Block replace: Hi I ended my block and replace... - Thyroid UK

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Block replace

Angelstar444
Angelstar444

Hi I ended my block and replace treatment on June 30th . Treated with 20mg carbimazole and 120 thyroxine for Graves' disease, hoping for it to go into remission.

Had bloods back , has come back abnormal. Tsh only level so far I have 0.02. Is it normal for results to drop and then go back up when thyroid kicks in on its own?

Any help please do not want to think remission has failed!

12 Replies
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Angelstar444,

What was your TSH when you were on B&R?

TSH 0.02 is suppressed and I would have expected the lab to check FT4 and FT3 as you were recently hyperthyroid.

Angelstar444
Angelstar444 in reply to Clutter

Everything was in range when in treatment. Plan was to stop all meds and hope Graves go into remission.

I don't have all the levels GP hasn't phoned. I'm hoping that levels drop and then rise and this is normal!! 🤞

Clutter
Clutter in reply to Angelstar444

Angelstar444,

No, sorry, as TSH has dropped remission isn't working.

Angelstar444
Angelstar444 in reply to Clutter

Thank you.

I can't believe it's happened so fast I stopped meds less than 2 weeks ago :-(

My thyroid hasn't even had a chance to get going!

Clutter
Clutter in reply to Angelstar444

Angelstar444,

Do you have Graves antibodies?

Angelstar444
Angelstar444 in reply to Clutter

Yes I did when first diagnosed 16mths ago.

I don't think I have been tested since so I don't know now

Clutter
Clutter in reply to Angelstar444

Angelstar444,

Permanent remission fails in more than 50% of Graves patients. However, your remission hasn't really started at all.

Angelstar444
Angelstar444 in reply to Clutter

I know! That's what I feel.

Do you think I needed longer on block and replace?

Clutter
Clutter in reply to Angelstar444

Angelstar444,

12-18 months is usually long enough. I think you'll have to go back on B&R if FT4 and FT3 are rising too.

Angelstar444
Angelstar444 in reply to Clutter

It's just so upsetting and frustrating! Pinned all my hopes on it working as was waiting to start trying for a baby

Clutter
Clutter in reply to Angelstar444

Angelstar444,

Being hyperthyroid doesn't stop you conceiving but you will need to switch to Propythiouracil (PTU) when you become pregnant as Carbimazole can cross the placenta.

Or you could try just Carbimazole. B&R didn't work for me but titrating Carb did.

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