Thyroid Medication
Carbimazole Dosage
Liver Enzymes
Weight Gain

Hi Elaine,
I hope this finds you well. I wrote to you not long ago to ask your opinion on what I should do because my latest test readings as outlined a little further below were causing me some concern. My liver enzyme readings were extremely high even though I was only on 7.5mg Carbimazole. Well, I had another test done and funny thing, the Endo and my GP had mistakenly looked at my ALT and AST readings from October last year! The enzymes had actually not been tested for in my July 2017 test so I have just had them done. I am relieved because they are normal.
Latest test results for 3rd August 2017. July and previous test results appear a little further below if you scroll down.
Free T4 - 12.7 (ref range 9.0-25.0) pmol/L
TSH - 0.01 (ref range 0.50-5.00) mIU/L
Free T3 - 8.2 (ref range 3.5-6.5) pmol/L
AST - 28 (<41)
ALT - 24 (<41)
I am still taking 7.5mg Carbimazole. My Endo did an ultrasound of my thyroid and it is still enlarged though not as enlarged as it was originally. He mentioned us looking at surgery or radiation if things do not improve! I so do not want to go down that path.
Elaine I practise intermittent fasting 16:8 and for the last 2 weeks OMAD (one meal a day with a one hour eating window) to try to manage systemic inflammation. I eat vegetables, protein and a minimal amount of fruit. I drink water, no alcohol. I do not consume fast or packaged foods and yet my weight remains the same. I have put on around ten kilos since being on Carbimazole (my original weight plummeted to the lightest I had ever been and now it has stabilized and crept back on.) My concern is that I am not losing weight despite fasting for 23 hours. What in my readings explains this? The TSH reading? Can you explain what is going on please? Is my metabolism completely shut down?
As always I am truly grateful to you for your time and support.

Kind regards,
Chiza

Previous post:
I took your advice and lowered rather than increased my Carbimazole dosage as my Dr had instructed me to. You mentioned my previous dose of 10mg was too high so I've been taking 7.5mg - 5mg in the am and 2.5mg in the pm and these are my latest test results.

Since my last blood test lowering my dosage on your advice to 7.5mg from 10mg my liver enzyme readings have shot up quite alarmingly which they also did when I was on PTU which is why I was swapped over to Carbimazole.

7/13/17 ALT 536 ref range (<41)UL from 27 ref range (3-30) on 10/22/16 and 54 ref range (5-30) on 3/28/17

7/13/17 AST 360 ref range (< 41)UL from 22 ref range (10-35)UL on 10/22/16 and 49 ref range (10-35) on 3/28/17

7/13/17 TSH <0.01 ref range (0.50-5.00) compared to 28/3/17 TSH <0.005 3/5/17 <0.02 (ref range 0.40-4.00)

7/13/17 Free T3 4.6 ref range (3.5-6.5) compared to 28/3/17 T3 6.8 3/5/17 9.9 (ref range 2.6-6.0)

7/13/17 Free T4 8.2 ref range (9.0-25.0) compared to 28/3/17 T4 10.1 3/5/17 21 (ref range 9.0-19.0)

I had my GP send away for the tests and haven't been back to my Endo in over 3 months although I will now have to I think.
Elaine I am traveling blind and have no one to advise me. With my reading like it is what should I do? Not continue taking 7.5mg? Is there anything else I should be doing?
Thanks Elaine.
Regards,
Chiza

Hi Chiza,
While your FT3 is slightly high, your FT4 is too low. A lower dose of carb, perhaps 5 mg daily taken in 2 divided doses, would help raise your FT4 and this should also eliminate the compensatory rise in FT3 (caused by FT4 being too low).
Your diet sounds really good but when FT3 is slightly high and FT4 low, this can prevent weight loss.
Intermittent fasting usually works well but for some people the low calories may be too low and this can change your metabolism, also contributing to weight gain. best, elaine