Carbimazole : Hi my daughter was diagnosed with... - Thyroid UK

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Carbimazole

AngelicUpstart profile image
11 Replies

Hi my daughter was diagnosed with graves, doctor put her on carbimazole.

She started taking carbimazole and after a few months I can hardly recognise her

Her eyes look unfocused and dull and her entire face seems to have sagged drastically.

She never longer resembles the happy girl with bright shining eyes.

She was recognisable prior to taking carbimazole.

They have scanned her thyroid and we are awaiting results.

Because carbimazole has made her feel so dreadful, she has now stopped taking it.

If scan shows a problem requiring surgery, after surgery could she feel better and not be dependent on thyroid replacement hormones as I've been taking levothyroxine for years and the first ten years were horrendous, brain dysfunction, starring eyes, weight gain and wouldn't wish that on my daughter.

Can surgery just remove part of her thyroid gland.

Also now she isn't taking carbimazole, before anyone mention the risks, she knows about the risks, but can anyone recommend alternative medicine for symptoms. Weight loss, palpitations, exhaustion.

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AngelicUpstart
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11 Replies
helvella profile image
helvellaAdministratorThyroid UK

That sounds appalling treatment.

Has the dose of carbimazole been reduced to ensure she has reasonable thyroid hormone levels? Or have they just prescribed it and left her to it?

Time and again we see people being treated with carbimazole who are allowed to become hypothyroid, and much, much worse, allowed to remain so.

Carbimazole dosing can be tapered down to "just enough".

Carbimazole dosing can be high enough to suppress her own thyroid but she then takes levothyroxine as sole source of thyroid hormones.

They can try to adjust carbimazole and levothyroxine to reach a good point.

Obviously, it is also technically possible to include liothyronine with levothyroxine in the above but unlikely to be easy to persuade them.

Partial thyroidectomy is, surgically, a possibility. But it needs much more consideration and I do not know sufficient.

AngelicUpstart profile image
AngelicUpstart in reply to helvella

She's on 20 mg, dose has never changed. Not sure if it's a high or low dose. She doesn't take levothyroxine, was thinking if she had surgery would she then have to take levothyroxine.

helvella profile image
helvellaAdministratorThyroid UK in reply to AngelicUpstart

People can need quite a range of carbimazole doses.

Quite often people start on a higher dose (20 to 40 milligrams) and then it gets reduced when the thyroid hormone level is in control. That might take a few weeks, even a few months. That point can arrive quite suddenly and many find themselves hypothyroid, at least for a short while.

Sometimes dose can can be reduced to as low as 5 milligrams. Just enough to prevent thyroid hormone levels rising.

It really sounds as if no-one was monitoring her. And the switch from hyperthyroid to hypothyroid was not noticed. And she has remained getting more and more hypothyroid.

She really MUST get tested as soon as practicable. FT4, FT3 and TSH.

I appreciate that she doesn't currently take levothyroxine. But taking both carbimazole AND levothyroxine is an option.

If the amount of carbimazole completely suppresses thyroid hormone production, it is called Block and Replace. For some people, it works really well.

She should NOT be rushed into surgery. People can be on carbimazole (with or without adding levothyroxine) for many months, even years.

It is likely that she would need to take levothyroxine if she had a thyroidectomy. But this can be discussed and considered over time.

pennyannie profile image
pennyannie

Helo again:

I did suggest an alternative AT drug to you last time you posted on the forum :

Maybe PTU - Propylthiouracil will suit her better ?

Do you have any current readings and ranges and her initial blod test results at diagnosis detailing some / hopefully all of the following :-

TSH - Free T3 and Free T4 - + thyroid antibodies - TPO - TgAB - readings and ranges or a TSI - TSH Thyroid Receptor reading with a single number <> :

I think I also sent you the most recent research - have you looked back and can see my previous reply ?

pennyannie profile image
pennyannie in reply to pennyannie

To find everything you have written and all your replies simply press the Profile icon - on this page it is top right right facing me on my laptop - if on a phone guess the opposite - and this takes you to all your posts on Healthunlocked :

AngelicUpstart profile image
AngelicUpstart in reply to pennyannie

PTU, ? Can you tell me more about it please, sorry I posted last time and life got turned up side down so wasn't aware of your reply.

I asked her to get results with ranges but they fobbed her off and just said folic was low, liver enzymes high but no treatment given for either issue.

GP calling tomorrow for review of thyroid scan so will no more then. Specialist diagnosed Graves a while back. But kept her on same dose carbimazole that GP set.

pennyannie profile image
pennyannie in reply to AngelicUpstart

Both Carbimazole and Propylthiouracil - PTU - are Anti Thyroid drugs - and patients get switched between the 2 for various health reasons - liver issues being a common issue.

All these AT drugs do - is buy the patient time - while we wait for the immune system to calm back down again - and quite why the immune system turned and started attacking the body - rather than defending the body - is the 64 million $ question.

There can be a genetic predisposition with a family member a generation away with a thyroid health issue or Graves can just occur ' out of the blue ' - with stress and anxiety tending to be common triggers for this poorly understood and badly treated Auto Immune disease.

It's a bit like being a plane put into a holding position in the air - while waiting for a landing slot - the plane circles above loosing fuel and height and then when it is safe and the runway is clear it makes a smooth landing.

Similarly the AT drug semi-blocks the thyroid hormones T3 and T4 rising higher and higher and slowly these over range T3 and T4 levels start to fall - and the AT drug is adjusted down as the thyroid levels fall back down - and the hope is that the thyroid will reset itself without the need for any drugs.

If with Graves - this is an Auto Immune disease for which there is no cure - and we need to make sure the correct antibody blood test has been run and there is a positive TSI or TSH Thyroid Receptor antibody reading - as there is more than 1 reason why the thyroid malfunctions - and only Graves should be treated with an Anti Thyroid drug.

The NHS generally allocates a treatment window with an AT drug of around 15-18 months and if remission isn't ' found ' - a more invasive treatment is suggested such as a thyroidectomy or RAI thyroid ablation - in which case the patient becomes primary hypothyroid and on thyroid hormone replacement for the rest of their life - and living without a thyroid - is not the walk in the park for many - as suggested it is - by mainstream medical.

Most recent research -

pubmed.ncbi.nlm.nih.gov/338...

ncbi.nlm.nih.gov/pubmed/306...

All things Graves Disease - books and website - elaine-moore.com

SlowDragon profile image
SlowDragonAdministrator

She needs FULL thyroid, including all thyroid antibodies, and vitamin D, folate, ferritin and B12 tested

Has she definitely had Graves’ disease confirmed by testing TSI or Trab antibodies

Autoimmune HYPOthyroid disease, also called Hashimoto’s, frequently starts with transient hyperthyroid results and symptoms before becoming increasingly hypothyroid

Bloods should be retested 6 weeks after each dose change in Carbimazole

For full Thyroid evaluation she needs TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once for Hashimoto’s

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease - Graves or Hashimoto’s

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Link about Graves’ disease

thyroiduk.org/hyperthyroid-...

Graves Disease antibodies test

medichecks.com/products/tsh...

Please add most recent results and ranges

AngelicUpstart profile image
AngelicUpstart in reply to SlowDragon

They've done bloods, also specialist did bloods and diagnosis was graves.

They tested all blood, folic was low, liver enzymes high, everything else no mention off so I'm guessing there in range somewhere??.

SlowDragon profile image
SlowDragonAdministrator in reply to AngelicUpstart

She’s legally entitled to printed copies of actual results and ranges

See EXACTLY what has been tested

Bloods retested regularly

Test early morning

helvella profile image
helvellaAdministratorThyroid UK in reply to AngelicUpstart

To emphasise what SlowDragon has said, ask for prints of results.

It is far too easy to make mistakes doing it any other way. And you might need to ask the hospital for their results separately.

I have not ever done this, but do you have access to the NHS app for your daughter? If so, at least some results might appear there.

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