Block & Replace Therapy?: Hi Guys, Just back from... - Thyroid UK

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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?


13 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.

Gavbkk83 in reply to IreneRalph

Hi Irene

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

Gavbkk83 in reply to IreneRalph

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.

Yes I was on it just finished it Monday.... I was on 40mg of Carbazole and 150mg of Levothyroxine.

Monday after 18 months, told to stop all meds, see if it kick starts my thyroid into working again on its own.

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