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THE Q & A

Welcome to The Q&A with Elaine Moore. Registered members are invited to ask any question of Elaine Moore on autoimmune diseases, Graves' disease, other thyroid diseases and subconditions, laboratory work, traditional and complementary medicine, triggers and environmental influences, thyroid and immune disorders in pets and animals, and other relevant areas of inquiry.

Each thread represents one question with one answer and will only appear at the time it is answered. Once answered, further replies cannot be made to the same thread since each thread represents only one question. A new thread will need to be started for additional questions.

Questions are answered solely by Elaine Moore, a medical writer and clinical laboratory scientist, MT, CLS, with more than 30 years of experience in immunology. Moore has also authored and edited over a dozen books in the area of health sciences and is an editor for McFarland Publisher's Health Topics Series.


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 2/21/2012 2:29 PM
 

Hello again, Elaine!

First of all I want to thank you so much for all that you are doing to help and educate all of us who are struggling with Thyroid Disease.

As you know, I have been struggling with finding a doctor to dose me by my FT4 levels rather than my (fully suppressed) TSH levels. Because of this, and the adverse health effects I have been having due to the high dosing, I have started to taper down my Methimazole on my own.

I started off with a Methimazole dose of 30 mg (and the doctors urging me to increase to 40 mg) and decreased to 20 mg. This helped in some areas (eyes / periods), but after 9 weeks (probably too long) on the 20 mg I was feeling extremely tired again, and napping 2-3 times a day. I was also having a lot of anxiety.

Because of this, as soon as I had my blood levels drawn, I decreased my dose to 15 mg, and began to feel better. My goiter is smaller / softer, my eyes are completely back to normal, and I have less anxiety. There are times, lately, that a feel absolutely great! However, I still need to nap occasionally, although only once a day as needed. Because of this, and feeling physically that I was close, but not quite there, I was pretty sure that I would have some wiggle room when the labs came back to try to get down to at least 10 mg of Methimazole / day (I've been aiming for the recommended 2.5 - 10 mg / day dose).

My previous two FT4's were 1.08 (which I felt terrible at), and 1.13 (still didn't feel well, even though I was mid-level).

I was surprised today to find out that my FT4 level was 1.39 this time. (My scale is 0.76-1.46). And this was on my 20 mg dose.

I'm a little unsure as to what to do now. Should I go back on my 20 mg dose, according to the lab work, or continue on my 15 mg dose , according to my symptoms, until my next labs (end of March)?

Every time I think I've got this figured out, Grave's throws me a curve ball!

I was also wondering if it's harder to taper down Methimazole if you've been on higher doses of it too long. Does the body "get used" to the drug and need it?

Thanks again for all your help. I don't know what I would do without you!

Brightmorningsky

P.S. Your suggestion for using Melatonin to help with the stress of the night shift has been extremely helpful!

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 2/21/2012 9:05 PM
 

Hi Bright,

Most labs use an FT4 range of 0.8-1.8 so your level of 1.39 may not be as high as it seems. Having been on too high of a dose long-term shouldn't affect your current response to meds. Still, though you wouldn't want your FT4 to rise higher than the reference range or it'll seem as if you relapsed. For this reason, you might want to stay on the 20 mg dose or alternate the 20 mg and the 15 mg dose. I'm glad your symptoms have started to improve, and happy to hear that the melatonin has helped.

Take care, Elaine

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TO USERS: Q&A posts are visible to all readers. Users can delete their own threads at any time. Users must provide information which is true and correct to the best of their knowledge as well as provide sources or references to any health / medical information if not taken from personal experience. All users including the moderator must behave at all times with respect and honesty. Advertising and self-promotion is not allowed. The moderator or site administrator has the right to ban users with or without warning for not following the basic rules of this site. All posts by default are not to be considered that of medical professionals unless otherwise indicated. As sole moderator, Moore has no conflicts of interest in the sponsorship of this forum.

 

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