Newbie with possible hyperthyroidism and looking for advice please.

[Anaheim]

Hello. I’ve been lurking on this forum just reading posts and trying to find something similar to my symptoms. I’m a 52 year old female, first went to see my gp a few months ago with really itchy arms, I thought it was the menopause and it was (and still is) driving me mad. I am also hot all of the time, my head and back sweats to the point it’s embarrassing. I also suffer with heart flutters, feels like it thumps every so often and then races. I’ve stopped exercising as it’s worse when I get my heart rate up, I then go really light headed.

My GP checked my blood pressure and it was 210/122! I am overweight and really struggle to lose, I’ve been on the 5:2 fasting diet for years and have lost but it’s really slow going. I’m on 3 different types of BP medications now as it’s refusing to budge.

She ordered a blood test as she did say that it’s probably hormonal.

April results

TSH <0.01 [0.35 - 3.5] serum free T4 12 [8.0 - 21.0]

Was told to come back for a repeat test in June

June results

TSH <0.01 [0.35 - 3.5] serum free T4 13 [8.0 - 21.0]

Was again told to come back for a repeat test in July

July results

TSH <0.01 [0.35 - 3.5] serum free T4 13 [8.0 - 21.0] serum free triiodothyronine 6.1 [3.8 - 6.0]

I saw a locum doctor with these latest results who has sent a referral to endocrinology.

She did say that I am most likely hyperthyroid and may be started on a low dose of carbimazole before I get an appointment through and I should wait for a prescription.

I wondered what would happen when I am first seen?

I am off to America for 3 weeks, is carbimazole likely to give me side effects or help with my current symptoms if I am taking it before I go?

I should mention that I haven’t had any other blood tests apart from regular urea and electrolytes due to the BP medication.

Sorry for the long post! Thanks for reading.

[greygoose]

I would strongly suggest that you don't take anything until they've tested your antibodies:

TSI or TRAB for Grave's (hyperthyroidism)

TPOab and TgAB for Hashi's (which can start with a period of hyperthyroidism, and then you go hypo)

I somewhat doubt it's Grave's because your FT4 is quite low. And carbimazole is not the right treatment for Hashi's. The problem is, doctors don't know the difference.

[Anaheim in reply to greygoose]

That’s helpful, thank you

[greygoose in reply to Anaheim]

You're welcome.

[cjrsquared]

You would expect your ft4 to be over range as well as your ft3 in hyperthyroidism. It is much more likely you have hashimoto’s disease which ultimately causes hypothyroidism, underactive thyroid. This is an auto immune disease which results in the body attacking your own thyroid, when this happens part of the thyroid dies and releases a temporary surge of thyroid hormone into the circulation resulting in a short period of over active symptoms. Once this surge has dissipated thyroid function is then reduced, ie underactive as there is less functioning thyroid than before ( this phenomenon is sometimes called a hashimoto’s flare). The blood test for hashimoto’s is for thyroid peroxidase antibodies and for Graves’ disease (overactive) TGAB antibodies. Ask your gp to test for both of these before starting any medication.

[SlowDragon Ambassador]

As others have said ....if you had hyperthyroidism FT4 would be high....your FT4 is LOW

Your symptoms more likely suggest hypothyroidism

It's possible you have autoimmune thyroid disease which is hypothyroid- also called Hashimoto's. This often starts with hyperthyroid type phase, a mix of high and low levels

Alternatively you have central hypothyroidism- where the problem is with TSH not responding as it should

With LOW FT4 your TSH should be high

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested to test for Hashimoto's

Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

If TPO or TG antibodies are high this is most commonly Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease). You can have slightly raised TPO or TG antibodies with Graves (hyperthyroid)

About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's or Graves

Food intolerances are very common too, especially gluten.

So it's important to get TPO and TG thyroid antibodies for Hashimoto's and Graves and TSI or TRab antibodies tested for Graves at least once .

Private testing for suspected Graves - TSI or TRab antibodies

medichecks.com/thyroid-func...

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

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

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

List of hypothyroid symptoms

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

Posts about central hypothyroidism- which needs managing by a thyroid specialist endocrinologist

Central hypothyroidism

endocrinologyadvisor.com/en...

pituitary.org.uk/informatio...

healthunlocked.com/thyroidu...

[Anaheim]

Thank you all for your replies, I have lots of reading to do!

[Regx]

Starting on carbimazole some times seems really tough but the I found out that taking it on an empty stomach is the best option, I take 3 tabs 5mgs each a day and for the heart rate I do indreal 2tabs a day and just after about 2 weeks I felt really greater started doing my gym again, the heavy sweating is no more, can carry about 80kgs now at a normal heart rate with my 68kgs though I keep doing my tests preparing for thyrodoctomy. Gather more advise I know it helps and I do not support your fasting idea about your weight.