Over and underactive? Need advice please.

[wavingordrowning]

Last year i was diagnosed with a toxic nodular goiter resulting in hyperthyroidism.

I have since been taking Carbimazole 5mg, daily.

These are my two most recent blood tests

Dec 2019

Tsh 0.05 (0.27 4.20)

Free T4 19.6 (12 - 22)

Free T3 6.1 (3.1 - 6.8)

Feb 2020

Tsh <0.05 (0.27 4.20)

F T4 12.6 (12 - 22)

F T3 4.8 (3.1 - 6.8)

Although my T4 is still in range it is now on the lower side of normal and my tsh has not budged! Unsure at this stage if i should continue even taking the Carbimazole or what my next step should be 🤷‍♀️🤷‍♀️.

Any advice appreciated

[pennyannie]

Hey there wavingordrowning :

I think we have spoken before :

Looking at the above, presume you felt better on the December results ?

If that is the case could you halve the anti thyroid dosage ?

The TSH is just 1 of 3 markers to be looked at with the T3 and T4 offering more reliable results and information of the ratio of conversion appropriate for you.

I'm with Graves post RAI treatment, a treatment I deeply regret, and have learnt of my own situation some 8 years after treated and now manage lingering Graves, thyroid eye disease and hypothyroidism and am now self medicating.

[wavingordrowning in reply to pennyannie]

Hi, yeah i felt better with the December results. I am on. 5mg so dont know if i can half the dose. Considering stopping it altogether.

I have also been considering rai or even surgery as i am now so fed up.

[pennyannie in reply to wavingordrowning]

How long have you been on just 5 mcg ;

The Carbimazole will have blocked your own thyroid production and your TSH may never come back up - personally I'd concentrate on the T3 and T4 levels.

December was looking good and you felt better than now, so think I'd consider halving the anti thyroid tablet.

Vitamins and minerals are very important and these need to be kept at optimal levels, so yes, think it best to get these tested.

Living without a thyroid isn't much fun, especially when you can't access the full thyroid hormone replacement on the NHS : I understand it's a difficult time :

[SlowDragon Administrator]

Ft4 and Ft3 now low. TSH can be very slow to respond. Or may not respond at all if been suppressed for awhile

Have you had all four thyroid antibodies tested to rule out Hashimoto’s or Graves’ disease

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

Important to test vitamin D, folate, ferritin and B12

These are frequently too low and improving levels can improve symptoms

[wavingordrowning in reply to SlowDragon]

I have been on the carbimazole 5mg since start of November with not even the slightest improvement to my tsh level. I am now considering stopping the carbimozole to allow my t4 to recover slightly. Is this wise?

I have had all antibody tests of which all were negative. I havent had vitamins tested for a while however so may be worth getting this done.