Hyperthyroid New Test Results

Hello danR

My doctor just told me to continue taking Carbimazole and Propranolol after my Anti bodies result which my self couldn't understand it.

01/06/17 Range

TPO- 183 IU/mL « 5.61

TSH Receptor- 13 IU/L« 1.80

And I also saw these

Hashimotos Disease 75% : 64%

Graves Disease 75% : 92%

Hi charles98819, TPO might stand for anti-thyroid peroxidase antibodies. This value indicates inflammation of your thyroid and is typically raised in patients with Hashimoto's thyroiditis. It can also be raised in patients with Graves' disease. Your thyroid might be slightly swollen and inflamed and leak thyroxine as a consequence. 

TSH stands for TSH receptor antibodies. These are typically raised in patients with Graves' disease. There are different kinds of TSH receptor antibodies. For more info check the page on wikipedia. The ones responsible for the overproduction of thyroxine are called thyroid stimulating immunoglobulins (TSI). TSIs activate the thyroid receptors that are normally only activated by TSH (thyroid stimulating hormone). They mimic TSH and trick the thyroid into overproducing thyroxine.

Doctors try to treat Graves' disease by suppressing the thyroid output long term (with anti-thyroid medication) in the hope that eventually your immune system normalises and stops producing TSH receptor antibodies. I had to take Carbimazole for about 18 months (at a low dose after about 6 months).

From your posts, I gather that you are in tune with your body and realised that something was wrong after reducing the dose of Carbimazole. At the moment it is important to rest a lot, sleep well, eat well, and restrict strenuous physical exertion. In a few months, you might find that you are very tired, with a low heart rate, etc. This might indicate that your thyroid levels are tending towards hypothyroidism and your Carbimazole dose should be reduced. I often knew before my endocrinologist in what state I am. 

You can try to eat plenty of goitrogens, vegetables and fruit that reduce the thyroid output.  

I also benefitted from taking Acetyl-L-Carnitine at a low dose (500mg /day). You might want to research about Carnitine, read about side-effects and ask your doctor.

   

Thanks a lot I really do appreciate.

Does Acetyl-L-Carnitine raises heart rate (Palpitations)? Am having presently Palpitations so I don't want to take something that has that side effects.

In some people yes. I did not have this side effect. Maybe my dose was rather small. 

Hello danR

Am on Propranolol 40mg twice a day. Is it ok to take Acetyl-L-Carnitine? I started 500mg today?

Hi Charles, I can only tell about my own experience. I was prescribed Propranolol as and when required (depending on my heart rate). However, I did not do well on Propranolol. It caused my lower legs to swell up it looked scary. The first time it happened we were debating if I should go to the emergency clinic. 

I started to take Acetyl-L-Carnitine mainly to ameliorate my severe muscle pain and muscle wasting. With some people, ALC can have an effect similar to coffee. I would recommend taking it in the morning. See how you feel. After all, it is an amino-acid derived substance that your body continuously generates. Hyperthyroid patients are often deficient as their metabolism runs too high. 

At first, I started to take 500mg capsules but after I finished the first bottle I got it in powdered form. It is much cheaper and you can lower the dose if required. It dissolves well in water. It tastes slightly sour (like lemon water) if you put 500mg ALC into a large glass of water. 

Would be great if you could keep us updated about how you are getting along. Did you mention the supplement to your GP or endocrinologist?  

 

 

Hi Dan

No I have not inform my GP yet. I took my first ALC 500mg this afternoon. I do take my 20mg Carbimozole and 40mg Propranolol in the mornings. Because I was not sure i didn't take ALC with it

Hi Charles, 

I used to take my 30mg Carbimazole in the evening. That is because I usually felt worse during the night. The output of T4 follows a daily rhythm (circadian rhythm) with a maximum around 3am and a minimum around 3pm. I used to wake up every night like clockwork at 3am with a pounding heart and unable to sleep again. 

ALC is a peripheral antagonist of the thyroid hormones meaning it inhibits T4 and T3. Since mainly T3 pushes up your metabolism and consequently heart rate it could prove beneficial overall.  

Thanks a lot Dan I really appreciate. Did you take ALC and Propranolol same time? Or do you think it can be taking same time?

Have look at this post:

https://patient.info/forums/discuss/acetyl-l-carnitine-propranolol-586834

One user replied: I took all my meds at the same time. 

Morning Dan

Just woke up this morning and sleep was very bad just after one day of taking Acetyl-L-Carnitine. I think it has to do with Mirtazapine I have been taking for 6 years now for anxiety and sleep. Mirtazapine also has to do with the brain. I remember I took Taurine and I had this same problem. What do you advice on ALC?

Hi Charles, you could try to take it in the morning and reduce the dose (or take it on alternative days).

If it still impacts your sleep you could try non-acetylated Carnitine. L-Carnitine does not cross the brain blood barrier.

Hello Dan

Hello Linda

Have been having problem with sleeping. Actually I fall asleep but wake up after I think 4hours or so and I couldn't sleep anymore and having Palpitations....i don't know if Propranolol might be the cause

Hi Charles, the output of thyroxine peaks around 3 am. This has caused me many sleepless nights after waking up with a pounding heart. To cope better I got used to taking my Carbimazole late evening around 1 hour before going to bed. Carbimazole has a half-life of around 4-5 hours. Taking it in the evening will make sure that the maximum dose of Carbimazole in your blood stream occurs during the night. 

After waking up I would usually go down to have a lite meal. That helped me to calm down and after around 1 hour I would get tired again. This routine gave better results compared to lying in bed and trying to sleep again. 

Btw, I was never prescribed Propranolol as a daily dose but as a maximum dose to be taken if and when required. I would usually take it when the palpitations got too much. When taking Propranolol make sure that your heart rate does not decrease too much (below 60 beats per minute).  

Thanks a lot Dan. I will start taking my Carbimozole in the evening after dinner then

Hello Dan

Am still having my not too good sleep. I wake up very early and wonder must times if I actually slept. I read is because Propranolol cross across the brain. Do you know of people taking Atenolol with Carbimozole? Am thinking if to suggest to my doctor to switch to Atenolol

Hi Charles. Sorry, can't comment on Atenolol vs Propranolol. Is your heart rate elevated? Do you think you still have to take beta-blockers? 

Hello Dan

My heart is not really elevated just that I can feel my heart beat. I can actually count my heart pulse. Is always on average 75/minute.

Hello Dan

My result I did last week-

25-07-17..........Range

T4- 15.3 ...............7.2 - 16.4pmol/L

T3- 6.9................3.7- 6.0

Tsh-0.005..........still the same compared to my last 4 results since April.

Please is it possible to still have Palpitations with these ranges?

Hi Charles, as you can see your T3 is above range. T3 is the active form of the thyroid hormone and is more potent than T4. As such it can cause your symptoms.

Did you ever have a scan of your thyroid to check for nodules? Sometimes autonomous thyroid nodules can secrete excess T3.  

Yes Dan I did and Dr said my scan was fine

Hi Dan

My last results, Ranges

T4- 16.6.........................12 to 22

T3- 6.99..........................3.10 to 6.88

Tsh- 0.00500..................0.290 to 4

I saw an endocrinologist 3 weeks ago who told me to start L'thyroxine 75 MCG. Any advice if should already start with these range of my test and what to expect with L'thyroxine

Hi Charles, my advise is to follow the instructions of your endo to the letter. If you are still taking Carbimazole then your endo is following the block and replace method. You can read more about it in the internet.

Thanks Dan

Hi Dan

My new results-

T4- 5.7.........................12 to 22

T3- 4.3..........................3.10 to 6.88

Tsh- 8.843 ..................0.290 to 5

Is like I have gone hypo? I have added weight and my cholesterol is very high too. I saw my doctor today and he reduced my Carbimozole 20mg to 5mg. Please any advice?

Hi Charles, are you taking your prescribed Levothyroxine? Many patients with hypothyroidism also have a raised cholesterol level. 

Hi Dan

No I have not started yet. My Doctor i saw today actually prefer i reduce my Carbimazole instead of taking L'thyroxine for Block & replace.

Hi Charles, It looks like you're going hypo because the anti-thyroid med you took is over-suppressing your thyroid to produce T4 in a sense of high dose. This "hypo" condition is not the evidence that your thyroid is not functional to produce hormones which would be real hypothyroidism. So I think your doctor is right to reduce your Carbi dose. And wait until next test to see if to take Levot. Just my 2c.

Thanks a lot Koa, really appreciate your advice

Hi Dan

Is it not strange for my TSH to rise from 0.0005 to 8.8 just in 4 weeks?

Hi Charles, TSH varies continuously depending on the concentration of T4 (thyroxine) and T3 in your blood stream. Since your T4 is below range it is only normal for your TSH to rise as your body is trying to maintain a set level of thyroxine. 

 Your endo will probably monitor your thyroid levels on a low dose of Carbimazole. Hopefully, in the near future you will be fine without the need for Carbimazole. 

Thanks a lot Dan for your usual useful advice.