Hyperthyroidism

[Chungi]

I was diagnosed with overactive thyroid 2 months ago.I am on carbimazole 10mg daily and propranolol 40mg daily.i have developed forgetfulness,I even forget of whether I have taken the drugs or not.I forget almost everything.This has been worrying me alot and of late I just want to be alone.I am a student aged 27 years this is affected my student life please help on how to go about it.

[SlowDragon Administrator]

Welcome to the forum

You need blood test to see if levels are now dropping too low

What results do you have from your diagnosis?

Important to test vitamin D, folate, ferritin and B12 too

[pennyannie]

Hello Chungi and welcome to the forum :

It sounds like your medication may need to be adjusted -

What were you initial symptoms - have these been alleviated - and are you now with a set of different symptoms ?

Did you have any blood tests run before you were put on these medications ?

Do you have copies of any blood tests showing a TSH, T3, T4 and / or antibodies, usually written as TSI, TR ab, TPO, and or a Tg ab ;

Can you please share with forum members any results and ranges :

What did your doctor say was causing this ' overactive thyroid ' - and have you been seen yet by an endocrinologist at the hospital ?

[Chungi in reply to pennyannie]

T3 was 250.15nmol/L. Normal (78-184)T4 9.90nmol/L. Normal (1.3-2.7)

TSH. 0.104u/ml. Normal (0.4-4)

The above is the only blood test done plus an anterior neck ultrasound

The normal ranges and unit of measurement is used in Kenya.

I was not told what was causing it, Initially I didn't have a problem with forgetfulness before the diagnosis.I only had finger tremors, fatigue, fainting episodes,excess sweating, palpitations and sleep apneas. It's now a weeks since I started forgetting almost everything.

[pennyannie in reply to Chungi]

Ok - so these results show your T3 and T4 over the ranges and your TSH low which is suggestive of an overactive thyroid - I hope you found some relief from the medicine prescribed :

The Carbimazole is anti thyroid drug which blocks your own T3 and T4 levels rising any further and slowly your T3 and T4 should drop back down and into the ranges.

The Propranolol is a beta blocker and taken to try and control the heart and reduce high blood pressure.

The issue now is that we also need to know what further test were run, probably from this same first blood sample as there should also be results showing over range and positive antibodies and this is the medical evidence of what illness you have, and what is causing your overactive thyroid symptoms.

Unless you are aware of a swelling, or a lump in your neck restricting your breathing or eating, there are 2 main auto immune disease that can cause these symptoms, and they can only be identified, initially, by which antibodies are positive and over range.

It could be Graves Disease, an autoimmune disease which is said to be life threatening if not treated with AT drugs, like Carbimazole.

It may be Hashimoto's Disease, another auto immune disease but which is not usually treated with anti thyroid drugs.

It does sound more like Graves by the symptoms described - I remember experiencing that fine tremor on the middle finger, but you need this confirmed through those antibodies exclusive to Graves, namely either a TSI ( a thyroid stimulating ) or a TR ab ( a thyroid blocking ) .

Obviously you are in Kenya and the medical language maybe slightly different to here in the UK, but please get confirmation of the medical evidence and on which your medication should have been prescribed.

I think you need to go back to your doctor / hospital and explain for forgetful you have become and that you have whole new set of symptoms you don't understand.

Your mediation likely needs adjusting .

Graves is a stress and anxiety driven auto immune disease and something has triggered your immune system to attack your thyroid causing your thyroid hormones T3 and T4 to go way over range and made you hyperthyroid.

Rest as much as you can.

Do you have any friends there who you can offer you practical help, and whom you keep in contact with - this disease can tend to isolate the person suffering with it, we are here to help and advise if you want to talk things through.

P.S, what was said about the neck ultrasound ?

P.P.S. Are you experience issues with your eyes being dry, sore and or light sensitive ?

[Chungi in reply to pennyannie]

Thank you very much, the ultrasound summary was that I have "diffuse goitre"I stay alone in my hostel though I have friends who visits frequently.I have an appointment with my doctor on 11th July 2022.But I feel overwhelmed with the symptoms.Thank you very much, I'll call my doctor and request for an appointment, where I'll ask about the antibody test and share with him my current feeling

[pennyannie in reply to Chungi]

Good idea - talk through everything with your doctor and make an urgent appointment as I don't think you can wait another month as clearly the medication isn't working well for you.

Write notes to yourself so you don't forget anything at the appointment.

A goitre is an enlargement of the thyroid gland and there is excessive over production of thyroid hormones, as we saw in your blood test results.

Are you able to swallow and breathe with ease ?

There are various reasons why this has happened - it could be iodine deficiency, it could be because of Graves or Hashimoto's, both auto immune thyroid disorders.

Is there anybody in your family who has experienced similar - maybe a generation away from you.?

If you go into Thyroid UK website - thyroiduk.org - this is the charity who support this forum and where you can read more on goitres, and all things ' thyroid ' .

[PurpleNails Administrator]

I too was dreadful for remembering to take my medication / getting the timings right - Not taking or taking double on occasions. In the end I got a pill organiser & downloaded an app which reminded me which medicine to take & when. The app I used gave you an interesting picture at the end of each day once you ticked off every medication. Or you could set an alarm on mobile.

Spreading everything out throughout the day consistently help a lot. It also helped remind me to drink plenty of water frequently, something I would also forget!

I still use a pill organiser, but don’t need reminders anymore. The only time I set alarms now is when of I’m cooking - otherwise I get distracted and burn it.

I always found list / diary’s helpful for planning & organising.

You can help yourself with your health by keep a separate diary of symptoms, medications & supplements doses & tracking levels & results carefully. It will also help you by making a note of following up when tests & appointments are due.

For full thyroid test you need:

TSH (thyroid stimulating hormone) this is a pituitary hormone which signals to thyroid to produce new hormone. Doctors often focus on this a conclude if this is in range so must actual levels but this is not always the case.

FT4 Thyroxine

FT3 Triiodothyronine, the more active thyroid hormone

TPO & TG antibodies (autoimmune conditions - Autoimmune thyroiditis & can also be present with Graves)

TSI or TRab must be tested to confirm Graves * if suspected - was this done? Drs often assume all low TSH is Graves but you must ensure this have been checked.

Also important to test:

Folate

Ferritin

B12

Vitamin D

We are legally entitled to view our own blood test results, always obtain copies online or printed. (Never verbal or hand scribbled) as the lab reference range is needed (each lab range varies, so required for each result)

Was 10mg your starting dose? As that’s a very low starting dose. You should really be monitored - and have a repeat blood test every 6 weeks - was that done? It’s very important you stay in range and don’t remain too high / become too low.

[Chungi in reply to PurpleNails]

Thanks very much.That was my starting dose,I don't have the results will.Will try the alarm method and the pill organizer

[PurpleNails Administrator in reply to Chungi]

A low starting dose might mean your levels FT4 / FT3 levels were not very high, but it’s quite important to recheck them. 2 months along is too long not to be monitored.

Hyper can be transient and if caused by autoimmune thyroiditis ( Hashimoto’s) it can precede a natural drop in levels (under active thyroid) so an additional antithyroid medication will hasten the drop & not correct treatment.

As you don’t have your results & don’t know whats been tested (or have diagnosis of cause) its possible the right antibodies haven’t been tested to determine reason for hyper so obtain your results & arrange for a thyroid function to be re-checked.

If GP / specialist can’t organise test quickly or won’t check every marker you need (TSH, FT4, FT3 antibodies, folate, ferritin B12 & vitamin D) there are private options. (Are you in UK?) You can do a fingerprick sample at home and post for testing. Results online within a few days.

[Chungi in reply to PurpleNails]

Thank you very much,I posted my results as a reply to my question.Im in Kenya

[Chungi]

T3 was 250.15nmol/L. Normal (78-184)T4 9.90nmol/L. Normal (1.3-2.7)TSH. 0.104u/ml. Normal (0.4-4)

The above is the only blood test done plus an anterior neck ultrasound

The normal ranges and unit of measurement is used in Kenya.

I was not told what was causing it, Initially I didn't have a problem with forgetfulness before the diagnosis.I only had finger tremors, fatigue, fainting episodes,excess sweating, palpitations and sleep apnoea. It's now a weeks since I started forgetting almost everything.

[PurpleNails Administrator in reply to Chungi]

I think these are test results for Total T4 & T3. Which doesn’t give you the information you need. You need a test for Free (unbound) levels which are available for the body to use.

Ranges vary between machines there’s not a standard measure for a certain country.

Do you see a general (family) doctor or are you able to see a specialist?

I don’t know anything about healthcare system in Kenya and of you have ways to guide treatment eg requests certain tests or use private services.

[Buddy195 Administrator]

Welcome to the forum Chungi.

Forgetfulness can be linked to anxiety, Having a thyroid diagnosis can be somewhat overwhelming & can make your anxiety levels rise further, which in turn causes adverse symptoms. For me, following ‘mindfulness’ guided meditations helped me unwind. What helps you relax/ unwind?