Hi. Thanks for reading. I am on 150mg PTU a day. I went and did a blood test yesterday and these were my results
ALT 157 range 0-30
AST 103 range 10-50
GGT 55 range 10-30
I have been feeling sick and nauseous this week on and off and lost my appetite. Apart from that all good. I cannot tolerate Carbimazole so it’s not an alternative option.
Any advice or past experience?
i have no experience , but just found this report .. pubmed.ncbi.nlm.nih.gov/118... i don't know how high your AST/ALT etc are in relation to this patient , so no idea if you should be concerned or not , but in this case PTU was stopped and methimazole used instead... ..not sure but sounds like 'methimazole' is basically a different form of carbimazole , so possibly not much help blog.nus.edu.sg/phcdgs/2017...
Also in this case report karger.com/article/fulltext...
AST 76 UI/L and ALT 88
then AST 72 and ALT 104
are described as mild liver dysfunction , and no action seems to have been taken at that time , ( but she was pregnant ) however when in her case ALT levels later peaked at 531 she was hospitalised urgently.
So it sounds like there is a spectrum from 'mild asymptomatic without bilirubin increase' to 'extremely serious liver failure'
Hi Tatty. I will read the article. The ALT is 5 times over the range so moderately elevated. The AST is just double so my dr won’t be concerned about that. I tried carbimazole and could not tolerate that so that’s how I got on to PTU. I’m worried I’m on my way to a thyroidectomy. My absolute last option.
My remark on my blood test results said hepatocellular damage was occurring so exactly what the article was saying and PTU was stopped. I have only been back on the PTU for 2 weeks.
Exactly like your article said. My GGT is also elevated at 55 range 0-35 so not a lot over. Not enough to be concerned about and my Birrillium was 10 range 2-20.
edited above rply to add another reference on levels.
I can’t catch a break right now. I’ll read your articles. Thank u. You’re always so kind. My love to u 🥰
not sure but sounds like 'methimazole' is basically a different form of carbimazole
Not exactly, but close...
Carbimazole is metabolised into methimazole in the body. See first paragraph here :
en.wikipedia.org/wiki/Carbi...
Just a point of interest...
In the US carbimazole is used to treat animal hyperthyroidism. Methimazole is used to treat human hyperthyroidism. I don't know why this situation arose.
Note the comment from drugs.com :
drugs.com/international/car...
In some countries, this medicine may only be approved for veterinary use.
I'm hoping there is no need to panic yet.. and if it did get serious enough to put liver in danger then you have no choice anyway . Don't forget.... we don't know you'd have a crap time after a thyroidectomy . we are just trying to avoid it in case you are one of the minority who can't find the right replacement hormone therapy afterwards... don't forget that we are the minority .. there is much more chance you'd be fine anyway ....my aunty was fine after thyroidectomy on Levo and went off to live in a hut in papua new guinea.
I’m not a risk taker in anyway and I fell this is a risk I don’t want to consider. Wait and see. I would t mind the levels but some of the symptoms are there like the nausea and lack of appetite.
Deep breaths.... keep calm and carry on.... no need to worry today. If bad shit might be going to happen , you don't need to deal with it till it's happening , and if it does it's easier to deal with because you have no choice.
So let's assume this is OK for the moment .. it's the most useful belief to have.
Yes I do agree with that. Keep calm and carry on. Let’s hope everything will be ok. Thanks Tatty.
xxx I'm really looking forward to you coming on here one day and saying "i'm so boring , nothing crap has happened for ages"
Go and sit in the garden and think 'boring' thoughts.. maybe it will help
Oh Tatty, You have made me laugh, tears r rolling down my face. How I long for that day myself. I am currently in A&E with my 21 yr old son. Yet another concussion, his 4th, all football related as he’s the goalie. That’s all I have done for 6 years is hospitals.
lol. you currently get 0/10 for 'being boring' .. really , you must try harder.
But don't worry i'm sure it will come in time if you embrace it.. i'm excellent at it now....my 30yr old son hasn't done anything to scare me for a few years , and just comes over to pat his boring mum on the head and make sure i haven't died of boredom... he get's his parcels sent to my house just so i can have some excitement.
Goalies are the coolest.... I used to be a hockey goalie and we used to win nearly everyone.
I still remember winning 11-0 once..
Tell 'boy' to use his bloody arm's and legs instead of his head next time.
xx
My son got hit in the head with another players arm as they jumped for a ball. 8 men all tucked in tightly. How nice your son sends u wee suprises to your house. I do that too to my mum and I’m 48.
Ah ...It's much easier to keep them away from you in Hockey.. they give to you a big stick to hit them with.
oh no .. the surprises are not FOR me ....he lives in the house behind mine and is out at work , so yesterday i got an exhaust pipe for a volvo .. last week i got a box of electrical components and a packet of relay switches...today i'm apparently expecting a new circuit board for the boiler.... maybe one day he'll stop rebuilding random vehicles in his back garden and i'll be allowed to cut my grass without having to go round a pile of spare wheels from a beach buggy.My daughter also sends parcels that are not for me.. hers are usually more expensive looking though.
...sometimes she send's takeaway's from the Indian that are not for me.. and text's me to put some plates in the oven ready for when she arrives with her friend.
I day dream about leaving home and living on my own on the beach in a truck, since it seems apparent that they have no intention of leaving home 
Oh u have my family laughing. My daughter is like your daughter. My husband said put the plates in the oven but don’t turn it on. Plates were put in the oven he said. I appreciate none of the suprises are for you. Your son is hilarious. U have made me laugh so hard. I did mention to the dr at A&E about my bloods and she said sounds like I was having a reaction. I needed some anti nausea meds whilst my son was there. Two patients for the price of one. I’m not ready to let my children go. They have it to good at home. U have brightened my night. My husband is a mechanic so I know what u mean about all the parts and nothing works. Mine loves motorbikes. U r funny. We have a lot in common.
once upon a life .. i was a biker too. ... my son doesn't approve of motorbikes in the garden... he prefers to keep them in the kitchen so they don't go rusty.
~~~~~~~
Life is all change ,
but i am flexible as the wind.
I will meet whatever comes to me with courage,
For Life is right in any case,
and my heart is as open as the sky.
~~~~~~~
Be like the bird ,
that pausing awhile on bough's too slight,
feels them give way beneath her,
and yet sings,
Knowing that she hath wings.
~~~~~~~~
Whatever happens it will be alright, this is me in my different life after thyroid problems came to bugger it up... but it's still a very nice life...
Again I’m laughing hard at the storage option of the motorbikes. Poem is lovely. Ah yes the simple life of the van. My husband would love that life although I appreciate the freedom and simplicity. Gotta go and get the boys car now. Love to u Tatty
They dont even prescribe T3 in New Zealand. I did ask my dr this. Seriously we r living in the dark ages. No NDT here either. Only T4.
Hello there, I've not really got much to add but I'm on block and replace due to graves. I have not yet achieved remission and always have the possibility of a thyroidectomy at the back of my mind.Yes I will do all I can to keep my thyroid but realise that in some cases this is not possible.I try to remember that people come on here when they have a problem so there must be many people out there who have no problems after.It sort of magnifies it on here.I am in no way diminishing the problems people have but this is how I'll rationalise it to myself if I ever get to that stage.Hope things work out for you.
I’m the same as you. I am doing all I can to keep my thyroid. I’ll have to wait for the dr to give his opinion. Everything will be ok.
Of course there are many who don’t have problems but there are also a lot who haven’t found this forum who believe every word their GP says or are too scared to stand up to them - my DIL for one who has “done” the MMH blood test which shows her T3 to be too low for her TSH/FT4 measurement but is too afraid to tell her GP that she’s done it. Her GP has put her on PPI’s and AD - such a shame.
I too have found this forum invaluable.I can't remember my GP or my endo explaining anything to me at all and I certainly didn't know which questions to ask .I have learnt everything I know from here and thyroid UK.And it certainly helps listening to other's experiences and makes you feel less alone.I can certainly see how many people will believe that there is nothing more that can be done and this is as good as it gets.Thinking like that makes me even more nervous of a possible thyroidectomy in the future.Thankyou for making the point I hadn't really thought of it like that.I will try and exhaust all other avenues first.
Please try hard to keep your thyroid if at all possible. I was railroaded into having RAI way too soon, a decision I bitterly regret. I have poor conversion but NHS Endo says he can’t prescribe T3 and is totally against NDT so, like many others I’m left with DIY or private. It’s absolutely appalling the way we get treated. They put me in this position, I was doing well on a low dose of carbimazole which I tolerated well and within 4 months tops they started pressuring me to make a decision between RAI or TT.
Yes I will do.I think I have been left longer than normal due to covid and have only had telephone consultations for I don't know how long.I can't have RAI due to thyroid eye disease so thyroidectomy would be my only choice and I presume they are also way behind due to covid.This may be a plus for me and give me more time.Unusually for me they have never mentioned it to me apart from my 1st endo consult when it was just listed as a range of treatments available including medication.Thankyou for sharing your experience.
I’m doing my best. I may not have a choice though as I could not tolerate carbimazole and now liver enzymes are elevated on PTU.
Hi Nikegirl,
I had similar levels to yours in 2013 (although mine were due to a heart attack, not medication). At the time my GP re-tested 8 wks later, and sent me for an ultrasound.
ALT.............145 (0 -52)
AST............159 (38 - 126)
GGT.............73 (12 - 43)
It took about 2 yrs for results to return to normal levels, and apparently I have been left with a lesion, which doesn't bother me at all.
My results earlier this year
ALT.............19 (0 -39)
AST............90 (30 - 130)
GGT...........15 (0 - 39)
I am so sorry that you are going through such a tough time, and I hope that you find a solution asap. 🤗
Should I be worried?
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Elevated FT3 and liver enzymes on NDT
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