Agranulocytosis (or neutropenia) Carbimazole induced

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Did anybody have suspected agranulocytosis or neutropenia (low white cells count) Carbimazole induced?

I have started taking Carbimazole 4 weeks ago. Last week I have developed a fever, a sore throat and a few mouth ulcers (never suffered from them before). As advised by the endocrinologist, due to the rare possible complication of agranulocytosis induced by Carbimazole, I have done an urgent blood count the day after at my GP surgery. Although my values are in the norm, the neutrophil and total white cell count dropped significantly since my previous blood count 6 weeks ago: neutrophil went from 4.6 to 2.1 (range from 2.00 to 7.5) and total white cell from 7.5 to 5.2 (range from 4.00 to 11.00). The rest of the values have been completely unchanged from 6 weeks ago. The endocrinologist said there is most likely nothing worrying and it is probably due to a viral infection, and to repeat the blood count in 10 days.

As the neutrophil are now at the very bottom of the range (I never had it this low in any blood test I ever taken in my life), I worry a little and I am looking for experience of low white blood cell count while on Carbimazole.

The medicine is helping me immensely with hyperthyroidism symptoms: I have gotten rid of tremors, heart rate is under control (although still highl for me), my periods are back and I can sleep 4 to 6 hours per night (vs the 2 maximum 3 of 6 weeks ago). So I would hate to have to stop it because of neutropenia.

Thank you for sharing your experience!

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  • Posted

    Hey there Rita I've noticed the same thing on my bloods but Drs don't seem to worry!? Strange isn't it! Try and speak to your endocrinologist ? I think it's important to try and support your body as much as possible when it's loaded with these toxins. Like keep your liver cleaned and detoxed naturally by taking milk thistle and eating clean! Paleo has helped me immensely ??

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  • Posted

    Those are some of the concerns of using Carbimazole or Methimazole which is why my Endo (and most Endos) check CBC and Liver function tests every blood draw.  This usually happens on the higher dosages rather than the lower ones.  I was able to take lower dosages when I added supplements to my treatment plan.
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    • Posted

      I learned that vitamin D is most important for hyperthyroid patients and we are usually low in it so I take 1,000 IU per day of that.  I take Magnesium approximately 200 mg per day, and right now I take 500 mg a day of Regular L-Carnitine along with 2.5 mg of Methimazole 3 or 4 times a week.  If my TSH lowers too much then I take 500 mg of Acetyl-L- Carnitine on the days I take the meds and 500 mg of Regular L-Carnitine on the days I am off meds.  When my TSH was less than 0.001 for two years, I started at much higher dosages of the carnitine like 3,000 mg of the Regular L-Carnitine and 1,000 mg of the Acetyl-L-carnitine, however, the Acetyl requires very close monitoring and frequent adjustments to avoid going hypo.
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  • Posted

    Hi Rita, neutropenia in hyperthyroid patients is well documented and may be attributed to vitamin deficiencies (e.g. folic acid or B12), decreased neutrophil circulation time, reduced marrow granulocytic reserve, etc. Additionally, anti-thyroid drugs have the potential to further suppress the generation of while blood cells. 

    I had mild neutropenia (neutrophil count around 1.5 [2-7.5]) for more than a year while being treated for hyperthyroidism (Graves'wink. As long as your neutrophil count does not get too low your endocrinologist will advise you to continue taking Carbimazole. 

    A low neutrophil count means that your immune system is not working at full throttle and that you are more likely to catch a cold or other infection. After you catch an infection it may take longer to resolve itself and the symptoms may be stronger. 

    It's best to keep a distance from people who are coughing or sniffling and to carry a small bottle of hand disinfectant in your handbag. Ironically, the place where you are likely to catch a bug is the GP waiting room. 

    Hope that your neutrophil count stabilises and you can continue to take Carbimazole seeing that you responded well to it. 

     

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    • Posted

      I plan to measure b12 and folic acid at the next blood test. I am severely vit D deficient (last value was 7, reference from 75 to 500...).
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  • Posted

    Thank you everyone for sharing your experience and thoughts.

    I forgot to mention that I have Graves and that I am on a low dose of 20mg of Carbimazole, in two doses of 10 per day.

    I eat very well and very clean, I don't have any processed foods since 2 years ago and I have gone gluten free 4 weeks ago, which I believe is making me feel better together with Carbimazole. My resting heart rate has lowered to 65/70 which is still hubby by comparison with 50 of 4 months ago but much better than the crazy 110 I had in December 😕

    I have talked to the endocrinologist and she suggested repeating he full blood count every 3 weeks, which is what I am doing now. I have had always values bang in the middle of the range in any other blood test I had in my life, including the Ines were thyroid values were already off, so I am pretty sure this is due to the medicine. But I still love this medicine, it helped me so much so quickly!

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