I've had 4 episodes of graves disease in 13 years. Each time I'm treated with 40mg carbimazole per day for 6 months. Each time I go into remission for a 3-4 years. With my last/current episodes of graves I was also tested for antibody levels. After 6 months on the block & replace treatment my hormone levels had returned to normal, but my antibody levels were still high.
My endocrinologist seems to think that if I stay on the 40mg carbimazole for another few months my antibody levels might decrease towards normal levels, and that this would increase my chances of staying in remission.
Does anyone know if this is the new approach to treating graves disease, or is my endocrinologist using me to test her own theory?
I'm wondering if it's worth continuing with block & replace on a high dose of carbimazole for longer than 6 months, if I go into remission anyway after 6 months.
40mg Carbimazole is a blocking level. As it’s preventing any hormone being (over) produced you need the replacement how much replacement do you take?
What are TSH, FT4 & FT3? Usually b&r is used when getting stable control or balancing FT4 / FT3 is difficult.
but it’s been used each time & for only 6 months. 6 months is too short.
b&r masks what naturally going on with your levels and the stop / start might not be helping.
Resuming carbimazole creates higher risk or reactions / side affects.
Longer term low dose carbimazole give better outcomes & chance of remission.
What are TSI & or TRab levels?
Types of treatment regimen
Most use “tritiation” (adjusting carbimazole, to keep levels in range)
“b&r” To stop & levo to restore
“Add Back” a mix of carbimazole & levo. Which seems to have a stabilising affect without high dose carbimazole.