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Suggest Treatment For Palpitations And High TSH Count
Question: 3 weeks since stopping carbimazole. Bloods at cessation tsh 3.9 free t4 20. Bloods now tsh 1.8 free t4 25. Feel pretty nervy and hot. Pvcs etc. Can't see doc due to work for two weeks. I have supply of carbimazole. Should I take say 5mg a day to settle matters.
Brief Answer:
Hello
Detailed Answer:
Good day.
Please don't take neomercazole now. As I mentioned earlier, you need to find correct diagnosis first. If you have fast heart beats or feeling nervous, you may take Propranolol (INDERAL) 20 MG THREE TIMES A DAY for now. Regarding further treatment, it's best to meet an endocrinologist and get a Tc scan and other blood works.
If I am right, your TSH was never low and just 5 he FT4 was elevated. This need a diagnosis . XXXXXXX
Hello
Detailed Answer:
Good day.
Please don't take neomercazole now. As I mentioned earlier, you need to find correct diagnosis first. If you have fast heart beats or feeling nervous, you may take Propranolol (INDERAL) 20 MG THREE TIMES A DAY for now. Regarding further treatment, it's best to meet an endocrinologist and get a Tc scan and other blood works.
If I am right, your TSH was never low and just 5 he FT4 was elevated. This need a diagnosis . XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So will my free t4 just continue to rise completely unchecked untill I get diagnosed? I never understood why I was on it but surely it provides a safety net from letting free t4 go wild making my life a misery. I will use propranolol as I am on it antway.
Brief Answer:
Hi
Detailed Answer:
We will have to carefully follow up. Please repeat TSH and Free T4 after few days. Till then Propranolol will keep your palpitations under control
If FT4 is rising and TSH has fallen below normal range, then the diagnosis of hyperthyroidism is obvious and you may restart neomercazole.
If TSH is staying normal range and FT4 alone is rising, please get a FT3, TBG and a Total T4 if possible.
I Agree that the High FT4 and normal TSH is a tricky and rare situation and most general physicians and internists can't diagnose this situation. You need an endocrinologist.
Regards
Binu
Hi
Detailed Answer:
We will have to carefully follow up. Please repeat TSH and Free T4 after few days. Till then Propranolol will keep your palpitations under control
If FT4 is rising and TSH has fallen below normal range, then the diagnosis of hyperthyroidism is obvious and you may restart neomercazole.
If TSH is staying normal range and FT4 alone is rising, please get a FT3, TBG and a Total T4 if possible.
I Agree that the High FT4 and normal TSH is a tricky and rare situation and most general physicians and internists can't diagnose this situation. You need an endocrinologist.
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
i saw an endo last year who just dismissed my bloods ...also no way my health provider will agree to bloods in next few days as he told me the earliest i would have more bloods is in four weeks...so you see my predicament. i am away with work for next two weeks anyhow which was why i asked if a temporary restarting of carbimazole was a necessary evil . i will be XXXXXXX for the next two weeks due to work trip so the only health care provider i have to ask such a question is your good self. so i do feel caught between a rock and a harder rock but there we have it. thank you for your patience it is appreciated.
Brief Answer:
hi
Detailed Answer:
Dear Friend,
I agree that you are in a tight situation. The logical answer to your question would be "yes" you may restart neomercazole in this situation. However please be aware that, neomercazole works only if there is problem with in thyroid gland and also it prevents conversion of FT4 to FT3. It has no role in thyroid hormone resistance or central hyperthyroidism. But in your situation of no immediate medical help, it's wiser to restart and stop it when you return near the vicinity of a medical help. But you may need to stop this at least be weeks before you see an endo and further blood works. I am sorry, it's the best advice I can give you
hi
Detailed Answer:
Dear Friend,
I agree that you are in a tight situation. The logical answer to your question would be "yes" you may restart neomercazole in this situation. However please be aware that, neomercazole works only if there is problem with in thyroid gland and also it prevents conversion of FT4 to FT3. It has no role in thyroid hormone resistance or central hyperthyroidism. But in your situation of no immediate medical help, it's wiser to restart and stop it when you return near the vicinity of a medical help. But you may need to stop this at least be weeks before you see an endo and further blood works. I am sorry, it's the best advice I can give you
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
It always did a good job on a dose never higher than 5mg of getting Mt free t4 in range (upper range I XXXXXXX you) so I will restart as a safety blanket. Thank you.
Brief Answer:
Hi
Detailed Answer:
Sure. But make sure you get a correct diagnosis later.
More than happy to help you.
Regards
Binu
Hi
Detailed Answer:
Sure. But make sure you get a correct diagnosis later.
More than happy to help you.
Regards
Binu
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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