Free T4 increased in Carbimazole

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Anybody else had this? I started on carbimazole 30mg a day two weeks ago my TSH was 0.02 (0.35-5.5) Free T4 30.9 (7.0-17) and free T3 9.2 (3.5-6.5). I was then told to reduce to 10mg by GP but I decided to go for 20mg so I had results back today and my TSH has remained the same and my free T4 has RISEN to 35.5!!! She told me to try 30mg and if not then 20mg but I feel like this isn't even enough, I'm so upset as I did not expect it to rise. Still not hadd appointment for endo either. I feel like I will never be well again and just to top it off i have a sinus infection so on antibiotics as well. Is there any hope on this carbimazole? Thank you

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  • Posted

    It sounds like you need a higher does of carbimazole  as it is not high enough to block the over production of thyroxine.  It takes 4- 8 weeks to become euthyroid. 

    Be patient, it takes a lot of juggling to get it right.  Make sure  you have regular blood tests. x

     

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    • Posted

      Hi Emma, thank you I just feel defeated at the moment with the rise in T4, I'm hoping 30mg will lower it by my next blood test and that I will get my endo appt soon! X

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  • Posted

    I consider 30mg carbi a very high dose (even 20mg is high) -- high dose ATM usually bring strong side effects.  ATM take time to lower T4 T3 (what's your T3 number?)  Also other conditions can interfere or negate ATM's effectiveness, e.g., stress etc.

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    • Posted

      20mg didn't work it just made my T4 increase even more, they didn't test my t3 this time but it was 9.2 two weeks ago, range is in my post up the top. Do you really think stress can suppress the medicatiom working? I wasn't very stressed but I am now after these results!

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  • Posted

    Carbimazole interferes with an enzyme that the thyroid needs to produce its hormones. At sufficiently high doses (typically at least 40mg per day) it can inhibit the production the thyroid hormone completely. High doses are used when the patient in on a block-and-replace treatment, and in this case thyroxine supplements are necessary. 

    As long as you have regular blood tests and adjust the medicine accordingly you will be fine.

    You can also monitor yourself by keeping a chart of your resting heart rate. In my case, the heart rate correlates pretty well with my thyroid hormone level. The more hyperthyroid I get the higher the resting heart rate. 

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    • Posted

      Thank you DanR, I am hoping the 30mg slows down the production by my next test, but maybe I need an even higher dose or it just hadn't had enough time to work, I did one week on 30mg and second week on 20mg.

      My resting heart rate varies between 80-90 right now and that's with calcium beta blockers! Sometimes its lower if im really relaxed but never under 70.

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    • Posted

      Also do you or anyone else know if any damage has been done to my heart, do they check you for that or not? And for bone health? I've started taking vitamin d3 with vitamin k2 just in case.

      And also (sorry for so many questions!) What foods do I need to avoid, I've seen dairy, salt, gluten etc I eat all those and have no idea where to begin!

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    • Posted

      My endo said it would not affect my heart - I also saw a cardiologist as I was paranoid - he said it was absolutely fine.  You will be very stressed and over anxious so try not to over think things.  Try and keep to a protein based diet and avoid sugar/high carbs -Take vitamin d, calcium, selenium and a good multivitamin.  Rest as much as possible while your body recovers.  The best advice I was given was just do one thing a day.  I could barely walk up the stairs.  I am now full of energy, enjoying life again and doing everything I want to, so you will get better, however it will take time so be patient. x
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    • Posted

      Thank you for your advice, I know I'm struggling at the moment with my fast heart rate and maybe anxiety is making it worse, the calcium beta blockers aren't that good! I hope ti see an endo soon I was referred over 2 weeks ago so not sure how much of a wait there is. I know what you mean about stairs I struggle with that. I have all the vitamins except selenium I have just added some to my basket tonight so hopefully they will help as well. My only downfall food wise is sugar as I like my chocolate and I eat toast and a sandwich at lunch although it's wholemeal not sure if that makes a difference! X

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  • Posted

    Hi, like emmaj43 above I would recommend a diet with plenty of protein to minimise loss of muscle mass. You could try to eat nutrient-rich food consuming a lot of vegetables, fruits, nuts, etc.

    If you are coeliac then it is important to strictly avoid gluten. Otherwise, it makes little sense to cut out entire food groups. There is plenty of information on the subject of thyroid and gluten that is based purely on anecdotal evidence and in some instances on obvious misinformation.

    The same goes for dairy. If you tolerate dairy products well, then you should include them in your diet as they provide high-quality protein, calcium, B vitamins, Vit D, etc. If you are lactose intolerant try fermented products like kefir or yoghurt or lactose-free products. In the UK dairy products are the main source of Iodine (as Iodine is added to animal feed).

    Unless you are advised by your doctor to have iodine free food, for example before treatment with radioactive iodine, there is no reason to avoid iodine entirely. Even if you are hyperthyroid at the moment your body needs a minimal amount of Iodine (around 150 micrograms per day). An Iodine deficient diet is the main cause of goitre as the thyroid becomes enlarged to absorb even more Iodine. On the other hand, it is very important to avoid too much Iodine as this may exacerbate your hyperthyroidism. In practice, this means restricting food that is super rich in Iodine like kelp and other seaweed types and strictly avoiding supplements that contain Iodine.  

    When it comes to salt, moderation is important. The daily recommended intake is 6 grams and if you would like to reduce your Sodium intake you could opt for low-sodium table salt (that will provide you with Potassium). However, again restricting your Sodium intake coupled with drinking a lot of water has the potential of causing more damage instead of being beneficial. A low Sodium level can cause vomiting, nausea, muscle cramps, etc. 

    https://patient.info/doctor/hyponatraemia-pro#nav-2

    Finally, I would recommend eating plenty of goitrogenic vegetables like cabbage, broccoli, kale, cauliflower (all from the cabbage family).

    Here is a recipe for stir-fried cabbage that is super fast to prepare and tasty.

    Ingredients: One tender heart cabbage (the little soft-leafed pointed cabbages), olive oil, red balsamic vinegar, salt, soy sauce.

    Method: Cut the cabbage into fine strips. Place it in a non-stick wok together with one tablespoon of oil and cook it for about 5 min on a rather high flame while covering with a lid and stirring occasionally. When tender add a dash of balsamic vinegar and season with salt or soy sauce (I prefer soy sauce). Fry for another minute and that's it. 

      

     

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    • Posted

      Hi thank you, you've given me useful information here I appreciate it. I was tested for coeliac a few years ago and I don't have it an I'm fine with dairy too. I have just read conflicting information with foods, they say stay away from iodine foods with hyper, but a lot of foods have iodine in, and to not eat dairy, gluten, salt, sugar etc but then it says you should consume dairy for the calcium as it's depleted in this condition. (I did drink at least 300mls of milk a day but I've stopped in case I'm making it worse for myself) I've looked up iodine content in general foods so I think I will stick to lower iodine ones and eat more chicken, broccoli,kale, fruits etc. My only downfall will be chocolate which I will have to try to cut down on.

      I have so many questions to ask the endo when I get my first appointment! In the meantime I'm taking vitamins except I need to buy selenium which I hope will help too and I'm drinking 3 cups of green tea.

      Do you know if orange juice is ok to drink or not, I can't find it online. I also have effervescent vitamin c drinks (without aspartame) are these ok, I'm not sure if I should be using a different type of vitamin c?

      Thank you

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    • Posted

      Some thoughts about foods: chocolate contains milk and sugar (except dark chocolate), also its main ingredient is cocoa; green tea contains caffeine (except decaf one); orange juice is not recommended because of high sugar content... just my 2c.
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    • Posted

      Hi, I forgot to say I only drink decaf green tea and water. I wasn't sure if drinking orange juice would be a better form of vitamin c than the effervescent drinks but did think sugar would be a problem, although a lot of fruits contain a lot of sugar even though its natural sugar.

      Anybody any thoughts on Omega 3? I've seen Algae omega 3 which claims to be a much better source than fish oil, would it be safe to take?

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