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What Causes Hypothyroidism After Increasing The Dosage Of Tapazole?

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Posted on Fri, 11 Sep 2015
Question: I am currently being treated for Graves Disease. I started taking Tapazole. I started about 9 months ago with 20 mg. One month later it was increased to 30 mg daily. Within 2 weeks my bloodwork went hypo and I was nauseous and pale. I went down to 10 mg daily. My last bloodwork showed my thyroid levels in order so my doctor cut me back to 5 mg daily. She is hoping I reach remission. Is it safe to stay on tapAzole if I am on such a low dose or should a seek a different treatment.
doctor
Answered by Dr. Binu Parameswaran Pillai (3 hours later)
Brief Answer:
Grave's disease

Detailed Answer:
Good day,
Noted your concern.
Grave's disease need treatment with Methimazole ( Tapazole) for atleast 15-18 months to acheive remission. So it is important to maintain on small dose of Tapazole for another few months. Another option is to undergo radio iodine ablation which is mostly a one time proedure. But you may develop hypothyroidism after the treatment.

Is the Grave's disease confirmed? How was it diagnosed? Only on the basis of thyroid function tes or did they do a nuclear scan?

Any eye involvement?

Regards
Binu


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (15 hours later)
No eye involvement
Diagnosis confirmed through bloodtests, scan and uptake and ultrasound
doctor
Answered by Dr. Binu Parameswaran Pillai (6 hours later)
Brief Answer:
Treatment options

Detailed Answer:
Thank you for the reply. If the diagnosis is confired by a nuclear scan, then as i mentioned, there are 3 treatent options
1) Anti Tyroid drugs: minimum 15 to 18 months treatment. Start with high dose and then continue on a maintanance dose ( like in your case).
2) Radio iodine treatment: One time procedure .
3) Surgery: least preferred option ( unless you have bad nodules).

In your case, treatment with Topazole seems to be a reasonale option as you responded well. However, to maintain remission, we need to continue treatment for total 15 to 18 onths. In most of my patients, i go a total 18 months in a small dose just enough to keep Free T4 and Free t4 in mid normal range
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1439 Questions

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What Causes Hypothyroidism After Increasing The Dosage Of Tapazole?

Brief Answer: Grave's disease Detailed Answer: Good day, Noted your concern. Grave's disease need treatment with Methimazole ( Tapazole) for atleast 15-18 months to acheive remission. So it is important to maintain on small dose of Tapazole for another few months. Another option is to undergo radio iodine ablation which is mostly a one time proedure. But you may develop hypothyroidism after the treatment. Is the Grave's disease confirmed? How was it diagnosed? Only on the basis of thyroid function tes or did they do a nuclear scan? Any eye involvement? Regards Binu