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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diagnosed With Graves Disease. On Medicines. Left Ankle Swollen, Tender To Touch. Solution?

4 weeks ago I was diagnosed with graves decease - it was toxic my medication is noemercazole. tablets just reduced from 9per day to 4 2 twice a day morning and night i am on metropole tartate and warfrin ( currently 6 gm daily until INR is maintained between 2-3. My left ankle is very swollen and was broken 10 years ago. quite a bit of fluid and very tender to the touch. My thyroid specialist said it should settle down now that my medication has been reduced as on of my T readings has gone into a negative position dure to taking such a hight dose of neomercazole previously. Will the ankle return to normal soon and is this common - how can I assist the swelling - currenly wearing a compression stocking and keeping foot elevated as pften as possible thanku
Thu, 27 Mar 2014
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Endocrinologist 's  Response
Hello,
Good day,
Noted that you are on Neomercazole and Warfarin. Why are you on Warfarin? Do you have Atrial fibrillation? If so, did that occur after you had Grave's Hyperthyroidism? If that is the case, AF might revert to normal once hyperthyroidism is controlled. One can develop Hypothyroidism with Neomercazole which can cause ankle swelling. But that usually, will not be tender.



. In rare chances, Warfarin can cause bleeding in joints and thus swelling. But that is very rare and occurs only if INR is too high. One more possibility of tender swellings in legs in Grave's disease is due to " Pretibial Myxedema".The best way is to examine your ankles and do an INR. I am sure that your endocrinologist would have thought of all these rare possibilities.

Do you have any breathing difficulty or shortness of breath on lying down??. Has an ECG been performed?

Regards
Binu

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Diagnosed With Graves Disease. On Medicines. Left Ankle Swollen, Tender To Touch. Solution?

Hello, Good day, Noted that you are on Neomercazole and Warfarin. Why are you on Warfarin? Do you have Atrial fibrillation? If so, did that occur after you had Grave s Hyperthyroidism? If that is the case, AF might revert to normal once hyperthyroidism is controlled. One can develop Hypothyroidism with Neomercazole which can cause ankle swelling. But that usually, will not be tender. . In rare chances, Warfarin can cause bleeding in joints and thus swelling. But that is very rare and occurs only if INR is too high. One more possibility of tender swellings in legs in Grave s disease is due to Pretibial Myxedema .The best way is to examine your ankles and do an INR. I am sure that your endocrinologist would have thought of all these rare possibilities. Do you have any breathing difficulty or shortness of breath on lying down??. Has an ECG been performed? Regards Binu