Beta blockers fit an overactive thyroid

[Britpol]

I have been taking cardicor 1.25 mg for years to help with my overactive thyroid that flares up now and then. Having had the right lobe removed 6 years ago due to neck pressure, I am now facing a complete thyroidectomy because the left lobe had grown so big that it causes swallowing problems. I have been on carbimaxole 2.5mg ( very low dose) for 8 months and since then my Tsh went up from 0. 09 to 1, T4 from 17 to 20 ( range 14-22) and t3 has always been mid-range at 4.5 -4.7 and the reason why doctors did not want to prescribe Carbimazole. They are very surprised that I have responded well to this very low dose, with sweating and anxiety attacks much reduced and sleep somewhat improved. Although feeling better, I am not well, with aching joints, serious digestive problems and now dangerous spikes in blood pressure of over 200/110. The doctor increased cardicor to 2.5 mg and is thinking about adding some other blood pressure pill. I wonder if I should be on propranolol, another beta blocker, that works not only on slowing down the heart but also the thyroid? Any advice would be welcome.

I expect my symptoms will continue until they finally remove my sick thyroid I struggled with all my life (am 72). The surgeon wants me to take Lugol iodide for one week before surgery but I fear it will send my thyroid crazy, as I find iodine-rich foods really upset it. Again, I would be very grateful for any advice.

[PurpleNails Administrator]

You were subclinical hyper because your thyroid levels were not over range, but you likely have a source of over activity because your had TSH dropped. 

Many wait until FT4 & FT3 are over range before considering treatment and confirming the cause.  

Most doctors want to see a low TSH brought up into range so I’m surprised they delayed it. 

You have been on a low dose of carbimazole & your FT4 & FT3 have not become too low, so it has been the right treatment for you. 

I was given propranolol & it’s often a combo with carbimazole as it has a slightly anti thyroid action & will reduce T4:T3 conversion. I did find stopping it an issue, the specialist stopped a high dose abruptly which made we Ill with migraines.  

The GP put me back on them for migraine prevention & I slowly reduced but still on low dose now. Other stop without any issue. 

If your about to have your thyroid taken out, you might find you don’t need propranolol. See how you are after surgery.

Taking Lugol iodide the week before surgery will reduce vascularity of thyroid.  So bleeding is minimised.  Iodine can be unpredictable with thyroid it can prevent hyper in some & cause hyper in others.  

As your having the thyroid taken out I think the benefit of lugol outweighs the chance it’s starting to over producing, & even it it did start going crazy and producing too much hormone it will be very short lived as once the surgery is complete they’ll be no more hormones naturally produced. 

Have a complete blood test with nutrients - folate, ferritin, B12 & vitamin D before surgery. This is essential so you have a pre benchmark for post surgery.  

Optimal nutrients will help the replacement hormone you’ll need once the thyroid is out to work well. 

Your TSH has previously been low so doctors must go by your FT4 & FT3 levels to decide on replacement doses & adjustments not the TSH.  TSH is especially unreliable after previously being hyper. 

Hope all goes well.

[Britpol in reply to PurpleNails]

Thank you very much for your very informative reply. I seem to react so strongly to medication that any changes to the usual regime, such as taking Lugol liquid , worries me, but from what you have said itis worth trying. I thought propranolol was increasing T4 to T3 conversion. If I do get it prescribed, I shall take a small dose. Doctors know my response to medication is very strong. Anyway, thank you again, especially fir advising me to do test before doing the full bloods before surgery .