Help!!

[ShellBellc1979]

can anyone explain these results to me in layman's terms these are after 3 weeks being on carbimazole & doctor said my levels haven't really changed since blood test mid August

[pennyannie]

Hey there again :

Do you have the results your doctor is talking about :

Currently your TSH is at 0.05 : low suppressed and what we would expect :

YourTBII (TRAB ) which are the Graves antibody are at 3.50 BUT no range ??

T4 is 23.10 so just over the top of a range of 12.00 - 22.00 :

T3 is 7.4 and just over the top of a range of 3.10 - 6.80 :

These blood tests are just a snapshot in time and tend to run behind symptoms experienced - how are you feeling ?

Your Carbimazole is controlling your T3 and T4 levels so if your doctor is looking for a greater adjustment in your T3 and T4 readings maybe the next step is to titrate up your Carbimazole to block your thyroid hormones more, though personally I think you should wait a little longer - how are you feeling - are you with uncomfortable symptoms.

[ShellBellc1979 in reply to pennyannie]

Hi again thank you i didn't receive a copy of tge results from tests last month. The letter does say to increase the dose of carbimazole. I am feeling better than i was but still not great still very shakey anxious & not sleeping well

[pennyannie in reply to ShellBellc1979]

OK then it's an option, or do you think the beta blocker you had last time would be more appropriate now and suit your symptoms better ?

[ShellBellc1979 in reply to pennyannie]

yeah i think so just really don't want radio iodine

[pennyannie in reply to ShellBellc1979]

So you just say - no thank you - and offer the endo copies of the research papers I gave you on a previous reply which pretty much covers the reasons why - and maybe, just maybe the endo may read these papers, think and learn something.

[ShellBellc1979 in reply to pennyannie]

i shall do that thank you

[PurpleNails Administrator]

The TSH (thyroid stimulating hormone) is a pituitary hormone which signals thyroid to increase / decrease the production of new thyroid hormone.  

When thyroid level are high is drops to try & reduce them & rises if low to increase them. 

The FT4 free thyroxine is a thyroid hormone so is FT3 is Free triiodothyronine

A tiny quantity of FT3 comes from the thyroid but most is converted from T4. 

FT3 is the more powerful hormone. If you been taking carbimazole it alters the was the body can use iodine to produce hormone & therefore lowers production. 

This causes the levels the drop, as the the existing store get used up. So the carbimazole dose needs adjusting to keep you in the right level.  

TSH trails behind levels and is not reliable until fully stable & even then it can remain down regulated long term.

The FT4 & FT3 are a little over range but doctors might be focussing on TSH.  

How much carbimazole were you prescribed?

Was is since adjusted? 

Are doctors recommending RAI?  Are you happy with that plan?

[ShellBellc1979 in reply to PurpleNails]

HI thank you im currently prescribed 20 mg but the letter does say to double the dose.

Radio iodine was mentioned at the appointment but he said he would leave it with the professor to decide, but i don't feel this is the right option for me

[PurpleNails Administrator in reply to ShellBellc1979]

I highly doubt you need to double dose.It takes a bit of time for levels to catch-up.  If the FT4 & FT3 have been brought down they will continue to drop on current 20mg dose for up to 8 weeks.   (TSH may take even longer) 

3 weeks is too soon.

Doubling it will likely drive the FT4 & FT3 too low by this state.

Doctors are going by TSH.

Arrange another function test should be done around 6 weekly initially.  Privately if necessary.  

Professor might suggest RAI it’s the best option but the decision is yours.  

[ShellBellc1979 in reply to PurpleNails]

thank you so much i did think that seemed a bit drastic!

[SlowDragon Administrator]

You need vitamin D, folate, ferritin and B12 levels tested

What vitamin supplements are you currently taking

When were vitamin levels last tested

Have you had coeliac blood test done

Are you on or tried strictly gluten free diet

[ShellBellc1979 in reply to SlowDragon]

ive not had any tests for these i don't take any supplements & not tried gluten free diet

[SlowDragon Administrator in reply to ShellBellc1979]

request GP test vitamins or test privately

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning. Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

[Fruitandnutcase]

When I was first diagnosed with Graves Disease I spent four weeks on 20mg carbimazole and nothing has happened.

When the results came back I got a letter from my consultant who I wasn’t due to see for another couple of months telling me to double up to 40mg carbimazole a day. I took that for the next two months unfortunately with no further blood tests until the week before I saw my consultant by which time I was very hypo. It was all sorted out as soon as I started on block and replace treatment but it showed me that being hypo and being hyper are different and each is very unpleasant in its own way, however I do think that if you are hyper you are more likely to be taken seriously by doctors.

[ShellBellc1979 in reply to Fruitandnutcase]

thanks you it does seem pretty drastic to double the dose when my levels are not too high, i think ill speak to my doctor about this