Alternate days or cut pill in half? : Hello guys... - Thyroid UK

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Alternate days or cut pill in half?

Jman86 profile image
16 Replies

Hello guys,

I just got my blood results back and now my tsh is slightly high, so my doctor told me to take 5mg carbimazole on alternate days. I've been told that is better to have a lower dose daily instead of alternate days... So what are your thoughts? should I cut the pills and have it daily or a full on alternate days? or it doesn't really matter/

Cheers

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Jman86
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16 Replies
PurpleNails profile image
PurpleNailsAdministrator

I wouldn’t think it matters wether you split or take every 2 day.  

The longer the gap the longer the thyroid had to start producing hormone - but at this very low dose fine tuning stage the impact is going to be very slight. 

If you were early on in treatment at higher doses my advise would be different.  

I currently take 10mg / 5mg alternate days & it’s working for me. 

Do you have a good memory? If you liable to get muddled and forget if today is a pill day or skip day you might want to stick with a half daily dose.  

I use a pill organiser or I would make mistakes.

If your TSH is high what is your FT4 & FT3 doing? Adjusting carbimazole dose by TSH is a no no. The TSH isn’t a reliable marker. 

Jman86 profile image
Jman86 in reply to PurpleNails

Thank you, but when you say "If you were early on in treatment at higher doses my advise would be different", I was also wondering about that, Since I was diagnosed hyper and now it has been only 5 months...So I'm glad I was able to manage it quickly but I also saw that staying on carbimazole on low dose long term is more beneficial, I'm also thinking long term which way would be more beneficial in my case.

PurpleNails profile image
PurpleNailsAdministrator in reply to Jman86

Early on taking a dose every other day wouldn’t be a good approach.  As levels are high -  Often taking 2 or 3 doses a day is beneficial as the length of time the thyroid can start making hormone is minimised. 

When starting treatment the dose tends to be much higher, but now your levels are likely low & TSH rising it’s appropriate to reduce.  

So it’s more about the thyroid levels and dose then how long since you stated the medication. 

Sorry I didn’t explain that very clearly. 

Jman86 profile image
Jman86 in reply to PurpleNails

Ok thank you again, but like you said it before about memory, I think I will cut it in half as might be easier to track, thank you 🙂

pennyannie profile image
pennyannie

Hello again ;

How are you feeling - are your symptoms resolved and glad that your immune system is calming down again and your dose of the AT medication being titrated accordingly.

i think it's easier to take a little every day - and would buy a pill cutter and chop the AT drug into two :

Did you get a copy of your actual TSH, T3 and T4 readings ?

It might also be wise to ask for your ferritin, folate, B12 and vitamin D readings as these can tend to nosedive when metabolism isn't sitting quite right for the individual and compromise your health issues further.

Jman86 profile image
Jman86 in reply to pennyannie

Hi Penny,This is my last result, on my previous post I made a chart with all my progress, are you able to see it?

In regards to symptoms I'm feeling good, a little more tired than before tho, but nothing major. In regards to vitamins I also included in the previous post. Whats your opinion on my progress?

Black and white
pennyannie profile image
pennyannie in reply to Jman86

Hey there :

Do you have the ranges for the T3 and T4 results ?

As  PurpleNails mentioned above -

it's now about maintaining your T3 and T4 at a level that gives you back your wellness -

So as you say you feel ' pretty good ' suggest we need to maintain your T3 and T4 at around these levels and no lower - which hopefully this small dose titration of the blocking - AT drug will do :

I aim for a ferritin of around 100: folate around 20 : active B12 75++ ( serum B12 500++ ) and vitamin D around 100 :

Looking back your ferritin is very high - this can also be because of inflammation -

and typical when the body is upset - do you have a CRP ( inflammation ) reading ?

Jman86 profile image
Jman86 in reply to pennyannie

Ranges:

T4- 12-22T3- 4-6.8

I didnt get a crp reading...

pennyannie profile image
pennyannie in reply to Jman86

Ok so your T4 is now at the bottom of the range -

so we do not want the T4 going any lower -

Your T3 is holding on at 5 but at risk of dropping and it is too low a T3 for you that gives you the equally disabling symptoms of hypothyroidism -

If your T4 and therefore your T3 fall further down the ranges there could be the option of Block and Replace - whereby we keep the block but add back in a dose of T4 - Levothyroxine - to try and maintain your T4 and T3 levels where you feel well.

I think it's generally offered when the dose of the AT drug is much higher and there is full suppression of the thyroid but maybe worth a thought.

Jman86 profile image
Jman86 in reply to pennyannie

Thank you,

But I need to admit it, this is so annoying cutting and adding medicines 😥 The dr asked for another test in a month so I guess I have to wait and see... But I was so hopeful that I was almost there 😥

pennyannie profile image
pennyannie in reply to Jman86

Well the issue is one of your immune system having been triggered to attack your body rather than defend it -

and it takes as long as it takes for one's immune system to calm down - as detailed in the link I believe I've already sent you regarding the longer the patient stays on the AT drug the better the long term option for the patient.

Generally once diagnosed Graves I'm not sure the antibodies are ever tracked or read again and likely why mainstream medical seem to ' fail ' finding remission, when stopping the AT drug too soon.

There again Graves is an auto immune disease, said to be stress and anxiety driven, but and only picked up medically, when the eyes and thyroid become the victims to its attacks on the body.

From memory your Graves antibody reading was only just over range so I hope we can take this to mean - it is not a serious case - and all I think I can say is to try and carry on doing what you are doing especially since your symptoms are pretty good and plat for time, as there is no ' quick fix ' and no cure.

If I haven't previously set you a couple of research papers etc - please let me know :

Jman86 profile image
Jman86 in reply to pennyannie

Yes I read as much as I could find about graves, thyroid etc, this web site helped me a lot and thank to you guys 🙂 I did an 360 degrees diet change, I left my old job, a d I started drinking cordyceps and a couple other natural extracts that helped other people, so I can say this illness actually was a blessing for opening my eyes and taking my mental and physical health more serious. In regards to my antibodies it was 6.69 with a range of <1.79 I believe So I guess that is quite high 🤔 and my other question would be how often should one test the antibodies?

pennyannie profile image
pennyannie in reply to Jman86

Oh, I'm sorry I thought I saw a much lower number of Graves antibodies - apologies.

Yes, you have made big changes in your life which seem to have stood you in good stead :

I'll pop out from here and read your previous posts - which I thought I had done first thing this morning !!

pennyannie profile image
pennyannie in reply to Jman86

Yes, apologies - I saw your blood test and for some reason highlighting the Graves antibody reading in Red didn't register and made my eyes just move on and miss the actual result and my brain registered your result as just above the range.!!

BallyHi10 profile image
BallyHi10

I'm on 5mg three times a week, but actually I have a pill cutter and take 2.5 mg every day except Saturday 😁 But honestly, I didn't notice that I felt any different when I was taking 5 mg on Tuesday, Thursday and Sunday to now. I think on a low dose like this it doesn't matter.

Fruityflapjack profile image
Fruityflapjack

Hi, I've been on a gradually decreasing dose of carbimazole since 2019 currently taking 1.25mg per day - Endos are quite happy for me to continue like this. Have to put my glasses on to cut the tablets into quarters, but I just like to know I'm taking my meds on a daily basis - what can I say, once a control freak, always a control freak 🤣

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