surgery as I have heart problems, and dont want unnecessary anesthesia!

Also as I have Graves (which is an autoimmune disorder) even if I have my thyroid removed or destroyed I will still have Graves (which they didnt tell me about), so I would rather keep it for now

[frian]

sorry you were so unwell lon B&R but thanks for your help I am trying to titrate on carb alone for now and see how I go on hope your remission continues