Carbimazole dose

[Someday_maybe]

Hi all,

Back again! As always, grateful for thoughts.

I've been on Carbimazole 10mg BD and Propanalol 40mg TDS for about 10 days now.

My heart rate before treatment was sitting around 130/140 with a peak of 167. Has been sitting 55-75 since starting Propanalol.

Bloods before treatment for free T4 was 39 (9-19) and then a few days into Carbimazole T4 had gone down to 30 (9-19) so still hyper but heading in the right direction.

The last 48hrs or so my heart rate has noticeably been up - I can feel it again and it's sitting 80-100 again. I'm hot again and feel hyper again.

I still don't have TRAb bloods back, waiting on Endocrinology appt and Thyroid Ultrasound and have Opthalmology appt tomorrow.

The Endocrinology Nurse is on leave this week.

Is it possible that the Carbimazole was working but now randomly isn't? Would it need a dose increase? I probably won't be able to get bloods done again until next week (although I will ask tomorrow but it's a different hospital, albeit same trust) so partly curious as to whether Carbimazole could stop being effective when it was, and then what the next steps/options might be.

[pennyannie]

Hello again ;

I would tend to think, at this point in time, your immune system is still in charge of your thyroid and responsible for this ramping up of symptoms and the logical first step is to increase the AT drug as you know it isn't as effective as it once was.

It's best to be comfortable and confident in your ability to function on a slightly higher dose at this point in time - and as your immune system calms down the AT drug will be adjusted back down again - all the AT drug does is ' buy you time ' and hopefully relieve the worst of the symptoms being tolerated - while we wait for your immune system to calm down.

You may be offered what is called Block & Replace -

whereby the AT drug dose is increased to fully block your own thyroid hormone production -

BUT a measured dose of T4 - Levothyroxine is also prescribed so your T3 and T4 do not fall too far through the ranges with you then suffering the equally disabling symptoms of hypothyroidism.

Hope tomorrow goes ok :