am I hyperthyroid ?

[Valkyria]

I am planning to take 10mg of carbimazole daily in single dose.

please help.

[greygoose]

Personally, i would say no, you're not hyperthyroid as such. Looks to me like a Hashi's 'hyper' swing. Have you had your TPO antibodies tested? If it is Hashi's, then the levels will go down by themselves. I wouldn't take carbi if I were you.

[Valkyria in reply to greygoose]

No, I have not got TPO antibodies tested

[Valkyria in reply to greygoose]

I had my TSH history for the past 3 years and it always low and free T4 always high,is it hashimoto ?

[greygoose in reply to Valkyria]

I don't know. But it would be a good idea to get your antibodies tested.

[Valkyria in reply to greygoose]

yeah i might see endo soon

[jimh111]

These results with a fully suppressed TSH and considerably elevated fT3 and fT4 clearly indicate hyperthyroidism. This should be managed by an endocrinologist who can examine your thyroid and check antibodies to determine the cause. You say you are planning to take carbimazole, has this been prescibed for you? Your condition should be managed, you shouldn't try and self treat hyperthyroidism, especially if the underlying cause has not been determined.

[Valkyria in reply to jimh111]

Havent tested the TPO

but my endo said I am hyper and need to take PTU 100mg 3 times a day, I am worry about PTU side effect so I am planning to take CBZ 10mg per day

[Valarian in reply to Valkyria]

PTU has a shorter half life than Carbimazole, so the dose is typically split, For higher doses of carbimazole (eg 40mg/day in total), the dose is often split, although this is less critical (when I was first diagnosed, i was on 20mg twice a day, but the endo said if I found I was forgeting the second dose, just to take the whole lot in the morning).

According to the British National Formulary, the recomended equivalent dose of carbimazole v PTU appears to be 1:10 - on this basis, your dose may be a bit low, so not sure how you decided how much to take. However, this is something you really need to discuss with your endo, as it goes onto say the dose may need to be adjusted according to response.

bnf.nice.org.uk/drug/propyl...

[Valarian]

Well yes, both FT3 and FT4 are elevated above normal range, and TSH is supppressed, you are hyperthyroid. The question is, what is causing this ? Have you been experiencing any symptoms ?

You say you are 'planning to take 10mg carbimazole' - presumably this has been prescribed for you ? What did the doctor who prescribed the carbimazole say about the cause of your thyroid levels ?

[Valkyria in reply to Valarian]

I feel weak and my heartbeat always fast

I need toilet after eating and I am very skinny, no the doctor prescribed PTU and did not say anything about the cause

[jimh111]

You need to speak to your endo about taking carbimazole. I'm a little surprised they prescribed PTU without checking your fT3 but there are various reasons for using PTU instead of carbimazole, particulary if the woman is planning pregnancy or nursing. It is very unwise to switch to carbimazole without consulting the endo. I doubt that you have got the dosage right and you will not be in a posistion to monitor it. It's important that hyperthyroidism is correctly treated and monitored. Your endo cannot care for you if they do not know what medication you are taking. I'm not sure where you would get carbimazole from if you don't have a prescription.

[Valkyria in reply to jimh111]

it was a year ago since I took PTU, also i dont live in the UK . carbimazole is kinda rare in here. I wont take PTU because I read it has higher chance to make your liver sick (from FDA site)

Btw i just took 10mg CBZ today and feel quite good.

[Valarian in reply to Valkyria]

It's unlikely that you would feel the effects of carbimazole within a single day. It will begin reducing production of new thyroid hormones immediately, but until anyhting already present in your body has worked through the system, you may not feel much better - this could take a few weeks. You're right, PTU is typically a second line option, but as JimH111 has said, it is routinely prescribed, including to women planning to get pregnant, in their first trimester, or anyone who has an adverse reation to carbimazole. However, neither of these medications is to be messed with, and in the UK, they can only be obtained with a prescription (and often only under specialist supervision). Can you be sure your carbimazole is from a reputable source ? Would your doctor be wiling to provide testing and advice if you self-source the medication ?

You need TSH, FT3 and FT4 to be retested approximately every 8 weeks at the most. You also need to keep pushing your doctor for a cause, which almost certainly means antibody tests (starting with TPO and TRAb or TSI).

Here is some information on possible causes:

thyroiduk.org.uk/tuk/about_...

btf-thyroid.org/information...

[Valkyria in reply to Valarian]

I am pretty sure my carbimazol is authentic.

and thanks for your info, i will try to find a good endo. and do a blood test next month

[jimh111 in reply to Valkyria]

You should discuss your concerns with your endocrinologist. All drugs carry risks so it's a question of getting the right balance. Which country do you live in? If you have previously taken PTU without side effects you are likely to be OK on it now although it would help to find out why your endo is recommending it for you. How long have you been hyper? Drug therapy can be used for a long time but they should find out why you are hyper and whether a thyroidectomy or radio-iodine would be better options (probably not, but should be assessed).

[Valkyria in reply to jimh111]

I live in Indonesia. I once go to Malaysia and the doctor there told me that I had hyperthyroidism. He then prescribed me PTU

The second endo I visit told me to do the RAI and he said it will cure as soon I do the RAI. I did some digging and found out that most after RAI go to hypo and have to take med for the rest of life.

I think i got hyper from 2015

[jimh111 in reply to Valkyria]

I see your difficulty. I don't know about medicine in Indonesia but I'm familiar with Malaysia. I think you need to see an endocrinologist to discuss whether you can have carbimazole, possibly you could try asking the Malaysian doctor and ask why he prescribed PTU. RAI is an option but the impression I get (I don't have hyperthyroidism) is that RAI may have more adverse outcomes than carbimazole / PTU or surgery. Certainly RAI is successful for many patients but we get patients on the forum who did badly after RAI. The difficulty is to decide whether RAI really is not that good or whether people with bad experiences come to the forum. How successful is RAI?

A decision on RAI, surgery or long term drug treatment needs to be discussed with an endocrinologist. I know Malaysian doctors are more friendly that UK ones, even the ones that were trained in the UK! You do need to get prescriptions for PTU or carbimazole since Malaysia / Indonesia are not good places to buy medicine without prescriptions, the medicine might be as fake as the Rolex watches in the markets! I don't know whether you can afford consultations with an endocrinologist or whether you get any free medical care in Indonesia. This will unfortunately restrict your options.

[Valkyria in reply to jimh111]

Thanks for your brief explanations, I will try to find and see endo