[Butterfly1981]

#1059400

Just had my bloods done again after being on carbimazole for 7/8 weeks. They’ve shown a shift from HYPER to HYPO!!
August 2012 –
Blood results showed LOW TSH and HIGH FT3 & FT4 (sorry no actual results but endo assured me i was most definately thyrotoxic!!)
September 2012 –
Serum TSH 37 (0.5-4.7) HIGH filed as HYPOthyroid biochemistry
Free T4 6.2 (9-24) LOW
Free T3 4.2 (2.5-5.3)
I have an appointment at the thyroid clinic next tuesday but until then am on my own
Should I stop carbimazole?
Why if T3 in range when TH/T4 not, what does this mean?
Am I likely to be taken off carbimazole entirely?
Sorry I’m full of ifs/buts/whys/maybes at the minute, can anyone offer any advice please?

I also had an FBC done at the same time, and wondered if anyone could interpret the results please. My GP has asked for a re-test next week then I have to see him, but in the mean time I don’t know what it means.

(I’ve only included results with a lab comment)
Total white cell count 3.4 (4-11) LOW
Red cell distribution width 17.3 (11.5-16.5) HIGH
Neutrophil count 1.53 (2.0-7.7) LOW
Eosinophil count 0 (0.04-0.4) LOW

I currently have a cold and would have thought I should have seen an increase in white blood cells to fight the infection? Also shouldn’t I be cautious if my white cell count drops given I’m on carbimazole as its indication of agranulocytosis?
Any advice would be greatfully recieved, thanks in advance

[Kimberly]

#1174485

Hello – We’re fellow patients on this board, not doctors, so we’re not allowed to interpret labs or give medical advice. Here are a couple of general comments, though…

Agranulocytosis is a *severe* reduction in white blood cell count, and it is often accompanied by a severe sore throat with fever. If you are experiencing those symptoms, I would visit an emergency room or urgent care center ASAP. In the meantime, it’s certainly worth calling your doctor’s office to see if you should make any changes in your dosing prior to your next appointment.

Dosing with anti-thyroid drugs (like carbimazole) is really part art, part science. So it can take a few iterations before you find the “sweet spot” that will keep your levels normal and stable. For patients who go hypO on ATDs, options include reducing the dose or adding a small amount of replacement hormone to keep levels stable. (The latter approach is more common with children, but I’m hearing more docs use this approach on adults as well). Both are worth discussing with your doctor at your next appointment.

Take care!

[Butterfly1981]

#1174486

Thank you for your reply and sorry if I’ve caused problems in asking my questions, I will bear this in mind in the future.

Your comments make sense and will contact my doctor on Monday for more advice.

Thank you again for taking the time to reply.

[snelsen]

#1174487

Hi Butterfly! Welcome to the board and the forum. Almost all of us write to discuss interpretation of our labs! You are NOT causing problems! Kimberly gave you some good all-around advice. i think you have a very good question about what to do about your ATD’s. Is it possible for you to call now, even though it is Friday, and have the endo or on-call take a look at your labs, give you some advice in this area? I’d be wondering the same thing. Be ready with your symptoms, too. Are you feeling hyPO, or hyper, or can you tell?

Your other questions about labs you can also ask an on-call this weekend. They can give you good guidelines on your other labs. If they can’t retrieve them electronically, just read them to the doc.

You are not alone here. So many of us have the same questions and concerns (and feel crappy.)
Shirley

[Butterfly1981]

#1174488

Hi snelsen,
Thank you for your reply, although I only just got chance to pick it up.
Given its now Sunday pm (here in UK) I will wait until tomorrow morning before I give the endo a ring, although I am seeing them on Tuesday anyway. Its just annoying that you’re left in the dark by the medical professionals.
I definitely feel different to when I was Hyper, I actually feel quite good just tired and have weak muscles!
Thanks for your support xxx

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