Overactive thyroid

[Starl-]

I am taking carbimazole for an overactive thyroid . 5mg . . I have gained around 6 lbs and i am finding it very difficult to lose the weight . Is it possible to lose weight as i am taking care to eat healthily . My doctor says pills are working but i dont know if i can come of the pills any time soon .

[Lalatoot]

Starl please tell us more about your condition so we can offer helpful advice How was your hyperthyroidism diagnosed? Have you blood test results you can share with us?

The reason we ask is that hypothyroidism and hyperthyroidism can both present in the same way in the initial stages. It is not uncommon for doctors to miss this.

Don't be alarmed by that statement as there there is help on here if you can give more information.

[Starl- in reply to Lalatoot]

I am 75 and was diagnosed with an overactive thyroid about a year ago ( unknown to me this was actually diagnosed away back in 2014 but i was never seen by a doctor about it ) . Due to another medical problem i was again diagnosed for the same problem and only started carbimazole 5mg in may of this year . My doctor has said pills are working but my main concern is i am gaining weight although i am eating healthily . Weight gain is minimal at the moment but i dont want to gain any more . Any ideas please

[Lalatoot in reply to Starl-]

Yes if you are actually hypo instead of hyper then your ft4 and ft3 will actually be too low in range for you. Hypos tend to weight gain.You really need to find out what the doctor tested and what the results were.

[PurpleNails Administrator]

What it the cause cause of your hyper? 

5mg is very low dose.  Where you started on higher dose? How long have you been taking it? 

Often when doctors say !hyper! it’s because the TSH is low - this throws them into a panic.

The TSH -thyroid stimulating hormone - is a pituitary hormone which signal thyroid to produce, doctors assume if low, it’s because your thyroid levels high.

TSH is very unreliable what are your FT4 & FT3 levels?[free thyroxine & triiodothyronine]

Find out what been tested & add results & range (ranges vary between labs, so must always have)

Carbimazole stops \ reduces production of new thyroid hormone.    

Stop / reduce it too much or levels naturally lower - your hormones stores get used up and your levels become low [hypothyroid].

But the TSH can takes a long time to respond, sometimes it stays low for a long time (or in my case permanently stays low) & being hypothyroid can make it difficult to lose weight.

Doctors say its because we have becomes accustomed to larger appetites while hyper, and that can happen too, but often it because of levels being too low.

Carbimazole itself doesn’t cause the weight gain, it’s the affect on thyroid hormones.  

I’ve been on carbimazole 4 years, & have lost weight.  I found it possible to lose weight when thyroid levels were better in range.  Although I gained weight when I had hyper, my levels were elevated & undiagnosed many years.  

[Starl- in reply to PurpleNails]

I dont know why dosage is so low , i do know my thyroid problem is mild . Maybe the low dosage . I dont really get an awful lot of info i just get blood tests every so often . I have an appointment at the hospital in a few weeks time so may get more insight . My only problem is weight gain .

[pennyannie in reply to Starl-]

Hello Stari and welcome to the forum :

Can you please ask your doctor what antibodies were found over range and positive and do you a copy of the TSH, T3 and T4 readings at diagnosis this time around ?

There are generally 2 main auto immune disease that cause an overactive thyroid and start off the same way but not both are treated the same way.

Graves is persistent high and over range T3 and T4 readings that continue to push the T3 and T4 readings higher and higher which is life threatening if not medicated with an anti thyroid drug like Carbimazole.

Hashimoto's however is transient hyper / hypo symptoms that can continue for a number years until the patient becomes sufficient hypothyroid to require thyroid hormone replacement in the form of T4 - Levothyroxine.

Initially the only way to tell these 2 AI diseases apart is to find out which antibodies have caused the hyperthyroidism.

[PurpleNails Administrator in reply to Starl-]

Having very high thyroid levels rarely goes unnoticed, people often become unwell, very quickly.  eg Graves autoimmune causing continuous hyper. 

If your thyroid fluctuations then slight rises occurs & then drops. This can mean you have low levels but the TSH isn’t reliable. eg autoimmune thyroiditis (known as Hashimoto’s) initially you can have high levels but then it drops to low function.   

Or you could have a over functioning nodule/s which causes the TSH to drop but the levels may not be over range.  This can go unnoticed as symptoms can build very gradually.  This is what I have my levels were elevated for many years. 

The fact you are now controlled on such a small dose makes me suspicious that  doctors are focusing on TSH not FT4 & FT3.  

Doctors never explain results or volunteer to share result with you. This saves them time as they don’t spend extra time explaining your condition & why a suggested treatment is given.  This might lead to you asking further questions & even challenging the treatment.  They prefer you don’t question - just comply.    Most of us do - until trusting doctor leaves us unwell. 

 You can legally view all your results.  Recommend you obtain them.  Ask reception for a printed copy.  [With lab ranges].  NOT verbal or handwritten or typed by email (they won’t include ranges & too high chance of error) 

Setting up online access to digital record is best method and includes notes, letters & referrals, but in meantime - Request copies.  

Sometimes staff want to confirm you can view results + but once they’ve been read & filed there no reason to obstruct.  Before I had online access I would telephone reception in advance, ask for results -a time period or date helps- & then say I collect in 2 working days.  This gives then time to print.

Doctors tend to be keen to recommend RAI.  I see in your profile, doctors have suggested it. It’s a very easily administered & efficient treatment and allows specialists to send you back to GP to manage the resulting hypOthyroidism with T4 replacement.  - But not everyone feels well treated after treatment.  

If doctors aren’t explaining what & why is going on - I would be concerned doctors are automatically following the easiest path - without really considering what best for you.  Doctors limit carbimazole but many stay on it long term.

You’ll have to research your options and be sure you do what’s right for you in your time.   

We can explain more once you post test results.