New hyperthyroid diagnosis, no treatment as yet.

[Embems1]

Hello kind people- thank you for reading. So I started the new year with a phonecall from my doctor informing me that indeed I wasn't peri-menopausal, but was infact suffering from hyperthyroidism instead. I'm guessing this was likely to have begun after giving birth to my last child in 2021 at the age of 43.

My blood test results are as follows:

• TSH <0.01 (0.27 - 4.20)

• FT4 25 (11 - 22)

• FT3 10.7 (3.1 - 6.8)

• TrAB 5.22 (no range)

Consultations so far:

• ENT nasal scope-larynx and oesophagus opening normal

• Ultrasound of thyroid-thyroiditis with moderate inflammation and reactive areas

• Endocrinology next month

Does this look like Graves to you? Are there other tests I should be having? And what's your opinion on starting the Carbimazole that has been sat awaiting my collection for over a week now?

I'm crushed by the news but also feel fortunate to be at the beginning of my journey, as yet unaffected by treatment or medication, and to have this forum to help inform my decisions. Thanks so much.

[PurpleNails Administrator]

welcome to forum

Trab is high by most ranges. I’d be suprised if in range. This confirms Graves’ disease & I recommend you begin carbimazole. FT4 & FT3 Levels are pretty high.

How much carbimazole is suggested?

Endocrinology will expect carbimazole to have brought levels down on subsequent tests. Please tell me GP or clinic have arranged follow up.

It’s unsafe to leave levels high waiting for an appointment or begin treatment without regularly reviewing & adjusting medication.

[Embems1 in reply to PurpleNails]

Thank you PurpleNails for responding so quickly.

Carbimazole prescription is for 5mg taken three times daily. Endocrinology appt 15th Feb and bloods arranged for 5th March. Nothing else in the diary as yet.

I do feel my care so far has been prompt but I worry that the treatment differs according to which type of hyperthyroidism I have...no-one has spoken to me about Graves disease but I agree that my results point in that direction.

Perhaps I'm still in denial about my diagnosis and so therefore worried about starting medication 🤷‍♀️ but my breathlessness and tachycardia seem to be a constant presence these days. I should probably get on with the Carbimazole I guess!

[PurpleNails Administrator in reply to Embems1]

I think that’s an appropriate starting dose. Too high will lower levels too quickly, too low won’t have sufficient impact. By March will be the right time to review & adjust dose. Might be able to reduce by 5mg or a dose at a time.

If symptoms are severe, I was also given propranolol along side carbimazole. This can help relieve symptoms (especially palpitations) until the levels come into range. This may not be suitable if you have asthma. I remain on it for migraine prevention which was worsened when high dose propranolol was stopped abruptly by endo. Should alway be reduced gradually.

Have nutrients been tested? These can become low with Graves’. Folate, ferritin, B12 & vitamin D? Testing for gluten also good idea. You need to be on gluten diet leading up to test. Allergy will show if positive but intolerance won’t be detected. So if negative, still trialing a strictly gluten free recommended.

There are private options if dr refuses.

Order a kit online and sample can be taken by fingerprick test, (extra fee for clinic visit / home visit venous draw) sample posted back & results available online often very quickly.

Sample recommended to be taken at 09.00 fast overnight, avoid biotin 3 days before test. Carbimazole can be taken as normal (those on replacement need to delay until after draw)

See link for private companies with discounts with many packages & options.

thyroiduk.org/testing/priva...

Medichecks thyroid advanced is as good option.

[Embems1 in reply to PurpleNails]

Glad to hear dosage sounds good to you! You've been so helpful-definately feeling more positive about starting carbimazole. Still nervous about possible side-effects but will hopefully be easier than dealing with my present issues.

Also pleased to hear I can take propanalol alongside carb, although it's barely touched my symptoms...perhaps I need a higher dose or a different beta-blocker? My GP said I should only take the propanalol when I'm feeling symptomatic, and also that both shouldn't be taken at the same time 🤷‍♀️? I'm more inclined to go with your wise words I have to say!

I shall certainly request that my nutrients are tested and look into gluten intolerance/allergy also.

Thanks PurpleNails, very grateful!