Carbimazole

[Rosan]

I am diagnosed with over active thyroid in 2013 ,took Carbimazole 20mg/day for 1 month

Then 2 weeks 10mg and later on 10mg/day for 2 more weeks.‎

Tsh ,T4,T3 level for one year.‎

Got same episode again in 2014 .repeated same therapy. And from 2014 everything was ok

Till June 2018.‎

I am now on Carbimazole again.‎

[Valarian]

Sorry to hear this Rosan. Unfortunately, one of the tough things about Graves’ is its tendency to recur.

Do you know what your thyroid results are (FT3, FT4, TSH) ? If you’re in the U.K. your go surgery should let you have a copy.

Has your endo suggested any alternatives to Carbimazole ?

[Rosan in reply to Valarian]

Thanks

Valarian

My doctor told me you have two option Kill (take radio active tablets) it or treat it .I opted to go with treatment

.

My T4, T3 and TSh before treatment (June 5) are 30.3, 11.5, <0.005.‎

Now two weeks later reading are 20.82, 7.22, <0.005‎

Hopefully this time it will last longer.‎

I live outside UK. I don’t know if there is an alternative to Carbimazole. It’s only available as

‎5mg tablet. Back in Germany when I was first diagnosed its available as 10mg tablet‎

[Valarian in reply to Rosan]

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.

Good luck !

[Rosan in reply to Valarian]

Thanks Valarian

You are right in how frequent test are done normally hear it is three months, but as I am

anxious to see what’s happening I opted t to go to private lab for testing.basicly I am a

worried person with lots of family responsibility. I did talk to my doctor of having part

Of my thyroid gland cut off, his answer was which part; frankly he is adamant to RAI

Solution .I am lucky as my sister is a nurse and I keep consulting with her.‎

As for Refs TSH (.27-4.2 uIU/ml),T4(12-22 pmol/L), T3(3.1-6.8 pmol/L).‎

Thanks again.‎