10 Days In…..

The methimazole is a drug that acts as a chemical block to the production of thyroid hormone. The trick is to take "just" the right dose of it. I think of it as the "Goldilocks" dose. If you are taking too much, you become hypothyroid. If you are taking too little, you remain hyperthyroid. And, how much any patient needs at the beginning (particularly) is a bit of a guess based on experience with other patients.

In addition, when we are given medications with Graves, we have to wait a period of time before new blood tests will show anything constructive. The medication has to have a chance to settle in, build up in the body, and then, the body has to register the changes. In our case, the pituitary gland acts as a "thermostat" for thyroid hormone levels. If the pituitary detects too little hormone, it increases the amount of its own hormone, Thyroid Stimulating Hormone (TSH) to try to prod thyroid cells into harder work. When it detects too much hormone, it reduces the amount of TSH. Our doctors use the TSH as a guide to how well our medications are working, and whether or not we need more, or less, of our meds. But the TSH number is sort of an average, a running average, of our thyroid levels and it takes a few weeks to accurately reflect dose changes of meds. That is why you are having to wait right now for new blood work.

Another wrinkle: The methimazole starts to work right away controlling the output of your thyroid cells, but the thyroid cells not only make new hormone, they store some for future needs. The methimazole ONLY affects the new supplies of thyroid hormone. The stored supplies are still there, and antibody action is causing the cells to release those stores until they are used up. So, until they are used up, we typically don’t feel much difference when we first start on the ATD (antithyroid drug — like methimazole). This could well be why you are still seeing symptoms of "problem" even though you are on a medication to correct it.

The whole thing is complicated, as you can probably start to tell from this post. One thing we patients with Graves have to develop — and it is sometimes extremely difficult — is PATIENCE. Nothing works overnight to correct the disease. Medication changes require weeks of waiting between blood tests, for those tests to accurately reflect the impact of the change. And then, hardest perhaps of all, even when we get to the right level of thyroid hormone again, it can take months AT normal levels for our bodies to heal from the damage done by being hyperthyroid. We DO get well again. But it happens in slow increments, not all at once.

I do hope you are feeling much better and soon.

yeah patience was not one of my best attributes either but i have been learning that is what its going ot take to get better! it took 3 weeks before i would even get out of bed to do anything. i felt hopeless. but when my endo dr. reduced my dosage on my methimazole and changed my beta blocker to atenolol. i was so much better the propanolol made things so much worse for me. i hyperventilated 3 times and had to call the ambulance casue i though it was my thyroid problems worsening. thank-goodness it was not. i was put on valium. it helps ALOT!! i am now feeling pretty good. able to exercise again and do housework and play with my kiddos and my levels are improving really well ” title=”Very Happy” />