new here as just recently diagnosed with an overactive thyroid but have a few questions if anyone would be kind enough to help please? My T4 level reading is 20 pmol/L and my T3 reading is 11.4 pmol/L.
Firstly, are these readings at the lower end of the scale for hyperthyroidism and if so can it be managed without medication?
I have just this very day been prescribed 10mg Carbimazole which I am due to take one a day of for the foreseeable future. I do not want to take any medication unless absolutely necessary.
If I refuse medication am I putting myself in danger?
Many thanks in advance
Luke
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lukaduka123
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It can be very important to know the cause of your hyperthyroidism.
For example, is it Graves? In which case you should have at least TSH receptor antibodies tested. (Possibly Thyroid Stimulating Immunoglobulin.) Or do you have a toxic multinodular goitre making thyroid hormone without the stimulation of TSH? Or could it be a transient period within Hashimoto's (sometimes called a 'swing') - though your lab results are rather higher than is usually seen.
Also, have you have any other tests?Any imaging like ultrasound? Or maybe you are taking some medicines, or even supplements?
If the results are as they appear, and continue rising, you are likely putting yourself in danger by not accepting treatment.
“Firstly, are these readings at the lower end of the scale for hyperthyroidism and if so can it be managed without medication?”
Well it depends of the scale because lab ranges vary. By most ranges we see it looks like your FT4 is borderline high & FT3 is quite high.
10mg isn’t a high starting dose, but have you had any investigation into what is causing hyper levels?
Any repeat test to see if levels change? Any other tests.
Have thyroid antibodies been tested? TPO, TG antibodies if continuous hyper graves is suspected TSI or TRab must be tested to confirm.
Important to test folate, ferritin, B12 & vitamin D.
I imagine your high FT3 is causing symtoms? but hyper can be transient and if levels are naturally dropping adding an antithyroid which temporarily pauses production of new hormone will hasten drop. Especially if you remaining on it for foreseeable future. Levels should always be tested after 6 weeks. We see GPs assuming hyper and because wait lists with endocrinology are so long a low dose is given.
What symptoms took you to the doctor and do you have any other health issues ?
If there is no obvious sign of a swelling in your neck area and no issues with your swallowing or breathing - there are 2 Auto Immune diseases that tend to attack the thyroid and or eyes - causing over range T3 and T4 readings - Graves and Hashimito's - and with similar symptoms the only way to tell these apart is by which antibodies were found positive in your original blood test.
If you have online access to your NHS medical records held at or GP surgery please look and advise and share if you can see :-
a TSH result / range + a range for your T3 result of 11.40 + a range for your T4 result of 20 and then is there any mention of TPO / TgAB / TSI / TRab results and ranges or written maybe a TSH Thyroid Receptor result - and a single number result / cut off number .
Graves Disease is said to be life threatening if not medicated as the T3 and T4 keep rising higher and higher - it is treated with an Anti Thyroid drug such as Carbimazole which semi-blocks your new daily, own thyroid hormone production and slowly your over range T3 and T4 should fall back down into range and your symptoms alleviated -
Hashimoto's is not treated with any medication in the short term as the hyper type swing in T3/T4 thyroid hormones and symptoms are transient as the immune system attacks are not continuous.
Both the above are caused by your immune system having been triggered to turn and attack your body - rather than defend it -and quite why this has happened now is the next question -
but first we need to know exactly what was the medical evidence at diagnosis and see a complete set of results and ranges from this initial blood test in order to help you better understand what is going on.
Ok - so I spy with my little eye - TSH 0.05 - range ( 0.40-5.00 ) - low/suppressed :
T3 @ 11.40 range ( 2.40- 6.00 ) almost double and over the top of the range at around 191% + with a T4 @ 20 range ( 9.00-19.00 ) at just 10% over the range - please confirm details correct as these results are not clear on my laptop,
Generally we see T4 higher in the range than the T3 - so your results are inverted - and shows your thyroid struggling to cope and I would imagine you feel quite uncomfortable -
What symptoms are you dealing with - this looks like Graves Disease in which case an Anti Thyroid drug such as Carbimazole is prescribed to ease this internal pressure you are dealing with - if your heart is involved and feeling this pressure build you may well be prescribed a beta blocker as well as AT drug - to make you feel more comfortable until your high over range starts falling back down into range -
but without the medical evidence of the antibodies found in your blood stream at diagnosis - I am guessing the cause of this phase of ill health.
Are your eyes ok - or a bit dry, feeling gritty, light sensitive, or steaming with tears -
Can you please share information as to the symptoms being tolerated - you age, sex etc there is nothing on your Profile - to help us understand your situation more clearly.
Are there any thyroid antibodies on page 2 of these blood tests as detailed previously ?
Yes you have read the results correctly. I am currently feeling very comfortable. My symptoms seem to be that I am slightly more irritable and have a loss of libido, also feel hotter quite easily.
I don't experience any of the eye symptoms you mention but I do have the odd day where I feel my eyesight is only very slightly weaker than normal but this is very minimal.
I don't believe I have been tested for Pernicious Anaemia. Do you have any recommendations for B12 and folate replenishing as per supplements please? I ask this as some supplements are better than others.
Before supplementing anything we need to rule out any underlying causes -
such as Pernicious anemia and celiac disease - which your doctor can test you for -
We also need optimal levels of vitamin D - I couldn't see any result / range for this -
though I saw a ferrritin level at nearly the top of the range - but this could be part -driven by inflammation - though couldn't see an inflammation ( CRP ) reading there.
I'm sorry - I am not a doctor and really do think you need a face to face appointment with your doctor for an explanation - as these blood tests limited -
I understand the hospital are under pressure and O/P appointments backed up and with very long waits before you get to see an endocrinologist -
Please - you need take the AT drug - as all it does is' buy you time ' - while we wait for more information as to what is going on.-
Maybe take someone with you for support - as you are clearly not well at this point in time - -
You say I'm clearly not well but I do feel fine. I'll just take the carbimazole and go for the ultrasound appointment and wait to see the endocrinologist. My brother has also got the same condition so I'm assuming I have got as it's genetic. Thank you for your reply.
The condition I assume that is genetic is hyperthyroidism as I've heard this is usually the case and as my brother has it is a fair assumption . Apologies pennyannie if the information I have given is limited but I have passed on all the information I have. I have only just found out about this and haven't had time to discuss it with my brother. What I am wanting to know from the patient to patient forum I thought would be glaringly obvious and that is the help and experience from others who have a similar condition.
Through my own experiences I will be happy to contribute to the forum in the future to aid people like myself who are very new to this condition and are seeking help/info.
It is all so new to me that I'm unaware and uneducated in the different forms of the conditions related to the thyroid gland so excuse my lack of knowledge. To that end is the reason I'm here to find out from people like yourself who can share their stories or shed light on different issues regarding symptoms, etc. When I have more info I will share it and see if it is relatable to anyone who can pass on any knowledge through their own experiences. I guess I'm seeking help from people who have actually have similar symptoms and how they have managed it as these are the people who really know, a doctor can only speak from 2nd hand experience unless they themselves have had the condition.
So is your condition now preferable to what it was?
I can only assume that I have been diagnosed with an overactive thyroid, I believe this is what my doctor suspects. As mentioned previously I am due a ultrasound scan and an appointment with an endocrinologist but until then my blood test results are the only info I have.
One of the problems with thyroid is that a lot of people who have thyroid issues have had them for a long time, at least mildly - and they can very much feel well. It is their normal.
This might be especially true of those who are slightly hyperthyroid.
Heredity is difficult. Few have thyroid disorders where they can see a close relative with one and predict some other relative will also get that. Though with identical twins, it might be much more predictable.
There is what appears a hereditary component for many. Having close relatives with thyroid issues certainly should act as a warning.
Sometimes it looks like thyroid issues skip a generation.
Sometimes it looks as though a thyroid issue inverts - a hyperthyroid parent having a hyperthyroid child or vice versa.
Sometimes it looks like a thyroid issue in a more distant relative - even one with absolutely no direct genetic contribution - has leapt across. (Which could result from generation skipping and looking further back.)
Sometimes, and this is likely very common, a thyroid issue will only occur if the person's environment combines with their genetic inheritance. That would include things like infectious diseases and potentially dietary issues.
Many thanks for your replies. I have only seen my GP and have been prescribed the medicine off the back of my blood test results, sorry I don't have any more info. Am due to have an ultrasound appointment and see an endocrinologist which will give me more info on my condition.
Have attached my blood test results if that helps.
If you do decide to accept Carbimazole, you might find it worth reading my blog:
helvella - Splitting Carbimazole Doses
A short discussion about Carbimazole primarily focussed on splitting doses but containing other information which may be helpful to anyone taking, or considering, Carbimazole.
I have read this and it makes sense to split dose as per your results. Can you advise me on the best way to split a pill that doesn't have a score line please?
Sorry - I have personally have been able to largely get by breaking tablets and have been lucky enough to mostly avoid splitting. I've used a tablet splitter in the past.
Hopefully someone might have experience of a splitter they've used on Carbimazole - though even then, the different makes might split differently.
I am due to see an endocrinologist but don't know when as yet and thanks for your advice. It is always interesting to ask what other peoples experiences are because that could lead you somewhere helpful. It is my opinion that the doctors advice isn't always the best so different opinions matter to me.
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