Could you please give me some advice for my Mother in Law. She is currently (temporarily until her flat is redecorated) in a care home. She was diagnosed with a slightly overactive thyroid when she was admitted to hospital in March and was put on Carbimazole 5mg (we were unable to get the blood test results as the hospital was too busy due to COVID19).
When I telephoned the care home yesterday to see how she is, during the general chit chat with the assistant manager I was told that "she can't remember that she has not eaten so we just give her double portions, she is too skinny and the Doctor said she is dangerously thin and needs to put weight on". This rang alarm bells because 1) we should have been told if the Doctor was concerned about her in any way, 2) although the care home are administering Carbimazole every morning, they were unaware that she has hyperthyroidism! 3) she has always been slight and has just spent 8 weeks in hospital, where nobody mentioned concern about her weight.
I just wanted to ask, is having a very large appetite a symptom of having hyperthyroidism? And am I correct in thinking that most people with hyperthyroidism are usually slim?
Many thanks.
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HKAnne
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It would be wise to get a copy of the blood test that was run and used in the diagnosis of your mother in law.
There are two auto immune thyroid diseases Hashimoto's and Graves and initially the symptoms can be similar so this diagnosis does need to be supported with the relevant antibody blood test since treatment options for each disease , are very different.
Carbimazole is prescribed for Graves Disease and is intended to block the patients own production of thyroid hormones, reduce the T3 and T4 back down into range and relieve the symptoms being experienced.
When ' hyper ' active the patient may experience, increased food consumption though loosing weight, nervousness, insomnia, exhaustion, mood swings and possibly experience some dry eye issues.
Look for a fine tremor on the middle finger - that's how my doctor saw my Graves after having had a blood test diagnosis, and before I was treated with AT drugs.
I was not slim when diagnosed with Graves but overweight, though being almost 6 feet carried it well, my main symptoms were insomnia, dry eyes and exhaustion.
I lost weight whilst on the carbimazole, so looking back, probably wasn't on the right dose.
Do you have an blood test results for your mother in law. ?
Graves presents with low suppressed TSH and high, above range T3 and T4 readings :
An antibody test is needed to confirm which thyroid AI disease you are dealing with.
Thank you so much, this is so helpful, I have Hashimotos myself but know very little about Graves.
It is impossible for me to get the blood test results from the hospital but I have asked the care home doctor to do some more tests as my Mother in Law has not been reviewed since starting on thyroid medication, I will insist on getting the results then. I shall certainly look for the tremor in the middle finger - thanks for the tip.
We were also told that my Mother in Law is anaemic and is taking two ferrous sulphate per day - does Graves cause iron deficiency?
Yes it does but so does Hashimoto's : I don't know when my fine tremor ' ceased ' ??
Whenever the thyroid comes under attack it seems vitamins and minerals take a hit, either when hyper or hypo, ferritin, folate, B12 and vitamin D need to be kept an eye on.
The iron tablets may cause constipation though I'm sure the nursing home are well versed with the knock on problems.
Actually, thinking about it, loose stools is a symptom of Graves - any thoughts there ?
Graves can occur because of a sudden shock to the system - like a car accident or unexpected sudden death of a loved one. ??
If it is Graves I would think they will keep her on a low dose of Carbimazole as the other options of either RAI thyroid ablation or thyroid surgery too radical treatment options to consider at this point in her life.
I wish I had been able to stay on a low dose of Carbimazole for the rest of my life, but at 56 obviously considered too young ( or maybe it was too costly ) to keep my thyroid.
P.S. I was fine on the Carbimazole but it doesn't suit some people. You should have a leaflet there about serious side effects, especially a sore throat or rash - there are alternatives, and once on the right dose of AT medication, your Mum in law should return to " her normal ' .
Thanks so much for all this information, we are not sure if she has Graves as I believe they only tested TSH, FT4 and FT3, she did not have the antibody tests.
I have just spoken to the care home and they are going to call the doctor tomorrow to arrange for some blood tests, it will probably just be the above again and ferritin.
We are taking her home once her flat is redecorated, so we can keep a closer eye on her then.
I don't think she ever had loose bowels, so that was not a symptom for her but she always had a fear of being constipated.
I hope you are keeping well and managing your thyroid condition.
Graves Disease, Hyperthyroidism is treated, your mum in law is taking 5mg carbimazole, but you also mentioned dementia these are two separate issues. Can't you speak to your mum in law yourself rather than get it second hand from the care home. You may need to investigate further rather than taking someone's word for it.
I was quite chunky when I was eventually diagnosed with Graves. I ate like a horse and still lost a couple of stones in weight. It went back on once my thyroid was fixed. I wouldn’t say most people with Graves are slim, they might end up slim before being treated.
I’ve never heard of checking someone’s middle finger before - the doctors did look at my outstretched arms and hands because they will be shaky. I had an unbelievable tremor.
Have a look at this link to see the symptoms Graves
I agree with the poster who said Graves and dementia are two separate things although if her vitamins and minerals - Vitamin D, B12, ferritin and folate are very low that certainly won’t be helping her and can cause all sorts of symptoms of their own so I would definitely push to have all of them tested as well as a full thyroid panel - although it is unlikely that they will test T3 on the NHS. Your mum also needs to be well hydrated, again that can cause problems in the elderly.
There are very good home fingerpick tests you can buy to test all that if you think you could get your mother to cooperate while you prick her finger and squeeze out a tiny test tube of blood.
Always ask for copies of all her blood test results with their ranges. The ranges are large and you want your mother in law’s vitamin D, B12, folate sand ferritin results to be near the top of their ranges to help her thyroid, also watch that she doesn’t become hypo while she is being treated, that is possible.
Thanks for all this information Fruit andnutcase. My Mother in Law has dementia and is temporarily in a care home. Finger prick tests are out of the question as we are not allowed to visit and rightly so, care staff will not undertake this task. I have requested that the local doctor should arrange blood tests asap.
My father n' law sound exactly like your mother n' law he was diagnoised as having dementia and is very thin and eats like he is starving I tell my mother n'law she needs to have his thyroid levels tested....but she never does she just thinks it's dementia because it runs in family. His weight is alarming he's 6'4 and super skinny lots of muscle wasting happening and he has very low Cholesterol levels (not sure how low).
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