carbimazole - thougts please?

[Debsoxford]

Hi Everybody

Thoughts advice please? as it's always been good and helped me a lot to keep well

I'm with my Dr sorta agreeing (he thought he'd take me of @ 20mg's) I disagreed! so his left me to it! So I'm coming down every 6 weeks in 5mg's Latest results are:

tsh 1.47 (.30-4.20)

3T4 12.3 (10.5 -20.009)

3T3 4.7 (3.5.6.5)

TPA 214.00 (<=600)

Thoughts please?

I'm feeling well,

[Valarian]

What do they think was causing you to be hyper ? It would be unusual to drop from a moderate dose of carbi such as 20mg to nothing at all if you were on titration therapy for Graves’ Disease, but you don’t mention TSI or TRAb, which are the usual antibody tests for this.

FT3 and FT4 are both within range, but FT4 especially is quite low. I presume you have another blood test in six weeks time ? Were the results shown after 6 weeks at 15mg, and are you now down to 10 ? How long have you been on Carbimazole overall ?

[Debsoxford in reply to Valarian]

Hi Valarian

Unsure what caused my hyper my mother was hypo and a big family history of PA so have been aware over the years. I've got graves as well but think im doing o.k. antibody wise you know what its like trying to get all bloods done on NHS! Yes Dr wanted me off at 20 but i disagreed so his leaving me to it!! Sensible man!! I've argued with him in the past he knows I research (with great support from lovely people on here) I've been on carb since end last year started on a low dose but had to increase now decreasing yes i will do bloods again and keep lowering dose I'm also seeing a brilliant herbalist who has a graves mixture and have acupuncture which I think really helps its certainly got rid of my arthritic knee!

Thank you for your reply

Best wishes

[Valarian in reply to Debsoxford]

It’s difficult to see how they could be sure it was Graves’ without antibody tests.

The problem is, some people with Hashi’s also apparently go through hyper periods. (I’ve got Graves‘ myself, so my knowledge of Hashi’s is limited). While they may need treating with Carbimazole for a while to bring their high thyroid levels within range, Hashi’s is primarily a hypO problem.

If people have Graves’, It’s generally accepted that they need to be treated with antithyroids for twelve to eighteen months to stand the best chance of achieving remission . It’s not unusual for the dose to be reduced in jumps of 10gm at once, sometimes even more - and if the endo has opted for “block and replace” therapy, (where antithyroids are prescribed alongside thyroid replacement) it will usually be stopped all at once from a fairly high dose.

It’s difficult to get the dose exactly right, and it’s not uncommon to dip below range as a result of being over medicated. In Graves’ patients, this is usually resolved very easily simply by reducing the dose a little further - and in any case, the key aim is to force the Graves’ into remission . However, I’m not sure how this works with Hashi’s patients, and whether dipping below range might be more of a problem for them.