I was recently (March 2022)diagnosed with hyperthyroidism. I was symptomatic with palpitations,pulse rate up to 140b/m, very irritable. all these started about a week after COVID infection(October 2021) and they thought it was post COVID symptoms so the GP won’t see me, they sent me to a walk in centre where I was told to rest and take paracetamol.
The symptoms persisted till but nobody saw me until I noticed 2 lymph nodes back of my neck below the hairline and I was sent for routine tests which showed the hyperthyroidism and raised liver enzymes. I had a telephone conversation with the endocrinologist who placed me on 10mg carbimazole which I’ve used for 6weeks now, )waiting for their appointment in 2weeks
Result before and 6 weeks after carbimazole as follows
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Omomi
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I forgot to add that my Neutrophils dropped with carbimazole from 2.17 to 1.67( range 2.0-7.0).Please what do I expect and any suggestions about question I need to ask the endocrinologist?
Coeliac test done, waiting for result.
Still waiting for ENT appointment as regards the lymph nodes.
You have positive TSI antibodies so that confirms you are dealing with Autoimmune Graves Disease.
The 10mg Carbimazole has reduced your levels but only very slightly. I think you might need a temporary increase. It is normal to start on a higher dose and then reduce. I had lower levels than you from a hyper nodule and started on 20mg for 2 months before reducing to 10mg.
Carbimazole reduces new hormone production, it doesn’t remove existing hormones which is why it has to be monitored and adjusted in this manner.
It might help to split the dose and take 12 hourly this prevents a window for the thyroid to start making more hormone.
The doctor needs to monitor the neutrophils very carefully as carbimazole can induce a drop. This is extremely rare & can be serious. The medication would likely be stopped. Read the patient information leaflet very carefully and report any issues.
There is another antithyroid - propylthiouracil (PTU). Doctors often say they are the same (and you will have same issues with PTU as carbimazole) but they are very different chemically & work slightly differently.
Do you have any eye issues? As this can occur with Graves.
Hello, thanks for your response. The only issue with my eyes is that they are dry and I have been advised to get artificial tears.I’ve gone through the leaflet and I’m very concerned about my neutrophils…… because I work with unwell people . I wouldn’t want to be infected with anything now . Unfortunately I have to wait 2 week to see them
I would phone GP and advise them this could be urgent. Do you have a contact number for endocrinologist department. Say you are waiting for appointment but concerned as neutrophils have dropped & GP will not see you for 2 weeks. Should you stay on carbimazole? Should you have a further full blood count?
Do you have any signs of sore throat, mouth ulcers, feeling unusually tired, odd bruising?
There is a warning card for users to present to doctors as its not well known. (Even suggests A&E visit if have any of those symptoms- if no help from GP or specialist is forthcoming)
Graves has association with thyroid eye disease (TED). Serious complications with TED are rare. DO NOT Google the condition and panic over worst case scenarios.
Many members find TED charitable trust as a excellent information source.
You can sign up for an information pack & they have a Facebook link too.
They can help find a specialist if necessary.
Main signs too watch for 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 eye
Ask for ophthalmology specialist referral if signs develop.
Opticians are usually helpful too & can write a letter for referral & recommends drop. Drops should be *preservative free*. Using different types of drops / wipes & Rotating different brands seems to help. Liquid versions for daytime & gel versions at nighttime.
Take 200mcg selenium (at first) this dose should only be taken maximum of 6 months. Then reduce to 100mcg.
I found that warm eye compresses (eg gel or wheat mask) & very gentle massage toward lash line helpful with dry eye. This “unclogs” the blocked Meibomian Gland & lipid oil layer protecting the eye and helps retains water. So can prevent watering eye too.
If you like to moisturise near your eye area use water based clear gels not cream/lotions. I did this as developed milia white spots round eye. I found the swelling also reduced when I switched.
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