4 weeks ago my GP, them compnsultajt diagnosed Graves' disease, having done some reasearch i ticked nearly all symptoms, however after 10days on carbimazole my consultant called to say I needed to come off it as my liver function had got worse and I was now showed as having hypothyroidism. He's requested another blood test in a week. Has this happened to anyone else? Should I be pushing to be checked for anything else or could this still just be Graves? Thank you
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Jabber99
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I don't know about the liver thing, but many people get diagnosed as having Grave's, and it turns out they actually have Hashi's. Many doctors don't do the antibody tests, just go by the TSH, and others don't know the difference between Hashi's and Grave's! Did your doctor test any antibodies? If not, you should insist on them being tested. If you have Hashi's, carbi is not the right treatment for you.
Jaundice can be a (rare) side effect. Carbimazole is contra-indicated for people with existing severe liver problems, and requires special precautions in those with mild/moderate issues. mhra.gov.uk/home/groups/spc...
Did you have any reason to suppose your liver function might have been an issue before being prescribed carbimazole ? I don't think a liver function test is a standard precaution a week or so after commencing carbi, although others may comment on this. How long had you been taking the carbi before the test was done ? Just wondering, because assuming it will have taken a couple of days to process the test, and for the consultant to get back in touch with you, it seems a very short period for you to have gone from hyper caused by Graves', to hypo, even with the help of a large dose of Carbimazole.
If you ask your doctor for your blood test results, and post them here, someone will be able to interpret them for you. The ranges should be shown next to the results, you will need to post those too (or the results may just indicate whether your test was high or low against the range).
I would follow up the liver function tests with your GP - ask why they were taken, and what they indicate.
By the way, how much carbi were you on ? And what blood tests has the consultant requested ? Also be aware that pregnancy can affect the thyroid.
If you had Graves' in the first place, the likelihood is that you still have it - it can't be cured, it goes into remission, but this usually takes months - or at least weeks - rather than days to achieve.
Thanks both, I'll ask for my test results. I know they all showed liver function too but not sure why. I was on the carbimazole for 10 days (a dose of 30), the doctor wanted to keep it to that as I'm breast feeding. I will mention Hashi's to the consultant and see what he says
The question to ask is what antibody tests they have run, and what were the results. Broadly, a positive TSI/TRAb antibody test, either on its own or with TPO, is indicative of Graves', while TPO on its own, or elevated to a lesser degree than TSI, suggests Hashi's. This is a very simplistic view, but if you get hold of the results, someone here will be able to help you interpret them. If they haven't done the antibody tests, I would ask how they are sure it's Graves'. thyroiduk.org.uk/tuk/about_...
There is also something called post-partum thyroiditis, which can develop in the first six months or so after pregnancy, and like Hashi's can have both hypo and hyper phases. Again, antibody tests will help with diagnosis. This quite often resolves itself within 6-12 months. btf-thyroid.org/information...
If you've got Graves' and can't take Carbimazole, the endo will suggest other options, and there is almost certainly someone here with experience of whatever they propose. in the meantime, your GP or endo may be able to prescribe something to help with some typical hyper symptoms such as palpitations, tremors and anxiety, but obviously you will need to talk through the implications for breastfeeding.
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