Latest visit to GP - does this make sense?

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My original blood results were:

TSH <0.01

​T4   49

T3 18

After two months on 20mg of carbimazole it is now:

TSH < 0.01

​T4 17.21

​I have been suffering from the most awful insomnia the last week despite having temazepam. Much worse than ever before. Like my body just starts buzzing at night and cannot sleep at all. So the doctor has increase my night time carbimazole to 15mg. So 10mg in the morning and 15mg at night. I am a little worried this might make me hypo. GP said he wouldn't let that happen, but my next bloods are not being done for 6 weeks so I'm worried I might go hypo. His reasoning behind the increase is that he thinks my thyroxine levels may be peaking at night and so the extra carb might help me sleep. What do you think?

​Thanks.

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7 Replies

  • Posted

    I'm no expert to say anything about your dose, but just wanted to reassure you about going hypo. I had a t4 of 16 and had my dose increased and 4 weeks later it was 9 which is borderline hypo. I felt great compared to what I had a few weeks earlier. I had my dose lowered a bit and I seem to be levelling out. It takes a bit of time to find the right dose it seems and everyone is different.

    I'm a bit surprised your GP is changing your doses, I have to see an endo who decides what dose I'm to be on and informs my GP. Didn't think GPs liked to do it since they aren't experts?

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    • Posted

      Thanks. He's a really good GP but yes, I was surprised when he told me they had decided to handle me in-house. However, I am pleased because he made himself available at the shortest of notice. At my worst, I was literally able to walk in the surgery and see him within 10 minutes without an appointment. I have also been having blood tests every two weeks which is more often than standard. It is only now that he has changed it to 6 weeks, probably because I am out of the danger zone. But I suppose I just don't understand why the dose has been increased now I am within a normal T4 range. I was expecting it to be lowered. I won't complain though if it helps me sleep!
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    • Posted

      Don't worry about going hypo. I have been on 60 mg carbimazole and then 40mg for over a year. Have never been hypo. So don't worry, n I get my tests done every 3 months.
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    • Posted

      Thanks, daku. Are you on block and replace? I'm just on carbimazole. I guess my TSH will start to rise again as soon as I reach the level my body wants to be.
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    • Posted

      No evergreen... I am only on carbimazole. Rise in TSH is very slow... Many a times T3 and 4 become normal but TSH remains low. I am at that stage right now. So don't worry. Focus on reducing T3 and T4. Do yoga... Breathing exercise in th morning Meditate before you go to sleep. It helps.
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  • Posted

    I had the same experience. As soon as I tried to sleep at night I could feel my heart beating strongly which would make me aggitated and unable to sleep. I started taking my whole dose of Carbimazole during the early evening hours. 

    After being absorbed, Carbimazole has to be first converted to Methimazole. The half-life in the bloodstream is about 5-6 hours. You could try to take the night dose well before going to bed to make sure the concentration peaks just when you are trying to fall asleep. 

    Btw, for me it got better after the TSH value started to rise towards normal values (after 6 month of treatment with Carbimazole). 

     

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    • Posted

      Oh thank you! That has been a great help. I can understand that more now. I'll switch my nighttime dose to 6pm and see if that helps. The GP did say something about my levels probably spiking just as I want to sleep.
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