Hi all I’m writing for help with a family member she was diagnosed with ‘graves’ disease around 2020! She is currently been told by endo to take 5mgs Carbimazole every other day. Her symptoms include losing hair again! Fatigue tiredness no energy and sleeping in the afternoon and then all night! Also she’s started itching again? Cold! Weight gain! (Bless her) she has no social life at the moment 😔
Her lastest blood test results are as follows: Nov 24
TSH 0.72 (0.27-4.2)
T4 15.3 (12-22)
T3 4.7 (3.1-6.8 pmol)
I believe she is becoming Hypothyroid or is this a hyper swing?
many thanks.
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Doris11
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Hyper swings are something that people with Hashi's experience. It doesn't happen with Graves'. And those blood test results are suggesting hyper at all.
How was this person diagnosed? Were antibodies tested? If so, which ones?
Her Frees are a little on the low side, which is why the endo has reduced her dose.
Hi greygoose unfortunately she can’t get her full results back only to 2020! Yes she was diagnosed with Graves by an Endo! So fours years on from diagnoses! Can people become Hypothyroid? Many thanks
Yes, many Graves patients become hypo after treatment with Carbimazole. It may be permanent or temporary. Because your relation is now registering a reasonable TSH level she could stop Carbimazole and check for remission. If blood tests show her fT3 below half way in range she would probably benefit from taking Levothyroxine
Thank you I wrote it down for her ( I think she’s becoming hypo) to tell the endo and he completely ignored her and said he will see her in 6 months 🤔🤔😔 so she now has to suffer with awful symptoms 😔.
fT4 is 33% through range and fT3 43% so levels not too bad. I would tell Endo/GP that because of the hypo symptoms I was stopping Carbimazole to check for remission and request a blood test in 6 weeks. Stopping Carbimazole might be sufficient to stop the hypo symptoms without needing to start on Levothyroxine. If she relapses Block and Replace would be the next step. Sometimes to feel well we need to make decisions for ourselves.
It might also be more beneficial and natural to chop the Anti Thyroid tablet in half and take 2.50 mcg daily as this will allow a little more T3 and T4 thyroid hormones into the blood stream every daily thereby - raising T3 and T4 a little more, and a step nearer coming off the medication.
As already detailed it is Hashimoto's that generally presents with swings in symptoms - but Hashimoto's is not treated with an AT drug as the thyroid hormones fall back down into range by themselves and the patient ultimately becomes hypothyroid - and needs thyroid hormone replacement - T4 Levothyroxine.
Hashimoto's antibodies would look like TPO or TgAB - with numbers and ranges alongside -
Graves antibodies are usually written as a TRab - a Thyroid Receptor Blocking - or a TSI - a Thyroid Stimulating Immunoglobulin or as a TSH Thyroid Receptor reading with a single number reading and a cut off number:
With Graves the T3 and T4 tend to just build higher and higher and why an AT drug is needed to block the thyroid hormone production and Graves is considered life threatening if not medicated and takes precedence over Hashimoto's in any treatment regime.
When the thyroid is under attack from the immune system there can be an overlap in symptoms and antibodies - and it is most important that the correct antibodies have been run as they represent the medical evidence and proof of diagnosis before a drug is prescribed.
We do now have some research that is of interest :-
When metabolism is running too fast as when hyperthyroid or too slow as when hypothyroid the body struggles to extract key nutrients from food no matter how well and clean one may eat - and non optimal levels of the core strength vitamins and minerals - ferritin, folate, B12 and vitamin D can compound ill health further than necessary.
Please ask that these essential body building blocks are measured and we can advise where best these need to be maintained during this phase of thyroid malfunction.
Graves is a poorly understood and badly treated Auto Immune disease with stress and anxiety seen as common triggers :
If wanting to read around and if in some doubt as to Graves or Hashimoto's -
Just seen I replied in some depth 7 months ago and you were planning to come back with the necessary facts as to antobidies etc.
You can find all your previous posts and replies by just pressing Profile on this page - on my laptop it is top right on this screen alongside My Hub-Chat-Post- Alerts and Menu icons.
Ok - they should have been run on the first set of blood tests results - 4 years ago -
maybe if we had details of the initial blood test results - TSH + T3 and T4 readings and ranges we could try and rule Hashimoto's out ?
I'm sure they have been run - and on her medical records held at her surgery - is she registered for online access - as then it's just a question of scrolling back through to the beginning of this period of ill health ?
We are all now legally entitled to copies of all our medical records - so she's not asking for anything out of the ordinary - with most surgeries now ' up to speed ' and able to offer this service.
She just needs to ask at her surgery for them to arrange for her to have computer access to her medical records -
the receptionist will give her a piece of paper to fill in -
name etc and she'll likely need some proof of ID -
and then she will be put on the NHS website automatically -
I don't understand apps - but I think I remember being given a letter back which included a code to enter and I can now access my NHS records through my laptop.
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