Sorry, I should have asked you to publish the ranges (usually shown in brackets) as well as the results. Against typical ranges, it looks as though both FT4 and FT3 started out high, and FT3 is probably still high. FT4 may now be in range, but possibly not quite as low as the endo would like it to be.
In the U.K., they would be pushing RAI by the third relapse, and in the US, I suspect you’d already have had it, so good to see you’re being given the choice.
By “alternatives”, I was really thinking of RAI and thyroidectomy, as currently there isn’t much choice of medication.
The first choice in Europe is usually carbimazole. In the US, it’s methimazole, the active form of carbimazole; carbimazole turns into methimazole in the body. There isn’t much practical difference between them . The second choice of drug throughout the world is PTU - this has more effect on the liver than carbimazole, but is less able to cross the placenta barrier, so it is preferred for women in the first trimester of pregnancy. It is also offered to people who react badly to carbimazole. The two medications work in much the same way, so you aren’t normally offered the alternative if you don’t achieve remission on the first. TSH is low, and may remain suppressed for weeks or even months - this isn’t usually anything to worry about.
In the U.K., carbimazole comes in 20mg and 5mg, so those of us on titration(the approach where the medication is reduced as thyroid levels come down) usually end up cutting tiny tablets in half, or taking them in multiples.
They seem to be reducing your dose quite soon, but maybe your thyroid levels came down quickly. Also you appear to be having tests more frequently than would be the case in the U.K, where they typically start out as every four to six weeks, and may then go to eight week intervals, so this would make it easier to monitor rapid dose reduction. Here, we are told to expect to stay on Carbimazole for twelve to eighteen months, as this is thought to give the best chance of remission.
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