I have been newly diagnosed with hyperthyroid (still undergoing tests as to why). I have been commenced on 40mg Carbimazole + 10-20mg Propanolol 3 x a day for symptom relief. I have a blood test Wednesday and one on the 23rd May.
My question is, how do people cope with shift work? Mainly nights? Do you find it heightens your symptoms or worsens your blood work? I'm a nurse and so far they have limited my nights to 2 and not 3 as the rota is already out and planned way in advance.
Thanks in advance
Written by
Pjd94
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I can't help with shift work but please make sure that all thyroid antibodies are tested:
TRAb (thyrotropin receptor antibodies) and TSI (thyroid-stimulating immunoglobulin) antibodies - positive results for these confirm Graves disease (overactive).
TPO (thyroid peroxidase) and Tg (thyroglobulin) antibodies - these are the ones that when positive are usually associated with Hashimoto's (underactive).
Some people are diagnosed with overactive thyroid and given Carbimazole when in fact they're in the often first "hyper" stage of Hashimoto's which then proceeds to underactive, in which case it is the wrong diagnosis and wrong medication.
Thank you for your reply. I had the usual thyroid test which showed high, then another antibody test which did not specifically show Graves' and then Wednesday I'm going for another type of antibody test - I'll ask my GP when she calls me with the results.
About June last year I had high levels also and my GP sent me for a scan which showed a normal thyroid (a little enlarge) and the endo wasn't excited at all! She also called them again to see if they want another scan but they just advised Carbimazole and then see me routinely.
Are you sure that is <35 and not >35? I would have thought they would give a number, most antibody results we see here do.
Plasma TSH level <0.01 mU/L
Plasma free T4 level 24.7 pmol/l
Plasma free T3 level 11 pmol/l
No ranges? FT3 is definitely over range, FT4 probably is but may not be too much over range. Ranges vary from lab to lab so we need them to be able to interpret results correctly.
I still think you need the Graves antibodies done to be absolutely sure.
There are 2 main reasons for your thyroid to have become overactive - and both Graves and Hashimoto's present initially in the same way and why its's essential that the antibodies are run to distinguish which AI condition you are dealing with as they are not treated with the same medication.
As to why this has happened - well something has triggered your immune system to attack your body, and when the thyroid is involved as with Graves, your T3 and T4 levels keep rising and Graves is considered life threatening if not medicated.
With Hashimoto's theses AI attacks and the erratic thyroid hormone production are transient and the T3 and T4 do not keep rising and fall back down into range by themselves and no AT medication prescribed.
The anti thyroid drug Carbimazole will block your thyroid hormones rising any further and slowly your T3 and T4 should drop back down into range and your symptoms alleviated.
Graves can be triggered by a sudden shock to the system, like a car accident or the sudden unexpected death of a loved one and there is likely a genetic predisposition with someone in your family, maybe a generation away from you with a thyroid health issue.
However we really do need the ranges along with these results as they can vary from lab to lab.
Those antibodies are generally more prevalent in Hashimoto's AI Disease though it is possible to have both Hashimoto's and Graves running at the same time.
Keeps us in the loop as we need the full antibody testing to distinguish between these 2
AI disease and the ranges for all results.
Maybe start a new post when you get more information as this rolling screen and the pressure from the number of posts can run very fast and generally every post is answered as fully as possible within the first 24 hours and not revisited by the many.
Since you have replied to me, I have been notified, and am here but other people who have replied to your post will not be notified and rarely have the time to look back at what's considered an answered question.
A new post gets all forum members attention and people look back at your previous posts to remind themselves if necessary.
I hope that makes some sense as I'd hate anyone to be waiting on replies and thinking they have been ignored.
I had a test back in may 2021 which just showed slightly high levels, but then I developed tachycardia + palpitations so asked again for a blood test + ECG and this was the results.
Looking back I probably had the nervousness/anxiety, I thought I had ADHD to be honest! but I never lost weight with it
yes there have been suggestions of covid vaccine potentially kicking it off / or relapse.... eg this one: healthunlocked.com/thyroidu... sars-cov-2-mrna-vaccination-and-graves-disease-a-report-of-12-cases-and-review-of-the-literature
Your symptoms are likely to be worse when you are are tired & stressed so it’s important to relax & rest as much as possible during day before shift. not overdoing things with chores & any strenuous activities or past times you would normally enjoy.
In terms of medication it is best to take as consistently as possible. Which might be more difficult if you have altering sleep pattern.
I used to use a pill organiser box and app which set alarms. So if you work out a schedule which fits for the day. Slight variations won’t cause issues.
I imagine your carbimazole is split into 2 smaller doses? So spacing the dose out 12 hourly eg 08.00 & 20.00 or what suits around your shift is best. Taking in 1 dose is safe but leaving a wider gap between doses might allow a window to start producing more hormone so 2 doses is beneficial.
Same with propranolol I used to take dose 08.00, 16:00, & 23.30 so spread throughout day.
When you plan to stop propranolol reduce slowly. I was told to stop abruptly & made me very Ill with migraines. Had to resume them, took a long time to reduce & still take low dose.
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