In bizarre and horrible twist to my recent hypothyroid diagnosis, my 40 year old daughter was diagnosed with hyperthyroidism last weekend after an emergency dash to a/e with pounding and rapid heart rate. After tests, she was sent home with propranolol. This helped a lot straight away but it was back to a/e the next day with an allergic reaction. Home again with carbimazole after Endo reviewed but didn’t come to see her. Meds tolerated ok so far but now heart rate speeding up. GP Pharmacy looking at any meds to help with that.
Any hyper people on here any advice please?
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Calceolaria
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Thanks Slow Dragon. She has just sent off the Advanced Test but was the finger-prick, damn. I sent her the link from here last week. So bizarre. Long story for her of six years fatigue and GP going down numerous pathways but thyroid only one TSH when symptoms first started. A nightmare six years! Only my diagnosis brought it back to the fore, so test was sent for even before the gallop to a/e.
She was tested on a/e assessment day ward (13 hours all told) and hyper was unequivocally given as diagnosis. All I know for sure is her T4 was then 27 and TSH was 0.001.
Such a worry. Thank you so much for help. I might just go mad yet!
Both Graves and Hashimoto's are thyroid auto immune diseases and can start off the same way, with high over range T3 and T4 levels and generally a low suppressed TSH reading.
In Graves Disease the T3 and T4 levels usually keep rising higher and higher and go way over range.
Graves is said to be life threatening if not treated and the treatment is an anti thyroid drug, like Carbimazole which blocks further own thyroid hormone production and slowly the T3 and T4 come back down into range, symptoms are relieved, and the AT drug titrated to keep the T3 and T4 in the range.
If the heart is involved a beta blocker such as Propranolol is also prescribed.
The NHS generally allocate around a 15-18 month window with this treatment option in the hope that the immune system calms down and the body resets itself.
In Hashimoto's the T3 and T4 levels do not rise so high, and are transient, and drop back down into range by themselves.
However with every immune system attack the thyroid becomes further damaged and thyroid hormone production becomes erratic and ultimately the patient needs the support of T4 - Levothyroxine as the gland is disabled and the patient becomes hypothyroid.
It is essential that the thyroid antibodies are run to distinguish between these 2 AI diseases and this maybe already be in the process of happening from the first blood sample taken.
We are looking for readings of TPO: TgAB: TSI; and or TR ab : do you have anything looking like this or wording such as thyroid receptor blocking - thyroid stimulating - thyroid peroxidase ?
Maybe your doctor can check to see if there has been a conformation from the hospital of the medical evidence and of which antibodies were found to be over range and positive.
Hi pennyannie. The hospital wouldn’t give her a printout of results ‘We can’t’. I’ve suggested she asks GP. Thanks for your help. She had a reaction to the propranolol so that’s out of the window!
Many end in the wording ' lol ' but am not qualified to know the subtle differences in the make up of these tablets so suggest you speak to your doctor -
It may be that the brand of propranolol contained a filler your daughter is intolerant or sensitive to, in which case another brand could be tried. If it is the actual drug itself, then there are alternatives. However, as pennyannie has said, we have no medically-based knowledge of these alternative medications, that will be for a GP/endo/cardiac consultant to decide. However, always check the PIL of any med or for both formulation and side-effects, although few people have many, if any of these side-effects, but the list is there to help if you do.
FT4 is high by most ranges, but not very unusual to see Graves level closer to 40.
TSH is suppressed but that can be caused by relatively mild elevations in FT4 & FT3. Which I what I had from a hyper nodule.
Full testing as detailed extremely important & the Graves associated antibodies.
How much carbimazole has she been given?
In severe cases doses reach 60mg spilt 2-3 times throughout day. If thyroid levels don’t appear as severely high lower doses can be tried first. But it’s still beneficial to split the dose.
I was given 20mg for 2 months then it was reduced to 10mg. Has she now stopped the propranolol, having had a reaction. It does helps with symptoms but not route cause. I was given high dose propranolol when initially diagnosed then told to stop after 2 month by specialist. I was quite Ill from being instructed to stop it abruptly, the GP resumed it. I managed to slowly reduce. I still take low dose as migraine prevention.
GPs say they can’t order a Trab or TSI antibody tests & has to be by specialist. Hope that this doesn’t take a long time to arrange
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