Becoming hypothyroid after taking carbimazole?

[Bumbles1000]

Was given carbimazole 20mg for 2 weeks when first diagnosed and now advised to take 10 mg and 40mg propanol 3 times 1 day. On repeat bloods my ft4- in normal range & ft3- 7.5 & tsh remain at <0.05. I stopped taking all medications over a month ago as I’m very concerned of going hypo. Has that happened to anyone else? Still have another month til I see endocrine. Also does anyone know if high renin blood results has any relevance with hyperthyroidism ?

[pennyannie]

Hello Bumbles and welcome to the forum ;

Carbimazole is an anti thyroid drug and blocks your own thyroid production.

This drug is generally given when your T3 and T4 thyroid hormone levels are over range as if at very high levels this situation can be considered life threatening

Too high a level of T3 and you have hyperthyroid symptoms, which presume you initially experienced and too low a level of T3 and you can experience symptoms of hypothyroidism.

Do you have your levels and ranges of TSH, T3 and T4 thyroid hormone from your first blood test ?

Were any antibodies tested from this first blood test sample ?

Carbimazole is generally prescribed for Graves Disease and you may see numbers and words referring to a TSI ( roughly translated as a stimulating ) antibody or maybe a TR ab ( roughly translated as a thyroid blocking ) antibody.

There are two main thyroid auto immune diseases which both initially present with hyper type symptoms but they are not both treated with AT drugs so it is important to know what the medical evidence is, and which antibodies are positive and over range.

The other reasons you are on the AT medication could be because of a nodule or goitre but presume you might have mentioned these in your initial post.

[PurpleNails Administrator]

You need frequent testing when starting carbimazole. It usual to start on higher dose and then adjust downward to ensure FT4 & FT3 levels stay in range. (Not TSH)

If you were advised to reduce but stopped altogether then your levels could rise again. Is the FT3 Is still above range?

I’ve not come across renin blood test before, although there are some mentions in past posts. What did your doctors advise about this? Are they investigating the cause? It’s a kidney enzyme which increases cortisol. Has cortisol been tested?

Were Antibodies tested? (TSI or TRab) should be tested if Graves suspected. Sometimes this is arranged by specialist not GP.

[SlowDragon Administrator]

How high were Ft4 and Ft3 results at diagnosis before starting on Carbimazole

Essential to test TSI or Trab antibodies to confirm Graves’ disease (autoimmune hyperthyroid)

Hashimoto’s (autoimmune hypothyroid) frequently starts with transient hyperthyroid results and symptoms before becoming increasingly hypothyroid. TPO and TG Antibodies should be tested for Hashimoto’s (can also be slightly raised with Graves’ disease)

Important to also test vitamin D, folate ferritin and B12. These are frequently very low with Hashimoto’s or Graves’ disease

[Bumbles1000 in reply to SlowDragon]

The only requested blood that’s been done was renin which was high. Thanks

[Bumbles1000]

Hi, my first set of bloods - tsh <0.01, ft4 37.5, ft3 23.1 & tsh receptor ab 9.40. My us showed thyroiditis. My last ft4 was 19.9 and ft3 7.5 (up). Still waiting to see specialist but decided to take myself off meds as all seem to be resolving. Thanks

[SlowDragon Administrator in reply to Bumbles1000]

You probably needed to reduce Carbimazole, not stop it

You shouldn’t suddenly stop propranolol. Should be reduced extremely slowly

Get bloods retested

[Danutza]

Hi, I was diagnosed with Graves' Disease and given Carbimazole - so the most important thing is too confirm if your hyperthyroid diagnosis is autoimmune hyperthyroid. The idea is that by taking an anti thyroid drug you are blocking your own production of thyroid hormones. If done the wrong way at the end of the treatment you may well find yourself in the hypothyroid range and still having the antibodies because most endocrinologgists do not refer the patient to an immunologist to deal with the aotuimmune part.

Thankfully I've put myself (with the help of a naturopath herbalist as the private endocrinologist I was seeing was of no help on the autoimmune part) into remission 4 years ago and managed not to get into hypothyroid.

The key is tapering off the antithyroid drug wisely and to work at reducing the antibodies at the same time - there are a few studies showing that Selenium may help with this so I took a Selenium supplement plus Omega 3, vitamin D3 (liquid form in olive oil) as they help reduce inflammation in the body (inflammation would be present due to antibodies attacking own body tissues) and strenghten the immune system. I have also taken Ashwagandha tincture as this adaptogen helps the body modulate the immune system response. Other things included by the herbalist in her tincture were lemon balm, motherwort, lion's mane - it is important to strenghten the nervous system against stress and balance the body's response to stress.

Even though I tested no having a leaky gut (often associated with autoimmune conditions ), after going into remission I was advised by my naturopath herbalist to go gluten free and dairy free and then try to reintroduce and see what happens. I was able to reintroduce dairy (always organic) without any problems, but when I tried to reintroduce gluten I would exhibit intolerance/allergic reactions such as brain fog, headaches, feeling confused and fatigued. I have been completely gluten free since then and all is very well. The issue with gluten is that if your body starts developing an intolerance to it the antibodies created can mistakenly identify thyroid cells as gluten and attack them and burst them open which floods your boddy with extra thyroid hormones - that is why the FT3 and FT4 levels are very high in Graves' Disease and the TSH is inexistent (so you have large amounts of thyroid hormones in your blood even though the brain is being told not to ask to increase production). Dr Tom O'Bryan (thedr.com website and FB) has a lot of free information on gluten and autoimmune issues, and Dr Izabella Wentz (thyroidpharmacist.com) specialises in hypothyroid - well worth checking her out as she has gone through the hypothyroid journey herself and come out kicking at the end of it.

Oh, the other thing with Carbimazole to keep an eye on is you may suddenly develop an allergy to it - it is very rare, but I did and ended up in A&E for a couple of nights at Christmas time 2015 (8 months into my Graves's disease journey).

Please let me know if you want to find out more about what I did.

All the best,

Daniela