advise please on first blood tests results since starting treatment if 20mg Carbimazole, once a day for 6 weeks

[Goatcheesesalad]

SerumTSH level - 0.01 range 0.27. -4.20mlU/L

Serum free T4 23.9 pmol/L range 12-22

serum free T3 level ) 12.7 range 3.10-6.80

TrAB 26.4

[SlowDragon Administrator]

Did you get hold of copies of test results from BEFORE starting on Carbimazole as discussed in previous post

healthunlocked.com/thyroidu...

Plus vitamin D, folate, ferritin and B12

[kittyelen]

I started on that end of last year! Your endo / endo nurse should explain the results to you. I am shocked if not, mine normally goes through what the results mean and what they are looking to get for the range then I receive a copy of the letter in the post afterwards.

Please bear in mind it takes some time for the body to catch up with the changes in meds as there is a rather a lag so it's probably more on the next blood test that you will see more changes and more improvements

[Goatcheesesalad in reply to kittyelen]

thank you Kittyelen. i have just come out of seeing the Endo Consultant who was very good and explained everything and a letter will follow. there is a lot to take in and learn.

[SlowDragon Administrator]

Sorry missed Trab result

What’s the range on Trab result…..looks high

[Goatcheesesalad in reply to SlowDragon]

Hi i have just come out from an appointment with a lovely Endo Consultant at Ipswich hospital, who confirmed that my Trab was high and confirmed graces disease. she is also prescribing me Propanolol to further reduce my tremor. she also said i had a goitre too.

[SlowDragon Administrator in reply to Goatcheesesalad]

Propranolol should help reduce Ft3

Hopefully endocrinologist also tested Vitamin D, folate, ferritin and B12

Graves’ disease frequently results in low vitamin levels

[Goatcheesesalad in reply to SlowDragon]

many thanks for your advice. it is so reassuring to think you can ask for advice and support anytime.

[PurpleNails Administrator]

Were these results from diagnosis or since taking carbimazole? How do results compare? Has carbimazole been adjusted or are you still taking same dose.

FT4 still slight over range and FT3 disproportionally higher. This is sometimes seen with Graves. Often they do balance out but if the FT4 drops too much and FT3 is still very high & above range specialist should offer block and replace regimen.

Have your symptoms improved?

[Goatcheesesalad in reply to PurpleNails]

Hi Purple Nailsthese are the results after taking Carbimazole for 6 weeks. i haven’t seen the original bloods that were taken at the hospital but the Endo did say that there wasn’t much change but to stay on the same dose for the time being and retest again in 6 weeks.

Some symptoms have improved eg i am less anxious but i do have terrible night sweats and hip and knee aches. i put this all down to being in menopause.

i have noticed i have now got red lines over my half moons in my nails and my eyes can ache now and again.

[PurpleNails Administrator in reply to Goatcheesesalad]

Specialist may be looking as TSH which can take ages to respond or in some cases stays suppressed, (like me - 7 years now)

I would image 10mg carbimazole daily is having a impact and the FT4 & FT3 would be coming down. Slower is sometimes better as doctors were often keen to bring them down quickly but that can sometimes cause more severe symptoms and requires more monitoring and adjustments.

GPs don’t have automatic access to hospital records. You can request copies of hospital results, either directly from the department which requested them. Approach the department secretary who should be able to send copies. If there’s any obstruction there are other ways to request copies of hospital records.

Hospital webpages usual lists a health records department / library. Often a person contact or department with email & address is listed. If not I would try the switchboard and ask it there’s a records department.

They usually have there own application form where you can request single, portion eg 3 years or entire record. Usually ID and a witness signature is required. I have done all via email.

Did you mention eye pain to specialist? Eye symptoms which are main concern are:

* Change in the appearance of the eyes (usually staring or bulging eyes)

* A feeling of grittiness in the eyes or excessive dryness in the eyes

* Watery eyes

* Intolerance of bright lights

* Swelling or feeling of fullness in upper or lower eyelids

* New bags under the eyes

* Redness of the lids and eyes

* Blurred or double vision

* Pain in or behind the eye, especially when looking up, down or sideways

* Difficulty moving the eyes

Specialist can be very poor at looking after those with eye issues.

British Thyroid foundation have created this early warning card -

btf-thyroid.org/Handlers/Do...

[Goatcheesesalad in reply to PurpleNails]

Hi PurpleNailsYes explained everything toEndo including achey eyes. She said my right looks slightly protruding but nothing to worry about yet. i can’t say i noticed!

i have an optician appointment in january. would they pick this up?

once again thank you.

[Goatcheesesalad in reply to PurpleNails]

7 years. why haven’t you had radioactive iodine or thyroidectomy? The specialist did say this may be possibility of future treatments

[PurpleNails Administrator in reply to Goatcheesesalad]

If one eye is starting to have a protruding appearance - then at what stage would it concern your doctor? I think you need to be referred to an ophthalmology specialist now - as early intervention is extremely important.

Don’t Google worst case images and worry it may happen to you. Severe complications are extremely rare but that shouldn’t mean you should be left to wait.

This charity has excellent information on all things related to thyroid eye disease (TED) tedct.org.uk. (They also have Facebook page & advice line). They can likely recommend a specialist near to you.

Other things you can do are take 200mcg of selenium supplements daily, reduce to 100mcg after 6 months, you can buy over the counter. Check the label for absorbable forms, selenium l-selenomethionine and yeast bound selenium are best, avoid selenite and selenate.

Opticians can be quite helpful, most recognise thyroid eye issues & can recommend drops. They can write a letter advising / supporting referral but ultimately a specialist would need to monitor and treat a case of TED.

If eyes are dry you may find warm compresses helpful and gentle fingertip massage toward lash line.

Using preservative free eye lid wipes and drops & sunglasses when outside.

Take regular photos of appearance of eye, but try not to look at them too much.

4 years before I was diagnosed I had gradually rising thyroid levels but wasn’t followed up properly by doctors & told of problem. I’ve been on carbimazole 3 years now. I was told I would be given RAI at first endo appointment. I wasn’t keen for a number of reasons and I have remained on carbimazole. I have a toxic nodule not graves.

[pennyannie]

Hey there again :

Commiserations on the Graves Disease diagnosis.

Do you have the first set of blood test results and ranges from when first diagnosed ?

Do you have the range for the TR ab antibody levels ?

You might like to start reading up on Graves Disease as it is a poorly understood and badly treated auto immune disease, and suggest for the greatest depth on all things Graves - the Elaine Moore Graves Disease Foundation website.

The NHS generally give a 15-18 month window for treatment with the AT drugs, and the hope is your immune system response calms down, your antibodies reduce and you can ride out this first phase of the disease.

It will help you, help yourself, if you detail your symptoms as you go through this process.

The AT drug is blocking your T3 and T4 levels rising any further, and as these start to come back down into range, you will likely need your AT dose reduced, as otherwise you risk experiencing the equally disabling symptoms of hypothyroidism, which is when you haven't enough T3 and T4 to run your body effectively.

There is a full list of both hyper and hypo symptoms on the Thyroid UK website, who are the charity who support this forum - and it can get confusing as some symptoms do cross on both conditions.

Your thyroid is the victim in all this and not the cause :

The cause is your immune system response, and Graves does tend to be stress and anxiety driven.

It is essential to maintain optimal vitamins and minerals, especially those of ferritin, folate, B12 and vitamin D.

When your metabolism isn't running perfect for you and either too fast, as in hyperthyroidism, or too slow, as in hypothyroidism, you may have trouble extracting key nutrients from you food, which in turn will pull you down further into ill health and you do need to keep your core strength strong and solid to help support you through this first phase of the disease.