Should I start Carb or wait a bit longer to see if hyperthyroid resolves?

[Munro282282]

I’ve been prescribed 10mg Carbimazole. I’m hesitating to take it since symptoms seem mild and TRab and TPO are improving (though only 2 tests). Any help appreciated😊.

1. Mild palpitations (week 1) triggered GP blood test. This and subsequent tests showed the following: consistently low TSH, high FT3, high / upper range FT4. TRab and TPO positive.

Date: 13 Feb | 21 Feb | 14 Mar

FT3: 13.1 | 11.7 | 13.7

FT4: (21.8) | 25.6 | (21.8)

TRAb: | 5.6 | 4.9

TPO: | 200 | 177

2. Symptoms mild and limited to: fine tremor, HR elevated by 5-10 bpm, slight leg stiffness. Stiffness and tremor now virtually gone (week 8). Slight pvc but have resisted taking Propranolol .

3. Diagnosed as GD by respected private consultant and by specialist at Chelsea & Westminster Hospital Endo

4. I am 69 year old male. Very fit. No family thyroid issues.

Any help appreciated. Thank you.

[SlowDragon Administrator]

suggest you get vitamin D, folate, ferritin and B12 levels tested

What vitamin supplements are you taking…..if any?

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

Ferritin, B12 and folate

10% off code here

thyroiduk.org/testing/priva...

monitormyhealth.org.uk/anae...

Has GP tested cholesterol levels

[Munro282282 in reply to SlowDragon]

Thank you SlowDragon. I forgot to say all other bloods inc ferritin, vitamins and cholesterol are all in range. I take ZMA, Vit C and D, omega 3 daily

My own theory for the trigger is combination of a ) stopped smoking 6 months prior b) very bad tonsillitis 5 months prior c) too much iodine (x6 RDA) in prior 6 months (cheese, yoghurt, eggs, etc).

[SlowDragon Administrator in reply to Munro282282]

Yes stopping smoking is a frequent trigger

Well done for quitting

iodine can cause a whole bundle of trouble and can take several months to leave your system

Please add actual results for vitamin D, folate, B12 and ferritin

Suggest you Retest full thyroid and vitamin levels in 2-3 months

[Munro282282]

thanks again. Are you suggesting to postpone the Carb for 2-3 months? And what would be the reason for that please?

Vit D: 95. Ferritin: 279. Folic Acid 10.5. B12: 791.

Thanks

[pennyannie]

Hello Munro and welcome to the forum :

When the thyroid malfunctions the symptoms experienced can be singular, minimal or extreme with a whole hosts of hyper and hypo symptoms and feel like being on a roller coa ster without any of the fun.

If Graves antibodies are found positive - Graves treatment take precedence as Graves is considered life threatening if not medicated and the treatment is with an Anti Thyroid drug which semi blocks your own new daily thyroid hormone production while we wait for your immune system to calm back down again and hopefully your thyroid reset itself without the need for any drugs.

Graves carries Blocking, Stimulating and Neutral antibodies and these vie for control of your thyroid. and at any given time can change from one to the other, expressing in extremes of symptoms and also periods of relative calm - and given enough time , Graves can burn itself out.

All the AT drug does is simply ' buys you time ' - dampens down your immune system response and hopefully offsets the worst of the hyper / hypo type symptoms possibly experienced in this first phase of Graves.

The NHSgereally allocate a treatment window with an AT drug - Carbimazole or - Propylthiouracil - PTU - for around 15-18 months and if ' remission ' isn't achieved suggest definitive treatment - RAI thyroid ablation or a thyroidectomy.

We do now have some research you might find interesting :-

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

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

The most rounded of all I researched though 10 years too late for me - as I had RAI thyroid ablation back in 2005 and became much ill afterwards and found no answers through mainstream medical-

is that of Elaine Moore - books and now website which we now need to access via the archives -

web.archive.org/web/2024122...