To titrate or no titrate carbimazole dose

[Fiaxseed]

This is the second time i've been treated with carbi for thyotoxicos/ multinodular goiter. And each time it seems to be triggered by something(not graves i'm told) the first time my small goiter was triggered into hyper was an iodine contrast my doctor ordered on my pancreas.it was diagnosed as von basedow phenomenon, given carbi for a few weeks and thyroid came right. I offered surgery but declined. 3years later i became thyrotoxic again offered surgery and declined. I opted for carbi. On 10mg a day for 6 months by my endo with no inbetween monitoring and in less than 3 months i became hypo. And again referred to the surgeon who told me to stop carbimazole you are underactive an its making my condition worse. He asked about my symptoms bless him and i almost fell over with joy. Because my gp overlooked the abnormal thyroid function test she herself ordered. Anyway my question is should i titrate or not titrate. I want to help my thyroid recover. Thank you

[Angel_of_the_North]

If you have autoimmune thyroid disease (aka Hashimotos - iodine can be a trigger for this), carbi is not the right treatment as the high hormone levels are caused by the destruction of thyroid tissue, not because the thyroid is producing too many hormones and the levels will just come down on their own, after which you will be more hypo. Beta blockers can help on a temporary basis if your heart rate is high. But if it is Graves/Basendow (they are two different names for the same thing see endocrineweb.com/conditions... - so you can't have one and not the other), then you do need carbi. Jod-basendow is something else again - a sort sensitivity to iodine which makes you go hyper. The only way to tell is to have your antibodies tested. TPO and/or TG are usually Hashis, while TSI and/or TRab are Graves. Do you have a full set of thyroid blood tests you can post here?

[Fiaxseed in reply to Angel_of_the_North]

I was tested for graves antibodies 3years ago. Negative trab. Given too high a dose of carbi by gp. Endo tells me. Dose reduced slowly and then stopped after exceess iodine had left my body . function ok. Thyroid swelling which gradualy went went down for years then swelled again few months ago. Had fna 3years ago. Neuclear done this time surgery recommended if carbi no good after 6 months. Swelling appeared on carbi. Hypothyroid. No action taken . no copy of current function sent to specialist. Referred to surgeon without them. Got a copy myself from gp reception and gave to surgeon. The hospital didn t have them. As far as i know basedow is short lived. And report from blood tests suspect autonomous nodules. Thought might be hashis but wouldn t the experts know? I just keep getting sent to the surgeon to have it out. More blood tests i will insist on next gp app . finally get hold of my doctor told to stop carbi cold turkey. I should have been told that sooner. I'm still told: Just have it out. No.

[ling in reply to Fiaxseed]

Blasted doctor!!

So thyroid swelling only occurs when you become hypo ie. your thyroid hormones are below range?

Any mention of the implications of autonomous nodules? This is multinodular goiter? Potentially, this sounds like a separate condition from the von Basedow phenomenon initially diagnosed, which might have acted as a trigger. If nodules do not resolve when thyroid normalises, and the nodules turn or are active, they can cause hyperthyroidism as well.

[Fiaxseed in reply to Angel_of_the_North]

Yes I will post definately.