Block & Replace Therapy?

Hi Guys,

Just back from the Endocrinologist here in Dublin and its not good news. I have Grave's but now I am Hypo. They have suggested block and replace, so now I am on Carbimozole and Eltroxin. Has anyone gone down this route at all? My Endo said its not really a method used in Ireland/Europe but common in Japan. Any advice, please?


12 Replies

  • Hi Gavin, I have Graves disease and was given 40 mgs Carbimazole daily to calm down/reduce some of my hypeR symptoms, I went hypO after being left on it for a few weeks too long. I was then put on the Block and Replace treatment (40 mgs Carbimazole and 100 mgs Levothyroxine for approx. 22 months. Block & Replace is a well used treatment as is Carbimazole Titration (the latter I am on now as B&R didn't work for me. Eltroxin is a brand name of Levothyroxine (so I've just read on Google) so don't understand why you have been told that it's not really a common method of treatment ?


  • I've seen block and replace recommended on several Graves' forums, and some patients stay on the protocol for more than a year, because it takes time for the Graves' antibodies to decrease. Sometimes, they're able to wean completely off the drugs after a few years. Here's a link that explains Graves' treatment options:

  • I've been on block and replace for 6 years and am very well on it.

  • Is your Endo happy with you being on B&R for so long? I was on it for 18 months, I came off it but I am relapsing. Endo now wants me to make a decision RAI or surgery :(

  • I came off it 5 years ago and relapsed within 3 months. Yes endo is happy with me staying on it. Hes been very good actually and very supportive. It wasn't always the case as at the beginning I saw a different one on each appointment.

  • Are you still on Carbimazole or did you have RAI?

  • I think I'll need a Thyroidectomy.

  • Just wondering why you have gone hypo? And why, if you are hypo, they have put you on B&R? Do you have your last blood results (with ranges) that you can post?

  • I got my thyroid removed 8 months ago as it was not stabilizing. Now I'm level on 100 microgrammes of Elthroxin. I get my blood tests done in my GPs. Thus was the right path for me to go down.

  • Hi Irene

    How was your surgery? It looks like I will need a Thyroidectomy myself.

  • Good to hear you're feeling good.

  • Hello Gavin I too have Graves just been diagnosed 4 weeks ago and started treatment 2 weeks ago 40mg of Carbimazole a day. Take a Copper supplement its brilliant!! i am so enthused about it..I feel fantastic so much better and have no side effects from the Carbi. It must be just Copper no Zinc.

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