The Wellness Q&A with Elaine Moore

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labs and methimazole dose
Last Post 27 May 2024 10:40 PM by Elaine Moore. 1 Replies.
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PamelaJeanUser is Offline New Member New Member Posts:
24 May 2024 01:26 PM
    Hi Elaine,

    First I will post a few of my labs, most recent first:

    May 21, 2024
    TSH 2.9 (0.470-4.680)
    FT4 0.91 (0.78-2.44)
    FT3 3.75 (2.45-5.93)
    all he said on the results were "good values"

    February 19, 2024
    TSH 2.31
    FT4 1.03
    FT3 3.96

    November 30, 2023
    TSH 2.34
    FT4 0.91
    FT3 3.99

    October 30, 2023
    TSH 0.464 L
    FT4 0.88
    FT3 4.38

    I have been on 15 mg. methimazole since September 29, 2023. When I received the results from May 21, I messaged my endo and asked if it is time to reduce. A nurse replied and she said since he said "good values" that means no change. I gather she isn't even going to tell him I asked. I hadn't had any afib episodes since last September until Monday, which is why I requested labs again. I get absolutely no guidance from him anymore. I haven't even seen him in person since July 2023. And my afib has been quite active since then, although he doesn't think it's my thyroid. My doctors are mixed in their opinions. In September last year my episode was in the middle of having radiation treatments for breast cancer. You thought it could have been the radiation that caused it. On Monday May 21 I woke up about 2 a.m. feeling horrible and used my KardiaMobile, sure enough "possible afb, rate 145". Since my labs are normal, I have no idea why I had this episode. It lasted about 11 1/2 hours. I sent a couple strips from the EKG to my EP. He thought the first one to be flutter and the other one I sent afib. Looking at the strips I think I was going back and forth between them. I take metoprolol and flecainide. I had just lowered the flec just over two weeks before this recent episode, with my EPs permission. Not sure if that had anything to do with or not. Surprisingly he didn't increase it again.

    Do you agree that I should be lowering methimazole? Do thyroid patients ever stay on methimazole for years? I weaned off in December 2021. I started back on it in October 2022 and have been on it ever since, in ever changing doses. I won't make any changes without his agreement, but I am still interested in your opinion.

    Thanks, Pam

    Elaine MooreUser is Offline Veteran Member Veteran Member Posts:4084
    27 May 2024 10:40 PM
    Hi Pam.
    Your last 3 sets of labs are on the low side but your doctor is probably hesitant to lower the dose because of your Afib although it doesn't seem to be thyroid related. If you feel good you could stay on the same dose but I personally think you'd feel better with slightly higher levels and a reduced dose of MMI. If you have any hypo symptoms, mention them if you call the office again. Best, Elaine
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